1.やさしい
Why is methadone used to treat opioid use disorder?
- AIt causes vomiting if other opioids are used
- BIt cures the liver damage caused by opioids
- CIt is a long-acting opioid that prevents withdrawal and craving
- DIt is a pure opioid antagonist that blocks all opioid effects
2.やさしい
Which drug is first-line for symptomatic bradycardia in adults?
- AAtropine
- BDigoxin
- CMetoprolol
- DAdenosine
3.やさしい
Why is carbidopa combined with levodopa?
- AIt converts levodopa into dopamine inside the gut
- BIt blocks dopamine receptors to reduce nausea in the brain
- CIt increases the breakdown of dopamine in the liver
- DIt stops levodopa turning into dopamine outside the brain
4.ふつう
Which rule applies to intravenous potassium chloride?
- AIt is mixed into blood products to save time
- BIt may be given intramuscularly if there is no IV access
- CIt must be diluted and given as an infusion, never as an IV push
- DIt is given as a rapid IV push to correct low levels quickly
5.ふつう
Why is testing for HLA-B*15:02 recommended before carbamazepine in people of some Asian ancestries?
- AIt greatly raises the risk of Stevens–Johnson syndrome
- BThis gene variant causes carbamazepine to raise blood glucose
- CThis gene variant makes carbamazepine ineffective
- DThis gene variant speeds up the kidney excretion of carbamazepine
6.ふつう
Which drug is used for torsades de pointes?
- AOral digoxin
- BIntravenous magnesium sulfate
- CIntravenous adenosine (rapid push)
- DIntravenous verapamil
7.むずかしい
A patient who uses insulin is taught sick-day rules. Which statement shows a need for further teaching?
- A"If I am ill and not eating, I will stop my insulin completely."
- B"I will keep drinking fluids, even if I cannot eat much."
- C"I will check my blood glucose and ketones more often while I am ill."
- D"I will seek help if I keep vomiting or have ketones."
8.むずかしい
A patient with severe chronic hyponatraemia receives hypertonic saline. Why is the rate of correction strictly limited?
- ARaising sodium too fast causes severe hypokalaemia and cardiac arrest
- BHypertonic saline is toxic to the liver at high rates
- CRaising sodium too fast can cause osmotic demyelination in the brain
- DFast correction causes immediate kidney failure
解答
- 1. C · It is a long-acting opioid that prevents withdrawal and craving
- 2. A · Atropine
- 3. D · It stops levodopa turning into dopamine outside the brain
- 4. C · It must be diluted and given as an infusion, never as an IV push
- 5. A · It greatly raises the risk of Stevens–Johnson syndrome
- 6. B · Intravenous magnesium sulfate
- 7. A · "If I am ill and not eating, I will stop my insulin completely."
- 8. C · Raising sodium too fast can cause osmotic demyelination in the brain
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