Tonics, Kampo, Sanitation, and Test Kits

Which of the following statements about the function of vitamin A is correct?

1. It helps red blood cell formation and is an important nutrient for keeping nerve function normal.
2. It is an important nutrient for maintaining night vision and keeping skin and mucous membrane function normal.
3. It promotes calcium absorption in the intestine and calcium reabsorption in the renal tubules, helping bone formation.
4. It is a nutrient essential for energy production from carbohydrates and also has a role in promoting intestinal motility.

Which of the following statements about excessive intake of vitamin A is correct?

1. There are reports of an increased rate of congenital anomalies in infants born to mothers who consumed 10,000 international units or more of vitamin A per day during the period from three months before pregnancy through the third month of pregnancy.
2. A pregnant woman within the third month of pregnancy, or a woman wishing to become pregnant, needs only to be mindful of vitamin A intake from medicine, and need not consider intake from food or other sources besides medicine.
3. The upper limit for the daily amount of vitamin A in an over-the-counter medicine is 10,000 international units.
4. Because the entire amount of beta-carotene contained in vegetables is converted as-is into vitamin A in the body, even intake from food other than medicine can easily lead to excessive intake.

Which of the following statements about vitamin D is incorrect?

1. A vitamin D main-ingredient preparation contains ergocalciferol or cholecalciferol as its main ingredient and is used for the prevention of rickets, among other purposes.
2. It is a nutrient that promotes calcium absorption in the intestine and calcium reabsorption in the renal tubules, helping bone formation.
3. Known excess conditions from vitamin D include hypercalcemia and abnormal calcification.
4. Hypercalcemia always presents subjective symptoms from an early stage.

Which of the following statements about vitamin E is correct?

1. It is involved in protein metabolism and is an important nutrient for maintaining skin and mucous membrane health and nerve function, used for neuralgia.
2. It is a nutrient that protects body lipids from oxidation and supports cell activity, and also has an action of improving blood flow.
3. Its intake can cause the urine to turn yellow.
4. It is said to have an action of suppressing melanin production and is a nutrient used to relieve symptoms of blemishes and freckles.

Which of the following statements about vitamin B1 is correct?

1. It is a nutrient essential for energy production from carbohydrates, has an action of maintaining normal nerve function, and also has a role in promoting intestinal motility.
2. It is involved in lipid metabolism and is an important nutrient for keeping skin and mucous membrane function normal, used to relieve eye hyperemia and mouth ulcers.
3. It is a nutrient that promotes calcium absorption in the intestine, helping bone formation.
4. It shows an antioxidant action that protects body lipids from oxidation, and is used to relieve blemishes and freckles and to prevent bleeding gums and nosebleeds.

Which of the following statements about vitamin B2 and vitamin B6 is correct?

1. Vitamin B2 is a nutrient involved in protein metabolism.
2. A vitamin B6 main-ingredient preparation is used to relieve dry eyes and night blindness.
3. Intake of vitamin B2 can cause the urine to turn yellow.
4. Vitamin B6 is an important nutrient involved in lipid metabolism.

Which of the following statements about vitamin B12 and vitamin C is incorrect?

1. Vitamin B12 is included in vitamin main-ingredient preparations and anti-anemia medicines, among others, as cyanocobalamin and similar forms.
2. Vitamin C shows an action of protecting body lipids from oxidation (antioxidant action) and is also said to have an action of suppressing melanin production.
3. A known excess condition of vitamin C is hypercalcemia.
4. Vitamin B12 helps red blood cell formation and is an important nutrient for keeping nerve function normal.

Which of the following statements about calcium, amino-acid ingredients, and the like included in tonic health medicines is correct?

1. Aminoethylsulfonic acid (taurine) is present throughout the body, in muscle, brain, heart, eyes, nerves, and elsewhere, and is important for normal cell function.
2. Cysteine is a main component of cartilage tissue, with a role in forming and repairing cartilage components, and is included for relief of joint pain and stiff shoulders.
3. A known excess condition of calcium is rickets, a skeletal abnormality in infants.
4. Glucuronolactone is a type of amino acid present in hair, nails, and skin, that suppresses melanin production in the skin and also promotes alcohol breakdown in the liver.

Which of the following statements about crude drug ingredients, among others, included in tonic health medicines is correct?

