國立陽明交通大學 111 學年度第 2 學期考試試題
班級：醫三牙二
範圍：第五次段考
學號：
姓名：
1. What is the name of the cellular mass for the endocrine portion of the pancreas?
(A) Islets of Langerhans
(B) Alpha cells
(C) Beta cells
(D) Delta cells
(E) Acini
2. Which gland secretes epinephrine and norepinephrine?
(A) Thyroid
(B) Pancreas
(C) Pineal gland
(D) Adrenal gland (cortex)
(E) Adrenal gland (medulla)
3. Which kind of cells of the pancreatic islets secretes somatostatin?
(A) Alpha cells
(B) Beta cells
(C) Gamma cells
(D) Delta cells (8-cells)
(E) Sigma cells
4. The right image is a male patient who was diagnosed with neck goiter syndrome.
According to your judgment, please choose the most likely answer.
(A) He is too strong.
(B) His fat acid is too high.
(C) He may have hypersecretion of thyroid stimulating hormone (TSH) or thyroid hormone (TH).
(D) He lacks the melamine.
(E) He has type II diabetes.
5. Which kind of cells of the parathyroid glands secret parathyroid hormone (PTH)?
(A) Chief cells
(B) Follicular cells
(C) C cells (parafollicular cells)
(D) Luànchibazau cells
(E) Sigma cells
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6. A type of neuron, or nerve cell, whose function is to translate neural signals into chemical stimuli.
Such cells produce secretions called neurohormones that travel along the neuron axon and are
typically released into the bloodstream at neurohemal organs. They also are found in the
hypothalamus and posterior pituitary. What are they?
(A) Islets of Langerhans
(B) Neurosecretory cells
(C) Secret-neural cells
(D) JG cells
(E) Follicular cells
7. Which following molecule is a second messenger?
(A) Diacylglycerol (DAG).
(B) Phosphodiesterase.
(C) Protein kinase A.
(D) Progesterone receptor.
8. In general, which following agonist is NOT acting via a cell surface receptor?
(A) Luteinizing hormone (LH).
(B) Insulin.
(C) Oxytocin.
(D) Estrogen.
9. Which statement of endocrine system is correct?
(A) It acts faster while compared with the nerve system.
(B) The original radioimmunoassay (RIA) is based on the competitive binding manner of an
isotope-labeled hormone.
(C) Only the cell surface receptors are important to perform hormones' functions.
(D) Hormone concentrations in tissues are in general within the M-mM range.
10. Which following molecule is NOT an amino acid-derived hormone?
(A) Glucagon.
(B) Serotonin.
(C) Epinephrine.
(D) Dopamine.
11. Which following statement is correct?
(A) Protein kinase A (PKA) is typically activated by inositol 1,4,5-trisphosphate (IP3).
(B) Protein kinase C (PKC) is typically activated by cyclic AMP.
(C) The pseudosubstrate sequence localizes within the regulatory subunit of PKA.
(D) PKA localizes only on the plasma membrane.
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12. Which statement is NOT correct?
(A) In general, enzyme-linked receptors do not belong to the G protein-coupled receptors.
(B) Cholesterol is a functional hormone to activate intracellular receptors.
(C) Ligand-occupied intracellular receptors bind selectively to specific DNA sequences to regulate
transcription.
(D) Steroid hormones may also bind to receptors on cell surface to elicit signal transduction
pathways.
13. Which following statement is correct?
(A) Somatotrope is the most abundant secretory cell type in anterior pituitary.
(B) Vasopressin is synthesized from anterior pituitary after receiving a signal from
hypothalamus.
(C) Synthesis of corticotropin-releasing hormone (CRH) in the corticotrope is mediated by
a proteolytic process from proopiomelanocortin (POMC).
(D) Prolactin is synthesized from posterior pituitary.
14. Which following description is correct?
(A) Portal system is only involved in regulation of hormone secretion from posterior pituitary.
(B) Melatonin tends to be secreted higher at the day time than the night time.
(C) Nursing is a negative regulator for antidiuretic hormone secretion.
(D) Growth hormone-releasing hormone (GHRH) acts on cell surface receptor.
