[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-115-1-basic-medicine-007":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":36,"lastmod":66},"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-115-1-基礎醫學-007","nurse-115-1-basic-medicine-007",115,1,7,"副甲狀腺素（PTH）作用在腎小管時會產生下列何種反應？",{"A":15,"B":16,"C":17,"D":18},"刺激遠曲小管對鈣離子的再吸收","刺激近曲小管對磷酸鹽的再吸收","增加管腔細胞膜上的 PTH 接受器","降低尿液中的環腺苷酸（cAMP）","A",null,[],"本題考點在於副甲狀腺素對腎小管鈣、磷處理的作用方向。依 PTH 升高血鈣、降低血磷的整體效應,它作用於遠曲小管促進鈣離子再吸收,故選 A。B 方向相反,PTH 抑制近曲小管的磷酸鹽再吸收,使尿磷排出增加而血磷下降。C 錯在受體位置與調節趨勢,PTH 受體位於腎小管細胞的基底側膜而非管腔側細胞膜,且持續高濃度刺激傾向使受體向下調節。D 錯在訊息傳遞方向,PTH 經 Gs 蛋白活化腺苷酸環化酶,使細胞內與尿中的環腺苷酸增加而非降低,尿中 cAMP 上升正是 PTH 作用的指標。","PTH 升鈣有三條路,一起記最省力:腎臟(遠曲小管留鈣、近曲小管排磷、活化 1-alpha 羥化酶生成活性維生素 D)、骨骼(經骨細胞的 RANKL 間接活化骨吸收細胞釋出鈣磷)、腸道(透過活性維生素 D 增加鈣吸收)。方向口訣:鈣進磷出。臨床對照:原發性副甲狀腺功能過高呈高血鈣、低血磷、尿鈣與尿 cAMP 上升;慢性腎病則因磷排不掉、活性維生素 D 不足而出現繼發性副甲狀腺功能過高。另一組容易混淆的是降鈣素,由甲狀腺 C 細胞分泌,抑制骨吸收細胞而降血鈣,與 PTH 恰好相反。延伸概念:Gs-cAMP-PKA 訊息傳遞、TRPV5 鈣通道。",[25,28,30,32,34],{"term":26,"count":27},"副甲狀腺素",3,{"term":29,"count":11},"遠曲小管鈣再吸收",{"term":31,"count":11},"近曲小管磷酸鹽排出",{"term":33,"count":11},"cAMP 訊息傳遞",{"term":35,"count":11},"活性維生素 D",[37,41,46,51,56,61],{"webId":38,"stem":39,"number":40,"year":10,"session":11},"nurse-115-1-basic-medicine-008","下列何種激素最可能造成孕婦發生妊娠糖尿病？",8,{"webId":42,"stem":43,"number":44,"year":45,"session":11},"nurse-106-1-basic-medicine-004","下列何者參與形成踝關節？",4,106,{"webId":47,"stem":48,"number":49,"year":45,"session":50},"nurse-106-2-basic-medicine-018","下列那些肌細胞有明顯的明暗相間之橫紋構造？",18,2,{"webId":52,"stem":53,"number":54,"year":55,"session":50},"nurse-107-2-basic-medicine-056","Flecainide 可用於治療具威脅生命之心室心律不整，但也容易引發致命的心律不整，主要原因為何？",56,107,{"webId":57,"stem":58,"number":59,"year":60,"session":11},"nurse-109-1-basic-medicine-020","下列那一腦區病變最可能造成表達性失語症（expressive aphasia）？",20,109,{"webId":62,"stem":63,"number":64,"year":65,"session":11},"nurse-110-1-basic-medicine-054","腎臟功能不良的高齡病人，若以 vancomycin 治療其嚴重感染症，要特別注意下列何種副作用？",54,110,"2026-08-06",1787299087530]