[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-1-basic-medicine-025":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":35,"lastmod":65},"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":11},"nurse-115-1-基礎醫學-025","nurse-115-1-basic-medicine-025",115,1,25,"急性心肌梗塞最常見且重要的病因為何？",{"A":15,"B":16,"C":17,"D":18},"細菌性心內膜炎導致心肌炎","冠狀動脈痙攣所致","冠狀動脈粥狀硬化引起之血管阻塞","血管炎，引起血流減少所致","C",null,[],"本題考點在急性心肌梗塞的主要病因。依冠狀動脈疾病的病生理,脂質與發炎細胞在血管內膜堆積形成粥狀硬化斑塊,斑塊的纖維帽破裂後暴露膠原與脂質核心,啟動血小板黏附聚集與凝血瀑布,血栓在數分鐘內完全堵住管腔,心肌持續缺血約二十至三十分鐘後開始出現不可逆壞死,這是絕大多數個案的機轉,故選 C。A 的細菌性心內膜炎主要破壞瓣膜並產生栓子,只有少數波及心肌;B 的冠狀動脈痙攣見於變異型心絞痛或古柯鹼使用者,屬少數成因;D 的血管炎(如川崎病)造成的心肌缺血同樣罕見,三者都不是最常見的病因。","機轉決定表現:斑塊完全阻塞管腔造成穿壁性壞死,心電圖呈 ST 段上升型心肌梗塞;不完全阻塞或有側枝循環時多為非 ST 段上升型或不穩定型心絞痛。心肌壞死標記的時程要分清楚,不要把兩種旋轉蛋白混用:cTnI 與 cTnT 一般在發作後數小時開始上升、約十二至二十四小時達高峰,但回到基線的時間不同——多數教材列 cTnI 約四至十天、cTnT 可延長到約兩週,因此判斷「再次梗塞」時常改用 CK-MB(約二至三天回歸基線)。危險因子分可改變(抽菸、高血壓、糖尿病、血脂異常、肥胖、久坐)與不可改變(年齡、男性、家族史)。可延伸複習:心肌缺血的疼痛轉移路徑、下壁梗塞與右冠狀動脈的對應、粥狀硬化的內皮損傷學說。",[25,27,29,31,33],{"term":26,"count":11},"冠狀動脈粥狀硬化",{"term":28,"count":11},"斑塊破裂與血栓形成",{"term":30,"count":11},"心肌不可逆壞死時程",{"term":32,"count":11},"心肌旋轉蛋白",{"term":34,"count":11},"冠狀動脈痙攣",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-115-1-basic-medicine-026","下列何種疾病會出現 Barts 氏血紅素（Hb Barts）？",26,{"webId":41,"stem":42,"number":43,"year":44,"session":11},"nurse-106-1-basic-medicine-022","下列何者藉由糖質新生作用增高血糖濃度？",22,106,{"webId":46,"stem":47,"number":48,"year":44,"session":49},"nurse-106-2-basic-medicine-036","下列那一種人類白血球抗原（human leukocyte antigen, HLA）專屬於抗原呈現細胞（antigen presenting cell），允許 CD4 輔助性 T 細胞辨識外來抗原，產生免疫反應？",36,2,{"webId":51,"stem":52,"number":53,"year":54,"session":49},"nurse-107-2-basic-medicine-074","下列何種細菌感染症較少經由節肢動物（arthropod）傳播？",74,107,{"webId":56,"stem":57,"number":58,"year":59,"session":11},"nurse-109-1-basic-medicine-038","狂牛病是何種病原感染所引起？",38,109,{"webId":61,"stem":62,"number":63,"year":64,"session":11},"nurse-110-1-basic-medicine-072","下列何者不是 prion 的主要特性？",72,110,"2026-08-06",1787299087715]