1.やさしい
細菌性肺炎に典型的な所見の組み合わせはどれですか?
- A発熱、湿性咳嗽、一領域のラ音
- B樽状胸郭と、何年も続く息切れ
- C発作時用の吸入薬で数分のうちに完全に消える喘鳴
- D肺は清明で発熱のない突然の胸痛
2.やさしい
Which precautions are needed for a patient with suspected infectious pulmonary tuberculosis?
- AAirborne precautions with a respirator mask
- BProtective isolation for the patient's own sake
- CContact precautions with gloves only
- DStandard precautions only
3.やさしい
Which sound is typical of a pleural friction rub?
- AFine bubbling sounds that clear with coughing
- BA creaking, grating sound with each breath
- CA high-pitched musical sound on expiration
- DA harsh sound on breathing in from the throat
4.ふつう
After an acute coronary syndrome, a patient with a normal cholesterol level is prescribed a high-intensity statin. Why?
- AStatins are given after an ACS mainly to lower the blood pressure
- BStatins reduce further events whatever the starting cholesterol
- CStatins are needed only if the cholesterol level is very high
- DStatins work as painkillers for chest pain
5.ふつう
Which side effect is particularly common with verapamil?
- ADry cough
- BHair loss
- CConstipation
- DDiarrhoea
6.ふつう
After an above-knee amputation, which measure helps prevent a hip flexion contracture?
- AKeeping a pillow under the stump at all times, day and night
- BSitting in a chair for most of the day with the hips bent
- CKeeping the hip bent to reduce stump swelling
- DLying prone for periods and avoiding pillows under the stump
7.むずかしい
A patient with severe sepsis becomes increasingly breathless over 24 hours. SpO₂ stays low despite high-flow oxygen, and the chest X-ray shows bilateral infiltrates. The heart function is normal. Which condition is most likely?
- AAcute respiratory distress syndrome
- BAcute left ventricular failure after an MI
- CSpontaneous pneumothorax
- DAn acute asthma attack
8.むずかしい
A patient had 40 minutes of chest pain at rest. The ECG shows ST depression without ST elevation, and the troponin is rising. What is the diagnosis?
- AStable angina
- BNon-ST-elevation myocardial infarction
- CAcute pericarditis
- DST-elevation myocardial infarction (STEMI)
解答
- 1. A · 発熱、湿性咳嗽、一領域のラ音
- 2. A · Airborne precautions with a respirator mask
- 3. B · A creaking, grating sound with each breath
- 4. B · Statins reduce further events whatever the starting cholesterol
- 5. C · Constipation
- 6. D · Lying prone for periods and avoiding pillows under the stump
- 7. A · Acute respiratory distress syndrome
- 8. B · Non-ST-elevation myocardial infarction
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