[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-111-1-basic-medicine-021":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":35,"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-111-1-基礎醫學-021","nurse-111-1-basic-medicine-021",111,1,21,"下列何者可協助維生素 D（vitamin D）轉換為骨化三醇（calcitriol）？",{"A":15,"B":16,"C":17,"D":18},"副甲狀腺素","降鈣素","抗利尿激素","胰島素","A",null,[],"本題考點在於維生素 D 活化為骨化三醇過程中,腎臟 1α-羥化酶的調控激素。維生素 D 在肝臟先羥化為 25-(OH)D,再於腎臟由 1α-羥化酶轉為活性型骨化三醇(1,25-(OH)₂D);此腎臟羥化步驟主要由副甲狀腺素(PTH)促進,故選 A。B 降鈣素作用相反,是降低血鈣,並不促進活化。C 抗利尿激素調節水分再吸收與滲透壓,與鈣代謝及維生素 D 活化無關。D 胰島素調控血糖代謝,亦與 1α-羥化無直接關係。血鈣下降時 PTH 上升、刺激腎臟活化維生素 D 以增加腸道鈣吸收,故正解為 A。","維生素 D 活化三部曲:皮膚(UVB 使 7-脫氫膽固醇→D₃)→肝臟(25-羥化→calcidiol)→腎臟(1α-羥化→calcitriol 活性型)。腎臟這步是速率決定與受調控的關鍵,促進因子包括 PTH↑、低血鈣、低血磷;抑制因子為 FGF23 與骨化三醇本身的負回饋。骨化三醇作用是增加腸道鈣、磷吸收並協同 PTH 動員骨鈣,共同拉高血鈣。降鈣素由甲狀腺濾泡旁細胞分泌,抑制蝕骨細胞、降血鈣,與 PTH 拮抗,是鈣恆定題的常見對照組。",[25,28,31,33],{"term":26,"count":27},"血鈣恆定",3,{"term":29,"count":30},"副甲狀腺素 PTH",2,{"term":32,"count":11},"骨化三醇 calcitriol",{"term":34,"count":11},"腎臟 1α-羥化酶",[36,40,44,49,54,59],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-111-1-basic-medicine-022","下列何者具有產生配子的功能？",22,{"webId":41,"stem":42,"number":43,"year":10,"session":30},"nurse-111-2-basic-medicine-038","關於甲狀腺機能亢進（hyperthyroidism）治療藥物 Propylthiouracil 之敘述，下列何者錯誤？",38,{"webId":45,"stem":46,"number":47,"year":48,"session":30},"nurse-112-2-basic-medicine-032","下列何種藥物的清除半衰期（elimination half-life）最長？",32,112,{"webId":50,"stem":51,"number":52,"year":53,"session":27},"nurse-113-3-basic-medicine-030","甲狀腺乳突癌（papillary carcinoma），下列何者最少見？",30,113,{"webId":55,"stem":56,"number":57,"year":58,"session":11},"nurse-115-1-basic-medicine-034","緩解支氣管平滑肌痙攣（bronchospasm），使用下列何種藥物最佳？",34,115,{"webId":60,"stem":61,"number":62,"year":63,"session":30},"nurse-106-2-basic-medicine-048","波特氏病（Pott disease）與那種病變最有關係？",48,106,"2026-09-04",1788510732856]