[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-2-basic-medicine-028":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-028","nurse-115-2-basic-medicine-028",115,2,28,"下列何者為腎病症候群（nephrotic syndrome）最主要的變化？",{"A":15,"B":16,"C":17,"D":18},"高血壓","腎小管間質損傷","腎絲球通透性過高","腎絲球纖維化","C",null,[],"本題考點是腎病症候群的核心病理變化。依腎病症候群的診斷組合(每日尿蛋白大於 3.5 公克、低白蛋白血症、全身性水腫、高血脂),其源頭是腎絲球濾過膜受損:足細胞與基底膜的陰電荷屏障與孔徑屏障失效,通透性異常升高,使大分子白蛋白大量漏入尿中,故最主要的變化是腎絲球通透性過高,選 C。選項 A 的高血壓較屬腎炎症候群的典型表現,在腎病症候群中不是主要機轉。選項 B 的腎小管間質損傷屬間質性腎炎的病理定位,不解釋大量蛋白尿。選項 D 的腎絲球纖維化是病程長期進展後的結構性終末變化,屬結果而非最主要的起始變化。","把兩個症候群並排記最有效率。腎病症候群(nephrotic):通透性問題,重度蛋白尿、低白蛋白血症、水腫、高血脂、易血栓(抗凝蛋白 antithrombin III 一起漏掉)與易感染(免疫球蛋白流失);常見病理型態為最小病變型(兒童最多)、膜性腎病變、局部節段性腎絲球硬化。腎炎症候群(nephritic):發炎與細胞增生問題,血尿伴紅血球圓柱、蛋白尿較輕、高血壓、少尿、氮血症;代表為急性鏈球菌感染後腎絲球腎炎。水腫機轉延伸:白蛋白下降使血漿膠體滲透壓降低,液體外移至間質,加上有效循環血量不足活化腎素—血管收縮素—醛固酮系統而保鈉保水,形成惡性循環,這解釋了為何水腫常從眼周與顏面開始。可連結複習:尿液試紙對白蛋白敏感的原理、蛋白尿與腎絲球濾過率的關係。",[25,28,30,33],{"term":26,"count":27},"腎病症候群",4,{"term":29,"count":11},"蛋白尿",{"term":31,"count":32},"腎絲球濾過膜通透性",1,{"term":34,"count":32},"腎炎症候群對比",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-115-2-basic-medicine-029","第二型糖尿病的致病機轉，與下列何者最不相關？",29,{"webId":41,"stem":42,"number":43,"year":44,"session":32},"nurse-106-1-basic-medicine-075","近年來，由於醫學發達，器官移植的可行性大為提高。下列何種病毒是可藉由輸血感染，尤其是在腎臟、骨髓移植後，接受免疫抑制治療時，更易再度活化？",75,106,{"webId":46,"stem":47,"number":48,"year":49,"session":32},"nurse-107-1-basic-medicine-009","主動脈體透過下列何者傳遞血液中 O 2 含量變化的訊息？",9,107,{"webId":51,"stem":52,"number":53,"year":54,"session":32},"nurse-108-1-basic-medicine-047","葡萄狀肉瘤（Sarcoma botryoides）為一種少見的原發陰道癌，病理是由下列那一種腫瘤構成？",47,108,{"webId":56,"stem":57,"number":58,"year":59,"session":11},"nurse-109-2-basic-medicine-011","頸部左側的頸總動脈直接源自下列何者？",11,109,{"webId":61,"stem":62,"number":63,"year":64,"session":11},"nurse-110-2-basic-medicine-045","顯微鏡下，肺腫瘤細胞的細胞質少且呈圓形或橢圓形，具有神經內分泌的特性，是下列那一種肺腫瘤？",45,110,"2026-08-06",1787299017642]