[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-107-1-basic-medicine-074":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":11},"nurse-107-1-基礎醫學-074","nurse-107-1-basic-medicine-074",107,1,74,"回歸熱疏螺旋體（Borrelia recurrentis）在人體引發重覆性的發燒、好轉，主要的原因為何？",{"A":15,"B":16,"C":17,"D":18},"宿主的自體免疫反應","此菌在宿主體內能夠進行抗原變異，再度造成疾病","此菌會間歇性的釋放出引起宿主發燒的外毒素","此菌會間歇性的抑制宿主之免疫反應，故宿主時好時壞","B",null,[],"本題考點為回歸熱疏螺旋體（Borrelia recurrentis）造成『發燒—退燒—再發燒』週期性病程的機轉。依免疫學,此菌表面帶可變的主要表面脂蛋白（VMP\u002FVlp 抗原變異系統),當宿主產生抗體壓制某抗原型的菌群使發燒緩解後,菌體透過基因重組更換表面抗原,逃脫既有抗體再度大量增殖,引發下一波菌血症與發燒,如此反覆,故選 B。A 錯,病程非自體免疫所致而是病原本身抗原變異。C 錯,週期性發燒源於抗原變異的免疫逃脫而非間歇釋放外毒素;螺旋體致病也非以外毒素為主。D 錯,菌並非主動抑制宿主免疫,而是靠變裝躲避已成形的抗體。","核心觀念:antigenic variation(抗原變異)是回歸熱的招牌,與瘧原蟲、錐蟲、淋病雙球菌 pilin 變異同屬『免疫逃脫』大家族。機轉可想成『每退一波燒,病原就換一件外衣』,抗體永遠慢半拍,直到宿主把所有變異型都認完才痊癒。臨床上回歸熱由體蝨(流行性)或軟蜱(地方性)傳播,治療用四環黴素或紅黴素,須注意 Jarisch-Herxheimer 反應。命題常把『抗原變異』與『外毒素\u002F自體免疫』對照設陷阱,抓住『變裝逃脫抗體』即可。",[25,27,29,31],{"term":26,"count":11},"Borrelia recurrentis(回歸熱)",{"term":28,"count":11},"抗原變異(antigenic variation)",{"term":30,"count":11},"免疫逃脫",{"term":32,"count":11},"週期性菌血症",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":10,"session":11},"nurse-107-1-basic-medicine-075","威脅生命的擴散性念珠菌症（disseminated candidiasis）主要發生在何種病人？",75,{"webId":39,"stem":40,"number":41,"year":42,"session":11},"nurse-108-1-basic-medicine-011","卵巢排卵（ovulation）時，下列何者不會隨著卵母細胞（oocyte）一起排出？",11,108,{"webId":44,"stem":45,"number":46,"year":42,"session":47},"nurse-108-2-basic-medicine-025","進入青春期，由下列何種激素刺激卵巢濾泡發育，使初級卵母細胞完成第一次減數分裂？",25,2,{"webId":49,"stem":50,"number":51,"year":52,"session":47},"nurse-109-2-basic-medicine-063","Caspofungin用於治療黴菌感染，下列何者為其作用機轉？",63,109,{"webId":54,"stem":55,"number":56,"year":57,"session":11},"nurse-111-1-basic-medicine-027","下列何者不屬於胰臟的外分泌蛋白質？",27,111,{"webId":59,"stem":60,"number":61,"year":62,"session":47},"nurse-112-2-basic-medicine-041","下列敘述何者錯誤？",41,112,"2026-09-04",1788510701598]