[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-107-2-basic-medicine-046":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":33,"lastmod":63},"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-046","nurse-107-2-basic-medicine-046",107,2,46,"14 歲女性，無性經驗，因為最近幾個月出現不正常子宮出血而就醫。她初經是在 12 歲。下列何者是造成其不正常出血最可能的原因？",{"A":15,"B":16,"C":17,"D":18},"無排卵週期","子宮內膜感染","子宮內膜癌","子宮肌瘤","A",null,[],"本題考點是青春期異常子宮出血的最常見原因。依婦科生理,初經後數年內下視丘—腦垂體—卵巢軸尚未成熟,常出現無排卵週期（anovulatory cycle);無排卵時無黃體形成、無足量黃體素對抗雌激素,子宮內膜在單一雌激素刺激下過度增厚後不規則剝落,造成青少女不規則出血,故選 A。B 子宮內膜感染多有發燒、疼痛與分泌物,非此情境最可能。C 子宮內膜癌好發於停經後婦女,14 歲極罕見。D 子宮肌瘤多見於生育年齡後期婦女,青春期少見,且此女無性經驗、無相關表現。","機轉:正常排卵週期靠排卵後黃體分泌黃體素,使增生期內膜轉為分泌期並規律剝落;青春期軸線未成熟→無排卵→只有雌激素持續刺激（unopposed estrogen)→內膜增生過度後隨機崩落,出血量與時間皆不規則,即「功能失調性子宮出血」。年齡對應記憶:青春期不規則出血＝無排卵;停經後出血＝先排除子宮內膜癌;生育年齡＝考慮懷孕相關、肌瘤、息肉。同一「無對抗雌激素」機轉也解釋停經前後與多囊性卵巢的異常出血。可連結:下視丘—垂體—卵巢軸、黃體素、增生期／分泌期內膜。",[25,28,29,31],{"term":26,"count":27},"青春期異常子宮出血",1,{"term":15,"count":27},{"term":30,"count":27},"無對抗雌激素刺激",{"term":32,"count":27},"下視丘垂體卵巢軸未成熟",[34,38,43,47,52,57],{"webId":35,"stem":36,"number":37,"year":10,"session":11},"nurse-107-2-basic-medicine-047","下列那種甲狀腺癌的腫瘤細胞的細胞核常呈清澈樣（clear）或有假包涵體（pseudo-inclusions）？",47,{"webId":39,"stem":40,"number":41,"year":42,"session":27},"nurse-108-1-basic-medicine-063","關於腸泌素類似物（incretin minetics）的敘述，下列何者錯誤？",63,108,{"webId":44,"stem":45,"number":46,"year":42,"session":11},"nurse-108-2-basic-medicine-077","下列關於感染結核分枝桿菌（Mycobacterium tuberculosis）的敘述，何者正確？",77,{"webId":48,"stem":49,"number":50,"year":51,"session":27},"nurse-110-1-basic-medicine-035","堵塞性血栓血管炎（thromboangiitis obliterans）最常侵犯身體何處的血管？",35,110,{"webId":53,"stem":54,"number":55,"year":56,"session":27},"nurse-111-1-basic-medicine-079","下列有關登革熱病毒的敘述，何者錯誤？",79,111,{"webId":58,"stem":59,"number":60,"year":61,"session":62},"nurse-112-3-basic-medicine-043","下列何種過敏反應主要是由 IgE 抗體所引起？",43,112,3,"2026-09-04",1788510723718]