[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-1-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-115-1-基礎醫學-029","nurse-115-1-basic-medicine-029",115,1,29,"第一型糖尿病最常見下列何種變化？",{"A":15,"B":16,"C":17,"D":18},"蘭氏小島發炎破壞","β細胞數量增加","類澱粉沉積","周邊胰島素阻抗","A",null,[],"本題考點是第一型與第二型糖尿病的病理變化差異。第一型糖尿病的機轉是自體免疫反應，T 細胞攻擊胰島 β 細胞，早期胰島可見淋巴細胞浸潤，也就是胰島炎，接著 β 細胞被破壞、數量大幅減少而終致胰島素絕對缺乏，故選 A 蘭氏小島發炎破壞。B 錯在方向相反，第一型的 β 細胞是減少而非增加。C 的類澱粉沉積是第二型糖尿病胰島的典型變化，來自胰島澱粉樣多胜肽堆積。D 的周邊胰島素阻抗屬第二型的核心缺陷，第一型病人主要問題是分泌不足。","自體免疫證據包括抗麩胺酸脫羧酶、抗胰島細胞與抗胰島素抗體，以及與人類白血球抗原 DR3、DR4 的關聯，這說明為何第一型多在兒童青少年發病、體型不一定肥胖，且從一開始就依賴胰島素治療、容易出現糖尿病酮酸中毒。第二型則是阻抗先行、β 細胞代償性分泌增加，長期後才衰竭，胰島出現類澱粉沉積與纖維化，高血糖危症以高血糖高滲透壓狀態為主。對比表可記三欄：致病機轉（自體免疫對阻抗）、胰島病理（胰島炎對類澱粉）、急性併發症（酮酸中毒對高滲透壓）。可連結概念：C 胜肽、蜜月期、酮體代謝。",[25,28,30,32],{"term":26,"count":27},"第一型糖尿病自體免疫",3,{"term":29,"count":27},"胰島素阻抗",{"term":31,"count":11},"胰島炎與 β 細胞破壞",{"term":33,"count":11},"第二型胰島類澱粉沉積",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-115-1-basic-medicine-030","葡萄狀肉瘤（sarcoma botryoides）的腫瘤細胞是往那個方向分化（differentiation）？",30,{"webId":40,"stem":41,"number":42,"year":43,"session":11},"nurse-106-1-basic-medicine-026","胎血循環中，靜脈導管連接臍靜脈與下列何者？",26,106,{"webId":45,"stem":46,"number":47,"year":43,"session":48},"nurse-106-2-basic-medicine-040","下列有關感染性單核球症（infectious mononucleosis）的敘述，何者錯誤？",40,2,{"webId":50,"stem":51,"number":52,"year":53,"session":48},"nurse-107-2-basic-medicine-078","依波拉病毒（Ebola virus）是經由下列何者傳播？",78,107,{"webId":55,"stem":56,"number":57,"year":58,"session":11},"nurse-109-1-basic-medicine-042","若家族中有第二型糖尿病的病史，罹患糖尿病的機會也將比較高。第二型糖尿病的遺傳模式屬於：",42,109,{"webId":60,"stem":61,"number":62,"year":63,"session":11},"nurse-110-1-basic-medicine-076","關於各型大腸桿菌（Escherichia coli）的敘述，下列何者正確？",76,110,"2026-08-06",1787299087764]