[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-109-1-basic-medicine-045":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":35,"lastmod":65},"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-045","nurse-109-1-basic-medicine-045",109,1,45,"一位 25 歲的女性近來莫名嗜睡且神智不清，影像學檢查發現胰臟有一個 2 公分的腫瘤，手術摘除後症狀完全消失，病理檢查結果為胰臟的神經內分泌瘤（neuroendocrine tumor）。她最可能罹患的是：",{"A":15,"B":16,"C":17,"D":18},"升糖素瘤（glucagonoma）","胰島素瘤（insulinoma）","胃泌素瘤（gastrinoma）","體制素瘤（somatostatinoma）","B",null,[],"本題考點是胰臟神經內分泌瘤的功能性分泌與臨床表現對應。病人嗜睡、神智不清是低血糖引起的神經性症狀，切除胰臟腫瘤後症狀消失，最可能是分泌胰島素的胰島素瘤（insulinoma），選 B。(A) 升糖素瘤造成高血糖、遊走性壞死性紅斑，與低血糖表現相反。(C) 胃泌素瘤（Zollinger-Ellison 症候群）造成頑固性消化性潰瘍、腹瀉，非低血糖。(D) 體制素瘤造成糖尿病、膽石、脂肪瀉，亦非低血糖。故引起低血糖神經症狀者為胰島素瘤，答案為 B。","胰島素瘤的診斷靠 Whipple 三徵：低血糖症狀發作、發作時血糖\u003C45–50 mg\u002FdL、給糖後症狀緩解；實驗室見胰島素、C-peptide、proinsulin 不當偏高（內源性）。低血糖神經性症狀源於腦部唯一燃料葡萄糖不足（意識混亂、抽搐、昏迷），自律性症狀為交感反應（心悸、出汗、顫抖）。多為良性、單發。對比功能性 PNET：胰島素瘤（低血糖）、升糖素瘤（高血糖＋壞死性遊走紅斑）、胃泌素瘤（潰瘍）、VIP瘤（大量水瀉）、體制素瘤（三聯：糖尿病、膽石、脂瀉）。",[25,27,29,31,33],{"term":26,"count":11},"胰島素瘤insulinoma",{"term":28,"count":11},"低血糖",{"term":30,"count":11},"Whipple三徵",{"term":32,"count":11},"神經內分泌瘤",{"term":34,"count":11},"C-peptide",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-109-1-basic-medicine-046","下列關於乳癌的敘述何者錯誤？",46,{"webId":41,"stem":42,"number":43,"year":10,"session":44},"nurse-109-2-basic-medicine-062","下列何者屬於腦下垂體後葉分泌的激素，可用於治療尿崩症？",62,2,{"webId":46,"stem":47,"number":48,"year":49,"session":11},"nurse-110-1-basic-medicine-076","關於各型大腸桿菌（Escherichia coli）的敘述，下列何者正確？",76,110,{"webId":51,"stem":52,"number":53,"year":54,"session":44},"nurse-111-2-basic-medicine-034","下列何者為 Ethosuximide 治療失神性癲癇（absence seizures）的主要作用機轉？",34,111,{"webId":56,"stem":57,"number":58,"year":59,"session":11},"nurse-113-1-basic-medicine-038","治療糖尿病的用藥canagliflozin，其主要作用機制為何？",38,113,{"webId":61,"stem":62,"number":63,"year":64,"session":44},"nurse-114-2-basic-medicine-032","下列何者不屬於毒蕈鹼拮抗劑（muscarinic antagonist）的臨床適應症？",32,114,"2026-09-04",1788510711293]