1. A medicinal liquor, having an action of promoting blood flow, is also suitable for a person who bleeds easily right after surgery or childbirth, and is widely used as a tonic.
2. Hanpi is a crude drug derived from the seed coat removed from the seed of Job's tears (Poaceae), used for rough skin and warts.
3. Coix seed (yokuinin) is a crude drug derived from the skin and viscera removed from the mamushi pit viper, used for its expected tonic, blood-flow-promoting, and invigorating (enhancing sexual function) effects.
4. Ginseng (ninjin) is a crude drug derived from the fine roots removed from the root of Panax ginseng (Araliaceae), and is said to increase resistance to external stress and boost metabolism.

Which of the following statements about tonic health medicines handled as medicines is incorrect?

1. A product in which the maximum daily amount of a vitamin ingredient exceeds a prescribed value is recognized only as a medicine.
2. The scope of efficacy/effect claims for a quasi-drug tonic health medicine is limited to tonic effects, improvement of a weak constitution, nutritional supplementation during and after illness, and the like.
3. Efficacy/effect claims for a specific site's symptoms, such as neuralgia, muscle pain, joint pain, or blemishes/freckles, are also permitted for a quasi-drug tonic health medicine.
4. Crude drug ingredients such as cashu, bezoar (goo), schisandra fruit (gomishi), rehmannia root (jio), and deer antler (rokujo) are permitted to be included only in medicines.

Which of the following statements about the basic concept of kampo formula preparations is correct?

1. A kampo formula should be understood as a combination in which the pharmacological actions of its individual constituent crude drugs are added together.
2. If a kampo formula that does not match the patient's sho (pattern/constitution) is selected, not only is the effect not obtained, but a side effect also becomes more likely.
3. Kampo medicines are invariably mild in action, and a serious side effect never occurs.
4. Medicines based on traditional Chinese medicine as currently practiced in mainland China (zhongyao) are included among kampo medicines, in the same way as Korean traditional medicines (hanbang).

Which of the following statements about the "shibari" (usage restriction wording) noted in the efficacy/effect statements of over-the-counter kampo formulas is correct?

1. For a formula suited to an excess (jitsu) pattern, the sho is expressed as "with weak physical strength."
2. A formula suited to a "yin" pattern is expressed with heat symptoms such as "prone to flushing, with a red complexion."
3. The specialized kampo term "sho" is used as-is in the efficacy/effect statements of over-the-counter kampo formulas.
4. For a formula widely used regardless of excess or deficiency pattern, the wording used is "regardless of physical strength."

Which of the following statements about the use of kampo formula preparations is incorrect?

1. For some kampo formula preparations, taking them can rarely cause symptoms to worsen.
2. When no lower age limit is set in the dosage and administration, the preparation can be used even on an infant under three months of age.
3. Many kampo formula preparations are focused mainly on improving the constitution underlying the symptoms, and are sometimes taken continuously for a relatively long period (about one month).
4. Use of a kampo formula preparation not suited to the patient's sho can also cause worsening of symptoms or a side effect.

Which of the following statements about interactions of kampo formula preparations and crude drug preparations is correct?

1. No interaction with a prescription medicine, such as that between Sho-saiko-to and an interferon preparation, is known.
2. If a crude drug ingredient is added on one's own judgment without proper basis, there is a risk that the balance of crude drugs will be disrupted and the formula will no longer function as intended.
3. Even when kampo formula preparations containing the same crude drug are used together, their action never becomes stronger and a side effect never becomes more likely.
4. A crude drug ingredient is never distributed as a food item (such as an herb).

Which of the following statements about boufuutsushousan (防風通聖散, bofu-tsusho-san) is incorrect?

1. It is known that, rarely, serious side effects such as liver dysfunction, interstitial pneumonia, pseudoaldosteronism, and mesenteric phlebosclerosis can occur.
2. It is a kampo formula preparation that contains licorice root (甘草, kanzo), ephedra (麻黄, mao), and rhubarb root (大黄, daio) as constituent crude drugs.
3. It is considered suited to a person with robust physical strength, much subcutaneous fat in the abdomen, and a tendency toward constipation, who has palpitations, stiff shoulders, flushing, swelling, or constipation associated with high blood pressure or obesity, or obesity itself.
4. It has an indication for use in children and can be used together with another laxative.

Which of the following statements about daisaikoto (大柴胡湯, dai-saiko-to) is correct?

