[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-110-2-medical-surgical-043":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"lastmod":66},"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-110-2-內外科護理學-043","nurse-110-2-medical-surgical-043",110,2,43,"有關席林試驗可協助診斷的貧血類別，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"缺鐵性貧血","惡性貧血","溶血性貧血","再生不良性貧血","B",null,[],"本題考點在辨識席林試驗(Schilling test)的診斷用途。此試驗以放射性標記的維生素B12併用內在因子,測量B12在腸道的吸收與尿中排出量,用以判斷B12吸收障礙是否源自內在因子缺乏。惡性貧血正是胃壁細胞萎縮、內在因子不足導致B12無法吸收的巨球性貧血,故選B。缺鐵性貧血屬小球性低血紅素貧血,診斷靠血清鐵與鐵蛋白,與B12無關;溶血性貧血靠網狀紅血球、膽紅素與Coombs試驗判斷;再生不良性貧血是骨髓造血功能衰竭,靠骨髓切片診斷,均非席林試驗適用範圍。","席林試驗分兩階段:先單獨口服放射性B12測尿中排出量,若偏低則加服內在因子再測;若補內在因子後吸收恢復正常,即證實為內在因子缺乏型的惡性貧血。記憶連結:惡性貧血=B12缺乏+內在因子下降+抗壁細胞抗體,血液抹片可見過度分節的嗜中性球與巨球性紅血球(MCV升高),神經症狀來自脊髓後索與側索退化。可對比葉酸缺乏同為巨球性貧血但無神經症狀。",[24,27,29,32,34],{"term":25,"count":26},"內在因子",5,{"term":15,"count":28},4,{"term":30,"count":31},"維生素B12",3,{"term":33,"count":31},"巨球性貧血",{"term":35,"count":10},"席林試驗",[37,41,47,51,56,61],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-110-2-medical-surgical-044","下列何者不是皮膚過敏試驗？",44,{"webId":42,"stem":43,"number":44,"year":45,"session":46},"nurse-111-1-medical-surgical-060","有關電解質失調之症狀評估結果，下列何者錯誤？",60,111,1,{"webId":48,"stem":49,"number":50,"year":45,"session":10},"nurse-111-2-medical-surgical-074","有關糖化血色素的敘述，下列何者正確？",74,{"webId":52,"stem":53,"number":54,"year":55,"session":31},"nurse-112-3-medical-surgical-032","有關器官移植後的護理指導，下列何者錯誤？",32,112,{"webId":57,"stem":58,"number":59,"year":60,"session":46},"nurse-114-1-medical-surgical-036","有關肺膿瘍病人的護理評估，下列何者最可能出現？",36,114,{"webId":62,"stem":63,"number":64,"year":65,"session":10},"nurse-115-2-medical-surgical-030","異位性皮膚炎病人血液中會出現下列何種免疫球蛋白升高？",30,115,"2026-09-04",1788510729187]