[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-107-2-basic-medicine-041":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":36,"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-107-2-基礎醫學-041","nurse-107-2-basic-medicine-041",107,2,41,"惡性貧血（pernicious anemia）的病因主要是缺乏下列何者：",{"A":15,"B":16,"C":17,"D":18},"維生素 B 12","葉酸","胺基酸","鐵","A",null,[],"本題考點是惡性貧血的病因。依血液學,惡性貧血（pernicious anemia）源於胃壁細胞的自體免疫破壞,導致內在因子（intrinsic factor）缺乏,使維生素 B12 無法在迴腸吸收,造成 B12 缺乏性巨球性貧血,故選 A。B 葉酸缺乏雖同屬巨球性貧血,但不伴神經症狀,且非「惡性貧血」的定義病因。C 胺基酸缺乏與此類貧血無直接關係。D 鐵缺乏造成的是小球低血色素性貧血,型態與惡性貧血相反。惡性貧血特有的神經學損害（脊髓後側索退化)正因 B12 參與髓鞘合成,可與葉酸缺乏鑑別。","機轉:胃壁細胞自體免疫萎縮→內在因子↓→B12 於迴腸末端吸收失敗。B12 是 DNA 合成與髓鞘維持所需,缺乏造成巨母紅血球生成（骨髓內無效造血)與神經病變——亞急性合併退化（subacute combined degeneration,脊髓後索與側索）。鑑別記憶:B12 缺乏＝巨球性貧血＋神經症狀;葉酸缺乏＝巨球性貧血但「無」神經症狀（且補葉酸會掩蓋 B12 缺乏使神經惡化）。診斷可用血清 B12、抗內在因子抗體。可連結:內在因子、迴腸吸收、Schilling 試驗概念。",[25,28,31,34],{"term":26,"count":27},"內在因子",6,{"term":29,"count":30},"惡性貧血",4,{"term":32,"count":33},"維生素 B12 缺乏",1,{"term":35,"count":33},"巨球性貧血與神經病變",[37,41,46,50,55,60],{"webId":38,"stem":39,"number":40,"year":10,"session":11},"nurse-107-2-basic-medicine-042","缺血性腸病（ischemic bowel disease）中，發生全腸壁性梗塞（transmural infarction）最主要的原因為何？",42,{"webId":42,"stem":43,"number":44,"year":45,"session":33},"nurse-108-1-basic-medicine-058","下列何種苯二氮平（Benzodiazepine）藥物，最易引起較嚴重之戒斷症狀（如：焦慮）？",58,108,{"webId":47,"stem":48,"number":49,"year":45,"session":11},"nurse-108-2-basic-medicine-072","下列對病毒的敘述何者錯誤？",72,{"webId":51,"stem":52,"number":53,"year":54,"session":33},"nurse-110-1-basic-medicine-030","在腎臟的近曲小管中，鈉離子主要與下列何種物質共同運輸進入上皮細胞？",30,110,{"webId":56,"stem":57,"number":58,"year":59,"session":33},"nurse-111-1-basic-medicine-074","下列關於痘病毒（poxvirus）的敘述，何者錯誤？",74,111,{"webId":61,"stem":62,"number":63,"year":64,"session":65},"nurse-112-3-basic-medicine-038","使用口服 Levothyroxine 治療甲狀腺功能低下（hypothyroidism）時，併用下列何種口服藥物最會降低 Levothyroxine 吸收？",38,112,3,"2026-09-04",1788510723654]