[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-107-1-basic-medicine-041":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":37,"lastmod":66},"基礎醫學","basic-medicine","基礎醫學(包括解剖學、生理學、病理學、藥理學、微生物學與免疫學)",{"id":8,"webId":9,"year":10,"session":11,"subject":4,"number":12,"stem":13,"options":14,"answer":19,"answerNote":20,"images":21,"explanation":22,"explanationDeep":23,"topics":24,"freq":27},"nurse-107-1-基礎醫學-041","nurse-107-1-basic-medicine-041",107,1,41,"下列何者最容易出現在全胃切除（total gastrectomy）後發生貧血之患者？",{"A":15,"B":16,"C":17,"D":18},"血清中攜鐵蛋白（transferrin）濃度上升","紅血球的葡萄糖-6-磷酸去氫酶（glucose-6-phosphatedehydrogenase）降低","血清中 vitamin B 12 值降低","血清中抗紅血球抗體上升","C",null,[],"本題考點在全胃切除後的貧血機轉。胃壁細胞(parietal cell)分泌內在因子(intrinsic factor),是迴腸末端吸收 vitamin B12 的必要載體;全胃切除後內在因子來源全失,B12 無法吸收,數年後血清 B12 值下降並導致巨球性貧血,故選 C。A 攜鐵蛋白上升反映缺鐵而非胃切除的典型結果,且缺鐵時常見鐵儲存指標下降;B 葡萄糖-6-磷酸去氫酶(G6PD)缺乏是 X 染色體遺傳的溶血病因,與手術無關;D 抗紅血球抗體上升屬自體免疫溶血性貧血,機轉與內在因子缺乏無關。","內在因子與 B12 結合後於迴腸末端經 cubilin 受體吸收;全胃切除或惡性貧血(自體免疫破壞壁細胞)都會切斷這條路徑,屬「巨球性\u002F大球性貧血」。記憶點:壁細胞同時分泌胃酸與內在因子,缺內在因子=惡性貧血=B12 缺乏。B12 缺乏除貧血外還會神經學損傷(脊髓後索與側索退化)。與葉酸缺乏的鑑別:兩者皆巨球性,但 B12 缺乏才有神經症狀,且補葉酸會遮蔽 B12 缺乏。",[25,28,31,33,35],{"term":26,"count":27},"壁細胞",5,{"term":29,"count":30},"巨球性貧血",2,{"term":32,"count":11},"內在因子(intrinsic factor)",{"term":34,"count":11},"vitamin B12 吸收",{"term":36,"count":11},"全胃切除",[38,42,46,51,56,61],{"webId":39,"stem":40,"number":41,"year":10,"session":11},"nurse-107-1-basic-medicine-042","Reed-Sternberg 細胞是一種特殊的腫瘤細胞，此種細胞出現在下列那種腫瘤？",42,{"webId":43,"stem":44,"number":45,"year":10,"session":30},"nurse-107-2-basic-medicine-058","一位年輕人時常服用止痛劑來緩解頭痛，最近發現有胃潰瘍情形，下列何種藥物比較有效改善此種胃潰瘍現象？",58,{"webId":47,"stem":48,"number":49,"year":50,"session":11},"nurse-108-1-basic-medicine-072","下列何者是正確的病毒複製步驟？①去殼（uncoating） ②認識目標細胞 ③巨分子合成 ④附著（attachment）穿入（penetration） ⑤病毒組合 ⑥病毒釋出",72,108,{"webId":52,"stem":53,"number":54,"year":55,"session":30},"nurse-109-2-basic-medicine-030","若以潮氣容積（tidal volume）200毫升，呼吸頻率40次／分鐘的方式持續呼吸30秒，會發生下列何種現象？",30,109,{"webId":57,"stem":58,"number":59,"year":60,"session":30},"nurse-110-2-basic-medicine-074","關於肉毒梭孢桿菌（Clostridium botulinum）感染之敘述，下列何者錯誤？",74,110,{"webId":62,"stem":63,"number":64,"year":65,"session":30},"nurse-112-2-basic-medicine-008","分泌鹼性黏液之布氏腺（Brunner’s glands）主要位於消化道何處？",8,112,"2026-09-04",1788510701228]