[{"data":1,"prerenderedAt":68},["ShallowReactive",2],{"q-nurse-108-2-basic-medicine-079":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":36,"lastmod":67},"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-108-2-基礎醫學-079","nurse-108-2-basic-medicine-079",108,2,79,"下列何種真菌感染，不建議以氟康唑（fluconazole）來治療？",{"A":15,"B":16,"C":17,"D":18},"白色念珠菌（Candida albicans）","杜氏假絲念珠菌（Candida dubliniensis）","克魯斯念珠菌（Candida krusei）","近平滑假絲念珠菌（Candida parapsilosis）","C",null,[],"本題考點為念珠菌對 azole 類抗黴菌藥的天然抗藥性。依抗黴菌藥理，克魯斯念珠菌（Candida krusei）對氟康唑（fluconazole）具內在（天生）抗藥性，臨床不建議以 fluconazole 治療，故選 C。（A）白色念珠菌（C. albicans）通常對 fluconazole 敏感，為適用對象。（B）杜氏假絲念珠菌（C. dubliniensis）多數對 fluconazole 敏感。（D）近平滑假絲念珠菌（C. parapsilosis）一般亦對 fluconazole 有反應。故唯 C. krusei 因先天抗藥而不宜使用。","Azole 類經抑制真菌 CYP51（14-α-去甲基酶）阻斷麥角固醇（ergosterol）合成。C. krusei 因標靶親和力低而『天生』抗 fluconazole，屬臨床選藥的重要例外；C. glabrata 則常呈劑量依賴性抗藥。遇 krusei 感染多改用棘白素類（echinocandins）或 voriconazole。記憶：非白色念珠菌中，krusei＝天生抗 fluconazole、glabrata＝易獲得抗藥，兩者是 azole 選藥的常考陷阱，本題直指 krusei 為不建議使用者。",[25,28,30,32,34],{"term":26,"count":27},"克魯斯念珠菌",1,{"term":29,"count":27},"fluconazole 內在抗藥性",{"term":31,"count":27},"azole 抑制麥角固醇合成",{"term":33,"count":27},"CYP51",{"term":35,"count":27},"非白色念珠菌",[37,41,46,51,56,62],{"webId":38,"stem":39,"number":40,"year":10,"session":11},"nurse-108-2-basic-medicine-080","目前認為下列那種吸蟲感染與人類膽管癌的發生最有關係？",80,{"webId":42,"stem":43,"number":44,"year":45,"session":11},"nurse-109-2-basic-medicine-016","交感神經中的大內臟神經（greater splanchnic nerve）其節前神經纖維來自下列何者？",16,109,{"webId":47,"stem":48,"number":49,"year":50,"session":27},"nurse-110-1-basic-medicine-030","在腎臟的近曲小管中，鈉離子主要與下列何種物質共同運輸進入上皮細胞？",30,110,{"webId":52,"stem":53,"number":54,"year":55,"session":27},"nurse-111-1-basic-medicine-068","利用黏試紙（scotch tape test）黏取肛門周邊之蟲卵是用於下列那一種寄生蟲診斷？",68,111,{"webId":57,"stem":58,"number":59,"year":60,"session":61},"nurse-112-3-basic-medicine-042","從胸腺發育而來，未曾受抗原刺激的 T 細胞，主要由下列何種細胞啟動第一步的活化？",42,112,3,{"webId":63,"stem":64,"number":65,"year":66,"session":27},"nurse-114-1-basic-medicine-036","Abciximab治療不穩定型心絞痛（unstable angina）的藥理機制為何？",36,114,"2026-09-04",1788510705488]