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Cannabis and Psychosis

Which one of the following is not a risk factor for developing psychosis associated with cannabis use?

  • Use of high potency tetrahydrocannabinol (a product with > 10% THC)
  • Frequent use
  • Female sex
  • History of a mental disorder (e.g., bipolar disorder, depression, anxiety)
Volume 41.1 - Question 15

Treatment of Early Syphilis

Persons with early syphilis, including persons with HIV infection, can be effectively treated on a single occasion with benzathine penicillin G administered in a single dose of 2.4 million units.

  • True
  • False
Volume 41.1 - Question 1

Silence in Serious Illness Conversations

When leading serious illness conversations, silence is a crucial element of the dialogue and should be utilized intentionally to convey empathy, affirmation, respect, and safety. Which one of the following statements about silence is false?

  • It can serve as a pause to slow down the pace of a serious illness conversation.
  • It allows patients and caregivers to process clinical information before moving ahead in discussions.
  • It allows patients and caregivers time to elaborate on their thoughts or perform further introspection.
  • It is not associated with improved patient-reported quality-of-life.
Volume 40.5 - Question 34

Propranolol in Anxiety

There is good evidence for the treatment of anxiety using propranolol.

  • True
  • False
Volume 40.3 - Question 20

Surgical Care for People Experiencing Homelessness

Of the few people experiencing homelessness who presented with early stage lung cancer, most (80%) received curative surgery and all completed follow up with no recurrences or deaths.     

  • True
  • False
Volume 39.5 - Question 28

Travel Medicine

For otherwise healthy airplane passengers at increased risk for deep venous thrombosis, which one of the following preventive measures is evidence-based?

  • Premium class seating
  • Graduated compression stockings
  • Aspirin
  • Low-molecular-weight heparin
Volume 35.61 - Question 1

Rotator Cuff Disorders

In patients with rotator cuff disorders, supervised progressive exercise is superior to a single best practice physiotherapy advice session in improving shoulder pain and function after 12 months. 

  • True
  • False
Volume 37.3 - Question 31

PoCUS & Pleural Effusion Detection

Point of care ultrasound assessment is more accurate than comprehensive physical examination in the detection of pleural effusions.

  • True
  • False
Volume 37.3 - Question 18

Waning immunity after 2 doses of Covid-19 Vaccination

In adults having received two doses of the BNT162b2 mRNA vaccine (Pfizer-BioNTech) Covid-19 vaccine, there is a gradual increase in the risk of infection over time seen in those having received their second dose at least 90 days earlier.

  • True
  • False
Volume 37.3 - Question 12

Physiotherapy for Sciatica

Early physical therapy for recent-onset sciatica improves disability scores compared with usual care without physiotherapy. 

  • True
  • False
Volume 36.6 - Question 39

FM/a Test and Fibromyalgia

Which one of the following statements about the use of FM/a test for the diagnosis of fibromyalgia is false?  

  • It is a cytokine assay of in-vitro stimulated peripheral blood mono-nuclear cells   
  • Patients must stop taking any medications that may alter their immune system for 14 days before the test   
  • The false-positive rate of the test is higher in patients with rheumatoid arthritis    
  • Studies have shown that it improves patient outcomes 
Volume 36.6 - Question 38

A Psychological Intervention for Chronic Pain

In patients with chronic pain, a brief psychological intervention delivered by psychologists within a primary care setting improves pain severity compared to treatment as usual. 

  • True
  • False
Volume 36.6 - Question 11

Chronic Back Pain

Which one of the following interventions in adults with chronic low back pain has demonstrated sustained benefit after the intervention has ended?  

  • Corticosteroid injections   
  • Exercise   
  • Acupuncture   
  • Spinal manipulation therapy 
Volume 36.5 - Question 36

mRNA Vaccine Allergy

Which one of the following statements about allergic reaction to mRNA vaccine is false? 

  • Most anaphylactic reactions occur in persons with a previous history of anaphylaxis.     
  • Acute allergic reactions occur in about 2% of recipients.   
  • Acute anaphylactic reactions occur in about 2 in 10,000 recipients.   
  • The mean time to anaphylaxis onset is 17 minutes. 
Volume 36.5 - Question 13

Psilocybin vs. escitalopram for depression

Over a 6-week period, psilocybin results in significantly better self-reported depression scores in patients with long standing moderate to severe depression as compared to escitalopram therapy.    

