[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-109-1-basic-medicine-055":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-109-1-基礎醫學-055","nurse-109-1-basic-medicine-055",109,1,55,"使用下列何種藥物，最易導致潛在結核病（latent tuberculosis）復發？",{"A":15,"B":16,"C":17,"D":18},"Infliximab","Rituximab","Tocilizumab","Leflunomide","A",null,[],"本題考點是哪類藥物最易誘發潛伏結核復發。TNF-α 是肉芽腫（granuloma）維持與巨噬細胞活化的關鍵細胞激素，能把結核桿菌局限在肉芽腫內。依此機轉，Infliximab 是抗 TNF-α 單株抗體，會瓦解肉芽腫使潛伏結核重新活化，故用藥前須先篩檢結核，選 A。B 的 Rituximab 標靶 CD20 清除 B 細胞，主要影響抗體免疫，非肉芽腫。C 的 Tocilizumab 阻斷 IL-6 受體，D 的 Leflunomide 抑制嘧啶合成，兩者結核再活化風險都明顯低於抗 TNF 製劑。","肉芽腫由活化巨噬細胞（epithelioid cell）與 T 細胞構成，TNF-α 負責募集並維持其結構完整；一旦被中和，桿菌從休眠態逸出增殖，故所有抗 TNF-α 生物製劑（infliximab、etanercept、adalimumab）仿單皆要求用藥前做 IGRA 或 TST 篩檢潛伏結核。對比記憶：抗 TNF→結核再活化風險最高；這也是為何生物製劑前必問結核病史。",[25,27,29,31],{"term":26,"count":11},"Infliximab 抗 TNF-α",{"term":28,"count":11},"肉芽腫維持",{"term":30,"count":11},"潛伏結核再活化",{"term":32,"count":11},"生物製劑篩檢",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":10,"session":11},"nurse-109-1-basic-medicine-056","Beta 腎上腺素受體拮抗劑用於治療心絞痛的藥理作用，不包括下列何者？",56,{"webId":39,"stem":40,"number":41,"year":10,"session":42},"nurse-109-2-basic-medicine-072","下列何者具有過濾血液中病原體以及清除衰老的血球細胞和血小板的功能？",72,2,{"webId":44,"stem":45,"number":46,"year":47,"session":42},"nurse-110-2-basic-medicine-006","有關消化道肌肉層的敘述，下列何者正確？",6,110,{"webId":49,"stem":50,"number":51,"year":52,"session":42},"nurse-111-2-basic-medicine-044","補體活化啟動一系列的蛋白質水解產生次單位「a」、「b」與其他次單位，具備不同的生物活性。下列何者是補體 C3b 主要的功能？",44,111,{"webId":54,"stem":55,"number":56,"year":57,"session":11},"nurse-113-1-basic-medicine-048","下列何者不屬於皮癬菌（dermatophytes）？",48,113,{"webId":59,"stem":60,"number":61,"year":62,"session":42},"nurse-114-2-basic-medicine-042","下列何者為正確的五大主要類型免疫球蛋白（immunoglobulin）？",42,114,"2026-09-04",1788510711388]