1.やさしい
Which symptom is the classic warning sign of bladder cancer?
- ALeaking urine when coughing
- BSevere loin pain that comes in waves
- CBurning pain on passing urine
- DPainless visible blood in the urine
2.やさしい
What is the most common cause of a high sodium in a frail older adult?
- ATaking too much insulin
- BDrinking too much water
- CEating too much fruit
- DNot drinking enough water
3.やさしい
How should a patient collect a midstream urine sample?
- ACollect urine from the toilet bowl afterwards
- BLet the first part go in the toilet, then catch the middle
- CCollect urine over 24 hours into one bottle
- DCollect the very first drops into the container
4.ふつう
Which signs suggest rejection of a kidney transplant?
- AA rash on the face after sun exposure
- BA cough, wheeze and a runny nose with sneezing
- CLess urine, a rising creatinine and a tender graft
- DMore urine, a falling creatinine and weight loss
5.ふつう
Why should antiepileptic drugs not be stopped suddenly?
- AThe drugs build up in the body and become toxic after stopping
- BStopping them suddenly causes permanent damage to the liver and kidneys
- CStopping them suddenly causes a dangerous rise in blood pressure
- DSudden withdrawal can trigger seizures, including status epilepticus
6.ふつう
急性腎障害のとき、またはリスクのある患者のヨード造影剤の前後に、メトホルミンが通常保留されるのはなぜですか?
- A腎臓が障害されると高カリウム血症を起こすから
- B造影剤を遮断して、画像が読めなくなるから
- C蓄積して乳酸アシドーシスのリスクが高まりうるから
- D造影剤と併用すると重度の低血糖を起こすから
7.むずかしい
手術後、バセドウ病の患者の体温が39.8 °C、心拍数が160/分で、興奮と嘔吐があります。最も適切な治療の組み合わせはどれですか?
- A発熱にアスピリンを使い、1週間以内にかかりつけ医に診てもらう
- B悪寒を鎮めるための、レボチロキシンと温かい毛布
- C冷却、β遮断薬、抗甲状腺薬、続いてヨウ素とステロイド
- D頻脈を治療するための、水分制限とループ利尿薬
8.むずかしい
A patient arrives five hours after the onset of a stroke. A CT angiogram shows a blockage of a large artery in the brain. What is the most appropriate next step?
- ANo treatment, because the time for any reperfusion has passed
- BUrgent referral for assessment for mechanical thrombectomy
- CGive aspirin and plan a review on the ward tomorrow
- DStart IV alteplase immediately without further imaging
解答
- 1. D · Painless visible blood in the urine
- 2. D · Not drinking enough water
- 3. B · Let the first part go in the toilet, then catch the middle
- 4. C · Less urine, a rising creatinine and a tender graft
- 5. D · Sudden withdrawal can trigger seizures, including status epilepticus
- 6. C · 蓄積して乳酸アシドーシスのリスクが高まりうるから
- 7. C · 冷却、β遮断薬、抗甲状腺薬、続いてヨウ素とステロイド
- 8. B · Urgent referral for assessment for mechanical thrombectomy
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