[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-1-basic-medicine-045":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-045","nurse-115-1-basic-medicine-045",115,1,45,"有關化膿性鏈球菌（Streptococcus pyogenes）的敘述，下列何者錯誤？",{"A":15,"B":16,"C":17,"D":18},"M protein 是主要作為致病菌株分型的其中一種蛋白質","造成風濕熱（rheumatic fever）的感染源主要來自於皮膚感染菌","又稱嗜肉菌，病人需合併抗生素及手術治療","會造成急性腎小球腎炎（acute glomerulonephritis），主要靠 ASO test 來確診","B",null,[],"本題考點在化膿性鏈球菌感染後的免疫性併發症。依 A 群 β 型溶血性鏈球菌的致病學,風濕熱只在上呼吸道咽炎之後發生,機轉是 M protein 與心肌、關節、腦組織抗原相似而引發分子模擬的交叉免疫反應;膿痂疹等皮膚感染不會引起風濕熱,故 B 的「感染源主要來自皮膚感染菌」錯誤。A 正確,M protein 是主要毒力因子,也是菌株血清分型依據。C 正確,壞死性軟組織感染俗稱嗜肉菌,處置需抗生素合併外科清創。D 的方向可接受,鏈球菌感染後急性腎小球腎炎確與前驅鏈球菌感染有關,但「靠 ASO 確診」的說法並不精確,相較之下 B 才是明確錯誤。","兩個後遺併發症的來源要分開記,這正是本題的鑑別軸:風濕熱只跟咽炎有關(記「風濕熱只認喉嚨」);鏈球菌感染後急性腎小球腎炎則咽炎與皮膚感染皆可能。因此選項 D 的瑕疵也講得通——腎炎的診斷主要靠臨床表現(茶色尿、血尿、蛋白尿、水腫、高血壓)加上補體 C3 下降,ASO 效價只是「曾有前驅鏈球菌感染」的佐證;而皮膚來源的病例 ASO 常不上升,改測 anti-DNase B 敏感度較好,所以嚴格說 ASO 不能當確診依據。國考此類「何者錯誤」題以最明確的錯誤為準,B 把風濕熱掛到皮膚感染是教科書層級的錯誤,優先於 D 的用語不精確。可延伸複習:Jones 準則、鏈球菌毒素(streptolysin O\u002FS、致熱外毒素)與猩紅熱、風濕性心臟病的二尖瓣狹窄。",[25,27,29,31,33],{"term":26,"count":11},"A 群 β 型溶血性鏈球菌",{"term":28,"count":11},"風濕熱與咽炎的分子模擬",{"term":30,"count":11},"鏈球菌感染後急性腎小球腎炎",{"term":32,"count":11},"ASO 與 anti-DNase B",{"term":34,"count":11},"M protein",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-115-1-basic-medicine-046","有關貓抓熱（cat-scratch disease）的敘述，下列何者最適當？",46,{"webId":41,"stem":42,"number":43,"year":44,"session":11},"nurse-106-1-basic-medicine-042","下列何者不是組織發炎時，白血球外滲（leukocyte extravasation）過程的步驟？",42,106,{"webId":46,"stem":47,"number":48,"year":44,"session":49},"nurse-106-2-basic-medicine-056","神經內科病人陳述時常嚴重單側頭痛，確診後為偏頭痛（migraine）。其治療處方為 sumatriptan，可使腦血管收縮，緩解頭痛。此藥物為下列何種自泌素之致效劑（agonist）？",56,2,{"webId":51,"stem":52,"number":53,"year":54,"session":11},"nurse-108-1-basic-medicine-014","位於禽距裂（calcarine fissure）上、下兩側的大腦皮質與下列何種感覺最有關？",14,108,{"webId":56,"stem":57,"number":58,"year":59,"session":11},"nurse-109-1-basic-medicine-058","關節炎之發炎反應可用 celecoxib 加以治療，其較少引發胃腸道出血。此藥物主要阻斷何種自泌素之生合成？",58,109,{"webId":61,"stem":62,"number":63,"year":64,"session":49},"nurse-110-2-basic-medicine-012","睪丸主要負責產生精子，是下列那一構造？",12,110,"2026-08-06",1787299087929]