沖縄中部病院マッチング情報

沖縄県立中部病院19期過去問

１．2ヶ月前に骨折（確か骨盤骨折）。入院していたが、突然の発熱38.2度で、BP 110/70という状態になった。考えられる原因は。
1.anaphylaxis
2.DIC
3.TTP
4.hypo…
5.fat embolism

２．７９歳、女性。非常に抵抗力の弱い状態。どのワクチンを優先して接種すべきか。
1.BCG
2.tetanus
3.influenzae
4.pertussis
5.pneumococcus

３．突然の右肩へ放散する痛み。BP左180/80、右0。考えられるものは
1.aortic dissection
2.MI
3.empyema
4.pulmonary embolism
5.spontaneus pneumothorax

4.A 65 years-old male painless bright red blood per rectum without clot he was in a shock state . Differentials include all of the following Except?
A) Colo rectal cancer
B) diverticular bleeding
C) Pneumatosis intestinalis
D) Lymphoma
E) Acute hemorrhagic rectal ulcer

5.A 43 years-old female came your clinic with esophagogastoricsonography report at private clinic noted as GERD. Appropriate advice include all of the following Except?
A) to take late evening snack
B) Discontinue nitrates or Ca channel blocker
C) PPI
D) change diet
E) Fowler position if possible while sleeping

6.The following are typical cause of PAINLESS cholestsis Except?
A) Ampulla tumor
B) Drug induced liver damage
C) Autoimmune cholangioathy
D) Obstructive cholangitis secondary to chondocholithiasis
E) Sepsis
7.The following are correct except
a）middle cerebral artery branch from internal carotid artery　　　　　　　　　　b）posterior inferior cerebllar artery branch from basilar artery　　　　　　　　　c）ophthalmic artery branch from internal carotid artery　　　　　　　　　　　　　d）anterior spinal artery branch from vertebral artery　　　　　　　　　　　　　　　　e）lenticulostriate artery branch from middle cerebral artery
8.Which of the following is deep sensation?
a. pain　b. temperature　c. touch　d. vibration　e. two-point discrimination
9.Parkinsonism includes the following except
a. resting finger tremor b. muscular rigidity c. Babinsky sign
d. Bradykinesia e. frozen gait
13. Which is the causative agent of osteomyelitis?
A. Staphylococcus aureus　 B. Streptococcus pneumoniae　 C. E. coli
D. Neisseria meningitides　 D. Mycobacterium tuberculosis
14. Which is the appropriate approach for meningitis?
A. Echo　 B. CT　 C. MRI　 D. Blood test　 E. Spinal fluid test
15. Which is the vaccinable organism?
A. Chickenpox　 B. Smallpox 　 C. Influenza A　 D. HBV　 E. HCV
16. exacerbation of acute asthma, EXCEPT
(A) drowsy or confused
(B) leg edema
(C) bradycardia
(D) silent chest
(E) decreased pulsus paradoxus

17. COPD manifestation, EXCEPT
(A) increased cough and sputum
(B) prrulent sputum?
(C) leg edema
(D) respiratory alkalosis
(E) wheeze

18. Systemic corticosteroid drugs is usually recommended in any following disease.
(A) overwhelming pneumonia
(B) acute exacerbation COPD
(C) tuberculosis meningitis
(D) acute asthma attack
(E) acute eosinophilic pneumonia

19. The patiant have right epigastrium pain , jaundice, fever.
What disease?

22. All of the following are charactaristic features of FSG(focal guromerular sclerosis )Except?
A) hypocomplementemia
B) IgM deposition
C) Freguent recurrence in transplant kidney
D) steroid resistant
E) glomerular tip lesion

23. All of the following are acceptable treatment for hypokaremia EXCEPT?
A) calcium gluconate
B) regular Insllin
C) beta-agonist
D) mannitol
E) cation exchange resins

24. All of the following are charactaristic findings of dialysis related amyloidosisEXCEPT?
A) corpal tunnel syndrome
B) bone cyst
C) destructive spondyloarthropathy
D) deposition of amyloid protein derived from beta-2 micro globulin
E) aseptic femoral head necrosis

