[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-113-3-basic-medicine-030":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":34,"lastmod":64},"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-030","nurse-113-3-basic-medicine-030",113,3,30,"甲狀腺乳突癌（papillary carcinoma），下列何者最少見？",{"A":15,"B":16,"C":17,"D":18},"BRAF 基因突變","TP53 基因突變","毛玻璃樣細胞核（ground-glass nuclei）","細胞核內假包涵物（intra-nuclear pseudo-inclusions）","B",null,[],"本題考點在於甲狀腺乳突癌(papillary carcinoma)的分子與病理特徵,為反向題,要挑出「最少見」者。甲狀腺乳突癌最常見的驅動突變是 BRAF 基因(尤其 V600E),其細胞學特徵包括毛玻璃樣細胞核與核內假包涵物;而 TP53 突變主要出現在低分化癌與未分化(退行性)甲狀腺癌,在典型分化良好的乳突癌中相對少見,故 B 為正解。A BRAF 突變是乳突癌最常見的基因異常。C 毛玻璃樣(ground-glass\u002FOrphan Annie eye)細胞核是乳突癌診斷性特徵之一。D 核內假包涵物(細胞質內陷入核形成)也是乳突癌典型的核特徵。掌握「乳突癌以 BRAF 為主、TP53 屬未分化癌標記」的分子分層即可辨識 B。","甲狀腺癌分子路徑分層:分化良好的乳突癌以 BRAF V600E、RET\u002FPTC 重排、RAS 為主;濾泡癌多見 RAS 與 PAX8-PPARγ;而 TP53 與 CTNNB1(β-catenin)突變是腫瘤去分化、進展為低分化或未分化甲狀腺癌的標誌,預後極差。乳突癌診斷靠核特徵而非結構:毛玻璃核(染色質清空)、核溝、核內假包涵物、砂粒體(psammoma body)。乳突癌整體預後好、常經淋巴轉移;濾泡癌多經血行轉移。記憶:BRAF 是乳突癌的招牌,TP53 一出現就代表細胞學走向惡化(未分化)。",[25,28,30,32],{"term":26,"count":27},"甲狀腺乳突癌",1,{"term":29,"count":27},"BRAF V600E 突變",{"term":31,"count":27},"TP53 與未分化癌",{"term":33,"count":27},"毛玻璃樣核與核內假包涵物",[35,39,45,50,55,59],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-113-3-basic-medicine-031","下列降血壓藥物中，何者能活化交感神經突觸前的 α 2 -adrenergic receptor？",31,{"webId":40,"stem":41,"number":42,"year":43,"session":44},"nurse-114-2-basic-medicine-027","關於 IgA 腎病變（IgA nephropathy）的敘述，下列何者最不適當？",27,114,2,{"webId":46,"stem":47,"number":48,"year":49,"session":27},"nurse-115-1-basic-medicine-021","有關血管受傷後的止血作用之敘述，下列何者錯誤？",21,115,{"webId":51,"stem":52,"number":53,"year":54,"session":44},"nurse-106-2-basic-medicine-039","心肌梗塞約在發生多久時，會在病灶中產生明顯纖維化？",39,106,{"webId":56,"stem":57,"number":11,"year":58,"session":27},"nurse-108-1-basic-medicine-003","下列何者連接顱腔與椎管？",108,{"webId":60,"stem":61,"number":62,"year":63,"session":27},"nurse-109-1-basic-medicine-037","下列那一種肝炎病毒主要是經口傳染的？",37,109,"2026-09-04",1788510751741]