[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-111-1-basic-medicine-042":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":33,"lastmod":62},"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":11},"nurse-111-1-基礎醫學-042","nurse-111-1-basic-medicine-042",111,1,42,"肝臟因為慢性右側心臟衰竭發生嚴重充血現象時，肝小葉中心區域出現出血性壞死，稱為：",{"A":15,"B":16,"C":17,"D":18},"脂肪肝","荳蔻肝","肉芽腫","潰瘍","B",null,[],"本題考點在於慢性右心衰竭導致肝臟嚴重充血後,肝小葉中央區出血性壞死的特殊病理名稱。慢性右心衰竭使靜脈回流受阻、肝靜脈與中央靜脈鬱血,肝小葉中央區缺氧壞死充血呈暗紅、周邊仍為正常或脂變的黃色,切面紅黃相間如荳蔻(肉豆蔻)剖面,故稱荳蔻肝(nutmeg liver),選 B。A 脂肪肝是脂肪堆積於肝細胞,與心衰竭鬱血機轉不同。C 肉芽腫是慢性發炎的聚集病灶,與鬱血無關。D 潰瘍是黏膜組織缺損,不用於描述肝鬱血。故正解為 B。","荳蔻肝(慢性被動性充血)機轉:右心衰竭→體循環靜脈壓上升→肝中央靜脈與肝竇鬱血→小葉中央區(第 3 區)最遠離肝動脈供氧、最易缺氧壞死呈暗紅,周邊區(第 1 區)血氧較佳仍偏黃或脂變,交錯形成荳蔻樣外觀。長期可進展為心因性肝硬化(cardiac cirrhosis)。臨床可見肝腫大、右上腹脹、肝頸靜脈回流徵。理解肝小葉「中央缺氧、周邊供氧佳」的血流分區,即能解釋為何壞死從中央開始、外觀呈紅黃相間,是心衰竭系統性後果的經典題。",[25,27,29,31],{"term":26,"count":11},"荳蔻肝 nutmeg liver",{"term":28,"count":11},"慢性右心衰竭",{"term":30,"count":11},"肝小葉中央區壞死",{"term":32,"count":11},"被動性充血",[34,38,43,47,51,57],{"webId":35,"stem":36,"number":37,"year":10,"session":11},"nurse-111-1-basic-medicine-043","下列何種免疫性疾病，病人幾乎都是男性？",43,{"webId":39,"stem":40,"number":41,"year":42,"session":11},"nurse-112-1-basic-medicine-009","負責平衡鼓膜（tympanic membrane）內外壓力的耳咽管（auditory tube），主要連通那兩個部位？",9,112,{"webId":44,"stem":45,"number":46,"year":42,"session":46},"nurse-112-3-basic-medicine-003","三塊聽小骨（auditory ossicle）位在那一塊骨頭之中？",3,{"webId":48,"stem":49,"number":11,"year":50,"session":11},"nurse-114-1-basic-medicine-001","心肌的肌內質網主要受何者刺激而釋放鈣離子？",114,{"webId":52,"stem":53,"number":54,"year":55,"session":56},"nurse-115-2-basic-medicine-005","胸骨左側第 2 肋間最靠近下列心臟的那個瓣膜？",5,115,2,{"webId":58,"stem":59,"number":60,"year":61,"session":56},"nurse-106-2-basic-medicine-069","婦女經期使用的衛生棉條不潔時，會引起毒性休克症候群，是下列何種細菌產生之毒素所引起的？",69,106,"2026-09-04",1788510733053]