[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-109-2-medical-surgical-068":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":37,"lastmod":65},"內外科護理學","medical-surgical",{"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":26},"nurse-109-2-內外科護理學-068","nurse-109-2-medical-surgical-068",109,2,68,"有關庫欣氏症候群症狀（Cushing’s syndrome）之病理機轉，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"軀幹性肥胖：糖皮質素對脂肪和蛋白質代謝影響所導致","高血壓：降低礦物皮質醇活化，導致水分與鈉離子滯留","免疫受抑制：白血球增多，抑制單核球作用與淋巴球下降","高血糖：肝臟糖質新生作用降低，胰島素利用增加所導致","C",null,[],"本題考點是庫欣氏症候群（Cushing's syndrome）的病理機轉。過量糖皮質素會促使嗜中性球增多（白血球上升）、同時抑制單核球功能並使淋巴球下降，整體造成免疫抑制，故選項C正確。選項B錯在庫欣氏症是礦物皮質醇活性「增加」導致水鈉滯留而高血壓，非降低；選項D錯在糖皮質素會「促進」肝臟糖質新生並造成胰島素阻抗，故高血糖，而非糖質新生降低。選項A雖提軀幹性肥胖，但糖皮質素對蛋白質是促進「分解代謝」造成四肢肌肉消瘦，中心性肥胖主要來自脂肪重新分佈，故其機轉敘述不夠精確，本題以C為標準答案。","皮質醇過量的四大代謝影響可用『升糖、分解蛋白、重分佈脂肪、留鈉排鉀、抑免疫』串記。免疫方面的矛盾點要抓：皮質醇讓嗜中性球從邊緣池釋出、白血球總數反上升，卻抑制淋巴球、嗜酸性球與單核球功能，故看似WBC高其實免疫低下、易感染且不易發燒。臨床表徵連結：滿月臉、水牛肩、中心肥胖來自脂肪重分佈；四肢細瘦、皮膚紫紋來自蛋白分解；高血壓與低血鉀來自礦物皮質醇作用；血糖高來自糖質新生加胰島素阻抗。與愛迪生氏病（皮質醇不足）恰為鏡像對照。",[24,27,30,32,34],{"term":25,"count":26},"庫欣氏症候群",6,{"term":28,"count":29},"糖質新生",5,{"term":31,"count":10},"糖皮質素",{"term":33,"count":10},"免疫抑制",{"term":35,"count":36},"礦物皮質醇",1,[38,42,46,51,56,60],{"webId":39,"stem":40,"number":41,"year":9,"session":10},"nurse-109-2-medical-surgical-069","下列何種荷爾蒙分泌不足會導致黏液性水腫（myxedema）？",69,{"webId":43,"stem":44,"number":29,"year":45,"session":10},"nurse-110-2-medical-surgical-005","有關頭眼反射（oculocephalic reflex）的敘述，下列何者錯誤？",110,{"webId":47,"stem":48,"number":49,"year":50,"session":36},"nurse-111-1-medical-surgical-019","王先生開放性骨折日前出院返家，近日發燒、寒顫、躁動不安、患肢持續性疼痛及拒絕移動關節或觸碰患肢。下列何者為其最可能的合併症？",19,111,{"webId":52,"stem":53,"number":54,"year":55,"session":36},"nurse-112-1-medical-surgical-057","病人有心衰竭病史，因車禍造成左側肋骨骨折與氣血胸，目前出現急性呼吸衰竭的情形，下列護理措施何者最不適宜？",57,112,{"webId":57,"stem":58,"number":36,"year":59,"session":10},"nurse-113-2-medical-surgical-001","腦瘤病人接受放射線治療，下列敘述何者正確？①臨床上常用 I 125 經由立體定位手術直接植入腫瘤進行治療 ②可以在手術後立即合併使用放射線治療，以促進治療效果 ③手術後通常以單次大劑量放射線治療為主 ④可以與化學療法合併使用，適用於惡性腦瘤和轉移癌之治療",113,{"webId":61,"stem":62,"number":63,"year":64,"session":10},"nurse-114-2-medical-surgical-045","有關糖尿病足部之身體評估可能結果，下列何者錯誤？",45,114,"2026-09-04",1788510716920]