15. Which following statement is correct?
(A) Hypothalamic hormones are in general large peptide (more than 200 amino acids)
hormones.
(B) Follicle-stimulating hormone (FSH) is secreted from posterior pituitary to act on the
ovary.
(C) Gonadotropin releasing hormone (GnRH) receptor in general localizes on cell membrane.
(D) GnRH plays important roles only in females.
16. In thyroid gland, which one is involved in iodide transport from the follicular cell to across the
apical membrane to join the colloid?
(A) Sodium-iodide symporter.
(B) Secretory vesicle.
(C) Pendrin.
(D) Sodium-potassium pump.
17. Propylthiouracil (PTU) is often used to reduce the production of thyroid hormones in patients
with hyperthyroidism, at least in part due to its effect on:
(A) Thyrotropin-releasing hormone (TRH) expression.
(B) Production of triiodothyronine (T3).
(C) Thyroid stimulating hormone (TSH) secretion.
(D) Transport of iodide into lumen of thyroid follicle.
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18. In general, which following is least likely to be involved in human growth?
(A) Thyroid hormone.
(B) Oxytocin.
(C) Estrogen.
(D) Growth hormone.
19. Which following tissue/organ plays an important role in conversion of tetraiodothyronine
(T4) to triiodothyronine (T3)?
(A) Adrenal gland.
(B) Testis.
(C) Thymus.
(D) Liver.
20. Which one is the major product from the thyroid gland?
(A) Triiodothyronine (T3).
(B) Reverse triiodothyronine (rT3).
(C) Tetraiodothyronine (T4).
(D) Tyrosine.
21. Which following statement is NOT correct?
(A) Thyroxine-binding globulin (TBG) is the site where all MIT, DIT, T3 and T4 can be produced.
(B) Monoiodotyrosine (MIT) is not a functional thyroid hormone.
(C) Tetraiodothyronine (T4) acts less potently than triiodothyronine (T3).
(D) Expression of the sodium-iodide symporter gene is inhibited by iodide.
22. Which following is NOT a source of calcium to regulate the intracellular cytosolic calcium
concentration?
(A) The extracellular environment.
(B) Trans Golgi network (TGN).
(C) Mitochondrion.
(D) Smooth endoplasmic reticulum (ER).
23. Which following tissue/organ is NOT directly involved in regulation of plasma Ca2+ levels?
(A) Pancreas.
(B) Skin.
(C) Thyroid.
(D) Kidney.
24. Which following is NOT a function of calcitonin (CT) to regulate calcium homeostasis?
(A) To increase osteoblast activity.
(B) To reduce osteoclast formation.
(C) To promote excretion of calcium into urine.
(D) To inhibit vitamin D maturation.
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25. Which following molecule appears to reduce bone resorption?
(A) Prolactin.
(B) Oxytocin.
(C) Estrogen.
(D) Thyroid hormone.
26. Which statement is correct?
(A) In the body, most mature functional vitamin D3 is produced in skin.
(B) Mature vitamin D can act only in a non-genomic manner.
(C) Kidney provides 25-hydroxylase to promote vitamin D maturation.
(D) Parathyroid hormone (PTH) can activate G protein-couple receptors to regulate calcium
homeostasis.
27. Which following description is NOT correct?
(A) Parathyroid hormone related peptide (PTHrP) can act on a cell surface receptor to
perform its function.
(B) When the plasma calcium is low, the calcium sensing receptor on parathyroid cells will result
in a decrease of intracellular cAMP level to induce parathyroid hormone (PTH) secretion.
(C) Vitamin D receptor localizes in diverse organs/tissues to affect physiological events.
(D) Activation of the PTH receptor can stimulate Gaq to turn on the downstream signaling.
