1.やさしい
Which side effect is typical of ACE inhibitors such as ramipril or lisinopril?
- AA fast, irregular heart rate
- BSwelling of both ankles
- CA persistent dry cough
- DA productive cough with green sputum
2.やさしい
What is cor pulmonale?
- ALeft-sided heart failure caused by a heart attack
- BInflammation of the lining around the heart
- CInfection of the heart valves
- DRight-sided heart failure caused by lung disease
3.やさしい
Which sound is typical of a pleural friction rub?
- AA creaking, grating sound with each breath
- BA harsh sound on breathing in from the throat
- CFine bubbling sounds that clear with coughing
- DA high-pitched musical sound on expiration
4.ふつう
Septic shock belongs to which category of shock?
- AHypovolaemic shock
- BObstructive shock
- CDistributive shock
- DCardiogenic shock
5.ふつう
患者の血圧が200/125 mmHgで、新たな錯乱とかすみ目があります。通常、どのように降圧しますか?
- A新しい経口錠剤で、1週間後に再評価する
- B脳が今は高い圧に依存しているので、まったく下げない
- C滴定した静注薬で、最初の1時間に最大約25%まで
- Dできるだけ速く、数分で正常値まで
6.ふつう
A patient's blood pressure is 120/60 mmHg. What is the approximate mean arterial pressure?
- A80 mmHg
- B60 mmHg
- C100 mmHg
- D90 mmHg
7.むずかしい
A fit 24-year-old marathon runner has a resting heart rate of 46/min on admission for minor surgery. He has no dizziness, chest pain or breathlessness, and his BP is 118/70 mmHg. What is the appropriate response?
- AGive IV atropine straight away to bring the rate above 60/min
- BDocument and report it, as this is often normal in an athlete
- CStart chest compressions
- DCancel the surgery and arrange a permanent pacemaker urgently
8.むずかしい
A smoker has severe shoulder and arm pain, a drooping eyelid, a small pupil and reduced sweating on the same side of the face. What should be suspected?
- AA stroke affecting the brainstem on the opposite side
- BA frozen shoulder with referred pain to the face
- CA tumour at the apex of the lung (Pancoast tumour)
- DA simple migraine
解答
- 1. C · A persistent dry cough
- 2. D · Right-sided heart failure caused by lung disease
- 3. A · A creaking, grating sound with each breath
- 4. C · Distributive shock
- 5. C · 滴定した静注薬で、最初の1時間に最大約25%まで
- 6. A · 80 mmHg
- 7. B · Document and report it, as this is often normal in an athlete
- 8. C · A tumour at the apex of the lung (Pancoast tumour)
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