25. メモとして残っているのは、
Hb↓、Ht30％、reticulocyte130％、診断は？
選択肢として�@TTP、�AITP
となっていました。
国試の過去問の中から、似た感じの問題を英語にしてみました｡
(96D-35)
A 32-year-old woman complains of purpura. The purpura have been until 5 months.2 weeks ago, she had bleeding in brashing her tooth. Anemia, jaundice, hepatosplenomegaly, and lymph node swelling is unremarkable. Labs show a hemogrobin of 10.5, reticulocyte of 15%, WBC count of 4500,aplatelet count of 20000, PT of 11.2s(11.3), APTT of 33s(32.2), fibrinogen of 310mg/dl(200-400), FDP of 3.8μg/ml(0-10). CRP, antinuclear antibodies, and direct Coombs' test are negative. Bone marrow examination reveals increased numbers of magakaryocytes, no heteromorphous cell. The most likely diagnosis is
(A) aplastic anemia
(B) malignant anemia
(C) myelodysplastic syndrome
(D) idiopathic thrombocytepenic purpura
(E) chronic myelocytic leukemia

26. メモは、凝固異常、PTT↑、PT→、
選択肢として�@�]�V因子、�A�]�U因子、�B�]�T因子、�C�\因子、�D抗リン脂質抗体
となっていました｡
(91F-26)
A 22-year-old woman complains of continuous bleeding in extraction. Physical examination is unrevealing. Her RBC count is 4,110,000, Hb is 12.1g/dl, Ht is 35%, WBC is 6400, and platelet count is 230,000. His bleeding time is 15min(1-3), PT is 11.2min(11.3), and APTT is 56.2s(32.2). Which of the following is the most likely diagnosis?
(A) Glanzmann disease
(B) Wiskott-Aldrich syndrome
(C) Von Willebrand disease
(D) Hemophilia A
(E) Vitamine K deficiency

27.メモとして残っているのは、
リンパ節腫脹の場所で�U型Hodgkin病となるものは？
となっていました｡　Hodgkin病の病期分類のAnn Arbor分類についての問だったと思います｡　96I-41を参考に作ってみました｡
A 30-year-old woman is diagnosed as Hodgkin lymphoma. On examination, she has swellings at her right neck and chest, and no swelling at her abdomen and pelvis. Which stage her disease in Ann Arbor's classification?
(A) �T
(B) �U
(C) �V
(D) �W
(E) �X

28.HOCMの治療法で正しいのはどれか。Except
(a)β−blocker
(b)dopamine
(c)myostomy
(d)tricuspid valve replacement
(e)pacemaker

29.Diastolic murmurが聞こえるのはどれか。Except
(a) aortic regargitant
(b) pulmonary regargitant
(c) mitral stenosis
(d) pericardial tamponade
(e) 房室間の血流が増加するとき。（ex.MR）

19th OCH Pediatrics
1. What is the first sign of puberty, of boy?
(A) changing voice
(B) pubic hair
(C) enlarge testis
(D) axillary hair
(E) growth spurt

1.the first sign of puberty in boys?
1.change of voice
2.growth of pubic hair
3.growth of Axillary hair
4.enlargement of testis
5.growth of sperms

2. congenital hypothyroidism
(A) irritable
(B) diarrhea
(C) tachycardia
(D) constipation
(E) inguinal hernia

3.Which disorder has advanced skeletal maturation?
A)Growth hormone deficiency
B)Hypothyroism
C)21 Hydroxyprogesteron?
D)psychosocial deprivation
E)constitutional delay of puberty

4.A 2 years-old who has not begun to speak is brought to hospital.
All of the following condition should be considered in the differenciated diagnosis Except?
A) Development delay
B) Autism
C) Neglect
D) Hearing impairment
E) Children schizophremia

8. Febrile more than five days,systemic rash,etc..what therapy is effect?
1) steroid
2) immunoglobrin
3)-5) ?

9. 5 years old male with ALL in a ward has a fever 38.5℃.
What is the appropriate approach, EXCEPT?
A. Acetaminophen
B. Blood culture
C. Steroid pulse
D. Administrating antifungal
E. moving to a private room

10. Which is the prognostic factor for ALL?
A. Sex
B. RBC count
C. Age
D. Morphology
E. LDH

13.A baby 3300 weight at gestation was delivered with thick meconium. Apgar score was 2 at 1minute. Nasopharyngeal suction was done. But the baby developed poor muscle tone and general cyanosis what is the next you should do
A) chest compression
B) tactile stimulation
C) Immediate intubation and suction via endotracheal tube
D) Immediate intubation and give the surfactant
E) Give the 100% O2 without positive pressure ventilation

14. Common symptoms seen in febrile convulsion include all of the following
a. 3-month old baby
b. seizure stopped within 15 minutes
c. high fever over 39℃
d. generalized tonic-clonic seizure
e. normal development
15.子供のcroupでみられるのはどれか。Except
(a) hoarseness
(b) inspiratory stridor
(c) barking cough
(d) sub epiglotic stricture
(e) tachypnea
19th OCH OB＆GY

3.What does not cover peritoneum in the pelvis?

