[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-026":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":65},"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-115-2-內外科護理學-026","nurse-115-2-medical-surgical-026",115,2,26,"有關乳癌之相關敘述，下列何者最不適當？",{"A":14,"B":15,"C":16,"D":17},"可能出現佩吉特氏病（Paget’s disease）","乳癌與 EGFR 基因的關聯性最高","改良式根除性乳房切除術適用於沒有胸大肌侵犯的病人","採用抗動情素劑（tamoxifen）的病人需注意臉部潮紅、噁心副作用","B",null,[],"本題考點在乳癌的分子標記與治療副作用。依乳癌遺傳與分子分型,遺傳性乳癌關聯性最高的是 BRCA1 與 BRCA2 胚系突變,臨床分型與標靶治療依據的是 ER、PR 與 HER2(ERBB2);EGFR 過度表現主要見於肺癌等腫瘤,並非乳癌關聯性最高的基因,故 B 最不適當。A 正確,乳房佩吉特氏病表現為乳頭與乳暈的濕疹樣、脫屑或滲液變化,常合併深部管內癌。C 正確,改良式根除性乳房切除術切除乳房組織與腋下淋巴結但保留胸大肌,適用於腫瘤未侵犯胸大肌者。D 正確,tamoxifen 屬選擇性動情素受體調節劑,阻斷動情素作用後常見臉部潮紅、噁心等類停經症狀。","延伸機轉:tamoxifen 在乳房組織是動情素拮抗,在子宮內膜卻呈部分致效作用,故長期使用與子宮內膜增厚、內膜癌及血栓栓塞風險相關,追蹤重點在異常陰道出血;停經後病人常改用芳香環轉化酶抑制劑,副作用轉為骨質流失與關節痠痛。標記對照好記法:BRCA 管遺傳風險、ER\u002FPR 決定抗荷爾蒙治療、HER2 陽性用 trastuzumab、三陰性(ER\u002FPR\u002FHER2 皆陰)預後較差且無荷爾蒙標靶可用;EGFR 記在肺癌那一格。佩吉特氏病要與乳頭濕疹區辨:濕疹多雙側、對類固醇有反應,佩吉特氏病常單側且持續不癒。可連結概念:乳癌分期與腋下淋巴結評估、前哨淋巴結切片、乳房自我檢查時機。",[24,27,29,31,33],{"term":25,"count":26},"BRCA1\u002FBRCA2 基因",1,{"term":28,"count":26},"HER2 與荷爾蒙受體分型",{"term":30,"count":26},"乳房佩吉特氏病",{"term":32,"count":26},"改良式根除性乳房切除術",{"term":34,"count":26},"選擇性動情素受體調節劑",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-115-2-medical-surgical-027","有關皮膚結構之敘述，下列何者正確？",27,{"webId":41,"stem":42,"number":43,"year":44,"session":26},"nurse-106-1-medical-surgical-073","關於糖化血色素（HbA1c）之敘述，下列何者正確？",73,106,{"webId":46,"stem":47,"number":48,"year":49,"session":26},"nurse-107-1-medical-surgical-007","有關多發性硬化症的敘述，下列何者錯誤？",7,107,{"webId":51,"stem":52,"number":53,"year":54,"session":26},"nurse-108-1-medical-surgical-045","有關生殖器疱疹的敘述，下列何者錯誤？",45,108,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-109-2-medical-surgical-009","有關闌尾炎身體評估檢查的結果，下列何者正確？①墨菲氏徵象（Murphy’s sign） ②麥氏點（McBurney’s point）壓痛 ③普氏徵象（Psoas sign） ④閉孔肌徵象（obturator sign）",9,109,{"webId":61,"stem":62,"number":63,"year":64,"session":10},"nurse-110-2-medical-surgical-043","有關席林試驗可協助診斷的貧血類別，下列何者正確？",43,110,"2026-08-06",1787299037159]