[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-046":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":64},"內外科護理學","medical-surgical",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":11,"stem":12,"options":13,"answer":18,"answerNote":19,"images":20,"explanation":21,"explanationDeep":22,"topics":23,"freq":26},"nurse-115-1-內外科護理學-046","nurse-115-1-medical-surgical-046",115,1,46,"格雷氏病（Grave’s disease）會出現下列何種臨床表徵？①神經質    ②眼球突出   ③怕冷   ④手指顫抖    ⑤脛前凹陷性水腫",{"A":14,"B":15,"C":16,"D":17},"①②④","①③⑤","②③⑤","③④⑤","A",null,[],"本題考點是格雷氏病的甲狀腺功能過高表現與其特有眼部、皮膚變化。此症為甲促素受體自體抗體持續刺激甲狀腺，使甲狀腺素過量分泌，代謝率與交感神經活性同時升高，故出現①神經質、情緒不穩與④手指細微顫抖；加上眼球後結締組織與脂肪因免疫發炎而增生，造成②眼球突出，答案為①②④，選A。③怕冷是甲狀腺功能低下的表現，功能過高因產熱增加而是怕熱、多汗與體重減輕。⑤格雷氏病相關的皮膚變化為脛前黏液水腫，因黏多醣沉積而呈非凹陷性、皮膚粗厚，凹陷性水腫則見於心臟衰竭或低白蛋白等體液滯留狀況。","格雷氏病是自體免疫造成的甲狀腺功能過高，三個標誌是瀰漫性甲狀腺腫大、眼球突出與脛前黏液水腫，後兩者屬抗體攻擊甲狀腺以外組織的表現，因此不會出現在其他原因的甲狀腺功能過高（如毒性結節），這是重要鑑別點。症狀邏輯可整理成「代謝加速全身踩油門」：怕熱多汗、心搏過速與心房纖維顫動、食慾增加但體重下降、腸蠕動加快腹瀉、手抖失眠焦躁、女性月經量減少。與甲狀腺功能低下對照記憶最有效率：低下＝怕冷、體重增加、便秘、嗜睡、心搏過緩、黏液水腫且反射遲緩。凹陷與非凹陷性水腫的區辨也常考：壓下留凹代表組織間隙是水（心衰竭、腎病、低白蛋白），壓下不留凹代表沉積的是黏多醣或纖維（脛前黏液水腫、淋巴水腫後期）。可延伸複習甲狀腺風暴的誘因與抗甲狀腺藥物的顆粒性白血球缺乏副作用。",[24,27,29,31,33],{"term":25,"count":26},"格雷氏病",2,{"term":28,"count":10},"甲狀腺功能過高症狀",{"term":30,"count":10},"眼球突出",{"term":32,"count":10},"脛前黏液水腫為非凹陷性",{"term":34,"count":10},"甲狀腺功能低下的怕冷",[36,40,45,49,54,59],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-115-1-medical-surgical-047","有關過敏性休克之敘述，下列何者正確？①接觸的過敏原可能來自藥物、食物、昆蟲叮咬等              ②發生嚴重支氣管擴張及呼吸困難           ③脈搏次數增快、血壓可能正常或降低   ④通常可立即注射 epinephrine改善情況",47,{"webId":41,"stem":42,"number":43,"year":44,"session":10},"nurse-106-1-medical-surgical-043","有關三度燒傷傷口的處置，下列何者錯誤？",43,106,{"webId":46,"stem":47,"number":48,"year":44,"session":26},"nurse-106-2-medical-surgical-057","肺炎病人接受抗生素治療，下列何者表示抗生素已發揮作用？",57,{"webId":50,"stem":51,"number":52,"year":53,"session":10},"nurse-108-1-medical-surgical-015","有關迴腸造口手術後造瘻口的正常顏色，下列何者正確？",15,108,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-109-1-medical-surgical-059","有關急性腎盂腎炎之敘述，下列何者正確？①常見於下泌尿道上行性感染 ②常見有肋骨脊柱角處疼痛 ③紅血球沉降速率（ESR）下降 ④急性期時應大量攝取液體",59,109,{"webId":60,"stem":61,"number":62,"year":63,"session":26},"nurse-110-2-medical-surgical-013","有關上腸胃道攝影的敘述，下列何者正確？①檢查前無需禁食 ②檢查前需清潔灌腸 ③檢查後多喝開水以促使鋇劑排出 ④檢查後 2～3 天可能解白色糞便，為正常反應",13,110,"2026-08-06",1787299089088]