28. 何者不是導致糖尿病的原因？
(A) 酒精 (Alcohol)
(B) 年齡 (Age)
(C) 基因遺傳 (Gene)
(D) 靜態生活 (Sedentary lifestyle)
29. 肥胖之糖尿病患者，建議體重減輕多少即可減少心臟病和中風的風險？
(A) 減輕至理想體重
(B) 減輕體重 0-5%
(C) 減輕體重 5-10%
(D) 減輕體重 10-15%
30. 對於血糖控制敘述，下列何者正確？
(A) 支持系統不佳 (Support system)的病人，應該嚴格控制血糖
(B) 低血糖 (Hypoglycemia) 風險大的病人，需放寬血糖控制標準
(C) 共病症 (Comorbidities)愈多，應該愈嚴格控制血糖
(D) 預期壽命 (Life expectancy) 長，應該放寬血糖控制標準
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31. 陳先生為病患者，營養師建議早餐可攝取 4 份醣類，除了 1 杯低脂牛奶 (240cc) 以外，
還可以吃多少蘇打餅乾？蘇打餅乾一盒內有 6 小包，每包熱量 117 大卡，有 3 片餅乾，
含蛋白質 2.0 公克，醣類 14.9 公克，脂肪 3.6 公克，請問陳伯伯最多可以吃幾包？
(A) 1 包
(B) 2 包
(C) 3 包
(D) 4 包
32. 糖尿病自我管理教育 (Diabetes Self-Management Education and Support, DSMES) 之敘述，
何者正確？
(A) 糖尿病自我管理教育，不建議在團體環境(如病友團體衛教)中執行
(B) 因人數眾多，不建議所有糖尿病患者參加糖尿病自我管理的衛教，學習了解糖尿病
(C) 應以病人為中心 (patient centered)，醫療團隊成員之間不必溝通
(D) 應以病人為中心 (patient centered)，由整個糖尿病照護團隊協助病人解決問題
33. 有關酒精與糖尿病之關係性，下列何者正確？
(1) 女性建議量為每日不超過 2 個酒精當量
(2) 男性建議量為每日不超過 1 個酒精當量
(3) 酒精會抑制糖質新生作用
(4) 酒精代謝不需要胰島素
(A) (1)+(2)
(B) (1)+(3)
(C) (2)+(4)
(D) (3)+(4)
34. 有關食物代換表 (Food exchange list) 的敘述，何者正確？
(A) 奶類、全穀雜糧類及水果類含有碳水化合物，糖尿病人需控制攝取量
(B) 吃蛋豆魚肉類會明顯升高血糖
(C) 奶類沒有甜味，只要不加糖，就可以大量攝取
(D) 6 大類食物均含有碳水化合物，都需要控制攝取量
35. 下列對於糖尿病人食物選擇的敘述何者錯誤？
(A) 建議選擇無糖優格或優酪乳，並限制攝取量
(B) 優先選擇精緻主食，如白飯、白吐司，並限制攝取量
(C) 吃新鮮水果控制份量即可，不建議選擇果汁或果乾
(D) 各類食物均建議選擇少加工、少添加物
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36. 有關升糖指數(Glycemic index) 的敘述，何者正確？
(A) 升糖指數 (Glycemic index) 即為升糖負荷 (Glycemic load)
(B) 為進食含 100 公克醣類的受試食物後血糖增加面積，與等量醣類之參考食物血糖增加
面積的比值
(C) 食物愈精緻或加工程度高者，其 Glycemic index 愈高
(D) 糖尿病患應多攝取 Glycemic index 高的食物，有利血糖控制
37. 依據 MNT (Medical nutrition therapy) 指引中，針對飲食型態與碳水化合物的建議方面，
何者正確？
(A) No carbohydrate, protein, fat ratio recommendations, meal plans should be individualized
(B) No eating patterns can be considered for the management of type 2 diabetes
(C) Reducing overall fat intake for individuals with diabetes has demonstrated the most
evidence for improving glycemia
(D) Carbohydrate intake should emphasize nutrient-dense carbohydrate sources that are low in
fiber
38. 何謂合理體重 (Reasonable Body Weight)？
(A) 可以達到改善慢性病症狀的體重
(B) 即理想體重,指身體質量指數 (BMI) 控制於 18.5~23.9 內的體重
(C) 指減重者與健康專業人員經過討論,認為可達成和維持體重
(D) 以上皆非
39. 依據 MNT (Medical nutrition therapy) 指引中，針對碳水化合物 (Carbohydrate) 的建議方
面，何者錯誤？
(A) Eating plans should emphasize nonstarchy vegetables, fruits, whole grains, as well as dairy
products, with minimal added sugars
(B) Drink as little sugar-sweetened beverages (including fruit juices) as possible.
