[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-107-2-basic-medicine-018":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-107-2-基礎醫學-018","nurse-107-2-basic-medicine-018",107,2,18,"下列何種毒素會抑制乙醯膽鹼酯酶（acetylcholinesterase, AChE）？",{"A":15,"B":16,"C":17,"D":18},"河豚毒（tetrodotoxin）","沙林神經毒氣","南美箭毒（curare）","殺蟲劑裡的有機磷","C","第18題答Ｂ或Ｄ者均給分",[],"本題考點在抑制乙醯膽鹼酯酶(AChE)的毒物辨識。就標準毒理學而言,會抑制AChE者為有機磷殺蟲劑與沙林(sarin)神經毒氣:兩者磷酸化AChE使其失活,導致乙醯膽鹼堆積而過度膽鹼作用。南美箭毒(curare)則是作用於神經肌肉接合處菸鹼型受體的競爭性拮抗劑,並非抑制AChE的酵素;河豚毒是鈉離子通道阻斷劑。故若嚴格依機轉,答案應落在沙林\u002F有機磷;本題官方標示為C(curare)與標準藥理不一致,屬答案存疑的題目,據實標confidence為low,不編造curare抑制AChE的機轉。","機轉澄清:AChE抑制劑(有機磷、沙林、neostigmine、physostigmine)使ACh堆積→毒蕈鹼(流涎、流淚、縮瞳、腹瀉、支氣管分泌增多)與菸鹼(肌肉顫動、無力)症狀;有機磷中毒解毒用atropine(拮抗毒蕈鹼)+pralidoxime(再活化AChE)。Curare作用恰為相反面向——阻斷菸鹼受體造成肌肉鬆弛,臨床上正是以AChE抑制劑(neostigmine)來逆轉其肌鬆效果。因此curare與AChE抑制在藥理上是「被逆轉」而非「抑制酵素」的關係。本題建議送人工複核題幹\u002F答案正確性。",[25,28,30,32],{"term":26,"count":27},"乙醯膽鹼酯酶(AChE)",1,{"term":29,"count":27},"有機磷與沙林(磷酸化AChE)",{"term":31,"count":27},"南美箭毒(菸鹼受體競爭性拮抗劑)",{"term":33,"count":27},"題目\u002F答案存疑",[35,39,44,48,53,58],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-107-2-basic-medicine-019","下列何者是以手電筒照射眼睛引起瞳孔反射的傳入神經？",19,{"webId":40,"stem":41,"number":42,"year":43,"session":27},"nurse-108-1-basic-medicine-035","岡氏複合體（Ghon’s complex）是下列何種微生物感染肺部所造成的臨床病理特徵？",35,108,{"webId":45,"stem":46,"number":47,"year":43,"session":11},"nurse-108-2-basic-medicine-049","下列何種藥物最常用來治療良性前列腺肥大症（benign prostatic hyperplasia）？",49,{"webId":49,"stem":50,"number":51,"year":52,"session":27},"nurse-110-1-basic-medicine-007","下列何者位於延髓（medulla oblongata）？",7,110,{"webId":54,"stem":55,"number":56,"year":57,"session":27},"nurse-111-1-basic-medicine-051","下列藥物和作用機轉之配對，何者錯誤？",51,111,{"webId":59,"stem":60,"number":61,"year":62,"session":63},"nurse-112-3-basic-medicine-015","下列何者為副交感（parasympathetic）神經興奮所引起之反應？",15,112,3,"2026-09-04",1788510723405]