問題解説・システム開発 : 内科医 米澤昌紘（れく）
観光旅行中に倒れたという外国人女性が救急車で搬入された。大きく呼びかける とかすかに目を開くが意思の疎通は取れない。同行の友人によると持病があるとの ことで、女性のかかりつけ医から預かった手紙を差し出した。
To whom it may concern:
This is to inform you that Ms. ■■(Birth Date 3/14/1998 )has 21-hydroxylase deficiency. Her condition has been well-controlled with 9 alpha-fludrocortisone and hydrocortisone. Although she does not experience any problems during her daily activities, there isasmall but certain possibility that she falls intoastate of adrenal failure, especially if she is confronted with severe stress on her week-long trip to Japan.
If she complains of severe fatigue, fever, anorexia, or is found unconscious, please give her intravenous hydrocortisone and sodium-containing fluid, and contact an endocrinologist immediately.
Thank you for your cooperation.
■■, M.D.
■■Clinic
まず行うべき処置はどれか。
a. 副腎皮質ステロイドの静注と乳酸リンゲル液の点滴静注
b. 副腎皮質ステロイドの静注と5%ブドウ糖液の点滴静注
c. 20%ブドウ糖液の静注と5%ブドウ糖液の点滴静注
d. アドレナリンの皮下注と生理食塩液の点滴静注
e. アドレナリンの筋注と生理食塩液の点滴静注