[{"data":1,"prerenderedAt":68},["ShallowReactive",2],{"q-nurse-113-3-basic-medicine-022":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":36,"lastmod":67},"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-113-3-基礎醫學-022","nurse-113-3-basic-medicine-022",113,3,22,"下列何者不是造成血漿滲透壓下降的原因？",{"A":15,"B":16,"C":17,"D":18},"腎病症候群（nephrotic syndrome）","肝硬化（liver cirrhosis）","蛋白質營養不良（protein malnutrition）","鈉滯留（sodium retention）","D",null,[],"本題考點在於血漿滲透壓(尤其膠體滲透壓)下降的成因,為反向題,要挑出「不是」原因者。血漿膠體滲透壓主要由血漿白蛋白維持,任何使白蛋白減少的情況都會使膠體滲透壓下降。A 腎病症候群大量蛋白尿流失白蛋白,會使血漿滲透壓下降。B 肝硬化肝臟合成白蛋白能力下降,亦致低白蛋白血症與滲透壓下降。C 蛋白質營養不良使白蛋白原料不足、合成減少,同樣降低滲透壓。D 鈉滯留主要增加的是血漿的鈉與水分、提高晶體滲透壓與血容量,並不會降低血漿膠體滲透壓,反而傾向使總滲透壓上升或維持,故 D 不是造成血漿滲透壓下降的原因,為正解。掌握「白蛋白流失\u002F合成不足→膠體滲透壓降、水腫」的軸線即可辨識鈉滯留的例外。","水腫成因可用 Starling 力解讀:微血管靜水壓上升(如心衰、鈉水滯留)、血漿膠體滲透壓下降(低白蛋白)、微血管通透性增加(發炎)、淋巴回流受阻皆可致組織液堆積。A、B、C 三者都經「低白蛋白→膠體滲透壓下降→水分外滲」造成水腫;而鈉滯留(如醛固酮過多、心腎功能不全)是經「增加靜水壓與血容量」致水腫,機轉不同。注意區分晶體滲透壓(主要由鈉決定,影響細胞內外水分移動)與膠體滲透壓(由白蛋白決定,影響血管內外水分)。臨床上嚴重低白蛋白(\u003C2.5 g\u002FdL)常見全身性水腫與腹水。",[25,28,30,33],{"term":26,"count":27},"血漿膠體滲透壓",5,{"term":29,"count":27},"Starling 力",{"term":31,"count":32},"白蛋白",4,{"term":34,"count":35},"鈉滯留機轉不同",1,[37,41,47,52,57,62],{"webId":38,"stem":39,"number":40,"year":10,"session":11},"nurse-113-3-basic-medicine-023","微生物可能和癌症有關，下列敘述何者最不適當？",23,{"webId":42,"stem":43,"number":44,"year":45,"session":46},"nurse-114-2-basic-medicine-019","失語症（aphasia）與下列那個腦區受損最為相關？",19,114,2,{"webId":48,"stem":49,"number":50,"year":51,"session":35},"nurse-115-1-basic-medicine-013","下列有關股四頭肌（quadriceps femoris）的敘述，何者錯誤？",13,115,{"webId":53,"stem":54,"number":55,"year":56,"session":46},"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":58,"stem":59,"number":60,"year":61,"session":46},"nurse-107-2-basic-medicine-075","白色念珠菌（C. albicans）的結構及生理特性，下列何者錯誤？",75,107,{"webId":63,"stem":64,"number":65,"year":66,"session":35},"nurse-109-1-basic-medicine-029","下列何者藉由輔助擴散（facilitated diffusion）的方式，通過小腸上皮細胞之頂膜被吸收？",29,109,"2026-09-04",1788510751680]