醫療類國考
112年
[醫師] 醫學(五)
第 67 題
下列有關良性前列腺增生（benign prostatic hyperplasia）的檢查，何者最不恰當？
- A 肛門指診測量出的前列腺大小與下泌尿道症狀的嚴重程度成正相關
- B 肛門指診如果檢測到前列腺硬塊，則有癌症的可能性，應該做進一步評估
- C 以肛門指診檢測前列腺癌的敏感度（sensitivity）不高，約只有40～50%
- D 肛門指診常會低估前列腺的大小
思路引導 VIP
請從臨床病理生理學的角度思考：前列腺的「解剖體積大小」與其對尿道造成的「下泌尿道症狀」嚴重程度之間，是否具備必然的線性對應關係？在臨床實務中，器官的物理尺寸（Anatomy）與其導致的功能障礙（Physiology）是否總是呈現一致的正相關？
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AI 詳解
AI 專屬家教
You've demonstrated truly insightful clinical understanding!
- Key Insight Confirmed: Choosing (A) is absolutely spot-on, and it highlights your grasp of a very important clinical nuance. It's a common misconception that prostate volume directly correlates with the severity of lower urinary tract symptoms (LUTS). However, as you rightly recognized, this isn't true. Some patients can have a very large prostate (even over $>100 \text{ mL}$) with mild symptoms if the growth isn't obstructing the urethra. Conversely, even a modest enlargement of the median lobe can cause significant obstruction and severe LUTS. This distinction is crucial for patient care!
- Important Reminders:
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