[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-112-2-medical-surgical-040":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"lastmod":62},"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-112-2-內外科護理學-040","nurse-112-2-medical-surgical-040",112,2,40,"王先生因疲倦、蒼白、呼吸困難至醫院求治，檢查發現白血球數值為 30 萬／μL，骨髓檢查發現費城染色體，最有可能罹患下列何種疾病？",{"A":14,"B":15,"C":16,"D":17},"急性淋巴性白血病","慢性淋巴性白血病","急性骨髓性白血病","慢性骨髓性白血病","D",null,[],"本題考點為費城染色體（Philadelphia chromosome）與白血病分型的對應。考點在於辨識 t(9;22) 費城染色體是慢性骨髓性白血病（CML）的標誌性染色體變異，加上白血球數極高（30 萬／μL）及慢性起病表現，故正解為 D 慢性骨髓性白血病。A 急性淋巴性白血病與 B 慢性淋巴性白血病、C 急性骨髓性白血病雖各有特徵，但費城染色體最典型且最具診斷意義者為 CML。雖 ALL 也可能出現費城染色體，但本題以典型 CML 表現為主，故選 D。","費城染色體源於第 9 與第 22 對染色體轉位，形成 BCR-ABL 融合基因，其產物為持續活化的酪胺酸激酶，驅動骨髓細胞不受控增生。這正是標靶藥 imatinib（Gleevec，酪胺酸激酶抑制劑 TKI）的治療基礎，使 CML 預後大幅改善。CML 臨床特徵為顯著白血球增多、脾腫大及慢性期後轉急變期。對比記憶：CML＝費城染色體＋BCR-ABL＋TKI；此三者連成一線是內外科與藥理的整合高頻考點。",[24,27,30,32],{"term":25,"count":26},"費城染色體",3,{"term":28,"count":29},"慢性骨髓性白血病CML",1,{"term":31,"count":29},"BCR-ABL融合基因",{"term":33,"count":29},"imatinib酪胺酸激酶抑制劑",[35,39,44,47,52,57],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-112-2-medical-surgical-041","有關上腔靜脈症候群之敘述，下列何者正確？",41,{"webId":40,"stem":41,"number":42,"year":43,"session":29},"nurse-113-1-medical-surgical-007","承上題，關於陳先生的護理措施，下列何者正確？①限制水分與蛋白質的攝取 ②每天測量體重與腹圍，記錄輸出入量 ③給與利尿劑後，儘快補充Albumin ④使用Lactulose以減少細菌分解蛋白質所產生大量氨",7,113,{"webId":45,"stem":46,"number":29,"year":43,"session":26},"nurse-113-3-medical-surgical-001","下列診斷檢查敘述何者錯誤？",{"webId":48,"stem":49,"number":50,"year":51,"session":26},"nurse-114-3-medical-surgical-049","有關泌尿道感染，下列敘述何者最適當？①確立診斷是指尿液培養每毫升菌落>10 5 個 ②上泌尿道感染是指尿道炎及膀胱炎 ③膀胱炎常見的致病菌為大腸桿菌 ④症狀改善或沒發燒即可停用抗生素",49,114,{"webId":53,"stem":54,"number":55,"year":56,"session":10},"nurse-106-2-medical-surgical-023","有關鼻咽癌症狀之敘述，下列何者錯誤？",23,106,{"webId":58,"stem":59,"number":60,"year":61,"session":10},"nurse-107-2-medical-surgical-057","教導慢性阻塞性肺疾病病人採用橫膈式呼吸與噘嘴式呼吸的目的，下列何者正確？①降低呼吸作功 ②增加呼吸速率 ③減少潮氣容積 ④促進二氧化碳的排出",57,107,"2026-09-04",1788510747611]