SARS-CoV-2 Vaccination and Disorders of Menstruation
There is an association between first-time SARS-CoV-2 vaccination and an increased risk of disorders of menstruation.
- True
- False
Allergy and Immunology
Peanut Allergy
The incidence of peanut allergy has declined following the publication of guidelines recommending early introduction in infants.
- True
- False
Volume 41.4 - Question 1
Chronic Spontaneous Urticaria
You are seeing a 26-year-old female-identifying patient in the office who has been previously diagnosed with chronic spontaneous urticaria (CSU). They are struggling with frequent appearance of wheals and would like to discuss treatment options. A stepwise approach to CSU management is recommended, beginning with the identification and elimination of potential underlying causes and triggers.
Volume 41.1 - Question 38
Managing Angioedema
Which one of the following statements regarding angioedema is false?
- Histamine-mediated angioedema is the most common form.
- Most patients with hereditary angioedema experience their first episode within the second decade of life.
- In patients requiring an emergent airway intervention, surgical airway intervention is common.
- Tranexamic acid has no role in treatment.
Volume 41.1 - Question 16
Penicillin Allergy
In low-risk patients, an oral challenge can safely be used to remove an incorrect label of penicillin allergy.
- True
- False
Volume 40.6 - Question 14
Diagnosis and Management of Eosinophilic Esophagitis
Your patient, a 42 year-old male, presented in the clinic with recurrent difficulty swallowing. IMPACT behaviors can help to identify dysphagia.
Volume 40.5 - Question 35
Reaction Risk to Direct Penicillin Challenges
A 23-year-old male suffers frequently from tonsillitis. You recall that his chart states that he is allergic to penicillin. This is based on what he heard from his mom: when he was around 6 years old, he developed a rash after taking amoxicillin for tonsillitis.
Volume 40.4 - Question 37
Chronic Urticaria
A 34-year-old patient presents to your office with a 3 month history of “hives”. There is a history of asthma but there are otherwise no medical concerns. After examination you diagnose chronic urticaria.
Volume 40.21 - Question 16
Food Allergies
A 30-year-old mother is at your office today because she suspects her 4 year-old daughter has food allergies. Her daughter experiences wheezing, diarrhea, and hives when she eats shellfish.
Volume 40.21 - Question 9
Food Allergy
You are seeing a 21-year-old patient with known peanut and shellfish allergy. Up until this age, they have strictly avoided food triggers, though unfortunately they have required the use of epinephrine via autoinjector a couple of times. They are seeing you today as they have heard there may be other treatment options available for their food allergies.
Volume 40.21 - Question 8
Chronic Urticaria
A 34-year-old patient presents to your office with a 3 month history of “hives”. There is a history of asthma but there are otherwise no medical concerns. After examination you diagnose chronic urticaria.
Volume 40.2 - Question 40
Food Allergy
You are seeing a 21-year-old patient with known peanut and shellfish allergy. Up until this age, they have strictly avoided food triggers, though unfortunately they have required the use of epinephrine via autoinjector a couple of times. They are seeing you today as they have heard there may be other treatment options available for their food allergies.
Volume 40.1 - Question 39
Omalizumab for the Treatment of Food Allergies
In persons as young as 1 year of age with multiple food allergies, omalizumab treatment for 16 weeks was superior to placebo in increasing the reaction threshold for peanut and other common food allergens.
- True
- False
Volume 39.6 - Question 11
Vaccination in Patients with Egg Allergy
Which one of the following statements regarding vaccinating patients with a history of egg allergy is false?
- Measles, mumps and rubella vaccine can be administered in a routine manner.
- Yellow-fever vaccine may be administered without any additional evaluation.
- Influenza vaccine may be administered regardless of the severity of the patient’s previous reaction to egg.
- For, rabies vaccination, inactivated human diploid vaccine is preferred.
Volume 39.6 - Question 9
Occupational Dermatitis
Which one of the following statements about occupational dermatitis is false?
- Up to 1/3 of health care workers develop occupational dermatitis.
- Hypoallergenic gloves are rubber accelerator-free.
- Allergies to metals such as chromium and cobalt contribute to dermatitis in certain industries such as construction.
- Fragrances and hair dyes are common causes.
Volume 39.4 - Question 21
Eosinophilic Esophagitis
Which one of the following statements about eosinophilic esophagitis is false?