1. It is considered suited to a person with robust physical strength, discomfort from the flank to the pit of the stomach, and a tendency toward constipation, who has gastritis, habitual constipation, or stiff shoulders, headache, or constipation associated with high blood pressure or obesity.
2. It is a kampo formula preparation that contains ephedra (麻黄, mao) as a constituent crude drug.
3. It is considered suited to a person with weak physical strength, low energy, weakened digestive function, and a tendency to tire easily, who has a weak constitution, fatigue, debility after illness or surgery, poor appetite, or night sweats.
4. When used for habitual constipation, if no improvement in symptoms is seen after about a week of use, it should nonetheless be continued indefinitely for three months.

Which of the following statements about boiogito (防已黄耆湯, boi-ogi-to) is correct?

1. It is considered suited to a person with robust physical strength, much subcutaneous fat in the abdomen, and a tendency toward constipation, who has palpitations, stiff shoulders, flushing, swelling, constipation, or obesity associated with high blood pressure or obesity.
2. No serious side effect is known, and it never causes liver dysfunction or interstitial pneumonia.
3. It is considered suited to a person of medium build or weaker, who tires easily and tends to sweat readily, who has joint swelling or pain, swelling, excessive sweating, or obesity (so-called "water-type" obesity) associated with obesity.
4. It is a kampo formula preparation that contains rhubarb root (大黄, daio) as a constituent crude drug and is used for a person with a tendency toward constipation.

According to the Guide, which of the following kampo formula preparations is said to contain all three of licorice root (甘草, kanzo), ephedra (麻黄, mao), and rhubarb root (大黄, daio) as constituent crude drugs?

1. Boiogito (防已黄耆湯, boi-ogi-to)
2. Orengedokuto (黄連解毒湯, oren-gedoku-to)
3. Boufuutsushousan (防風通聖散, bofu-tsusho-san)
4. Daisaikoto (大柴胡湯, dai-saiko-to)

Which of the following statements about seijoubofuto (清上防風湯, seijo-bofu-to) is incorrect?

1. It contains licorice root (甘草, kanzo) as a constituent crude drug.
2. It is considered suited to a person of medium build or stronger, with a ruddy complexion and sometimes flushing, who has acne, eczema/dermatitis of the face or scalp, or rosacea (red nose).
3. It is known that, rarely, serious side effects such as liver dysfunction, pseudoaldosteronism, and mesenteric phlebosclerosis can occur.
4. It is considered most suitable for a person with weak digestion.

Which of the following statements about orengedokuto (黄連解毒湯, oren-gedoku-to) is correct?

1. It is considered suited to a person of medium build or weaker, who tires easily and tends to sweat readily, who has joint swelling or pain, swelling, excessive sweating, or obesity (so-called "water-type" obesity) associated with obesity.
2. When used for nosebleeds or hangover, even if no improvement in symptoms is seen after five to six uses, it should nonetheless be continued indefinitely for one month.
3. It is considered most suitable for a person with a weak constitution (a person whose physical strength has declined, or who has a weak body).
4. It is considered suited to a person of medium build or stronger, prone to flushing with a red complexion, who tends to be irritable and restless, who has nosebleeds, insomnia, or hangover, among other conditions.

Which of the following statements about a false negative in an over-the-counter test kit is correct?

1. A "false negative" refers to a case in which, even though the target substance is present in the specimen, the test result is negative because its concentration is below the detection sensitivity, or because of interference from another substance affecting the detection reaction.
2. The minimum concentration needed for the detection reaction to occur is called a "false negative," distinguished from the detection sensitivity.
3. A "false negative" refers to a case in which, even though the target substance is not present in the specimen, interference from another substance affecting the detection reaction causes a non-specific reaction with an unrelated substance, and the test result is positive.
4. If a test kit is used properly as directed in the package insert, false negatives and false positives can be completely eliminated, so a misjudgment never occurs.

Which of the following statements about the detection sensitivity and false positives of an over-the-counter test kit is correct?

1. An over-the-counter test kit is considered usable even for diagnosing a serious disease such as a malignant tumor, myocardial infarction, or a hereditary disease, and such uses are not excluded from its scope.
2. A "false positive" refers to a case in which the test result is negative because the concentration of the target substance in the specimen is below the detection sensitivity.
3. A "false positive" refers to a case in which, even though the target substance is not present in the specimen, a non-specific reaction occurs with an unrelated substance, causing the test result to be positive.
4. Even if a test kit is left in a place that becomes hot, or stored in a refrigerator, its designed detection sensitivity is never affected, and it can always give an accurate result.

