1.やさしい
Which test is used to screen for an abdominal aortic aneurysm?
- AA peak expiratory flow test
- BA resting 12-lead ECG
- CAn abdominal ultrasound scan
- DA plain chest X-ray
2.やさしい
What does "hypovolaemia" mean?
- AA high level of fluid in the tissues
- BA low level of sodium in the blood
- CA low level of haemoglobin with a normal blood volume
- DA reduced volume of blood in the circulation
3.やさしい
What is the normal resting heart rate range for an adult?
- A30–50 beats per minute
- B60–100 beats per minute
- C100–140 beats per minute
- D40–60 beats per minute
4.ふつう
A patient with chest pain has a first troponin result within the normal range one hour after the pain started. Why is a repeat test arranged?
- ATroponin may take a few hours to rise after muscle damage
- BThe first sample is always contaminated
- CThe repeat test is only needed for patients over 80
- DTroponin falls during an MI, so a lower value confirms it
5.ふつう
Dダイマーが上昇していることは何を意味しますか?
- A抗凝固薬の用量が少なすぎるため、増やす必要がある
- B肺塞栓症またはDVTが確定した
- C深部静脈血栓症が安全に除外された
- Dフィブリンの分解があるが、血栓があることの証明にはならない
6.ふつう
A patient uses a glyceryl trinitrate (nitroglycerin) patch for angina. Why is it usually removed for several hours each day?
- AA nitrate-free interval prevents tolerance
- BIt lowers the risk of a high potassium level
- CThe patch works only during the night
- DThe skin needs a break to absorb a larger dose
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?
- ADelay fluids until a chest X-ray has been reported
- BWait for the sputum culture result before choosing an antibiotic
- 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 being treated for infective endocarditis of the mitral valve suddenly develops slurred speech and weakness of the right arm. What is the most likely cause?
- ALow blood glucose from a reduced appetite
- BA side effect of the IV antibiotic on the nerves
- CA migraine aura triggered by the fever
- DAn embolus from a valve vegetation causing a stroke
解答
- 1. C · An abdominal ultrasound scan
- 2. D · A reduced volume of blood in the circulation
- 3. B · 60–100 beats per minute
- 4. A · Troponin may take a few hours to rise after muscle damage
- 5. D · フィブリンの分解があるが、血栓があることの証明にはならない
- 6. A · A nitrate-free interval prevents tolerance
- 7. D · Take blood cultures and give IV antibiotics within the first hour
- 8. D · An embolus from a valve vegetation causing a stroke
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