[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-108-1-basic-medicine-077":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-108-1-基礎醫學-077","nurse-108-1-basic-medicine-077",108,1,77,"病患若呈現面部痙攣（facial spasm）、牙關緊閉（trismus or lockjaw）、心律不整、嚴重流汗、脫水等，最有可能是下列何種疾病？",{"A":15,"B":16,"C":17,"D":18},"格蘭氏陰性細菌引起之敗血症（sepsis）","細菌性食物中毒（food poisoning）","肉毒桿菌素中毒（foodborne botulism）","破傷風（tetanus）","D",null,[],"本題考點在破傷風的典型臨床表現辨識。面部痙攣、牙關緊閉（trismus\u002Flockjaw）、伴自律神經不穩（心律不整、大量流汗、脫水）是破傷風毒素造成持續性骨骼肌僵直與痙攣的特徵，故選 D 破傷風（tetanus）。A 格蘭氏陰性菌敗血症以發燒、低血壓為主，無牙關緊閉的強直痙攣。B 細菌性食物中毒以腸胃道症狀為主。C 肉毒桿菌素中毒的毒素抑制乙醯膽鹼釋放，造成的是『鬆弛性』麻痺與下行性無力，與破傷風的『僵直性』痙攣正好相反，故不選。","破傷風毒素（tetanospasmin）逆行運送至脊髓，抑制甘胺酸與 GABA 等抑制性神經傳導物釋放，使運動神經失去抑制而持續放電，造成牙關緊閉、角弓反張、苦笑面容與自律神經風暴。對比記憶：破傷風毒素『擋抑制性訊號→僵直痙攣（痙攣性麻痺）』；肉毒毒素『擋興奮性 ACh 釋放→鬆弛性麻痺』，兩者皆屬梭菌外毒素卻方向相反。破傷風以類毒素疫苗（DTaP\u002FTd）主動免疫、傷口高風險者另給免疫球蛋白被動免疫預防。",[25,28,30,32,34],{"term":26,"count":27},"破傷風",2,{"term":29,"count":11},"破傷風毒素",{"term":31,"count":11},"牙關緊閉",{"term":33,"count":11},"抑制性神經傳導物抑制",{"term":35,"count":11},"肉毒毒素對比",[37,41,46,50,55,60],{"webId":38,"stem":39,"number":40,"year":10,"session":11},"nurse-108-1-basic-medicine-078","下列有關白色念珠菌（Candida albicans）之敘述何者錯誤？",78,{"webId":42,"stem":43,"number":44,"year":45,"session":11},"nurse-109-1-basic-medicine-014","下列何者不是常見的神經傳導物質（neurotransmitter）？",14,109,{"webId":47,"stem":48,"number":49,"year":45,"session":27},"nurse-109-2-basic-medicine-028","下列何者為心臟收縮最主要的能量來源？",28,{"webId":51,"stem":52,"number":53,"year":54,"session":27},"nurse-110-2-basic-medicine-066","下列何種補體的成分，可以活化吞噬細胞？",66,110,{"webId":56,"stem":57,"number":58,"year":59,"session":27},"nurse-112-2-basic-medicine-010","軟腦膜（pia mater）在脊髓兩側伸出一韌帶附著到硬腦膜（dura mater），此韌帶為：",10,112,{"webId":61,"stem":62,"number":63,"year":64,"session":65},"nurse-113-3-basic-medicine-004","DNA 雙股結構中的腺嘌呤（adenine）主要與下列何者配對？",4,113,3,"2026-09-04",1788510708740]