[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-109-2-basic-medicine-041":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-109-2-基礎醫學-041","nurse-109-2-basic-medicine-041",109,2,41,"一位58歲的女性出現雷諾氏現象（Raynaud’s phenomenon）及食道運動功能障礙，血清學檢查抗核抗體試驗呈陽性反應，此婦人最有可能罹患下列何種病症？",{"A":15,"B":16,"C":17,"D":18},"系統性紅斑性狼瘡（SLE）","斯耶格雷症候群","格雷夫氏症（Graves disease）","侷限性硬皮病（limited systemic sclerosis）","D",null,[],"本題考點是結締組織疾病的臨床與血清學辨識。依風濕免疫學,病人同時具雷諾氏現象、食道運動障礙且抗核抗體(ANA)陽性,最符合侷限性系統性硬皮病(即CREST症候群),故正解D。CREST代表鈣沉積、雷諾現象、食道障礙、指端硬化與微血管擴張,與題幹高度吻合。A系統性紅斑性狼瘡雖ANA陽性,但典型以蝴蝶斑、關節炎、腎炎為主,不以雷諾加食道障礙為核心。B修格連氏症候群以乾眼乾口與淋巴球浸潤腺體為主。C格雷夫氏症是甲狀腺自體免疫亢進,與雷諾及食道障礙無關。故選D。","硬皮病分侷限型與瀰漫型:侷限型即CREST(Calcinosis鈣沉積、Raynaud雷諾、Esophageal食道蠕動障礙、Sclerodactyly指端硬化、Telangiectasia微血管擴張),進展較慢,特異抗體為抗中節體抗體(anti-centromere);瀰漫型皮膚廣泛硬化、內臟(肺纖維化、腎危象)受侵較快,抗體為anti-Scl-70(anti-topoisomerase I)。雷諾現象是血管對冷或壓力過度收縮致手指變白-變紫-變紅三相。記憶:「雷諾+食道+ANA+指端硬→想CREST\u002F硬皮病」,以抗中節體 vs anti-Scl-70區分亞型。",[25,28,30,32,34],{"term":26,"count":27},"侷限性系統性硬皮病",1,{"term":29,"count":27},"CREST症候群",{"term":31,"count":27},"雷諾氏現象",{"term":33,"count":27},"抗核抗體",{"term":35,"count":27},"食道運動障礙",[37,41,46,50,55,61],{"webId":38,"stem":39,"number":40,"year":10,"session":11},"nurse-109-2-basic-medicine-042","下列有關空氣污染中，懸浮微粒（particulate matter；PM）的敘述，何者錯誤？",42,{"webId":42,"stem":43,"number":44,"year":45,"session":27},"nurse-110-1-basic-medicine-058","Alteplase 主要用於治療急性缺血性中風、心肌梗塞、肺栓塞、深部靜脈栓塞，其藥理作用機轉為何？",58,110,{"webId":47,"stem":48,"number":49,"year":45,"session":11},"nurse-110-2-basic-medicine-072","關於厭氧菌的敘述，下列何者錯誤？",72,{"webId":51,"stem":52,"number":53,"year":54,"session":11},"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":56,"stem":57,"number":58,"year":59,"session":60},"nurse-113-3-basic-medicine-014","下列何者促進脂質分解，增加血中脂肪酸濃度的效果最強？",14,113,3,{"webId":62,"stem":63,"number":64,"year":65,"session":27},"nurse-115-1-basic-medicine-008","下列何種激素最可能造成孕婦發生妊娠糖尿病？",8,115,"2026-09-04",1788510715120]