[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-109-1-maternal-pediatric-049":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"lastmod":62},"產兒科護理學","maternal-pediatric",{"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":10},"nurse-109-1-產兒科護理學-049","nurse-109-1-maternal-pediatric-049",109,1,49,"林小弟，13 歲，學校體檢時發現上肢血壓高，鼠蹊脈搏較上肢脈搏微弱，主訴頭痛，常常感覺腳部冰冷，林小弟可能罹患下列何種疾病？",{"A":14,"B":15,"C":16,"D":17},"心室中隔缺損","主動脈狹窄","肺動脈瓣狹窄","大血管轉位","B",null,[],"本題考點在於先天性心臟血管畸形的臨床定位,重點在於辨識主動脈狹窄(coarctation of aorta):13歲男童上肢血壓升高、鼠蹊(下肢)脈搏較上肢微弱、主訴頭痛且雙腳常冰冷,正是主動脈弓峽部狹窄造成狹窄近端(上半身)高血壓、遠端(下半身)灌流不足的典型「上高下低」表現,故選B。A心室中隔缺損以左向右分流、心雜音與心衰竭為主,無上下肢血壓落差。C肺動脈瓣狹窄影響右心排出至肺,不造成體循環上下肢差異。D大血管轉位為新生兒期即嚴重發紺的危急先心病,不符本題表現。因此正解為B主動脈狹窄。","主動脈狹窄的病生理核心是「一夾兩區」:狹窄處近端血壓高(上肢高血壓、頭痛、鼻出血),遠端灌流差(下肢脈弱、血壓低、跛行、腳冰冷),上下肢血壓差與股動脈脈搏延遲(brachiofemoral delay)是關鍵理學檢查。長期可致左心室肥厚,胸部X光可見肋骨下緣切跡(rib notching,側枝循環)。記憶要點:「上高下低、股脈弱、量四肢血壓」。凡看到上下肢血壓\u002F脈搏不對稱即優先想主動脈狹窄。可連結先天性心臟病分流與發紺型\u002F非發紺型分類複習。",[24,26,28,30],{"term":25,"count":10},"主動脈狹窄 coarctation",{"term":27,"count":10},"上肢高血壓下肢脈弱",{"term":29,"count":10},"brachiofemoral delay",{"term":31,"count":10},"非發紺型先天性心臟病",[33,37,42,47,52,57],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-109-1-maternal-pediatric-050","有關兒童白血病的敘述，下列何者正確？",50,{"webId":38,"stem":39,"number":40,"year":9,"session":41},"nurse-109-2-maternal-pediatric-066","有關體染色體隱性遺傳之疾病，下列何者錯誤？",66,2,{"webId":43,"stem":44,"number":45,"year":46,"session":10},"nurse-110-1-maternal-pediatric-080","有關兒童腦性麻痺的型態及表徵，下列敘述何者不適當？",80,110,{"webId":48,"stem":49,"number":50,"year":51,"session":41},"nurse-111-2-maternal-pediatric-038","有關精液檢查的敘述，下列何者錯誤？",38,111,{"webId":53,"stem":54,"number":41,"year":55,"session":56},"nurse-112-3-maternal-pediatric-002","有關拉梅茲倡議的生產措施，下列敘述何者正確？",112,3,{"webId":58,"stem":59,"number":60,"year":61,"session":56},"nurse-113-3-maternal-pediatric-046","有關排尿性膀胱尿道攝影（voiding cystoureterography,VCUG）的敘述，下列何者最適當？",46,113,"2026-09-04",1788510713556]