1.やさしい
What does "pleuritic" chest pain mean?
- ASharp pain that worsens on breathing in or coughing
- BDull pressure that spreads to the jaw on exertion
- CAching that is worse when the arm is moved
- DBurning pain behind the breastbone after meals
2.やさしい
血圧を最もよく下げる食事の変更はどれですか?
- Aコーヒーを増やし、砂糖入りの炭酸飲料を減らす
- B塩分を減らし、果物と野菜を増やす
- C赤身肉を増やし、パンを減らす
- D果汁を増やし、水を減らす
3.やさしい
What does the term "preload" describe?
- AThe force of contraction regardless of filling
- BThe amount of blood left in the atria after systole
- CThe stretch of the ventricle at the end of filling
- DThe resistance the ventricle pumps against
4.ふつう
Shortly after a permanent pacemaker is inserted via the subclavian vein, the patient becomes breathless with reduced breath sounds on that side. What complication should be suspected?
- APneumothorax
- BPericarditis
- CPulmonary oedema
- DAsthma
5.ふつう
How is orthostatic (postural) hypotension usually assessed?
- ABP lying after rest, then again after 1 and 3 minutes standing
- BBP once sitting, then once lying down straight after a large meal
- CBP only standing, after a brisk walk along the corridor
- DBP in both arms at the same moment while sitting
6.ふつう
A woman had lymph nodes removed from her left armpit for breast cancer. Which advice helps reduce the risk of lymphoedema?
- AKeep the left arm hanging down and as still as possible all day
- BUse only the left arm for heavy lifting to build up its muscles
- CAvoid BP cuffs and injections on the left arm where possible
- DApply tight jewellery to the left wrist
7.むずかしい
A patient with pneumonia has a heart rate of 118/min, BP 86/50 mmHg, RR 28/min and a high lactate. Sepsis is recognised. Which action should not be delayed?
- AWait for the sputum culture result before choosing an antibiotic
- BDelay fluids until a chest X-ray has been reported
- CGive oral antibiotics and reassess the next day
- DTake blood cultures and give IV antibiotics within the first hour
8.むずかしい
A patient with severe chronic kidney disease needs therapeutic anticoagulation for a DVT. Why might unfractionated heparin be chosen instead of a low-molecular-weight heparin?
- ALMWH is cleared by the kidneys and can accumulate
- BUnfractionated heparin is taken by mouth
- CLMWH cannot be given to anyone over 60
- DUnfractionated heparin has no bleeding risk at all
解答
- 1. A · Sharp pain that worsens on breathing in or coughing
- 2. B · 塩分を減らし、果物と野菜を増やす
- 3. C · The stretch of the ventricle at the end of filling
- 4. A · Pneumothorax
- 5. A · BP lying after rest, then again after 1 and 3 minutes standing
- 6. C · Avoid BP cuffs and injections on the left arm where possible
- 7. D · Take blood cultures and give IV antibiotics within the first hour
- 8. A · LMWH is cleared by the kidneys and can accumulate
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