[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-109-1-medical-surgical-045":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"lastmod":63},"內外科護理學","medical-surgical",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":11,"stem":12,"options":13,"answer":18,"answerNote":19,"images":20,"explanation":21,"explanationDeep":22,"topics":23,"freq":25},"nurse-109-1-內外科護理學-045","nurse-109-1-medical-surgical-045",109,1,45,"一位 30 歲女性主訴最近出現皮膚對光敏感、對稱性關節疼痛、口腔潰瘍，另補體 C 3 及 C 4 減少、抗核抗體（ANA）呈現陽性、紅血球沉降速率（ESR）明顯上升、血小板減少，下列何者為其最可能之診斷？",{"A":14,"B":15,"C":16,"D":17},"痛風性關節炎","後天免疫缺乏症候群","全身性紅斑性狼瘡","類風濕性關節炎","C",null,[],"本題考點為全身性紅斑性狼瘡(SLE)的診斷特徵。SLE屬多系統自體免疫疾病,依其典型表現:皮膚光敏感、對稱性關節痛、口腔潰瘍、補體C3\u002FC4下降(免疫複合體消耗補體)、抗核抗體ANA陽性、紅血球沉降速率上升、血小板減少,符合SLE多項分類準則,故選C。A痛風性關節炎為尿酸結晶沉積,以單關節急性紅腫熱痛與高尿酸為主,無ANA陽性;B後天免疫缺乏症候群以CD4下降與伺機性感染表現,非補體與ANA異常;D類風濕性關節炎以類風濕因子與對稱性小關節破壞為主,少見光敏感與補體下降,故最符合者為C。","補體C3、C4下降是SLE活動度指標,因免疫複合體沉積活化補體而被消耗;ANA敏感但不專一,anti-dsDNA與anti-Sm才是專一性抗體。可用ACR「SOAP BRAIN MD」記11項準則。血液三系減少(貧血、白血球低下、血小板低下)常見,反映自體抗體攻擊,是與其他關節疾病鑑別的重點。",[24,26,28,30],{"term":16,"count":25},12,{"term":27,"count":10},"抗核抗體ANA",{"term":29,"count":10},"補體C3\u002FC4下降",{"term":31,"count":10},"光敏感與對稱性關節炎",[33,37,42,47,52,57],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-109-1-medical-surgical-046","有關治療類風濕性關節炎使用之藥物，下列何者不適當？",46,{"webId":38,"stem":39,"number":40,"year":9,"session":41},"nurse-109-2-medical-surgical-062","有關導致腎病症候群病人全身水腫之病理機轉，下列何者正確？",62,2,{"webId":43,"stem":44,"number":45,"year":46,"session":10},"nurse-110-1-medical-surgical-076","有關第一期心腦肺甦醒術（cardiopulmonary cerebral resuscitation; CPCR）的執行步驟，下列何者最優先？",76,110,{"webId":48,"stem":49,"number":50,"year":51,"session":41},"nurse-111-2-medical-surgical-034","奇脈（paradoxical pulse）是指下列何種情況？",34,111,{"webId":53,"stem":54,"number":55,"year":56,"session":41},"nurse-112-2-medical-surgical-078","當車禍造成嚴重創傷的病人送到急診出現：脈搏 124 次／分、呼吸 32 次／分胸部起伏明顯，血壓 130\u002F100 mmHg、皮膚溼且冰冷、尿量減少、呈現呼吸性鹼中毒情形，下列休克階段的分期，何者正確？",78,112,{"webId":58,"stem":59,"number":60,"year":61,"session":62},"nurse-113-3-medical-surgical-042","有關愛迪生危機的特徵，下列何者正確？",42,113,3,"2026-09-04",1788510712735]