[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-2-basic-medicine-027":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":27},"nurse-115-2-基礎醫學-027","nurse-115-2-basic-medicine-027",115,2,27,"關於食道靜脈曲張的敘述，下列何者錯誤？",{"A":15,"B":16,"C":17,"D":18},"病人多合併有慢性肝炎及肝硬化疾病","機轉是由於下腔靜脈（inferior vana cava）高壓，使得血液回流不順","食道靜脈曲張的血液會直接連通到肝門靜脈","黏膜下血管不正常擴張及充血，若黏膜受傷，可能導致大出血而有生命危險","B",null,[],"本題考點是食道靜脈曲張的血流動力學來源。其成因是肝門靜脈高壓:肝硬化使肝內血流阻力上升,門脈血無法順行入肝,轉而經門脈—體循環側枝分流,其中胃左靜脈(冠狀靜脈)回流受阻使食道下段黏膜下靜脈擴張成曲張血管。選項 B 把高壓部位寫成下腔靜脈,錯在壓力源的解剖位置,故為錯誤敘述,選 B。選項 A 正確,慢性肝炎與肝硬化是門脈高壓最常見的背景。選項 C 正確,食道下段曲張靜脈經胃左靜脈與肝門靜脈系統相通,正是側枝循環的一環。選項 D 正確,黏膜下血管擴張充血後管壁薄,受食物摩擦或壓力驟升即可能大出血。","門脈高壓的定義是肝門靜脈與下腔靜脈之壓力差(HVPG)超過 5 mmHg,達到 10 mmHg 以上才會形成側枝,12 mmHg 以上才有明顯出血風險,這個數字階梯是理解「為什麼不是每個肝硬化都出血」的關鍵。四大側枝出口可用位置記憶:食道下段(胃左靜脈—食道靜脈—奇靜脈)、腹壁(臍周靜脈,形成 caput medusae)、直腸(上直腸靜脈—中下直腸靜脈,痔靜脈擴張)、脾—腎後腹腔分流。對比要點:下腔靜脈受阻的病生理是 Budd-Chiari 症候群或 IVC 阻塞,表現為下肢水腫與腹壁側枝血流方向由下往上,與食道靜脈曲張的機轉層次不同,命題者正是用這個對比設陷阱。可連結複習:肝硬化的其他門脈高壓表現(脾臟腫大、腹水、肝腎症候群)與 β 受體阻斷劑降低門脈壓的藥理原理。",[25,28,31,33],{"term":26,"count":27},"肝硬化",4,{"term":29,"count":30},"肝門靜脈高壓",1,{"term":32,"count":30},"門脈—體循環側枝",{"term":34,"count":30},"胃左靜脈",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-115-2-basic-medicine-028","下列何者為腎病症候群（nephrotic syndrome）最主要的變化？",28,{"webId":41,"stem":42,"number":43,"year":44,"session":30},"nurse-106-1-basic-medicine-074","病毒的構造是決定其是否能抵抗消毒劑的原因之一，下列何種病毒因不具套膜可以抵抗乙醚的破壞？",74,106,{"webId":46,"stem":47,"number":48,"year":49,"session":30},"nurse-107-1-basic-medicine-008","有絲分裂時，那一時期染色體會排列在赤道板上？",8,107,{"webId":51,"stem":52,"number":53,"year":54,"session":30},"nurse-108-1-basic-medicine-046","一般而言，腎結石以下列那一類結石最常見？",46,108,{"webId":56,"stem":57,"number":58,"year":59,"session":11},"nurse-109-2-basic-medicine-010","房室結（atrioventricular node）位於心臟的何處？",10,109,{"webId":61,"stem":62,"number":63,"year":64,"session":11},"nurse-110-2-basic-medicine-044","關於良性（benign）腫瘤的敘述，下列何者最不適當？",44,110,"2026-08-06",1787299017618]