1.やさしい
肺炎が疑われるとき、培養用の喀痰検体は理想的にはいつ採取しますか?
- A抗菌薬は培養に影響しないので、いつでも
- B抗菌薬治療の3日後
- C抗菌薬の初回投与の前に、投与を遅らせずに
- D1週間たっても改善しないときだけ
2.やさしい
When is pneumonia classed as hospital-acquired?
- AWhen it starts 48 hours or more after admission
- BWhen it starts within the first hour after admission
- CWhen the patient had symptoms before admission
- DOnly when it is caused by a virus
3.やさしい
Where are AED pads usually placed on an adult?
- ABelow the right collarbone and on the left side below the armpit
- BOn each upper arm
- CBoth pads on the back, side by side between the shoulder blades
- DBoth pads on the abdomen, just below the ribs on either side
4.ふつう
A patient with heart failure takes furosemide once a day. When is the best time to take it?
- AAt bedtime, so the effect lasts through the night
- BIn the morning, to avoid needing the toilet at night
- CWhenever the ankles look swollen, on those days only
- DJust before the evening meal, with a large drink
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肺塞栓症またはDVTが確定した
- B抗凝固薬の用量が少なすぎるため、増やす必要がある
- 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 young patient with hypertrophic cardiomyopathy asks why they are told to avoid dehydration. What is the best explanation?
- ADehydration is the cause of the inherited condition
- BDehydration makes the heart muscle grow thicker within a few hours
- CLow blood volume can worsen obstruction of blood leaving the heart
- DFluids dissolve the extra muscle in the heart wall
7.むずかしい
After a car crash, a patient is severely breathless with absent breath sounds on the right, a deviated trachea, distended neck veins and BP 76/40 mmHg. What is the immediate management?
- AA chest X-ray to confirm the diagnosis before any treatment
- BUrgent needle or finger decompression of the right chest
- CLying the patient flat with the legs raised
- DInsertion of a urinary catheter to monitor output
8.むずかしい
Four surgical patients need VTE prevention. For which patient is mechanical prophylaxis alone most appropriate?
- AA patient with cancer having bowel surgery
- BAn obese patient after hip surgery
- CA patient after an uncomplicated knee replacement
- DA patient who had a brain haemorrhage two days ago
解答
- 1. C · 抗菌薬の初回投与の前に、投与を遅らせずに
- 2. A · When it starts 48 hours or more after admission
- 3. A · Below the right collarbone and on the left side below the armpit
- 4. B · In the morning, to avoid needing the toilet at night
- 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. C · Low blood volume can worsen obstruction of blood leaving the heart
- 7. B · Urgent needle or finger decompression of the right chest
- 8. D · A patient who had a brain haemorrhage two days ago
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