4.Uterus cervical canser 1 pattern postope. Left anterior region of thigh is sensory paralysis. What nerve is obstruction?

5. During which of the following conditions would the serum prolactin level be greatest?
A) menopause
B) ovaulation
C) parturition
D) sleep
E) puberty

6. Menstrual flow is associated with
A) prolonged maintenance of estorogen
B) prolonged maintenance of progeteron
C) withdrawal of FSH
　D) withdrawal of LH
E) withdrawal of progesterone

9.preeclampsiaの治療法はどれか。
(a) magnesium sulfate
(b) delivery
(c) anti hypertension therapy
(d) bed rest
(e) dialysis

10.胎児循環において最も酸素化されているのはどの部位か。
(a) ascending aorta
(b) discending aorta
(c) left ventricle
(d) ductus arteriosus
(e) umbilical vein

11. Amenorrhea for 8 week, 1 week of unilateral adnexal pain acute abdomen on examination rapidly falling hematocrit, positive pregnancy test.
Which is appropriate sign and symptoms / Dx?
(A) ectopic pregnancy
(B) PID
(C) endometriosis
(D) appendicitis
(E) UTI
(F) ruptured corpus luteum cyst of the ovary

12.Bilateral equal adnexal pain ,cervical motion tenderness ,direct abdominal tenderness ,temperature 39.5℃　WBC 12000.
Which of the following is matching the appropriate sign or symptoms with the most appropriate diagnosis?
A) ecotopic pregnancy
B) PID
C) Appendicitis
D) Endometoriosis
E) UTI
F) Raptured corpus luteum cyst of the ovary
15. Delayed menstruation, sudden onset of syncope, pregnant test (-).
What is the most likely diagnosis?
A. Ectopic pregnancy
B. PID
C. Appendicitis
D. Urinary tract infection
E. Rupture of corpus luteums
19th OCH Surgery

１． Supra condylar （上腕骨顆上骨折）ダメージをうけるのは
1,
2,damage of branchial artery
3.reduction of flex
4.medium nerve palsy
5.malunion

２． Medullary carcinoma of thyroid.EXEPT
1.arise from parafollicular
2.カルシトニン産生
3.hormone independent
4.MEN
5.partial thyroidectomy

３． DIC
1.fibrinogen down
2.fibrin up
3.�[ up
4.platelet down
5.morphygial abnormarity of RBC

4.All of the following are associated with hypokalemia EXCEPT?
A) Villous adenoma of rectum
B) purgative abuse
C) diuretic therapy
D) Cushing syndorome
E) pheochromocytoma

5.Chronic pancreatitis is a recognized manifestation of the
A) hyperlipidemia
B) hyperparathy
C) chronic alchol abuse
D) parotid tumor
E) gallstones

6.Recognizing feature of subarachnoid hemorrhage include
A) epilepsy
B) hemiplegia
C) paraplegia
D) cranial nerve palsy
E) sign of meningitis

16. hemolytic transfusionに関する問題でした。

17. estrogen receptor (+)に関する問題でした。
　選択肢にホルモン療法がありました。

18. pancoast tumor に関する問題でした。
　選択肢にHorner syndromeがあったのでこれが正解だと思いました。

19．Indication of aorta-coronary artery bypass
1) unstable angina
2) congestive heart failure
3) miserable angina is not adjustment
4) operation is risk of 10%
5) three vessel disease is only adaption
20. Seminomaの定義
1) 5 years survival rate is 50%
2) Radiation is not effect
3) This tumor is the most one of testis tumor
4) ?
5) ?
21. Deal with pubic fracture and superior urethral injury
1)-5) ?

25. メモとして残っているのは、"顔面外傷で顔面を修復するのは全身状態が安定してから"とありました。

26. メモでは60kgで50％の熱傷、8時間の輸液量は？
となっていました｡Baxterの公式で答えはでると思いますが｡

28.ショックに関連するものはどれか。Except
(a) ventricular tachycardia
(b) aortic dissection
(c) myocardial infarction
(d) pulmonary embolism
(e) subarachnoid hemorrhage

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