[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-1-basic-medicine-022":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":11},"nurse-115-1-基礎醫學-022","nurse-115-1-basic-medicine-022",115,1,22,"關於慢性肉芽腫病（chronic granulomatous disease）的敘述，下列何者正確？",{"A":15,"B":16,"C":17,"D":18},"因吞噬細胞氧化酶（phagocyte oxidase）基因缺陷，導致無法毒殺細菌","特徵是吞噬小體（phagosome）與溶酶體（lysosome）無法融合","因補體調節蛋白的缺陷，導致過度發炎反應","患者有陣發性水腫，影響皮膚與黏膜表面為表徵","A",null,[],"本題考點在於原發性免疫缺乏症與其分子缺陷的對應。依慢性肉芽腫病的病理,患者吞噬細胞氧化酶(NADPH 氧化酶)基因缺陷,使呼吸爆發無法產生超氧陰離子與過氧化氫,吞噬細菌後仍無法有效毒殺,對過氧化氫酶陽性菌尤其易感,故 A 正確。B 所述吞噬小體與溶酶體無法融合是 Chediak-Higashi 症候群的特徵。C 補體調節蛋白缺陷造成的是補體過度活化相關疾病,而非吞噬殺菌障礙。D 陣發性皮膚與黏膜水腫則是 C1 抑制因子缺乏的遺傳性血管性水腫表現。","疾病名稱本身就是線索:細菌被吞進去卻殺不死,巨噬細胞只能不斷聚集包圍形成肉芽腫,故名慢性肉芽腫病;多數為 X 染色體連鎖遺傳(gp91phox 缺陷),男嬰居多,反覆出現皮膚膿瘍、淋巴結炎、肺炎與肝膿瘍。診斷靠嗜中性球氧化功能試驗(二氫羅丹明流式細胞術,舊法為硝基藍四氮唑還原試驗)。「過氧化氫酶陽性菌易感」的邏輯值得記:過氧化氫酶陰性菌被殺時自身產生的過氧化氫可被患者借用,陽性菌則把它分解掉,患者因此束手無策。對照組表:吞噬功能缺陷看慢性肉芽腫病與白血球黏附缺乏,體液免疫缺陷看 X 連鎖無伽瑪球蛋白血症,細胞免疫缺陷看 DiGeorge 症候群。",[25,27,29,31,33],{"term":26,"count":11},"慢性肉芽腫病",{"term":28,"count":11},"NADPH 氧化酶與呼吸爆發",{"term":30,"count":11},"Chediak-Higashi 症候群",{"term":32,"count":11},"遺傳性血管性水腫",{"term":34,"count":11},"吞噬細胞功能缺陷",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-115-1-basic-medicine-023","下列何者不屬於體染色體（autosome）數量異常的疾病？",23,{"webId":41,"stem":42,"number":43,"year":44,"session":11},"nurse-106-1-basic-medicine-019","下列何者並非動作電位的特性？",19,106,{"webId":46,"stem":47,"number":48,"year":44,"session":49},"nurse-106-2-basic-medicine-033","下列何者不是可逆性細胞損傷的變化？",33,2,{"webId":51,"stem":52,"number":53,"year":54,"session":49},"nurse-107-2-basic-medicine-071","Bordetella pertussis 造成百日咳的病程中，那一時期菌量最高，也最具傳染力？",71,107,{"webId":56,"stem":57,"number":58,"year":59,"session":11},"nurse-109-1-basic-medicine-035","下列那一種狀況，急性期較不會出現肋膜積液？",35,109,{"webId":61,"stem":62,"number":63,"year":64,"session":11},"nurse-110-1-basic-medicine-069","包氏螺旋體（Borrelia）感染除了萊姆病（Lyme disease）外，主要造成何種人類疾病？",69,110,"2026-08-06",1787299087682]