(C) When using fixed insulin doses, individuals should be provided education about consistent
pattern of carbohydrate intake with respect to time and amount
(D) Replace water or low calorie, no calorie beverages with fruit juices
40. 依據 MNT (Medical nutrition therapy)指引中，針對蛋白質(Protein)的建議方面，何者錯
誤？
(A) Carbohydrate sources high in protein should be avoided when trying to treat or prevent
hypoglycemia
(B) For people with diabetes and diabetic kidney disease, reducing the amount of dietary
protein below usual intake is recommended
(C) Evidence is inconclusive to recommend an ideal amount of protein intake for
optimizing glycemic control
(D) Protein intake goals should be individualized.
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41. 依據 MNT (Medical nutrition therapy) 指引中，針對脂肪 (fat) 的建議方面，何者正確？
(A) Eating foods rich in long-chain ω-3 fatty acids, such as fatty fish and nuts and seeds, is
recommended to prevent or treat cardiovascular disease
(B) Mediterranean-style eating pattern rich in monounsaturated and polyunsaturated fats
may not be considered to improve glucose metabolism
(C) Fat quantity appears to be far more important than quality
(D) The amount of dietary saturated fat, cholesterol, and trans fat recommended for people with
diabetes is lower than recommended for the general population
42. 根據代謝症候群 (Metabolic syndrome) 診斷標準，下列何者錯誤？
(A) 空腹血糖異常標準為血糖≧100mg/dl
(B) 診斷因子為高血壓、空腹血糖異常、高密度脂蛋白膽固醇、三酸甘油酯與尿酸
(C) 高血壓標準為收縮壓≧130mmHg 及舒張壓≧85mmHg
(D) 五項中符合三項即診斷為代謝症候群
43. Which of these events follows the absorption of glucose?
(A) Glucose is stored as glycogen in adipose tissue.
(B) Glucose is converted to fat in the liver.
(C) Glucose is used to make energy by only the brain.
(D) Glucose is converted to amino acids in the muscles.
44. Which is TRUE regarding chylomicrons?
(A) They readily cross the plasma membrane of adipocytes.
(B) They are converted to monoglycerides and fatty acids by an enzyme inside muscle cells.
(C) They are converted to monoglycerides and fatty acids by an enzyme found inside capillaries.
(D) They are formed in the lumen of the GI tract by the action of bile salts.
45. What enzyme converts chylomicron triacylglycerols into fatty acids and monoglycerides?
(A) Pancreatic lipase
(B) Pancreatic amylase
(C) Lipoprotein lipase
(D) Pepsin
46. Which results from insulin binding to its receptor in skeletal muscle plasma membranes?
(A) Glycogen synthase is stimulated.
(B) Glycogen phosphorylase is stimulated.
(C) Glucose transport into the cell is inhibited.
(D) Protein catabolism is stimulated.
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47. You go see a scary movie. By the end of the movie your heart is racing thanks to high levels of
epinephrine in your bloodstream. You ate nothing during the movie, but your blood glucose level
is likely
(A) low due to the action of cortisol on blood glucose regulation.
(B) elevated due to healthy post-absorptive state mechanisms.
(C) elevated due to the action of epinephrine on blood glucose regulation.
(D) elevated due to the pasta meal consumed at home before the movie.
48. Mary is a busy store clerk on Black Friday. She ate breakfast at 7 am but was not able to take a
lunch break because the store was too busy. It's now 3 pm and she's beginning to feel a bit odd.
Which of the following does NOT describe Mary's physiological state?
(A) Hyperglycemia is occurring.
(B) Gluconeogenesis is occurring.
(C) Insulin secretion is lower than in the absorptive state.
(D) Glucagon secretion is higher than in the absorptive state.
49. Which of the following acts to decrease blood glucose levels?
(A) Insulin
(B) Cortisol
(C) Epinephrine
(D) Growth hormone
50. A chemical precursor for cortisol is
, which is made from
. Cortisol is
secreted by
when stimulated by
from the anterior pituitary.
