[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-110-2-medical-surgical-049":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"lastmod":64},"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":10},"nurse-110-2-內外科護理學-049","nurse-110-2-medical-surgical-049",110,2,49,"下列何者為初級免疫反應最先合成的免疫球蛋白？",{"A":14,"B":15,"C":16,"D":17},"IgA","IgD","IgG","IgM","D",null,[],"本題考點在初級與次級免疫反應中免疫球蛋白的合成順序。當抗原首次入侵,B細胞最先分泌的抗體是IgM,其為五聚體、分子量最大、活化補體能力強,故初級免疫反應最早合成者選D的IgM。IgA主要分布於黏膜與分泌液,負責局部黏膜免疫,非最先合成;IgD多附著於未成熟B細胞表面當抗原受體,血中含量極低;IgG則在次級免疫反應大量且持久產生、可通過胎盤,屬較晚出現的主力抗體,故均非本題答案。","記憶口訣:初級反應M先來、次級反應G當家。IgM為五聚體(10個抗原結合位)故凝集與活化補體效率高,但半衰期短;抗原再次入侵時因記憶B細胞而以IgG為主、反應更快更強更持久。臨床應用:急性感染驗IgM代表近期感染、既往感染或免疫力看IgG。可連結IgE(過敏與寄生蟲)與IgA(黏膜與初乳)完成五類免疫球蛋白功能對照。",[24,26,29,30,32],{"term":25,"count":10},"免疫球蛋白",{"term":27,"count":28},"初級免疫反應",1,{"term":17,"count":28},{"term":31,"count":28},"五聚體",{"term":33,"count":28},"次級免疫反應",[35,39,44,48,54,59],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-110-2-medical-surgical-050","有關愛滋病的傳染途徑，下列何者錯誤？",50,{"webId":40,"stem":41,"number":42,"year":43,"session":28},"nurse-111-1-medical-surgical-066","有關腎臟活體組織切片檢查之敘述，下列何者錯誤？",66,111,{"webId":45,"stem":46,"number":47,"year":43,"session":10},"nurse-111-2-medical-surgical-080","有關狂牛症（mad cow disease）的敘述，下列何者錯誤？",80,{"webId":49,"stem":50,"number":51,"year":52,"session":53},"nurse-112-3-medical-surgical-038","下列何者為細菌性肺炎病人必要的診斷檢查？①胸部電腦斷層 ②胸部 X 光攝影 ③肺功能檢查 ④痰液檢查",38,112,3,{"webId":55,"stem":56,"number":57,"year":58,"session":28},"nurse-114-1-medical-surgical-042","有關糖尿病酮酸中毒（DKA）之處置，下列何者正確？①建立靜脈輸液，由低劑量胰島素開始給與 ②最初2小時，給與0.45％生理食鹽水維持電解質平衡         ③等尿液排出量恢復正常，應補充鉀離子 ④血液pH值>7.1時，則與以重碳酸鈉（NaHCO 3）",42,114,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-115-2-medical-surgical-036","下列何者是急性呼吸窘迫症候群（ARDS）早期的重要徵象？",36,115,"2026-09-04",1788510729261]