1.やさしい
虚血性脳卒中のリスクを最も高める不整脈はどれですか?
- A運動中の洞性頻脈
- B洞性不整脈
- C心房細動
- D運動選手にみられる洞性徐脈
2.やさしい
What should patients starting rifampicin (rifampin) be told about their urine, sweat and tears?
- AThey may turn green, which means infection
- BThey will become completely colourless
- CThey may turn orange-red, which is harmless
- DThey may turn black, which means bleeding
3.やさしい
Amlodipine belongs to which drug class?
- AAngiotensin-converting enzyme inhibitors
- BCardioselective beta-blockers
- CLoop diuretics
- DCalcium channel blockers
4.ふつう
After repair of an abdominal aortic aneurysm, which regular assessment helps detect a blocked graft or clots in the legs?
- AChecking leg pulses, colour, warmth and sensation
- BChecking the pupils' response to light
- CTesting the gag reflex every four hours after surgery
- DMeasuring the blood glucose every hour through the night
5.ふつう
A patient on ramipril is to start sacubitril/valsartan for heart failure. What is the key safety point?
- ASacubitril/valsartan is safe to start on the same morning
- BThe ACE inhibitor must be stopped first, with a gap before starting
- CBoth drugs should be taken together each day for the best effect
- DThe ACE inhibitor dose should be doubled during the change
6.ふつう
A patient with heart failure starts dapagliflozin, an SGLT2 inhibitor. Which teaching is most relevant?
- AKeep the genital area clean, as fungal infections are more common
- BAvoid drinking any fluids at all for the first week of treatment
- CTake an extra dose if the ankles swell
- DExpect the urine to turn bright orange and stain underwear and clothes
7.むずかしい
A patient with crushing chest pain has ST elevation in leads V1–V4. Which coronary artery is most likely blocked?
- AThe left subclavian artery
- BThe circumflex artery
- CThe right coronary artery and its branches
- DThe left anterior descending artery
8.むずかしい
A patient on spironolactone and an ACE inhibitor has a potassium of 6.8 mmol/L (6.8 mEq/L) with peaked T waves. What is usually given first to protect the heart?
- AIntravenous calcium gluconate or chloride
- BAn IV furosemide bolus as the only treatment
- CA dose of digoxin
- DOral potassium supplements
解答
- 1. C · 心房細動
- 2. C · They may turn orange-red, which is harmless
- 3. D · Calcium channel blockers
- 4. A · Checking leg pulses, colour, warmth and sensation
- 5. B · The ACE inhibitor must be stopped first, with a gap before starting
- 6. A · Keep the genital area clean, as fungal infections are more common
- 7. D · The left anterior descending artery
- 8. A · Intravenous calcium gluconate or chloride
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