[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-115-2-basic-medicine-045":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":33,"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-115-2-基礎醫學-045","nurse-115-2-basic-medicine-045",115,2,45,"金黃色葡萄球菌（Staphylococcus aureus）若懸浮於人類的血漿中會促進纖維蛋白（fibrin）形成引發凝血，與下列那一種毒素最相關？",{"A":15,"B":16,"C":17,"D":18},"hyaluronidase","coagulase","enterotoxin","cytolysin","B",null,[],"本題考點是金黃色葡萄球菌各種毒力因子的功能對應。Coagulase 是金黃色葡萄球菌的標誌性酵素,能與血漿中的凝血酶原結合形成 staphylothrombin,直接把纖維蛋白原轉變為纖維蛋白,使菌體周圍凝結成纖維蛋白外衣以躲避吞噬,正符合題目所述的血漿中促凝現象,故選 B。選項 A 的 hyaluronidase 分解結締組織的玻尿酸基質,功能是幫助菌體在組織間擴散,與凝血無關。選項 C 的 enterotoxin 屬超級抗原,造成潛伏期短的嘔吐型食物中毒。選項 D 的 cytolysin 破壞細胞膜造成細胞溶解與組織壞死,三者都不涉及纖維蛋白形成。","coagulase 在檢驗上的意義比機轉更常被考:葡萄球菌屬的第一步鑑別就是 coagulase 試驗,陽性者為金黃色葡萄球菌,陰性者為表皮葡萄球菌、腐生葡萄球菌等凝固酶陰性葡萄球菌群(前者與人工植入物及導管相關感染有關,後者與年輕女性泌尿道感染有關)。金黃色葡萄球菌其他毒力因子可依「功能分類」記:黏附用的 protein A(結合 IgG 的 Fc 段而阻斷調理作用)與纖維蛋白原結合蛋白;擴散用的 hyaluronidase、staphylokinase、lipase;破壞用的 α-toxin 與 leukocidin(含 PVL,與壞死性肺炎及嚴重皮膚感染相關);超級抗原類的 enterotoxin(食物中毒)與 TSST-1(毒性休克症候群,大量活化 T 細胞使細胞激素風暴);以及剝離性毒素 exfoliatin(引起燙傷樣皮膚症候群)。記憶對照:食物中毒型的毒素是預先形成的耐熱毒素,所以復熱食物無法防止,潛伏期只有數小時且以嘔吐為主,和沙門氏菌感染型的發燒腹瀉可清楚區隔。",[25,28,29,31],{"term":26,"count":27},"金黃色葡萄球菌毒力因子",1,{"term":16,"count":27},{"term":30,"count":27},"纖維蛋白形成",{"term":32,"count":27},"hyaluronidase 與超級抗原",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":10,"session":11},"nurse-115-2-basic-medicine-046","鬆脆桿菌（Bacteroides）存在人類黏膜組織，屬於共生菌，若造成疾病，常以多菌種的方式混合感染（polymicrobial mixture）。下列對其致病機轉的敘述，何者錯誤？",46,{"webId":39,"stem":40,"number":41,"year":42,"session":11},"nurse-106-2-basic-medicine-012","下列何者分別與食道及十二指腸相接？",12,106,{"webId":44,"stem":45,"number":46,"year":47,"session":27},"nurse-107-1-basic-medicine-026","有一位病人的收縮壓為 120 毫米汞柱（mmHg），脈搏壓為 30 毫米汞柱，請問其平均動脈壓為多少毫米汞柱？",26,107,{"webId":49,"stem":50,"number":51,"year":52,"session":27},"nurse-108-1-basic-medicine-064","下列何種反轉錄酶（reverse transcriptase）抑制劑，不適用於人類免疫不全病毒（HIV）感染的治療？",64,108,{"webId":54,"stem":55,"number":56,"year":57,"session":11},"nurse-109-2-basic-medicine-028","下列何者為心臟收縮最主要的能量來源？",28,109,{"webId":59,"stem":60,"number":61,"year":62,"session":11},"nurse-110-2-basic-medicine-062","有關體重控制藥物 Lorcaserin 的敘述，下列何者錯誤？",62,110,"2026-08-06",1787299017831]