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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

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

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

Bone Mineral Density Testing

Repeated bone mineral density (BMD) testing three years after baseline BMD in postmenopausal women should not be routinely performed.  

  • True
  • False
Volume 36.3 - Question 35

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

Elevated D-Dimer in COVID-19

Increased D-dimer levels measured on hospital admission are significantly correlated with the severity of COVID-19 pneumonia. 

  • True
  • False
Volume 36.3 - Question 15

Esophageal Cancer Screening

Over 90% of diagnoses of esophageal adenocarcinoma are made while investigating patients with alarm symptoms. 

  • True
  • False
Volume 36.3 - Question 9

Inflammatory Bowel Disease in Children

Calprotectin testing of children with suspected inflammatory bowel disease (IBD) in primary care accurately distinguishes IBD from a functional gut disorder. 

  • True
  • False
Volume 36.3 - Question 1

Emergency Department Non-infarct Troponins

Which one of the statements about troponin elevation is false? 

  • In nearly half of patients, it is associated with a condition other than myocardial infarction.   
  • It can be caused by increased membrane permeability in inflammatory states such as sepsis.   
  • It can be caused by myocardial injury without critical coronary vascular obstruction in demand ischemia.   
  • It occurs in 1% of patients with pulmonary embolism. 
Volume 36.2 - Question 32

Serological Testing in SARS-CoV-2

 Which one of the following statements about serological testing for SARS-CoV-2 infection is false?  

  • Health Canada’s recommended target specificity of 98% or higher would result in a positive test having a highly predictive value in most Canadian populations.   
  • Antibody levels may not correlate with disease immunity. 
  • Case definitions for multisystem inflammatory syndrome in children due to SARS-CoV-2 include the use of serology results. 
  • Serological testing is not currently recommended on an individual level to guide the use of personal protective equipment. 
Volume 36.1 - Question 13

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

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

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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