- Females are 3–4 times more likely than males to develop the condition.
- Patients often present initially with a food bolus obstruction in the esophagus.
- Topical corticosteroids are an effective treatment.
- Elimination of cows’ milk compared to a 6-food elimination diet shows similar symptom remission.
Volume 39.4 - Question 20
DRESS Syndrome
A 54-year-old female presents to your rural emergency department with a complaint of a new rash. She has a history of gout and has been started on allopurinol over the last few months. She has a diffuse morbiliform rash, is febrile, and is found to have elevated LFTs and eosinophils. You suspect drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome.
Volume 38.21 - Question 18
Paxlovid
Which one of the following statements about Paxlovid for treatment of COVID-19 infection is false?
- It can reduce rate of hospitalization.
- It can reduce the rate of death.
- It is contraindicated for use with drugs that are highly dependent on CYP3A for clearance.
- It can be started after 5 days of symptom onset.
Volume 38.21 - Question 7
Tdap in Pregnancy
Which one of the following statements is true regarding tetanus, diphtheria, and acellular pertussis (Tdap) vaccination during pregnancy?
- Maternal vaccination with Tdap does not affect the incidence of pertussis in infants.
- The National Advisory Committee on Immunization recommends that Tdap be administered in every pregnancy in Canada, regardless of preconception vaccination status.
- The majority of pregnant patients receive Tdap vaccination during their pregnancy.
- The primary reason for pregnant patients’ nonvaccination is not wanting to be vaccinated during pregnancy.
Volume 38.21 - Question 2
Vaccine hesitancy
In strongly vaccine-hesitant adults, provision of information on collective benefits reduces hesitancy to a greater extent than information on personal benefit.
- True
- False
Volume 37.3 - Question 11
Pediatric Allergy Prevention
For infants at high risk of developing food allergies whose mothers cannot or choose not to breastfeed, hydrolyzed formulas are recommended to prevent food allergies.
- True
- False
Volume 37.3 - Question 7
Paxlovid
Which one of the following statements about Paxlovid for treatment of COVID-19 infection is false?
- It can reduce rate of hospitalization.
- It can reduce the rate of death.
- It is contraindicated for use with drugs that are highly dependent on CYP3A for clearance.
- It can be started after 5 days of symptom onset.
Volume 37.3 - Question 1
COVID-19 Vaccine for Adolescents
The risk of syncope is higher in adolescents than in adults following COVID-19 vaccination.
- True
- False
Volume 36.6 - Question 14
Allergic Conjunctivitis
Which one of the following statements about allergic conjunctivitis is false?
- Ophthalmic H1-antihistamines are at least as effective as oral second-generation H1 -antihistamines for treatment of ocular itching.
- Topical ketorolac is less effective in relieving ocular symptoms than an ophthalmic H1-antihistamine.
- Ophthalmic corticosteroids can be considered for use in patients that fails to respond to other drugs.
- Most ophthalmic products used in the treatment of allergic conjunctivitis contain the preservative benzalkonium chloride, which does not cause stinging.
Volume 36.6 - Question 13
Meningococcal Vaccine
MenQuadfi is the only vaccine available in Canada for use in persons ≥ 56 years old for the prevention of invasive meningococcal disease caused by Neisseria meningitides serogroups A, C, W, and Y.
- True
- False
Volume 36.6 - Question 12
The Treatment of Allergic Rhinitis
Which one of the following statements about the treatment of allergic rhinitis is false?
- Intranasal H1-antihistamines have a more rapid onset of action than oral H1-antihistamines.
- Intranasal H1-antihistamines are at least as effective as oral H1-antihistamines.
- An intranasal fixed -dose combination of azelastine (an H1-antihistamine) and fluticasone propionate has improved symptoms more than either drug alone in patients with seasonal allergic rhinitis.
- Cetirizine does not cause sedation in recommended doses.
Volume 36.5 - Question 12
Hereditary Angioedema
Which one of the following statements about hereditary angioedema is false?
- It is mediated by bradykinins.
- Urticaria is generally absent.
- It does not respond to antihistamines.
- It responds to corticosteroids.
Volume 36.4 - Question 13
Cytokine Storm
Which one of the following statements about cytokine storm is false?
- Nearly all patients are febrile.
- Neurologic toxic effects occur early.
