[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-108-1-medical-surgical-072":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":62},"內外科護理學","medical-surgical",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":11,"stem":12,"options":13,"answer":18,"answerNote":19,"images":20,"explanation":21,"explanationDeep":22,"topics":23,"freq":26},"nurse-108-1-內外科護理學-072","nurse-108-1-medical-surgical-072",108,1,72,"有關庫欣氏症候群的診斷檢查，下列何者最具特異性？",{"A":14,"B":15,"C":16,"D":17},"24 小時尿液游離皮質醇排泄量","核醫腎上腺皮質掃描","標準二天類固醇抑制試驗","蝶鞍核磁共振影像檢查","A",null,[],"本題考點為庫欣氏症候群（Cushing syndrome）的篩檢與定位診斷。庫欣氏症候群的核心是皮質醇過量，24 小時尿液游離皮質醇能直接量測一整天的皮質醇總排泄量，不受單次抽血脈動波動影響，特異性與敏感性俱佳，是首選篩檢，故選 A。選項 C 標準二天低劑量類固醇抑制試驗雖也是常用篩檢，但屬功能性抑制反應、易受藥物與生理壓力干擾，特異性不及尿游離皮質醇。選項 B 核醫腎上腺皮質掃描與選項 D 蝶鞍核磁共振屬「定位」影像，用於確認病灶在腎上腺或腦下垂體，並非確立皮質醇過量本身的診斷，故非最具特異性者。","診斷邏輯採兩步：先確認皮質醇是否過量（生化篩檢），再定位病灶（影像）。三大生化篩檢為 24 小時尿游離皮質醇、隔夜低劑量 dexamethasone 抑制試驗、深夜唾液皮質醇。定位則靠 ACTH 高低分流：ACTH 上升指向腦下垂體腺瘤（Cushing disease）或異位分泌，做蝶鞍 MRI；ACTH 低下指向腎上腺本身，做腎上腺影像。記憶對比：庫欣『症候群』是皮質醇過量的總稱，庫欣『病』專指腦下垂體 ACTH 瘤。連結概念：晝夜節律喪失、月亮臉水牛肩、高血糖與低血鉀。",[24,27,29,31],{"term":25,"count":26},"庫欣氏症候群",6,{"term":28,"count":10},"24小時尿游離皮質醇",{"term":30,"count":10},"皮質醇過量篩檢",{"term":32,"count":10},"dexamethasone抑制試驗",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-108-1-medical-surgical-073","有關剛接受腦下垂體切除術後病人的護理措施，下列何者錯誤？",73,{"webId":39,"stem":40,"number":41,"year":42,"session":10},"nurse-109-1-medical-surgical-009","有關肛門瘻管手術治療後常見的併發症，下列何者正確？①出血 ②腹股溝疝氣 ③瘻管復發 ④解便失禁",9,109,{"webId":44,"stem":45,"number":46,"year":42,"session":47},"nurse-109-2-medical-surgical-023","有關鼻竇炎術後的護理措施，下列何者錯誤？",23,2,{"webId":49,"stem":50,"number":51,"year":52,"session":47},"nurse-110-2-medical-surgical-061","有關急性腎絲球腎炎的敘述，下列何者錯誤？",61,110,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-112-1-medical-surgical-025","有關心包填塞（cardiac tamponade）的徵象，下列何者錯誤？",25,112,{"webId":59,"stem":60,"number":41,"year":61,"session":10},"nurse-113-1-medical-surgical-009","有關膽道疾病的敘述，下列何者錯誤？",113,"2026-09-04",1788510710135]