[{"data":1,"prerenderedAt":69},["ShallowReactive",2],{"q-nurse-112-2-basic-medicine-021":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":38,"lastmod":68},"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-021","nurse-112-2-basic-medicine-021",112,2,21,"一位 18 歲男性因四肢水腫而就醫。他被發現有明顯蛋白尿和高血脂，但是腎臟功能和血壓均正常。腎臟切片的光學顯微鏡檢查顯示正常腎小球構造，但電子顯微鏡檢查發現足細胞（podocyte）突起消失。引起此病人水腫的最可能機轉為下列何者？",{"A":15,"B":16,"C":17,"D":18},"鉀離子貯積","血管內壓上升","高血脂症","血液滲透壓下降","D",null,[],"本題考點在於腎病症候群（nephrotic syndrome）水腫的核心機轉。依題目線索，光鏡正常、電鏡見足細胞突起（foot process）消失，符合微小病變腎病；大量蛋白尿造成血中白蛋白流失、血漿膠體滲透壓（oncotic pressure）下降，使血管內水分留不住而外滲至組織間隙產生水腫，故選 D。A 鉀離子貯積與腎功能衰竭相關，但本題腎功能正常；B 血管內壓上升屬心因性或高血壓性水腫機轉，與此不符；C 高血脂是低白蛋白的代償結果之一，並非造成水腫的直接原因。","腎病症候群四聯徵：大量蛋白尿（>3.5 g\u002F日）、低白蛋白血症、水腫、高血脂。微小病變（minimal change disease）為兒童及青年最常見型，光鏡幾乎正常、電鏡見足突消失是招牌診斷特徵，對類固醇治療反應佳。記憶關鍵：白蛋白漏光→膠體滲透壓降→水外流。可對比腎絲球腎炎（血尿、高血壓為主）建立鑑別。",[25,28,30,33,36],{"term":26,"count":27},"血漿膠體滲透壓",5,{"term":29,"count":27},"低白蛋白血症",{"term":31,"count":32},"腎病症候群",4,{"term":34,"count":35},"微小病變腎病",1,{"term":37,"count":35},"足細胞",[39,43,48,53,58,63],{"webId":40,"stem":41,"number":42,"year":10,"session":11},"nurse-112-2-basic-medicine-022","多發性骨髓瘤（Multiple Myeloma）引起的類澱粉沉積症（Amyloidosis），下列何者為類澱粉來源的蛋白質前趨物質？",22,{"webId":44,"stem":45,"number":46,"year":47,"session":35},"nurse-113-1-basic-medicine-018","下列何者調控並可加速肝臟分泌膽汁？",18,113,{"webId":49,"stem":50,"number":51,"year":47,"session":52},"nurse-113-3-basic-medicine-012","車禍造成大腦枕葉損傷，最可能造成下列何種症狀？",12,3,{"webId":54,"stem":55,"number":56,"year":57,"session":35},"nurse-115-1-basic-medicine-010","負責消化道運動功能之主要結構組織層為下列何者？",10,115,{"webId":59,"stem":60,"number":61,"year":62,"session":11},"nurse-106-2-basic-medicine-034","下列那一器官遭受到可逆性傷害時，最常以脂肪變性（fatty change）來呈現？",34,106,{"webId":64,"stem":65,"number":66,"year":67,"session":11},"nurse-107-2-basic-medicine-068","有關人類主要組織相容性複合體（MHC）分子的敘述，下列何者正確？",68,107,"2026-09-04",1788510746332]