(A) androstenedione; progesterone; adrenal cortex; corticotropin-releasing hormone (CRH)
(B) progesterone; cholesterol; adrenal medulla; adrenocorticotropic hormone (ACTH)
(C) testosterone; cholesterol; adrenal medulla; adrenocorticotropic hormone (ACTH)
(D) progesterone; cholesterol; adrenal cortex; adrenocorticotropic hormone (ACTH)
51. Which of the following is NOT stimulated by cortisol during long-term fasting?
(A) Gluconeogenesis
(B) Protein catabolism
(C) Glucose uptake into muscle cells
(D) Triglyceride catabolism in adipose cells
52. You are designing an experiment to quantify the levels of stress experienced by different
individuals. Which of the following tests would reveal insight as to a patient's chronic stress?
(A) Testing plasma levels of growth hormone
(B) Testing plasma levels of parathyroid hormone
(C) Testing plasma levels of dopamine
(D) Testing plasma levels of cortisol
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53. If the pituitary gland is removed from a human subject, which of the following is likely to
occur?
(A) The adrenal gland will hypertrophy to increase cortisol production.
(B) The adrenal gland will atrophy and plasma cortisol levels will be reduced.
(C) The hypothalamus will secrete less CRH.
(D) There will be increased negative feedback on growth hormone by insulin-like growth
factor 1 (IGF-1)
54. The negative feedback in HPA axis occurs when hormones from the
inhibit hormone
secretion by the
(A) hypothalamus; anterior pituitary
(B) adrenal cortex; hypothalamus
(C) anterior pituitary; hypothalamus
(D) anterior pituitary; adrenal cortex
55. 比較女性骨盆 (female pelvis) 與男性骨盆 (male pelvis) ，女性骨盆具有以下何種顯著特
徵？
(A) 骨盆腔空間較窄，呈倒三角錐形
(B) 恥骨弓 (pubic arch) 角度較大
(C) 骨盆入口 (pelvic inlet) 較小，呈心型
(D) 坐骨粗隆 (ischial tuberosity) 內彎
(E) 薦岬 (promontory of sacrum) 較突出
56. The roof of the pelvis cavity is formed by which of the following?
(A) Obturator fascia
(B) Urogenital diaphragm
(C) Levator ani
(D) Obturator internus muscle
(E) External anal sphincter
57. 儲精囊 (seminal vesicle) 的淋巴引流入
(A) Internal iliac nodes
(B) External iliac nodes
(C) Para-aortic nodes
(D) Superficial inguinal nodes
58. 射精管 (ejaculatory ducts)：開口於下列何者？
(A) 前列腺囊 (Prostatic utricle)
(B) 前列腺竇 (Prostatic sinuses)
(C) 儲精囊 (Seminal vesicle)
(D) 球尿道腺(Bulbourethral glands)
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59. 下列何者不附著於會陰體 (Perineal body)？
(A) 肛門外擴約肌 (External anal sphincter)
(B) 球海綿體肌 (Bulbospongiosus muscle)
(C) 尾骨肌 (Coccygeus muscle)
(D) 提肛肌 (Levator ani)
60. 下列何者與子宮頸的支持的無關？
(A) 提肛肌 (Levator ani)
(B) 子宮頸橫韌帶 (Transverse cervical ligament)
(C) 恥骨子宮頸韌帶 (Pubocervical ligament)
(D) 肛尾骨肌 (Anococcygeal body)
61. 下列何者與維持子宮於 anteversion 與 anteflexion 的位置有關？
(A) Pubocervical ligaments
(B) Levator ani
(C) Round ligaments of uterus
(D) Cardial ligaments
62. 下列哪一條不為髂骨內動脈的分枝？
(A) 臍動脈
(B) 直腸中動脈
(C) 膀胱下動脈
(D) 卵巢動脈。
63. 下列何者位於會陰淺隙 (superficial perineal pouch)？
(A) 陰莖腳 (Crus of penis)
(B) 膜部尿道 (Membranous part of urethra)
(C) 深會陰橫肌 (Deep transverse perineal muscle)
(D) 陰莖背側神經 (Dorsal nerves of the penis)
◼
50 歲男性因為晚上起來上很多次廁所，導致失眠，至門診求診。經門診醫師檢查後，發
現患者意識清楚，對答如常，體溫 36.5°C，心跳每分鐘 110 下，呼吸每分鐘 20 下，血壓
125/70mmHg，皮膚乾燥且彈性減少。
64. 以下關於多尿(polyuria)的評估，何者不適當？
(A) 多尿的定義是一天上超過 5 次廁所
(B) 多尿的情況,可能會使得身體缺水,造成體重減輕
(C) 多尿可能是因為血糖高,造成尿糖比較高的關係
(D) 多尿可能跟腦部調節口渴的中樞異常有關係
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65. 關於多尿的鑑別診斷，下面哪一個是第一步要做的檢查?
