[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-108-2-basic-medicine-034":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":34,"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-034","nurse-108-2-basic-medicine-034",108,2,34,"一位 35 歲男性因車禍造成右大腿骨折，兩天後病人出現呼吸困難、躁動不安、神智不清等症狀。就醫後發現病人有皮下點狀出血和血小板減少。下列何者是引起病人臨床表現的最可能原因？",{"A":15,"B":16,"C":17,"D":18},"脂肪栓塞","硬腦膜下出血","細菌性肺炎","急性肺梗塞","A",null,[],"本題考點在長骨骨折後的典型併發症辨識。依病理機轉，長骨（如股骨）骨折後骨髓脂肪釋入血流形成脂肪栓子，經12至72小時潛伏後阻塞肺與腦微血管，出現呼吸困難、意識混亂躁動，以及因血小板黏附於脂肪滴而致的血小板減少與皮下點狀出血，此三聯徵正符合病人表現，故選A脂肪栓塞。B硬腦膜下出血以局部神經學缺損為主，不會有點狀出血與血小板減少。C細菌性肺炎以發燒膿痰為主，與外傷時序及點狀出血不合。D急性肺梗塞多見於深部靜脈栓塞，也不解釋皮膚點狀出血。","脂肪栓塞症候群（fat embolism syndrome）經典三聯徵：呼吸窘迫、神經異常、點狀出血（好發於前胸、腋下、結膜）。機轉雙軌：機械性阻塞微血管，加上游離脂肪酸對血管內皮的化學性毒性引發發炎。時間差是關鍵鑑別點——不像立即發生的失血或氣胸，脂肪栓塞有12至72小時的『空窗期』。記憶要訣：年輕人＋長骨骨折＋一兩天後三聯徵＝脂肪栓塞。可連結：Gurd準則、游離脂肪酸毒性、ARDS、點狀出血。",[25,28,30,32],{"term":26,"count":27},"脂肪栓塞症候群",1,{"term":29,"count":27},"長骨骨折併發症",{"term":31,"count":27},"點狀出血三聯徵",{"term":33,"count":27},"潛伏期時序",[35,39,44,48,53,58],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-108-2-basic-medicine-035","人類免疫不全病毒（HIV）進入 T 細胞需要何種分子當作病毒的高親和力受體？",35,{"webId":40,"stem":41,"number":42,"year":43,"session":27},"nurse-109-1-basic-medicine-051","迷幻藥 LSD 主要影響腦部的何種神經系統？",51,109,{"webId":45,"stem":46,"number":47,"year":43,"session":11},"nurse-109-2-basic-medicine-065","當體細胞受到病毒感染後，主要啟動下列何種細胞的功能，可以有效的控制病情？",65,{"webId":49,"stem":50,"number":51,"year":52,"session":27},"nurse-111-1-basic-medicine-023","下列由內皮細胞分泌的因子中，何者不會使血管舒張？",23,111,{"webId":54,"stem":55,"number":56,"year":57,"session":11},"nurse-112-2-basic-medicine-047","下列關於產氣梭孢桿菌（Clostridium perfringens）的敘述，何者錯誤？",47,112,{"webId":59,"stem":60,"number":61,"year":62,"session":63},"nurse-113-3-basic-medicine-041","為了降低抗藥性細菌的發生率，應該採取下列那一種措施？",41,113,3,"2026-09-04",1788510705092]