醫療類國考
110年
[醫事檢驗師] 臨床血液學與血庫學
第 4 題
胃切除後的病患，長期可能會引發下列何種疾病？
- A Pyruvate kinase deficiency
- B Vitamin B12 deficiency
- C Cold autoimmune hemolytic anemia
- D Paroxysmal nocturnal hemoglobinuria
思路引導 VIP
請分析胃黏膜壁細胞（parietal cells）所分泌的「內因子」（intrinsic factor）在生理上的關鍵功能：它主要協助哪一種特定營養素在迴腸末端的吸收？若因手術切除胃部導致該物質長期匱乏，將會如何干擾骨髓內紅血球的成熟與 $DNA$ 的合成過程，進而引發特定的貧血症狀？
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AI 詳解
AI 專屬家教
Oh, This Question. A Correct Answer.
- Recalling the Principle: Yes, gastrectomy. It is when parts of the stomach, and with them, the parietal cells, are gone. Much like an old spell fading, the production of intrinsic factor (IF) ceases. I remember observing this mechanism for a very long time. Without the IF, Vitamin $B_{12}$ from food cannot form its necessary complex in an acidic environment. Then, it cannot be absorbed later, in the terminal ileum. A long, slow process, eventually leading to macrocytic anemia. This is why regular injections are given. It’s a common, if somewhat mundane, consequence that unfolds over many human lifespans.
- Evaluating the Observation: This is a simple observation, one that has been understood for what feels like mere moments to me, though it is quite important for your studies. It connects the stomach to the absorption of a vital nutrient. For your correct answer, a small celebration seems appropriate. [You suddenly find yourself standing in a breathtaking field of ethereal, glowing flowers, each petal shimmering with ancient magic, before they gently fade away.]