[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-108-2-basic-medicine-024":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":35,"lastmod":64},"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-108-2-基礎醫學-024","nurse-108-2-basic-medicine-024",108,2,24,"一位 50 歲女性有低血鈣、高血磷與低尿磷等症狀，注射副甲狀腺素（PTH）治療會增加尿液中 cAMP 的濃度，此女士可能罹患下列何種疾病？",{"A":15,"B":16,"C":17,"D":18},"原發性副甲狀腺機能亢進","次發性副甲狀腺機能亢進","原發性副甲狀腺機能低下","次發性副甲狀腺機能低下","C",null,[],"本題考點為副甲狀腺功能低下的鑑別。患者低血鈣、高血磷,注射副甲狀腺素(PTH)後尿中cAMP能上升,代表腎臟對PTH的受體反應正常,問題出在PTH分泌不足,屬原發性副甲狀腺機能低下,選C。A原發性亢進會呈高血鈣、低血磷,與本題相反。B次發性亢進多因慢性腎病或低血鈣長期刺激,PTH代償升高,血鈣多偏低但PTH是高的。D次發性低下並非標準診斷框架,且若為受體阻抗(假性低下),注射PTH後尿cAMP不會上升。判斷關鍵在於「注射PTH後cAMP有反應,排除受體缺陷,定位於PTH本身分泌不足」的原發性低下。","PTH經腎小管上皮的Gs蛋白偶聯受體活化腺苷酸環化酶,產生cAMP為第二傳訊者,促進磷排除、鈣再吸收與維生素D活化。此題屬經典的Ellsworth-Howard試驗邏輯:注射外源PTH後,若尿cAMP與尿磷上升→受體正常→原發性低下(PTH不足);若無反應→受體或Gs缺陷→假性副甲狀腺低下。對比記憶:副甲狀腺低下=低鈣高磷;亢進=高鈣低磷。「cAMP有反應=零件沒壞,只是料不夠」。",[25,28,31,33],{"term":26,"count":27},"副甲狀腺素",3,{"term":29,"count":30},"原發性副甲狀腺低下",1,{"term":32,"count":30},"低血鈣高血磷",{"term":34,"count":30},"尿cAMP反應",[36,40,45,49,54,59],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-108-2-basic-medicine-025","進入青春期，由下列何種激素刺激卵巢濾泡發育，使初級卵母細胞完成第一次減數分裂？",25,{"webId":41,"stem":42,"number":43,"year":44,"session":30},"nurse-109-1-basic-medicine-041","一位接受骨髓移植的病患，在術後數週後，皮膚出現皮疹，此皮膚症狀與下列何者最為相關？",41,109,{"webId":46,"stem":47,"number":48,"year":44,"session":11},"nurse-109-2-basic-medicine-055","下列何種抗癲癇藥物也可用於治療帶狀疱疹後神經痛？",55,{"webId":50,"stem":51,"number":52,"year":53,"session":30},"nurse-111-1-basic-medicine-013","下列何者是位於迴腸最外層之結構？",13,111,{"webId":55,"stem":56,"number":57,"year":58,"session":11},"nurse-112-2-basic-medicine-037","下列何種藥物是屬於長效型治療氣喘的藥物，但不具有抗發炎作用，無法快速緩解急性氣喘發作？",37,112,{"webId":60,"stem":61,"number":62,"year":63,"session":27},"nurse-113-3-basic-medicine-031","下列降血壓藥物中，何者能活化交感神經突觸前的 α 2 -adrenergic receptor？",31,113,"2026-09-04",1788510704985]