Question 1

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 2

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/min

Blood pressure: 130/80 mm Hg

Temperature: 37.3 °C

A non-contrast computed tomography shows a 6 mm stone in the distal left ureter with mild associated

hydronephrosis. 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

Question 3

A 43-year-old man comes to your office for the first time. He has not seen a doctor in over 5 years and has no known past medical history. On examination, his blood pressure is 120/70 mm Hg, and the remainder of his examination is normal. As part of the initial visit, you order some screening blood work that reveals a fasting blood glucose of 6.3 mmol/L (3.3–5.8) and a hemoglobin A1c of 6.1% (4–6). Which one of the following is the best next step?

Options :

A : Order thyrotroph (thyroid-stimulating hormone) level.

B : Test capillary blood glucose 4 times a day.

C : Order a urine albumin:creatinine ratio.

D : Perform a 75 g oral glucose tolerance test.

E : Order an exercise stress test.

Answer: D

Question 4

A 30-year-old woman presents to the office with her partner and reports that they are planning for her to conceive soon. They visited Mexico recently and are concerned about exposure to the Zika virus. Which one of the following is the best next step?

Options :

A : Refer the couple to an infectious disease specialist

B : Request serologic testing

C : Recommend ceasing conception until 3 months after the couple's return to Canada

D : Explain that condoms are ineffective in preventing sexual transmission of Zika virus

E : Prescribe a prophylactic antiviral medication

Answer: C

Question 5

A 26-year-old man presents with pain, numbness, and weakness in his right upper extremity. He works as a computer programmer, and his BMI is 32. Symptoms have worsened since he started spending more time on the keyboard. He reports that his right hand feels clumsier while he is typing. Physical examination reveals mild weakness in the intrinsic muscles of that hand, with a positive Tinel sign at the ulnar nerve. Which one of the following is the best next step?

Options :

A : Wrist splint to test for carpal tunnel.

B : Physiotherapy.

C : Elbow extension brace for use during sleep.

D : Magnetic resonance imaging of the cervical spine.

E : Nerve conduction studies to localize the level of the lesion.

Answer: E

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