Diagnostic - Imaging - Laboratory

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Foreign Body Ingestion in Children

In patients younger than 6 years, a coin is not likely to pass if it is the size of a quarter or larger.

  • True
  • False
Volume 41.5 - Question 8

Social Media Posts and Health Behaviour

Which one of the following statements with respect to posts relating to medical tests on social media platforms made by influencers is false?

  • The risk of overdiagnosis is mentioned in less than 10% of posts.
  • Posts that include evidence are less likely to mention test benefits.
  • Physicians are more likely to mention potential harms of tests than non-physicians.
  • Evidence is used in the majority of posts.
Volume 41.1 - Question 6

Computed Tomography in Children

In CT scans done for blunt abdominal trauma, over a third of children will have non-trauma related incidental findings noted.

  • True
  • False
Volume 40.6 - Question 2

Endometrial Thickening

Postmenopausal women without bleeding or risk factors do not require further investigations if they are found to have endometrial thickness < 11 mm on ultrasound.

  • True
  • False
Volume 40.3 - Question 14

Carpal Tunnel Syndrome

Which one of the following statements about carpal tunnel syndrome (CTS) is false?

  • Thenar atrophy has a very high specificity for CTS.
  • Phalen test and Tinel sign individually have high sensitivity and specificity.
  • Nerve conduction studies are normal in up to 15 to 25% of patients.
  • There is limited evidence for the use of ultrasonography for the diagnosis of CTS.
Volume 40.2 - Question 11

Lumbar Spinal Stenosis

Which one of the following statements about lumbar spinal stenosis is false?

  • Loss of balance associated with low back pain has a 70% sensitivity for lumbar spinal stenosis.
  • A wide-based gait with a positive Romberg sign has a 90% specificity for lumbar spinal stenosis.
  • Computed tomography myelography is recommended over MRI to provide diagnostic information for patients with lumbar spinal stenosis symptoms.
  • Symptoms are aggravated by walking and relieved by bending forward.
Volume 39.6 - Question 22

Childhood and Adolescent Sports-Related Overuse Injuries

A 14-year-old male who plays competitive baseball is at your office today because he is experiencing progressively worsening, diffuse, proximal shoulder pain with throwing that resolves with rest. He is one of the star pitchers on his team; however, he is reporting a decrease in his pitching velocity and accuracy. When you examine him, you notice that he has tenderness to palpation over the lateral aspect of the proximal humerus and deficits in shoulder flexion, external rotation, and internal rotation due to pain.  
Volume 39.5 - Question 44

Subarachnoid Haemorrhage

The use of non-contrast multislice CT alone is unable to rule out aneurysmal subarachnoid haemorrhage at 24 hours after headache onset.  

  • True
  • False
Volume 38.21 - Question 15

Rapid Diagnostic Testing (RDTs) for SARS-CoV-2

Which one of the following statements about rapid diagnostic testing (RDTs) for SARS-CoV-2 is false?

  • Nucleic acid amplification tests can remain positive for months after infection.  
  • Antigen-based RDTs can detect infection within 5 to 7 days after symptom onset.  
  • Home-based RDTs are just as accurate when performed by untrained persons.     
  • Testing is generally not useful in the first 48 hours after exposure.
Volume 38.21 - Question 4

Microscopic Hematuria

Which one of the following statements about microscopic hematuria is false?

  • A single urinalysis is sufficient for detection.
  • A workup should be performed for patients on anticoagulation.
  • Patients at high risk for bladder cancer should have cystoscopy.
  • Urine cytology should be included in the initial evaluation.
Volume 37.3 - Question 15

Adenomyosis

Which one of the following statements about adenomyosis is false?

  • Up to one-third of patients can be asymptomatic.
  • Less common symptoms include dyspareunia and chronic pelvic pain.
  • Dysmenorrhea occurs in most patients.
  • Diagnosis is based on clinical suspicion as well as imaging.
Volume 37.3 - Question 8

Cancer Diagnosis

Which one of the following statements about cancer diagnosis in primary care is false? 

