Question 1

A 60-year-old woman presents with a 7-day history of bloody diarrhea and diffuse mild abdominal tenderness. Stool tests (culture, ova/parasites) are negative. Which one of the following is the best next step?

Options :

A : Prescribe broad-spectrum antibiotics.

B : Order a diagnostic colonoscopy.

C : Recommend symptomatic observation.

D : Recommend a trial of loperamide.

E : Prescribe tapered-dose steroids.

Answer: B

Question 2

During an office visit, your 14-year-old patient requests a prescription for oral contraceptives. The province where you are working does not have a statutory age of consent. Which one of the following is the best next step?

Options :

A : Notify child protective services because of the possibility of sexual abuse.

B : Give her the prescription and book a follow-up appointment.

C : Advise her to return with her parents so that legal consent can be obtained.

D : Determine her understanding of the medical issues before prescribing the pills.

E : Refuse to prescribe the pills because she is less than 18 years of age.

Answer: D

Question 3

A 37-year-old man comes to the office for follow-up of his opioid use disorder. He receives opioid agonist treatment, including some take-home doses. At this follow-up visit, he reports some nonprescription opioid use since his last visit. Which one of the following is the best next step?

Options :

A : Taper the dosage of the opioid agonist

B : Discontinue take-home doses

C : Increase the frequency of follow-up visits

D : Prescribe a cannabinoid

E : Slowly taper and discontinue the opioid agonist

Answer: C

Question 4

There are many expenses which are considered part of providing care to patients. Under Canadian legislation, which one of the following is an acceptable means of covering these costs?

Options :

A : Collecting annual fees from patients to supplement fees disbursed by the public payer for insured services.

B : Collecting fees from patients for home visits.

C : Collecting fees from patients for uninsured services provided.

D : Offering rapid access to insured services for a fee.

E : Collecting fees from patients who are seen after hours.

Answer: C

Question 5

A 25-year-old woman presents to the Emergency Department with a 4-hour history of severe left flank pain.Her vital signs are as follows:Heart rate: 94/minBlood pressure: 130/80 mm HgTemperature: 37.3 °CA non-contrast computed tomography shows a 6 mm stone in the distal left ureter with mild associatedhydronephrosis. In addition to appropriate analgesia, which one of the following is the best next step?

Options :

A : Provide reassurance

B : Prescribe antibiotics

C : Administer an alpha blocker

D : Refer for urology consultation

E : Increase intravenous fluids

Answer: C

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