[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-110-1-basic-medicine-064":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":35,"lastmod":64},"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-110-1-基礎醫學-064","nurse-110-1-basic-medicine-064",110,1,64,"下列何者與磺胺藥（sulfadoxine）混合使用，以治療弓形蟲（Toxoplasma gondii）之感染？",{"A":15,"B":16,"C":17,"D":18},"Ciprofloxacin","Metronidazole","Pyrimethamine","Trimethoprim","C",null,[],"本題考點是抗弓形蟲的協同用藥組合。考點在於葉酸合成路徑的雙重阻斷：Pyrimethamine抑制二氫葉酸還原酶，與抑制二氫喋酸合成的磺胺(sulfadoxine)前後接力，協同阻斷原蟲葉酸代謝，為弓形蟲與瘧疾標準療法，故選C。Ciprofloxacin屬氟喹諾酮，作用於DNA旋轉酶，抗一般細菌非原蟲；Metronidazole針對厭氧菌與阿米巴、滴蟲，對弓形蟲非首選；Trimethoprim雖同抑制DHFR，但臨床搭配的是sulfamethoxazole而非sulfadoxine。答案為C。","機轉延伸：磺胺類為PABA類似物、抑制dihydropteroate synthase，Pyrimethamine抑制dihydrofolate reductase，兩藥卡住葉酸合成的前後兩步，形成序列阻斷(sequential blockade)產生協同殺蟲效果。記憶口訣：Pyrimethamine+sulfadoxine即抗瘧複方Fansidar，同一組合亦可對付弓形蟲。使用時常併補leucovorin以減輕骨髓抑制。",[25,28,29,31,33],{"term":26,"count":27},"二氫葉酸還原酶",3,{"term":17,"count":11},{"term":30,"count":11},"磺胺類",{"term":32,"count":11},"葉酸合成序列阻斷",{"term":34,"count":11},"弓形蟲",[36,40,44,49,54,59],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-110-1-basic-medicine-065","下列何者存在於動物細胞，而不存在於細菌？",65,{"webId":41,"stem":42,"number":11,"year":43,"session":11},"nurse-111-1-basic-medicine-001","下列何者主要是由膜（membrane）構成的胞器？",111,{"webId":45,"stem":46,"number":47,"year":43,"session":48},"nurse-111-2-basic-medicine-015","體制素（somatostatin）主要由消化道何處分泌？",15,2,{"webId":50,"stem":51,"number":52,"year":53,"session":11},"nurse-113-1-basic-medicine-013","下列何者兼具屈曲和伸展肩關節的功能？",13,113,{"webId":55,"stem":56,"number":57,"year":58,"session":48},"nurse-114-2-basic-medicine-017","下列何種疾病主要是視錐細胞（cone cells）基因突變異常所致？",17,114,{"webId":60,"stem":61,"number":62,"year":63,"session":11},"nurse-106-1-basic-medicine-011","大腸的那一構造，是由縱走的平滑肌束構成？",11,106,"2026-09-04",1788510719689]