  • Urgency has a higher positive predictive value for prostate cancer compared to hematuria.   
  • Cough has a lower positive predictive value for lung cancer compared to hemoptysis.   
  • For clinically low risk and asymptomatic prostate cancer, no staging investigations is required.   
  • Abdominal pain with repeat presentations has a lower positive predictive value for cancer than abdominal pain with one presentation. 
Volume 36.6 - Question 7

SAMP Ankylosing Spondyloarthropathy

A 37-year-old woman presents to your office after attending the ER with acute unilateral eye pain, redness, photophobia, and blurred vision. She was diagnosed with anterior uveitis. Screening blood tests included a positive HLA-B27.  
Volume 36.5 - Question 42

SAMP Cauda Equina Syndrome

A 42 year old woman presents to the ER with a five day history of low back pain with burning pain radiating into her right foot. She has a 12 year history of chronic low back pain with intermittent left sided “sciatica” pain in her thigh. She notes “tingling” in her genital area. There is no incontinence.   On examination, you find that her anal tone and perianal sensation are normal, as are power, tone, reflexes, and sensation in the legs. You recommend analgesics and advise her to seek review if she develops bilateral sciatica, becomes incontinent, or develops leg weakness.   Three days later, she returns with cauda equina syndrome (CES) and undergoes surgical decompression. She is left with lower limb weakness, numbness of the genitalia, loss of sexual function, and urinary and faecal incontinence. 
Volume 36.5 - Question 40

Temporal Arteritis

Which one of the following has the highest likelihood ratio of being associated with giant cell arteritis?

  • Limb claudication   
  • Jaw claudication   
  • Temporal artery loss of pulse   
  • Erythrocyte sedimentation rate greater than 100mm/hr 
Volume 36.4 - Question 27

Inguinal Hernias

The diagnosis of inguinal hernias in women often requires imaging. 

  • True
  • False
Volume 36.4 - Question 21

Pediatric Fractures & Ultrasound

Ultrasound has an excellent diagnostic accuracy for non-elbow upper extremity fractures in children:

  • True
  • False
Volume 37.1 - Question 17

Lung Cancer Screening

Annual low-dose CT screening has been recommended in adults 50 to 80 years of age who have a 20 pack-year smoking history.

  • True
  • False
Volume 37.6 - Question 6

Rapid diagnostic testing (RDTs) for SARS-CoV-2

Which one of the following statements about rapid diagnostic testing (RDTs) for SARS-CoV-2 is false?

  • Nucleic acid amplification tests can remain positive for months after infection.
  • Antigen-based RDTs can detect infection within 5 to 7 days after symptom onset.
  • Home-based RDTs are just as accurate when performed by untrained persons.
  • Testing is generally not useful in the first 48 hours after exposure.
Volume 37.4 - Question 1

Scrotal Masses

Your next patient is 28 years old and new to your family practice. He has no known medical problems and considers himself healthy. During your visit, he tells you that he is worried about a new scrotal mass.  
Volume 38.1 - Question 40

Early Point of Care Ultrasound for Flank Pain

In the assessment of a patient with undifferentiated acute flank pain, earlier use of Point of Care Ultrasound (PoCUS) is associated with a shorter length of stay in the acute care setting, without compromising diagnostic accuracy.  

  • True
  • False
Volume 38.1 - Question 16

Quick Point-of-Care Ultrasound for Hydronephrosis

In using point-of-care ultrasound to diagnose hydronephrosis, longitudinal views of the kidney show good sensitivity and specificity compared with a combination of longitudinal and transverse views

  • True
  • False
Volume 38.2 - Question 10

Subarachnoid Haemorrhage

The use of non-contrast multislice CT alone is unable to rule out aneurysmal subarachnoid haemorrhage at 24 hours after headache onset.  

  • True
  • False
Volume 38.1 - Question 3

Bronchiectasis

A 60-year-old female in your practice presents with a 9-month history of chronic cough and intermittent shortness of breath. She says the cough is sometimes wet and sometimes dry. She has a history of mild asthma. She has been using her puffers regularly but they don’t always work well. She hasn’t presented before this because she just assumed she was getting different viruses being around her grandchildren who are in daycare. She has not had any fever, chest pain or weight loss. Her only other known medical condition is well controlled rheumatoid arthritis. She is a non-smoker. You wonder if she could have bronchiectasis.
Volume 38.3 - Question 40

Infectious Mononucleosis

A 19-year-old female university student athlete is at your office today because she has fever, sore throat, headache, abdominal pain, and fatigue. You discover that she has tonsillar exudate, anterior cervical lymphadenopathy, posterior cervical lymphadenopathy, and splenomegaly during your physical examination. You perform a rapid antigen test to rule out streptococcal tonsillitis, which is negative. You suspect this patient has infectious mononucleosis.
Volume 38.3 - Question 39

Late Endovascular Treatment for Ischemic Stroke

Endovascular treatment is efficacious for patients with ischaemic stroke caused by an anterior circulation large-vessel occlusion who presented 6–24 h from onset or last seen well, and who were selected on the basis of the presence of collateral flow on CTA.

  • True
  • False
Volume 38.5 - Question 38

Cancer Risk After CT in Childhood

In people under 25, there is an increased cancer risk in those who have received 4 or more CT scans in childhood.

  • True
  • False
Volume 38.5 - Question 11

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