[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-115-1-basic-medicine-046":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":34,"lastmod":63},"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":27},"nurse-115-1-基礎醫學-046","nurse-115-1-basic-medicine-046",115,1,46,"有關貓抓熱（cat-scratch disease）的敘述，下列何者最適當？",{"A":15,"B":16,"C":17,"D":18},"常使用乙內醯胺（β-lactam）類藥物治療","常引發局部淋巴病變","容易導致嚴重併發症","分離培養細菌是最有效的鑑定方式","B",null,[],"本題考點是貓抓熱的臨床病程與診斷方式。貓抓熱由巴東氏菌經貓抓咬或跳蚤傳入，典型病程是接種部位先出現紅色小結節，一至三週後同側引流區域淋巴結明顯腫大疼痛，因此最適當的敘述是 B 常引發局部淋巴病變。C 不適當，免疫功能正常者多為自限性，嚴重併發症少見。D 不適當，此菌培養極為困難費時，臨床主要依血清學與分子檢驗診斷。A 不適當，乙內醯胺類臨床反應不佳，常選用巨環類等可進入細胞內的抗生素。","巴東氏菌是革蘭氏陰性、生長緩慢且傾向細胞內存活的菌，這個特性一次解釋了三件事：為何培養不敏感而需靠聚合酶連鎖反應或抗體效價、為何作用於細胞壁的乙內醯胺類效果差、以及為何選擇能濃聚於細胞內的巨環類藥物。宿主免疫狀態決定表現差異也是常考軸線：免疫正常者為局部淋巴結炎，少數出現肝脾肉芽腫或帕里諾眼淋巴腺症候群；免疫嚴重低下者則可能出現桿菌性血管瘤或桿菌性紫斑肝。同屬的五日熱巴東氏菌以體蝨為媒介，與戰壕熱相關，可一併對照。鑑別診斷上，區域性淋巴結腫大還須考慮結核性淋巴結炎、非結核性分枝桿菌與淋巴瘤。可連結概念：細胞內病原、聚合酶連鎖反應診斷、巨環類抗生素、桿菌性血管瘤。",[25,28,30,32],{"term":26,"count":27},"巨環類抗生素",2,{"term":29,"count":11},"巴東氏菌",{"term":31,"count":11},"區域性淋巴結腫大",{"term":33,"count":11},"細胞內病原與培養困難",[35,39,44,48,53,58],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-115-1-basic-medicine-047","下列何種細菌可直接人對人傳染？",47,{"webId":40,"stem":41,"number":42,"year":43,"session":11},"nurse-106-1-basic-medicine-043","慢性胰臟炎最常見的原因是：",43,106,{"webId":45,"stem":46,"number":47,"year":43,"session":27},"nurse-106-2-basic-medicine-057","下列抗心律不整藥物，何者可以降低動作電位第四期的去極化，而減少竇房結的自主性？",57,{"webId":49,"stem":50,"number":51,"year":52,"session":11},"nurse-108-1-basic-medicine-015","下列何者位於延腦的錐體（pyramids）？",15,108,{"webId":54,"stem":55,"number":56,"year":57,"session":11},"nurse-109-1-basic-medicine-059","有關抗生素 amoxicillin 之敘述，下列何者錯誤？",59,109,{"webId":59,"stem":60,"number":61,"year":62,"session":27},"nurse-110-2-basic-medicine-013","腎小體（renal corpuscle）的過濾膜（filtration membrane），不含下列那一構造？",13,110,"2026-08-06",1787299087934]