[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-109-1-basic-medicine-027":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":11},"nurse-109-1-基礎醫學-027","nurse-109-1-basic-medicine-027",109,1,27,"那一段腎小管對水的滲透性最低？",{"A":15,"B":16,"C":17,"D":18},"近曲小管","亨式彎管上行支","遠曲小管","集尿管","B",null,[],"本題考點是腎小管各段對水的通透性差異。亨式彎管上行支（尤其粗段）細胞膜缺乏水通道、對水不通透，只主動再吸收 Na⁺\u002FK⁺\u002FCl⁻，形成「稀釋作用」與髓質高滲透壓，故對水滲透性最低，選 B。(A) 錯，近曲小管對水高度通透，等滲透性再吸收約 65% 濾液。(C) 錯，遠曲小管與集尿管對水的通透性受抗利尿激素（ADH）調控，有 ADH 時可通透，並非最低。(D) 錯，集尿管在 ADH 作用下插入 aquaporin-2，水可大量再吸收，通透性可很高。故對水最不通透者為亨式彎管上行支，答案為 B。","上行支（thick ascending limb）靠頂膜 Na⁺-K⁺-2Cl⁻ 共同運輸子（NKCC2，即 furosemide 作用位）重吸收電解質卻不帶水，稱為「腎的稀釋段」，同時把溶質泵入髓質間質，是逆流倍增建立髓質滲透梯度的引擎。相對地，下行支只通透水不通透溶質。集尿管的水通透性由 ADH 經 V2 受體→cAMP→aquaporin-2 上膜調控，決定最終尿液濃縮或稀釋。記憶：「上行支只搬鹽不搬水，撐起髓質高滲；集尿管聽 ADH 決定要不要留水」。",[25,26,28,30,32],{"term":16,"count":11},{"term":27,"count":11},"NKCC2共同運輸",{"term":29,"count":11},"逆流倍增",{"term":31,"count":11},"抗利尿激素ADH",{"term":33,"count":11},"aquaporin水通道",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-109-1-basic-medicine-028","下列何者是血液中運送二氧化碳的最主要方式？",28,{"webId":40,"stem":41,"number":42,"year":10,"session":43},"nurse-109-2-basic-medicine-044","下列何者不是出血病症（bleeding disorder）之原因？",44,2,{"webId":45,"stem":46,"number":47,"year":48,"session":11},"nurse-110-1-basic-medicine-058","Alteplase 主要用於治療急性缺血性中風、心肌梗塞、肺栓塞、深部靜脈栓塞，其藥理作用機轉為何？",58,110,{"webId":50,"stem":51,"number":52,"year":53,"session":43},"nurse-111-2-basic-medicine-016","河豚毒素（tetrodotoxin）對神經細胞最主要的影響為何？",16,111,{"webId":55,"stem":56,"number":57,"year":58,"session":11},"nurse-113-1-basic-medicine-020","下列那一個內臟的位移痛（referred pain）出現在左手臂內側皮膚？",20,113,{"webId":60,"stem":61,"number":62,"year":63,"session":43},"nurse-114-2-basic-medicine-014","下列何者為清醒狀態（awake state）時，神經傳導物質所媒介的神經元活性表現？",14,114,"2026-09-04",1788510711142]