- Many patients have hypertriglyceridemia.
- Patients can develop a stress-related or takosubo-like cardiomyopathy.
Volume 36.3 - Question 19
DRESS Syndrome
A 54-year-old female presents to your rural emergency department with a complaint of a new rash. She has a history of gout and has been started on allopurinol over the last few months. She has a diffuse morbiliform rash, is febrile, and is found to have elevated LFTs and eosinophils. You suspect drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome.
Volume 38.1 - Question 37
Monkeypox
Post-exposure prophylaxis with monkeypox vaccination for recently exposed persons is recommended.
- True
- False
Volume 38.2 - Question 27
Antihistamines for Allergic Rhinosinusitis
In the treatment of allergic rhinosinusitis, oral antihistamines combined with intranasal corticosteroids provide better symptom relief than intranasal corticosteroids alone.
- True
- False
Volume 38.1 - Question 11
Chronic Urticaria
Which one of the following statements about chronic urticaria is false?
- Most affected patients are men.
- There is usually no identifiable cause.
- A history of nonblanching lesions persisting for more than 24 hours that leave a residual bruise, suggests the alternative diagnosis of cutaneous vasculitis.
- Up to 30% of patients have cutaneous exacerbations provoked by the use of NSAIDS.
Volume 38.1 - Question 10
Tdap in Pregnancy
Which one of the following statements is true regarding tetanus, diphtheria, and acellular pertussis (Tdap) vaccination during pregnancy?
- Maternal vaccination with Tdap does not affect the incidence of pertussis in infants.
- The National Advisory Committee on Immunization recommends that Tdap be administered in every pregnancy in Canada.
- The majority of pregnant patients receive Tdap vaccination during their pregnancy.
- The primary reason for pregnant patients’ nonvaccination is not wanting to be vaccinated during pregnancy.
Volume 38.1 - Question 2
Angioedema and Predictors of Endotracheal Intubation
In a patient presenting to the emergency room with angioedema, a prior history of hypertension is predictive of the need for intubation.
- True
- False
Volume 38.4 - Question 14
Long COVID Diagnosis
Autonomic dysfunction (dysautonomia) such as postural orthostatic tachycardia syndrome commonly occurs in long COVID.
- True
- False
Volume 38.4 - Question 12
Food Allergies
A 30-year-old mother is at your office today because she suspects her 4 year-old daughter has food allergies. Her daughter experiences wheezing, diarrhea, and hives when she eats shellfish.
Volume 39.2 - Question 43
Allergic Rhinitis
Which one of the following statements about allergic rhinitis is false?
- If allergy testing is needed, skin testing should be performed instead of blood serum testing.
- Children who were breastfed as infants do not have lower rates (at age 6) of allergic rhinitis than those who were not breastfed.
- Intranasal corticosteroids are first-line treatment for allergic rhinitis.
- High-efficiency particulate air filters are effective at decreasing symptoms.
Volume 39.2 - Question 19
Peanut Allergy Desensitization
Peanut oral immunotherapy should be considered a treatment option for infants age less than 12 months with peanut allergies.
- True
- False
Volume 39.1 - Question 10
Vaccines for Prevention of RSV Disease
Vaccination for prevention of respiratory syncytial virus (RSV) reduces the incidence of RSV-associated lower respiratory tract disease in adults ≥ 60 years old.
- True
- False
Volume 39.1 - Question 7
Allergic Rhinitis
A 23-year-old mother of a newborn baby, is at your office today because she has been experiencing nasal congestion, runny nose, itchy nose, and sneezing for the past few weeks. She does not have a cold or the flu or COVID-19 infection. Her twin sister has a history of allergic rhinitis, asthma, and atopic dermatitis. Your patient has been diagnosed with asthma and atopic dermatitis in the past. You suspect that she has allergic rhinitis.
Volume 38.5 - Question 43
RSV Vaccination in Pregnancy
Which one of the following statements about vaccination in pregnancy to prevent respiratory syncytial virus (RSV) illness in infants is false?
- There is an increased risk of spontaneous abortion in subsequent pregnancies in vaccinated women.
- Serious adverse events are rare in the newborns of vaccinated women.
- It reduces the incidence of severe RSV-associated lower respiratory tract illness in infants within 90 days after birth.
- It is a single dose vaccine.