[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-115-2-basic-medicine-046":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":36,"lastmod":66},"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-046","nurse-115-2-basic-medicine-046",115,2,46,"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？",{"A":15,"B":16,"C":17,"D":18},"具有莢膜（capsule）結構，能抵抗吞噬作用","具有纖毛構造（fimbriae\u002Fpili），能進行黏附進而感染","能分泌外毒素，引起發炎反應及組織破壞","具有很強的內毒素活性，屬於生長快速的嗜氧菌","D",null,[],"本題考點是脆弱擬桿菌(Bacteroides)的氧氣需求與內毒素特性。Bacteroides 屬嚴格厭氧菌,是腸道與黏膜正常菌叢中數量最龐大的族群,在有氧環境下無法生長,培養也需厭氧條件;其脂多醣的 lipid A 結構與典型革蘭氏陰性菌不同,內毒素活性明顯偏低,故選項 D 同時把氧氣需求與內毒素活性都寫反,為錯誤敘述,選 D。選項 A 正確,莢膜多醣可抑制吞噬作用並促進膿瘡形成。選項 B 正確,纖毛與菌毛構造提供對黏膜上皮的黏附能力。選項 C 正確,此菌可分泌酵素與毒素(如 fragilysin)破壞組織並引發發炎,是腹腔內混合感染與膿瘡的常見成員。","厭氧菌感染的臨床辨識線索可整組記:感染部位鄰近黏膜屏障(口腔、腸道、女性生殖道)、組織壞死或缺血、膿液惡臭、產氣、常規需氧培養無菌生長卻仍化膿,以及多菌種混合。B. fragilis 的特別之處在於它在腸道菌叢中並非最多,卻是厭氧菌臨床分離株中最常見的病原,原因就是莢膜與 β-內醯胺酶等毒力優勢使它在腸道破損後最能存活致病。它幾乎都產生 β-內醯胺酶,故對盤尼西林抗藥,治療常用 metronidazole、clindamycin、carbapenem 或加 β-內醯胺酶抑制劑的組合;metronidazole 之所以專打厭氧菌,是因為它需要在低氧化還原電位環境下被還原成具細胞毒性的中間產物,需氧菌無法完成這個活化,這是「機轉決定抗菌譜」的漂亮範例。對比記憶:內毒素活性強的代表是大腸桿菌與腦膜炎雙球菌的 LPS,可誘發敗血性休克與瀰漫性血管內凝血;Bacteroides 的 LPS 活性弱,故其臨床表現以局部膿瘡為主而非猛暴型休克。",[25,28,30,32,34],{"term":26,"count":27},"脆弱擬桿菌",1,{"term":29,"count":27},"嚴格厭氧菌",{"term":31,"count":27},"內毒素活性",{"term":33,"count":27},"莢膜抗吞噬",{"term":35,"count":27},"混合厭氧菌感染",[37,41,46,51,56,61],{"webId":38,"stem":39,"number":40,"year":10,"session":11},"nurse-115-2-basic-medicine-047","採集疑似砂眼披衣菌（Chlamydia trachomatis）生殖泌尿道感染檢體進行細菌培養及鑑定時，檢體需要為？",47,{"webId":42,"stem":43,"number":44,"year":45,"session":11},"nurse-106-2-basic-medicine-013","下列那兩種皆屬於腹膜後器官？",13,106,{"webId":47,"stem":48,"number":49,"year":50,"session":27},"nurse-107-1-basic-medicine-027","正常的心動週期（cardiac cycle）中，動作電位會在何處有延遲傳遞的現象？",27,107,{"webId":52,"stem":53,"number":54,"year":55,"session":27},"nurse-108-1-basic-medicine-065","蛋白質感染原（prion）是非微生物性的病原體，下列敘述何者正確？",65,108,{"webId":57,"stem":58,"number":59,"year":60,"session":11},"nurse-109-2-basic-medicine-029","高鉀食物會造成下列那一段腎小管增加鉀的分泌？",29,109,{"webId":62,"stem":63,"number":64,"year":65,"session":11},"nurse-110-2-basic-medicine-063","下列何種藥物可以治療免疫不全病人，因感染巨細胞病毒（CMV）導致視網膜炎，以及對 acyclovir 無效之單純疱疹病毒感染？",63,110,"2026-08-06",1787299017849]