1.やさしい
Varenicline helps people stop smoking because it:
- AMakes cigarettes taste bitter
- BIs a form of nicotine absorbed slowly through the skin
- CIs a nicotinic partial agonist that reduces craving and reward
- DBlocks dopamine receptors in the brain completely
2.やさしい
Psyllium (ispaghula husk) is which type of laxative?
- AOsmotic
- BBulk-forming
- CStimulant
- DStool softener
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 stops levodopa turning into dopamine outside the brain
- DIt increases the breakdown of dopamine in the liver
4.ふつう
Which rule applies when giving phenytoin intravenously?
- AGive it in the same line as other drugs without flushing
- BMix or flush it only with normal saline and give it slowly
- CGive it as a rapid push to stop seizures faster
- DMix it with glucose 5% to prevent low blood sugar
5.ふつう
A patient is starting olanzapine. Which monitoring is most important over the following months?
- AWeight, blood glucose and blood lipids
- BHearing tests and vision tests every month
- CINR and platelet count
- DPeak expiratory flow
6.ふつう
Besides lithium levels, which blood tests are monitored in long-term lithium treatment?
- AINR and fibrinogen
- BLiver enzymes, serum amylase and lipase
- CKidney function and thyroid function
- DTroponin and CK-MB
7.むずかしい
A man taking spironolactone for heart failure develops painful breast enlargement. Which change may be considered?
- ADoubling the spironolactone dose to overcome the side effect
- BAdding testosterone injections
- CSwitching to eplerenone, which has fewer anti-androgen effects
- DSwitching to potassium chloride tablets
8.むずかしい
A patient on heparin for 7 days has a platelet count that has fallen by more than half, and a new leg vein thrombosis. What is the most likely cause and the key action?
- AWarfarin skin necrosis; switch from heparin to warfarin at once
- BVitamin K deficiency; give vitamin K and continue heparin
- CHeparin-induced thrombocytopenia; stop all heparin
- DNormal dilution of platelets; continue and recheck in a week
解答
- 1. C · Is a nicotinic partial agonist that reduces craving and reward
- 2. B · Bulk-forming
- 3. C · It stops levodopa turning into dopamine outside the brain
- 4. B · Mix or flush it only with normal saline and give it slowly
- 5. A · Weight, blood glucose and blood lipids
- 6. C · Kidney function and thyroid function
- 7. C · Switching to eplerenone, which has fewer anti-androgen effects
- 8. C · Heparin-induced thrombocytopenia; stop all heparin
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