Which of the following statements about the timing of urine collection for a urine glucose/urine protein test kit is correct?

1. For a urine glucose test, first-morning urine (urine immediately upon waking) is in principle used as the specimen, and urine after a meal is not used.
2. For a urine protein test, first-morning urine (urine immediately upon waking) is in principle used as the specimen, and collection right after strenuous exercise should be avoided.
3. If glucose is detected in a combined urine glucose/urine protein test, the presence or absence of disease can be judged from that result alone, without retesting.
4. It is desirable to collect the urine specimen right after strenuous exercise.

Which of the following statements about the method of collecting urine for a urine glucose/urine protein test kit is correct?

1. Because the initial stream of urine may have bacteria or secretions adhering to the urethra or external genitalia mixed in, it is desirable to collect and test midstream urine.
2. Because it can wash away bacteria and secretions adhering to the urethra or external genitalia, it is desirable to collect and test the initial stream of urine rather than midstream urine.
3. Soaking the test kit in the urine for a long time gives a more accurate test result.
4. It is desirable to let the collected urine sit for about half a day before testing, to suppress bacterial growth, and there is no need to test immediately after collection.

Which of the following statements about the timing of testing with a pregnancy test kit is correct?

1. A typical pregnancy test kit recommends testing from about one week after the expected date of menstruation onward.
2. A pregnancy test kit's result can be used immediately as a definitive diagnosis of pregnancy.
3. A typical pregnancy test kit recommends testing from one week before the expected date of menstruation.
4. Even if the test is performed earlier than the recommended time, a negative result can be taken as definitive proof of not being pregnant.

Which of the following statements about factors that affect the result of a pregnancy test kit is incorrect?

1. In a person using a hormone preparation such as an oral contraceptive or a medicine for menopausal disorders, urinary hCG can be detected even when the person is not pregnant.
2. A pregnancy test kit typically sets its detection sensitivity at the urinary hCG concentration around the fourth week after conception has actually occurred.
3. First-morning urine (urine immediately upon waking) is suitable as the specimen, but if the urine is too concentrated, an accurate result may not be obtained.
4. The room temperature of the location where the test is performed never affects the test result.

Which of the following statements about first-aid measures when a disinfectant has been accidentally swallowed is correct?

1. Once first aid has been given, there is no need to visit a medical institution.
2. If undiluted or concentrated liquid has been accidentally swallowed, the person should be made to vomit it up immediately.
3. Milk or the like is normally given, but if nothing is on hand, water is given first.
4. To delay absorption of the toxic substance, milk or the like is given several hours after the accidental ingestion.

Which of the following statements about first-aid measures when a disinfectant has accidentally gotten into the eyes is correct?

1. When an alkaline substance gets into the eyes, since it causes little irritation and little effect on tissue, a brief rinse with water is sufficient.
2. Turn the face to the side and let water flow from above, or, if using tap water, rinse with a weak stream of water, and thoroughly rinse the eye with running water (for 15 minutes or more).
3. When an acid gets into the eyes, it is appropriate to neutralize it with an alkali before rinsing with water.
4. When rinsing the eye, it is considered desirable to use as strong a stream of water as possible, so as to quickly wash away the contaminant that adhered.

Which of the following statements about organophosphate insecticidal ingredients is correct?

1. Because their toxicity to mammals is extremely high and they are not rapidly broken down and excreted in the body, they are no longer used today.
2. Their insecticidal action results from irreversibly binding to the enzyme that breaks down acetylcholine (acetylcholinesterase) and inhibiting its action.
3. Their insecticidal action does not involve binding to acetylcholinesterase, but instead results from acting directly on nerve cells to inhibit nerve transmission.
4. Their insecticidal action results from inhibiting the molting or metamorphosis of insects.

Which of the following statements about the mechanism of action, among other things, of insecticidal ingredients is incorrect?

1. Phenothrin is the only insecticidal ingredient applied directly to the human body (in a product intended to eliminate lice).
2. The insecticidal action of pyrethroid insecticidal ingredients results from acting directly on nerve cells to inhibit nerve transmission.
3. Pyrethroid insecticidal ingredients are ingredients developed from a component of pyrethrum, and are considered to be characterized by relatively rapid natural decomposition and low residual effect.
4. Carbamate insecticidal ingredients, like organophosphate insecticidal ingredients, irreversibly bind to acetylcholinesterase and inhibit its action.