1.やさしい
Which side effect is typical of ACE inhibitors such as ramipril or lisinopril?
- AA persistent dry cough
- BSwelling of both ankles
- CA fast, irregular heart rate
- DA productive cough with green sputum
2.やさしい
What is Kussmaul breathing?
- ABreathing that alternates between deep breaths and pauses
- BDeep, rapid breathing in response to metabolic acidosis
- CVery slow, shallow breathing from opioids
- DNoisy breathing caused by a blocked upper airway
3.やさしい
Which drug reverses the effect of unfractionated heparin?
- AVitamin K (phytomenadione)
- BProtamine sulfate
- CFlumazenil
- DNaloxone
4.ふつう
Which history is a contraindication to thrombolysis for a STEMI?
- AMild asthma controlled with inhalers
- BA previous haemorrhagic stroke
- CA previous appendicectomy many years ago
- DTreated high blood pressure
5.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?
- AThe repeat test is only needed for patients over 80
- BTroponin falls during an MI, so a lower value confirms it
- CTroponin may take a few hours to rise after muscle damage
- DThe first sample is always contaminated
6.ふつう
Which exercise advice is recommended for intermittent claudication?
- AStopping walking at the very first twinge of pain each time
- BComplete bed rest until the leg pain has gone for at least a month
- CWalking only on days when the legs feel warm and painless
- DSupervised walking until pain is near maximal, then rest and repeat
7.むずかしい
Four surgical patients need VTE prevention. For which patient is mechanical prophylaxis alone most appropriate?
- AA patient after an uncomplicated knee replacement
- BAn obese patient after hip surgery
- CA patient who had a brain haemorrhage two days ago
- DA patient with cancer having bowel surgery
8.むずかしい
During a cardiac arrest, the monitor shows an organised rhythm, but there is no pulse. What should the team do?
- AContinue CPR and give adrenaline (epinephrine), as the rhythm is non-shockable
- BDeliver an unsynchronised shock at once and then check the pulse
- CStop CPR, because an organised rhythm on the monitor means recovery
- DGive adenosine to slow the rhythm down
解答
- 1. A · A persistent dry cough
- 2. B · Deep, rapid breathing in response to metabolic acidosis
- 3. B · Protamine sulfate
- 4. B · A previous haemorrhagic stroke
- 5. C · Troponin may take a few hours to rise after muscle damage
- 6. D · Supervised walking until pain is near maximal, then rest and repeat
- 7. C · A patient who had a brain haemorrhage two days ago
- 8. A · Continue CPR and give adrenaline (epinephrine), as the rhythm is non-shockable
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