[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-2-basic-medicine-029":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-029","nurse-115-2-basic-medicine-029",115,2,29,"第二型糖尿病的致病機轉，與下列何者最不相關？",{"A":15,"B":16,"C":17,"D":18},"自體免疫（autoimmune）","胰島素抗性（insulin resistance）","肥胖（obesity）","ß 細胞功能異常（ß-cell dysfunction）","A",null,[],"本題考點是第一型與第二型糖尿病致病機轉的分野。第二型糖尿病的病生理核心是胰島素抗性加上胰島 β 細胞分泌功能逐漸衰退,兩者互為因果並常以肥胖、內臟脂肪堆積與慢性低度發炎為背景;自體免疫破壞 β 細胞則是第一型糖尿病的機轉,可測到抗 GAD、抗胰島細胞等自體抗體,與第二型關聯最低,故選 A。選項 B 的胰島素抗性是第二型的起點,周邊組織對胰島素反應下降。選項 C 的肥胖是最重要的可修正危險因子,脂肪組織釋出游離脂肪酸與發炎介質加重抗性。選項 D 的 β 細胞功能異常說明為何抗性存在多年後血糖才失控,屬第二型的必要環節。","兩型對照表在考場最好用。第一型:自體免疫或不明原因造成 β 細胞破壞,胰島素絕對缺乏,多在兒童青少年發病、體型偏瘦、易發生糖尿病酮酸中毒(DKA),必須依賴胰島素。第二型:胰島素相對缺乏加抗性,中年後居多但年輕化明顯,體型多過重,急性代謝危機偏向高血糖高滲透壓狀態(HHS)而非 DKA,可先用口服藥。機轉延伸:第二型早期 β 細胞代償性增加分泌,出現高胰島素血症,故空腹血糖仍可正常;當代償失敗、β 細胞質量下降,才顯現空腹高血糖,這也是「糖尿病前期」窗口存在的原因。特別留意成人隱性自體免疫糖尿病(LADA)這個中間型,臨床看似第二型但有自體抗體,是命題者延伸出題的素材。可連結複習:代謝症候群診斷指標、HbA1c 判讀切點。",[25,28,30,32],{"term":26,"count":27},"第二型糖尿病",3,{"term":29,"count":27},"第一型糖尿病自體免疫",{"term":31,"count":11},"胰島素抗性",{"term":33,"count":34},"β 細胞功能異常",1,[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-115-2-basic-medicine-030","有關發生在骨頭之轉移性腫瘤（metastatic tumors），下列敘述何者錯誤？",30,{"webId":41,"stem":42,"number":43,"year":44,"session":34},"nurse-106-1-basic-medicine-076","下列那一種病毒和子宮頸癌相關？",76,106,{"webId":46,"stem":47,"number":48,"year":49,"session":34},"nurse-107-1-basic-medicine-010","男性尿道，由尿道口為近端至遠端貫穿下列構造的順序為何？①尿道海綿體 ②泌尿生殖橫膈 ③前列腺",10,107,{"webId":51,"stem":52,"number":53,"year":54,"session":34},"nurse-108-1-basic-medicine-048","軟骨發育不全（Achondroplasia）的病人，他們的特徵符合下列那項敘述？",48,108,{"webId":56,"stem":57,"number":58,"year":59,"session":11},"nurse-109-2-basic-medicine-012","有關排尿，副交感神經興奮會造成下列何種現象？",12,109,{"webId":61,"stem":62,"number":63,"year":64,"session":11},"nurse-110-2-basic-medicine-046","關於發生於胃的黏膜相關淋巴組織淋巴瘤（mucosa-associated lymphoid tissue lymphoma, MALToma）之敘述，下列何者錯誤？",46,110,"2026-08-06",1787299017649]