  • True
  • False
Volume 36.5 - Question 11

PoCUS vs Landmarks for Arthrocentesis

Ultrasound guidance improves overall successful arthrocentesis of medium sized joint effusions (elbow, wrist or ankle).

  • True
  • False
Volume 37.6 - Question 19

Oral Minoxidil for Androgenetic Alopecia

Which one of the following statements about the use of oral minoxidil for androgenetic alopecia is false? 

  • It increases hair growth.   
  • It Increases hair thickness.   
  • It increases blood pressure.   
  • It can cause pedal edema. 
Volume 36.4 - Question 43

Nephrology Dapagliflozin and Chronic Kidney Disease

Among patients with chronic kidney disease, regardless of the presence or absence of diabetes, the risk of a composite of a sustained decline in the estimated GFR of at least 50%, end-stage kidney disease, or death from renal or cardiovascular causes is significantly lower with dapagliflozin than with placebo. 

  • True
  • False
Volume 36.4 - Question 35

Claudication and Hydration

In patients with disabling claudication and rest pain caused by peripheral vascular disease without a history of congestive heart failure or renal insufficiency, deliberate consumption of a minimum of 2.5 L of fluids per day is associated with increased treadmill endurance. 

  • True
  • False
Volume 36.4 - Question 31

Therapeutic Suggestions During General Anaesthesia

Therapeutic suggestions played through earphones during general anaesthesia may provide a technique to reduce postoperative pain and opioid use. 

  • True
  • False
Volume 36.4 - Question 20

Spinal Cord Stimulation

Spinal cord stimulation has been found to be an effective treatment for chronic neuropathic pain. 

  • True
  • False
Volume 36.3 - Question 40

Short-term Systemic Corticosteroids

Which one of the following conditions has evidence to support the use of systemic corticosteroids in its management?    

  • Acute pharyngitis    
  • Acute gout   
  • Lumbar radiculopathy    
  • Herpes zoster 
Volume 36.3 - Question 36

Acute Liver Failure

N-acetylcysteine improves overall survival in the treatment of non-acetaminophen-related acute liver injury. 

  • True
  • False
Volume 36.3 - Question 33

HPV Screening

Offering non-speculum clinician-taken HPV (human papillomavirus) sampling and self-sampling substantially increases uptake in lapsed attendee women aged 50-64.

  • True
  • False
Volume 37.6 - Question 14

Bedbugs

Which one of the following statements about bedbugs is false? 

  • Bedbug bites are painless.   
  • Attractant-based bedbug traps may be useful for detecting low-level infestations.   
  • Placing textile materials in most domestic-level freezers generally kills all bedbugs.   
  • Bedbugs are largely resistant to conventional insecticides. 
Volume 36.2 - Question 3

Obesity in Adults

Which one of the following statements about obesity in adults is false? 

  • The prevalence of obesity in Canada has increased threefold since 1985. 
  • The weight loss achieved with health behavioural changes is usually 10% of body weight.   
  • Liraglutide 3.0 mg is an option for adjunctive pharmacotherapy for weight loss.   
  • Bariatric surgery many be considered for people with BMI > 35kg/m2 with at least one obesity-related complication. 
Volume 36.2 - Question 2

IgA Vasculitis

Which one of the following statements about IgA Vasculitis is false? 

  • Most cases occur in children younger than ten years old.  
  • Gastro-intestinal bleeding can occur in approximately one third of patients.
  • Renal disease occurs in about half of patients.  
  • The associated arthritis causes joint damage.
Volume 36.1 - Question 36

Trigger Finger

Which one of the following statements about trigger finger is false?

  • It most frequently affects the ring finger.
  • Corticosteroid and lidocaine is associated with a higher rate of symptom resolution or significant relief compared with lidocaine alone.
  • Most patients relapse after steroid injection.
  • Compared with steroid injection, open surgical release is associated with improved symptom resolution at 6-12 months.
Volume 38.2 - Question 20

Management of Hyponatremia

Which one of the following statements about the management of hyponatremia is false?

  • Increasing daily protein intake to 1 g/kg improves hyponatremia in patients with Syndrome of inappropriate antidiuresis (SIAD).
  • Normalization of the serum sodium level at day 30 occurs in a majority of patients with SIAD treated with tolvaptan.
  • Desmopressin can be used to avoid overly rapid correction.
  • In acute water intoxication there is a high risk of osmotic demyelination.
Volume 38.2 - Question 16

Early-Career vs. Older-Career Physicians

Early-career physicians in Canada offer less comprehensive services than older-career physicians.

  • True
  • False
Volume 38.6 - Question 41

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