[{"data":1,"prerenderedAt":62},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-002":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"lastmod":61},"內外科護理學","medical-surgical",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":10,"stem":11,"options":12,"answer":17,"answerNote":18,"images":19,"explanation":20,"explanationDeep":21,"topics":22,"freq":25},"nurse-115-2-內外科護理學-002","nurse-115-2-medical-surgical-002",115,2,"有關阿茲海默症（Alzheimer’s disease）的病因病理，下列敘述何者正確？",{"A":13,"B":14,"C":15,"D":16},"初期主要侵犯海馬迴，呈現腦迴擴大、腦室萎縮","神經纖維糾結與神經斑塊是疾病的典型變化","腦中乙醯膽鹼濃度增加","腦中正腎上腺素和血清素分泌增加","B",null,[],"本題考點是阿茲海默症的病理變化。依病理學,此病兩大典型腦部變化為細胞內 tau 蛋白過度磷酸化形成的神經纖維糾結(neurofibrillary tangles),以及細胞外 β-類澱粉蛋白沉積形成的神經斑塊(senile\u002Fneuritic plaques),故選 B。A 錯在萎縮方向寫反:初期確實侵犯海馬迴而先影響短期記憶,但影像變化是腦皮質萎縮、腦溝變寬、腦迴變窄,腦室因腦組織流失而代償性擴大,不是腦迴擴大、腦室萎縮。C 錯在乙醯膽鹼是減少而非增加,膽鹼性神經元退化正是使用膽鹼酯酶抑制劑的理由。D 錯在正腎上腺素與血清素同樣呈下降趨勢,並非分泌增加。","機轉可拆成兩條線:一是類澱粉蛋白假說,Aβ42 異常切割與堆積形成斑塊並引發神經發炎;二是 tau 蛋白假說,微管失去支撐後神經元內部運輸崩解形成糾結。膽鹼性神經元自 Meynert 基底核開始退化,對應藥理治療 donepezil、rivastigmine、galantamine 抑制乙醯膽鹼分解,中重度再加 memantine 拮抗 NMDA 受體以減少麩胺酸毒性。鑑別重點:阿茲海默症是漸進、平滑的退化曲線,血管性失智症則因多次小中風呈階梯式惡化並常有局部神經學缺損。記法:AD = Amyloid(斑塊)+ 糾結的 tau。",[23,26,28,30],{"term":24,"count":25},"阿茲海默症",1,{"term":27,"count":25},"神經纖維糾結",{"term":29,"count":25},"β-類澱粉蛋白斑塊",{"term":31,"count":25},"乙醯膽鹼缺乏",[33,37,42,46,51,56],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-115-2-medical-surgical-003","有關成人腦室外引流系統裝置的護理措施，下列敘述何者錯誤？",3,{"webId":38,"stem":39,"number":40,"year":41,"session":25},"nurse-106-1-medical-surgical-049","有關全身性紅斑性狼瘡女性病人，於類固醇藥物治療後症狀緩解已 1 年之護理指導，下列何者錯誤？",49,106,{"webId":43,"stem":44,"number":45,"year":41,"session":10},"nurse-106-2-medical-surgical-063","有關腎前性急性腎衰竭之檢驗數據，下列何者錯誤？",63,{"webId":47,"stem":48,"number":49,"year":50,"session":25},"nurse-108-1-medical-surgical-021","與引起聽力問題有關之疾病，下列何者最不可能？",21,108,{"webId":52,"stem":53,"number":54,"year":55,"session":25},"nurse-109-1-medical-surgical-065","長期使用類固醇製劑而導致愛迪生氏症（Addison’s disease）之病人所呈現的臨床表徵，下列何者錯誤？",65,109,{"webId":57,"stem":58,"number":59,"year":60,"session":10},"nurse-110-2-medical-surgical-019","王先生，診斷痛風性關節炎，正服用秋水仙素（Colchicine）。有關此藥物的護理指導，下列何者正確？",19,110,"2026-08-06",1787299036955]