[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-109-2-basic-medicine-033":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":36,"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-109-2-基礎醫學-033","nurse-109-2-basic-medicine-033",109,2,33,"乳癌的病人，手術切除乳房後常引起同側手臂水腫，下列何者為最主要的致病機轉？",{"A":15,"B":16,"C":17,"D":18},"血管內靜水壓增高","血漿滲透壓下降","血管通透性增高","淋巴管阻塞","D",null,[],"本題考點是乳癌乳房切除後同側手臂水腫(淋巴水腫)的病生理機轉。依水腫生成原理,乳房根除手術常一併廓清腋下淋巴結並切斷淋巴管,使該側上肢的淋巴回流受阻,組織間液的蛋白質與液體無法經淋巴系統帶走而滯積,形成高蛋白性淋巴水腫,故正解D「淋巴管阻塞」。A血管內靜水壓增高多見於心衰竭或靜脈阻塞的水腫,非本情境主因。B血漿滲透壓下降(低白蛋白)見於肝腎疾病或營養不良的全身性水腫,非局部單側手臂。C血管通透性增高屬發炎或過敏反應(如組織胺作用),與術後淋巴回流受阻的機轉不同。故選D。","水腫四大機轉:①微血管靜水壓↑(靜脈阻塞、心衰)②血漿膠體滲透壓↓(低白蛋白)③血管通透性↑(發炎、過敏)④淋巴回流阻塞。乳癌腋下淋巴結廓清屬第④類,術後淋巴水腫可能延遲數月至數年出現,且高蛋白間質液易反覆感染(蜂窩性組織炎)。護理重點在患肢避免抽血、量血壓、外傷,並抬高、按摩引流。記憶:局部單側+手術病史→想淋巴阻塞;全身對稱→想滲透壓或心腎因素。",[25,28,30,32,34],{"term":26,"count":27},"膠體滲透壓",8,{"term":29,"count":11},"淋巴水腫",{"term":31,"count":11},"水腫機轉",{"term":18,"count":33},1,{"term":35,"count":33},"腋下淋巴結廓清",[37,41,46,50,54,60],{"webId":38,"stem":39,"number":40,"year":10,"session":11},"nurse-109-2-basic-medicine-034","斯耶格雷症候群（Sjogren syndrome）的病理學變化，下列何者在唾液腺有大量浸潤？",34,{"webId":42,"stem":43,"number":44,"year":45,"session":33},"nurse-110-1-basic-medicine-050","下列何者不是抗癲癇藥物的作用機轉？",50,110,{"webId":47,"stem":48,"number":49,"year":45,"session":11},"nurse-110-2-basic-medicine-064","抗癌藥物中，下列何者有明顯的周邊神經毒性與肝毒性？",64,{"webId":51,"stem":52,"number":11,"year":53,"session":11},"nurse-112-2-basic-medicine-002","下列何神經興奮可使膀胱壁之迫尿肌收縮、尿道內括約肌舒張？",112,{"webId":55,"stem":56,"number":57,"year":58,"session":59},"nurse-113-3-basic-medicine-006","淋巴液是在何處匯入靜脈？",6,113,3,{"webId":61,"stem":62,"number":44,"year":63,"session":59},"nurse-114-3-basic-medicine-050","有關傳染性蛋白質（prion）的特性，下列敘述何者最適當？",114,"2026-09-04",1788510715037]