[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-112-2-basic-medicine-018":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":36,"lastmod":65},"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-112-2-基礎醫學-018","nurse-112-2-basic-medicine-018",112,2,18,"尿素和下列那一種物質的累積會造成腎臟髓質組織間的高滲透度（ hyperosmolar medullary renal interstitium）？",{"A":15,"B":16,"C":17,"D":18},"二氧化碳","葡萄糖","麩醯胺酸","氯化鈉","D",null,[],"本題考點在於腎臟逆流倍增機制（countercurrent multiplier）維持髓質高滲透壓的溶質來源。依此機轉，亨利氏環（loop of Henle）主動再吸收氯化鈉，加上尿素在集尿管的再循環，兩者共同堆積在髓質組織間隙，形成由皮質往髓質遞增的滲透梯度，故選 D。A 二氧化碳為代謝廢氣、經肺排出，與髓質滲透無關；B 葡萄糖正常於近曲小管完全再吸收，不會堆積於髓質；C 麩醯胺酸參與腎臟氨的生成與酸鹼調節，並非構成髓質高滲透的主力溶質。","髓質高滲透壓是尿液濃縮的關鍵，滲透梯度愈陡，抗利尿激素（ADH）作用下集尿管回收水分的能力愈強。兩大溶質記憶：NaCl（亨利氏環上行支主動運輸、不通透水）+ 尿素（集尿管內側再循環）。這也解釋為何蛋白質攝取不足或長期利尿劑使用會削弱尿素梯度，降低尿液濃縮能力，可連結逆流交換機制與 ADH 作用一併複習。",[25,28,30,33,34],{"term":26,"count":27},"尿液濃縮",3,{"term":29,"count":11},"逆流倍增機制",{"term":31,"count":32},"腎髓質",1,{"term":18,"count":32},{"term":35,"count":32},"尿素",[37,41,46,50,55,60],{"webId":38,"stem":39,"number":40,"year":10,"session":11},"nurse-112-2-basic-medicine-019","有關換氣過度（hyperventilation）的敘述，下列何者錯誤？",19,{"webId":42,"stem":43,"number":44,"year":45,"session":32},"nurse-113-1-basic-medicine-015","下列何者是負責供應肝臟充氧血的血管？",15,113,{"webId":47,"stem":48,"number":49,"year":45,"session":27},"nurse-113-3-basic-medicine-009","下列何者分泌內在因子（intrinsic factor），以協助維生素 B 12 之吸收？",9,{"webId":51,"stem":52,"number":53,"year":54,"session":32},"nurse-115-1-basic-medicine-007","副甲狀腺素（PTH）作用在腎小管時會產生下列何種反應？",7,115,{"webId":56,"stem":57,"number":58,"year":59,"session":11},"nurse-106-2-basic-medicine-031","在紅血球中，下列何者是催化二氧化碳與水結合形成碳酸最重要的酵素？",31,106,{"webId":61,"stem":62,"number":63,"year":64,"session":11},"nurse-107-2-basic-medicine-065","下列何類抗生素主要影響細菌 DNA 的複製？",65,107,"2026-09-04",1788510746306]