[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-114-3-basic-medicine-029":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-114-3-基礎醫學-029","nurse-114-3-basic-medicine-029",114,3,29,"庫欣症候群（Cushing syndrome）病患，左右兩側腎上腺變大，血中 ACTH 上升，下列病因何者最為可能？",{"A":15,"B":16,"C":17,"D":18},"腎上腺皮質腺瘤（adrenocortical adenoma）","腎上腺嗜鉻細胞瘤（pheochromocytoma）","腦下垂體前葉腫瘤","長期使用類固醇","C",null,[],"本題考點在於庫欣症候群(Cushing syndrome)依ACTH高低鑑別病因。題目為雙側腎上腺增大且血中ACTH上升,屬『ACTH依賴型』,表示過量ACTH持續刺激兩側腎上腺皮質增生;最常見來源為腦下垂體前葉分泌ACTH的腺瘤(即庫欣氏病),故選C。腎上腺皮質腺瘤(A)自主分泌皮質醇會負回饋壓低ACTH、對側腎上腺萎縮;嗜鉻細胞瘤(B)分泌兒茶酚胺、非皮質醇病因;長期使用類固醇(D)為外因性,同樣抑制ACTH、腎上腺萎縮,皆與『ACTH上升且雙側增大』不符,故錯。","鑑別關鍵先看ACTH:ACTH高→依賴型(腦下垂體腺瘤最常見=庫欣氏病,或異位ACTH如小細胞肺癌);ACTH低→非依賴型(腎上腺腫瘤或外因性類固醇)。再用高劑量地塞米松抑制試驗區分腦下垂體(可被抑制)與異位分泌(不被抑制)。『雙側增大+ACTH高』是垂體來源的典型組合。",[25,28,30,32],{"term":26,"count":27},"庫欣症候群",1,{"term":29,"count":27},"ACTH依賴型",{"term":31,"count":27},"腦下垂體ACTH腺瘤",{"term":33,"count":27},"腎上腺皮質增生",[35,39,45,50,55,60],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-114-3-basic-medicine-030","下列何種疾病是因為 FGFR3 基因突變而造成侏儒症（dwarfism）？",30,{"webId":40,"stem":41,"number":42,"year":43,"session":44},"nurse-115-2-basic-medicine-026","B 型血友病（hemophilia B）是因缺乏下列何種凝血因子所造成？",26,115,2,{"webId":46,"stem":47,"number":48,"year":49,"session":27},"nurse-106-1-basic-medicine-070","下列何種疾病是由葡萄球菌引起的？",70,106,{"webId":51,"stem":52,"number":53,"year":54,"session":44},"nurse-107-2-basic-medicine-028","若腎臟之水分過濾（filtration）體積為 X，水分分泌（secretion）體積為 Y，水分重吸收（reabsorption）體積為 Z，則水分排除體積為何？",28,107,{"webId":56,"stem":57,"number":58,"year":59,"session":44},"nurse-108-2-basic-medicine-072","下列對病毒的敘述何者錯誤？",72,108,{"webId":61,"stem":62,"number":42,"year":63,"session":27},"nurse-110-1-basic-medicine-026","有關紅血球生成素（erythropoietin）的分泌與作用，下列那些敘述正確？①缺氧時會分泌減少 ②主要在腎臟合成分泌 ③可促進紅血球之生成 ④主要標的器官為紅骨髓",110,"2026-09-04",1788510761187]