→ morrobay:贊成！ 08/05 01:10
※ 引述《chihuahua (chihuahua)》之銘言：
: [申覆] 醫學六 31
: 答案: B.懷孕前服用葉酸及多種維生素,懷孕後接受高層次超音波檢查
: 這答案好像已經把etiology設定為:Folic acid deficiency
: 其它的etiology也包括了:Genetic factors
: -->那麼D也應該是答案之一
前文恕刪
Neural-tube defects are classical examples of multifactorial inheritance.
Their development is influenced by environment, diet, physiological
abnormalities such as hyperthermia or hyperglycemia, teratogen exposure,
family history, ethnic origin, fetal gender, amnionic fluid nutrients, and
various genes. The fact that certain defects are associated with specific
risk factors suggests that many genes are likely to be involved in
neural-tube development. For example, those associated with type 1 diabetes
mellitus are likely to be cranial or cervical-thoracic defects; hyperthermia
has been associated with anencephaly; and valproic acid exposure with
lumbosacral defects (Becerra and colleagues, 1990; Hunter, 1984; Lindhout and
associates, 1992).
Although Hibbard and Smithells (1965) postulated more than
30 years ago that abnormal folate metabolism was responsible for many
neural-tube malformations, a specific gene defect only recently has been
implicated. A thermolabile variant of the enzyme 5,10-methylene
tetrahydrofolate reductase (MTHFR), which plays a key role in folate
metabolism, has been associated with neural-tube defects.
資料來源：國考指定用書
Cunningham, Gary; Leveno, Kenneth J.; Gilstrap, Larry C.. Williams Obstetrics
(22nd Edition).
Blacklick, OH, USA: McGraw-Hill Companies, The, 2005. p 302.
http://site.ebrary.com/lib/taimedical/Doc?id=10176686&ppg=318
Copyright c 2005. McGraw-Hill Companies, The. All rights reserved.
申覆理由：由課文可知，已有確定的gene異常導致其葉酸代謝出問題，並致neural-tube
defects，故D選項夫妻接受染色體檢查應該也是可行的選項。
建議B、D均給分。
不知道這樣的佐證有沒有比較有力= =
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