1.やさしい
A patient on warfarin asks what an INR of 2.0 means. Which explanation is best?
- AYour warfarin dose is twice what it should be
- BYour blood takes about twice as long as normal to clot
- CYou have twice the normal number of platelets
- DYour blood clots about twice as fast as is normal
2.やさしい
Chronic kidney disease is usually defined by an eGFR below which value for more than 3 months?
- A90 mL/min/1.73 m²
- B120 mL/min/1.73 m²
- C15 mL/min/1.73 m²
- D60 mL/min/1.73 m²
3.やさしい
A low mean corpuscular hemoglobin concentration (MCHC) means that the red cells are:
- AMore numerous than normal
- BLarger than normal (macrocytic)
- CShaped like a sickle
- DPaler than normal (hypochromic)
4.ふつう
When should a blood sample for a digoxin level be drawn to be interpreted correctly?
- AOnly after a meal, because food is needed for absorption
- BAt least 6–8 hours after a dose, often just before the next one
- CWithin 30 minutes after an oral dose to show the peak level
- DAt any time, because digoxin levels do not change during the day
5.ふつう
A patient takes low-dose methotrexate weekly for rheumatoid arthritis. Which laboratory tests are monitored regularly?
- ASerum amylase, lipase and blood ketones
- BTroponin, creatine kinase and myoglobin
- CSerum lithium, sodium and urine specific gravity
- DComplete blood count, liver tests and kidney function
6.ふつう
Which IV fluid can be given through the same line as a red cell transfusion?
- A0.9% sodium chloride
- BLactated Ringer's (Hartmann's) solution
- C0.45% sodium chloride
- D5% dextrose in water
7.むずかしい
A middle-aged man has fatigue, joint pain, a raised ALT and new diabetes. His ferritin is very high and his transferrin saturation is above 60%. Which condition is most likely?
- AAnemia of chronic disease
- BHereditary hemochromatosis
- CIron-deficiency anemia
- DAcute viral hepatitis A
8.むずかしい
A patient with long-standing rheumatoid arthritis has a hemoglobin of 10.5 g/dL (105 g/L), a low serum iron, a low total iron-binding capacity (TIBC) and a high-normal ferritin. Which condition fits best?
- AVitamin B12 deficiency anemia
- BIron-deficiency anemia
- CAnemia of chronic disease (inflammation)
- DAcute blood loss anemia
解答
- 1. B · Your blood takes about twice as long as normal to clot
- 2. D · 60 mL/min/1.73 m²
- 3. D · Paler than normal (hypochromic)
- 4. B · At least 6–8 hours after a dose, often just before the next one
- 5. D · Complete blood count, liver tests and kidney function
- 6. A · 0.9% sodium chloride
- 7. B · Hereditary hemochromatosis
- 8. C · Anemia of chronic disease (inflammation)
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