[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-107-2-basic-medicine-048":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":35,"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-107-2-基礎醫學-048","nurse-107-2-basic-medicine-048",107,2,48,"40 歲女性，有全身疲倦、輕度發燒及關節僵硬，特別是清晨起床時，左右手指及肘關節。抽血檢查發現有類風濕性因子（rheumatoid factor）。這位女性最有可能罹患下列何者疾病？",{"A":15,"B":16,"C":17,"D":18},"黏連性脊椎關節炎（ankylosing spondyloarthritis）","類風濕性關節炎（rheumatoid arthritis）","退化性關節炎（degenerative arthritis）","痛風性關節炎（gouty arthritis）","B",null,[],"本題考點是對稱性小關節晨僵合併類風濕因子的診斷。依風濕病學,類風濕性關節炎的典型表現為對稱性侵犯手指（掌指、近端指間關節)與腕、肘等小關節、晨間僵硬超過一小時、且多數病人類風濕因子陽性,與本題吻合,故選 B。A 黏連性脊椎炎好發年輕男性、以中軸與薦腸關節為主、與 HLA-B27 相關,非對稱性手部小關節。C 退化性關節炎為機械性磨損,好發承重與遠端指間關節、晨僵短暫,類風濕因子陰性。D 痛風性關節炎多為急性單關節（典型第一蹠趾關節)紅腫熱痛,與尿酸鹽結晶有關,非對稱性晨僵。","鑑別要點——類風濕性關節炎:自體免疫、對稱、小關節（MCP／PIP、腕)、晨僵＞1 小時、類風濕因子與抗 CCP 抗體陽性、可致關節破壞變形（尺側偏移、天鵝頸)。退化性關節炎:磨損性、非對稱、遠端指間關節（Heberden 結節)與承重關節、晨僵＜30 分鐘。晨僵時間長短是快速鑑別關鍵:發炎性長、退化性短。抗 CCP 抗體專一性高於類風濕因子。可連結:HLA-B27 與脊椎關節病、尿酸與痛風、自體抗體。",[25,28,31,33],{"term":26,"count":27},"類風濕性關節炎",3,{"term":29,"count":30},"對稱性小關節與晨僵",1,{"term":32,"count":30},"類風濕因子與抗 CCP",{"term":34,"count":30},"退化性關節炎對比",[36,40,45,49,54,58],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-107-2-basic-medicine-049","肝臟代謝藥物的反應可分為第一相（phase I）及第二相（phase II）。有關藥物代謝的敘述，下列何者正確？",49,{"webId":41,"stem":42,"number":43,"year":44,"session":30},"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":46,"stem":47,"number":48,"year":44,"session":11},"nurse-108-2-basic-medicine-079","下列何種真菌感染，不建議以氟康唑（fluconazole）來治療？",79,{"webId":50,"stem":51,"number":52,"year":53,"session":30},"nurse-110-1-basic-medicine-037","下列何者不是潰瘍性結腸炎（ulcerative colitis）的臨床病理特徵？",37,110,{"webId":55,"stem":56,"number":30,"year":57,"session":11},"nurse-111-2-basic-medicine-001","下列何種胃腺細胞，其分泌物質與大腸杯狀細胞所分泌的相似？",111,{"webId":59,"stem":60,"number":61,"year":62,"session":27},"nurse-112-3-basic-medicine-045","造成軟性下疳（chancroid）的病原菌為何？",45,112,"2026-09-04",1788510723741]