(A) 血糖
(B) 尿液白血球
(C) 尿液鈣離子濃度
(D) 尿液滲透壓
66. 患者抽血檢驗的結果如下:白蛋白 4.0g/dL(參考範圍:3.7-5.3g/dL)、鈉離子 138mmol/L
(參考範圍:135-147 mmol/L)、鉀離子 4.0mmol/L(參考範圍:3.4-4.7 mmol/L)、鈣 12.0
mg/dL(參考範圍:8.4-10.6mg/dL)、磷離子 1.7mg/dL(參考範圍:2.1-4.7mg/dL)、空腹血糖 115
mg/dL(參考範圍:65-100 mg/dL)、肌酐酸 2.3 mg/dL(參考範圍:0.5-1.5mg/dL)。以下關於患者
身體狀況的推測何者為非?
(A) 病人的白蛋白指數在正常範圍內，目前不需要用白蛋白校正鈣離子濃度
(B) 病人有高血鈣、低血磷的問題，進一步檢驗副甲狀腺賀爾蒙濃度是必要檢查
(C) 維他命 D 中毒的患者，也會有類似如此高血鈣、低血磷的現象
(D)患者的腎功能不佳，可能跟高血鈣還有脫水有關，需要進一步檢驗尿素氮
◼ 患有原發性副甲狀腺機能亢進症(primary hyperparathyroidism)的患者，對於是否需要接
受副甲狀腺切除手術治療，感到困擾。身為醫師，您應該如何評估患者的手術風險和手
術必要性?
67. 原發性副甲狀腺機能亢進症需要接受手術的狀況，以下何者為非？
(A) 血鈣濃度過高，造成意識狀態改變
(B) 有腎結石，尿鈣過高
(C) 骨質缺乏，有骨折
(D) 年紀輕，小於 50 歲
68. 副甲狀腺切除手術的風險之一，是骨頭飢餓症候群。關於這種情況，以敘述何者為非？
(A) 因為手術後副甲狀腺素濃度快速下降，造成骨頭大量吸收鈣離子、磷離子、鎂離子，
形成鈣離子、磷離子、鎂離子過低的狀況
(B) 評估低血磷，可以輕敲耳朵前方的臉頰，看臉部肌肉是否會有不自覺的抽動，或者在
手臂使用血壓計壓脈帶束壓數分鐘後，看手腕及手指是否會有不自覺的彎曲
(C) 磷離子濃度在骨頭飢餓症候群是低的，但在副甲狀腺功能低下時可能是高的
(D) 骨頭飢餓症候群的治療以校正電解質為主
69. 副甲狀腺切除手術的風險之一，是造成術後聲音沙啞。關於這種情況，以敘述何者為非？
(A) 此種狀況跟手術中影響到喉返神經(recurrent laryngeal nerve)有關
(B) 如果是傷害到喉返神經，此種聲音沙啞可能會是永久性的影響
(C) 如果並未真正傷害到喉返神經，手術後的聲音改變可能是暫時性的
(D) 副甲狀腺手術直接傷害到聲帶，造成聲帶麻痺，也是造成聲音改變的原因
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標準答案：
題號 01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
A
E
D
C
A
B
A
D
B
A
C
B
A
D
C
C
B
B
D
C
題號 21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
A
B
A
D
C
D
B
A
C
B
C
D
D
A
B
C
A
C
D
B
題號 41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
A
B
B
C
C
A
C
A
A
D
C
D
B
B
B
C
A
A
C
D
題號 61
62
63
64
65
66
67
68
69
C
D
A
A
D
C
C
B
D
答案
答案
答案
答案
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