[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-2-basic-medicine-047":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":27},"nurse-115-2-基礎醫學-047","nurse-115-2-basic-medicine-047",115,2,47,"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？",{"A":15,"B":16,"C":17,"D":18},"尿道清澈之流出物","生殖道滲出之膿液","受感染部位含有細胞之檢體","女性患者的陰道拭子","C",null,[],"本題考點是砂眼披衣菌的生活型態如何決定檢體採集方式。Chlamydia trachomatis 屬絕對細胞內寄生菌,缺乏自行合成 ATP 的能力,只能在活細胞內完成由感染體到網狀體的複製週期,無法在一般人工培養基上生長;因此培養或鑑定用的檢體必須含有受感染的宿主上皮細胞,採集時需以拭子刮取黏膜以帶下細胞,故選 C。選項 A 的尿道清澈流出物主要是分泌液,細胞含量不足。選項 B 的膿液以嗜中性球與壞死物為主,缺少可供病原存活的柱狀上皮細胞。選項 D 的陰道拭子取到的多為鱗狀上皮,並非此菌偏好的感染部位,子宮頸內或尿道黏膜刮取才是適當取樣。","披衣菌的雙型態生活週期是理解一切檢驗與治療特性的鑰匙:感染體(elementary body)體積小、代謝不活躍、可存於細胞外並負責傳播;進入細胞後轉為網狀體(reticulate body),代謝活躍、行二分裂增殖,最後再轉回感染體釋出。因為它是細胞內寄生且無胜肽聚糖細胞壁,β-內醯胺類抗生素無效,治療須用能進入細胞的巨環類(azithromycin)或四環類(doxycycline)。臨床譜要分開記:血清型 A 到 C 造成砂眼(反覆感染導致結膜結痂與眼瞼倒插而致盲);D 到 K 造成生殖泌尿道感染(男性非淋菌性尿道炎、女性子宮頸炎與骨盆腔發炎,後續輸卵管沾黏與不孕)以及新生兒經產道感染引起的結膜炎與肺炎;L1 到 L3 造成性病性淋巴肉芽腫。診斷方法的世代演進也是考點:細胞培養曾為標準但耗時且要求嚴格,目前臨床以核酸增幅檢驗為主,靈敏度高且可用尿液檢體,但本題問的是細菌培養與鑑定,故仍以含細胞檢體為準。",[25,28,31,33],{"term":26,"count":27},"絕對細胞內寄生",4,{"term":29,"count":30},"砂眼披衣菌",1,{"term":32,"count":30},"感染體與網狀體週期",{"term":34,"count":30},"含細胞檢體採集",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-115-2-basic-medicine-048","有關於白色念珠菌（Candida albicans）之敘述，下列何者最不適當？",48,{"webId":41,"stem":42,"number":43,"year":44,"session":11},"nurse-106-2-basic-medicine-014","支配骨骼肌的運動神經元細胞體是位於脊髓的何處？",14,106,{"webId":46,"stem":47,"number":48,"year":49,"session":30},"nurse-107-1-basic-medicine-028","下列構造何者可以進行腎臟之逆流交換（counter-current exchange）？",28,107,{"webId":51,"stem":52,"number":53,"year":54,"session":30},"nurse-108-1-basic-medicine-066","下列自體免疫疾病中，何者為自體抗體模擬特定分子結合在受體上導致細胞活化及增生，而非造成該細胞的破壞及死亡？",66,108,{"webId":56,"stem":57,"number":58,"year":59,"session":11},"nurse-109-2-basic-medicine-030","若以潮氣容積（tidal volume）200毫升，呼吸頻率40次／分鐘的方式持續呼吸30秒，會發生下列何種現象？",30,109,{"webId":61,"stem":62,"number":63,"year":64,"session":11},"nurse-110-2-basic-medicine-064","抗癌藥物中，下列何者有明顯的周邊神經毒性與肝毒性？",64,110,"2026-08-06",1787299017855]