[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-2-basic-medicine-043":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":34,"lastmod":64},"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-115-2-基礎醫學-043","nurse-115-2-basic-medicine-043",115,2,43,"下列有關病毒感染所引起的免疫防禦機制，何者錯誤？",{"A":15,"B":16,"C":17,"D":18},"CD8 + T 細胞直接毒殺受感染之標的細胞","抗體可中和存在於細胞內之病毒","自然殺手細胞可利用 ADCC（antibody-dependent cellular cytotoxicity）的方式毒殺受感染之標的細胞","CD4 + T 細胞可分泌 IFN-γ 刺激巨噬細胞，以促進巨噬細胞分泌腫瘤壞死因子（TNF-α）及釋出含氧自由基攻擊受感染細胞","B",null,[],"本題考點是抗體與細胞性免疫在抗病毒防禦上的分工界線。抗體屬體液性免疫的分子,分布於血液與細胞外體液,無法穿透細胞膜進入細胞內,因此只能中和尚在細胞外的游離病毒顆粒、阻止其吸附與進入宿主細胞;已進入細胞內複製的病毒必須靠細胞性免疫清除,選項 B 稱抗體可中和細胞內病毒,故為錯誤敘述,選 B。選項 A 正確,CD8 陽性細胞毒性 T 細胞辨識標的細胞表面第一類 MHC 呈現的病毒抗原並直接毒殺。選項 C 正確,自然殺手細胞經 Fc 受體結合已附著抗體的感染細胞,以抗體依賴細胞媒介細胞毒殺作用清除之。選項 D 正確,CD4 陽性輔助 T 細胞分泌干擾素 γ 活化巨噬細胞。","抗病毒免疫可依時間軸分三段:感染初期由被感染細胞產生第一型干擾素(IFN-α、IFN-β)造成鄰近細胞進入抗病毒狀態並活化自然殺手細胞;中期自然殺手細胞依「失去自我」原則,辨識病毒為躲避細胞毒性 T 細胞而下調第一類 MHC 的細胞並殺之;後期抗原專一性的細胞毒性 T 細胞與抗體大量擴增,前者清除細胞內病毒庫,後者阻斷病毒在細胞間播散並提供再感染時的保護。這個分工正好解釋兩件常考的事:為何抗體效價可作為疫苗保護力的指標(阻斷進入),以及為何抗體高卻仍可能有慢性細胞內感染(清不掉細胞內病毒)。細胞毒性 T 細胞的殺傷機轉為 perforin 打孔加 granzyme 誘發凋亡,或以 Fas-FasL 途徑誘發凋亡。抗體依賴細胞媒介細胞毒殺作用要記住兩個要素:靶細胞表面必須先被 IgG 覆蓋、效應細胞必須帶 FcγRIII(CD16),這也是 rituximab 等治療性抗體發揮作用的機轉之一。",[25,28,30,32],{"term":26,"count":27},"體液性免疫抗體中和作用",1,{"term":29,"count":27},"細胞毒性 T 細胞",{"term":31,"count":27},"抗體依賴細胞媒介細胞毒殺作用",{"term":33,"count":27},"干擾素 γ 與巨噬細胞活化",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-115-2-basic-medicine-044","下列何種自體免疫疾病是由免疫複合物媒介（第三型過敏反應）？",44,{"webId":40,"stem":41,"number":42,"year":43,"session":11},"nurse-106-2-basic-medicine-010","關於子宮的敘述，下列何者正確？",10,106,{"webId":45,"stem":46,"number":47,"year":48,"session":27},"nurse-107-1-basic-medicine-024","偵測人類絨毛膜性腺激素是確定懷孕之重要指標。請問人類絨毛膜性腺激素何時開始分泌？",24,107,{"webId":50,"stem":51,"number":52,"year":53,"session":27},"nurse-108-1-basic-medicine-062","下列何種藥物，是藉由活化氯離子通道而增加腸道液體的釋放，用於治療慢性便祕？",62,108,{"webId":55,"stem":56,"number":57,"year":58,"session":11},"nurse-109-2-basic-medicine-026","18歲女性外表，沒有月經，性染色體為XY，其細胞對雄性素不敏感，在此病人所表現的病徵中，下列何者是因為缺乏雄性素接受器所造成？",26,109,{"webId":60,"stem":61,"number":62,"year":63,"session":11},"nurse-110-2-basic-medicine-060","有關具黏膜保護作用的 Sucralfate 敘述，下列何者錯誤？",60,110,"2026-08-06",1787299017798]