1.やさしい
A 13-year-old boy has sudden, severe pain in one testis with nausea and vomiting. How should this be treated?
- AAs a urine infection to be treated at home
- BAs a sports strain that will heal with rest
- CAs a surgical emergency
- DAs normal growing pains of puberty
2.やさしい
Why do children with long-standing cyanotic heart disease develop a high red blood cell count (polycythaemia)?
- ABecause the heart makes red blood cells
- BBecause of too much iron in the diet
- CTo compensate for chronic hypoxia
- DBecause the spleen stops working
3.やさしい
What is the first-line treatment for anaphylaxis in a child?
- AIM adrenaline (epinephrine)
- BOral paracetamol (acetaminophen)
- CAn inhaled corticosteroid via a spacer
- DAn oral antihistamine
4.ふつう
Why are IV fluids for young children given with an infusion pump or a volume-control set?
- ATo allow the child to adjust the rate
- BTo prevent accidental fluid overload
- CTo make the fluid warmer before it enters the vein
- DTo remove bacteria from the fluid
5.ふつう
Which stool pattern is typical of Hirschsprung disease in an older child?
- AChronic constipation with thin, ribbon-like, foul-smelling stools and distension
- BPale, bulky, fatty stools that float and are hard to flush, with a large appetite
- CNormal stools with occasional itching around the anus at night
- DFrequent bloody diarrhoea with fever after eating chicken
6.ふつう
A child with type 1 diabetes is unconscious from hypoglycaemia at school. What should be done?
- AGive the child's usual dose of insulin
- BLet the child sleep and check again in an hour
- CGive a glass of orange juice by mouth
- DGive glucagon and call emergency services
7.むずかしい
A child has suspected septic shock. Which action is the most time-critical?
- AStarting antibiotics after the fever has been present for 24 hours
- BGiving IV antibiotics as soon as possible, ideally within the first hour
- CWaiting for the blood culture results before starting any antibiotic treatment
- DGiving oral antibiotics and reviewing the child again in the morning
8.むずかしい
脳室腹腔シャントのある子どもの所見のうち、直ちにフォローアップが必要なものはどれですか?
- A食欲と遊びが正常
- Bシャントの走行に沿った治癒した傷跡
- C弁の上の小さく柔らかい、変化のないふくらみ
- D頭痛、繰り返す嘔吐、増していく傾眠
解答
- 1. C · As a surgical emergency
- 2. C · To compensate for chronic hypoxia
- 3. A · IM adrenaline (epinephrine)
- 4. B · To prevent accidental fluid overload
- 5. A · Chronic constipation with thin, ribbon-like, foul-smelling stools and distension
- 6. D · Give glucagon and call emergency services
- 7. B · Giving IV antibiotics as soon as possible, ideally within the first hour
- 8. D · 頭痛、繰り返す嘔吐、増していく傾眠
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