Preventive Medicine - Education

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Screening Tool for Depression

Depression screening using a screening tool has little effect on health.

  • True
  • False
Volume 41.3 - Question 7

Herpes Zoster Vaccination and Dementia

Receiving the live-attenuated herpes zoster vaccine is associated with a reduced probability of a new dementia diagnosis.

  • True
  • False
Volume 41.3 - Question 5

Adverse Pregnancy Outcome and Risk of Stroke

Women who have an adverse pregnancy outcome (preterm delivery, small for gestational age, preeclampsia, other hypertensive disorders, and gestational diabetes) need early prevention and long-term clinical care to reduce their lifelong risk of stroke.

  • True
  • False
Volume 41.2 - Question 12

Falls

Integration of a fall prevention program (comprised of balance and functional exercises and community-engaged health education) in a primary care system has been associated with a significant reduction in the risk of self-reported falls among rural older people.

  • True
  • False
Volume 41.2 - Question 7

Sunscreens

Which one of the following statements about sunscreens is false?

  • Benzene (a known carcinogen) has been found in some spray sunscreens.
  • Sunscreens should be used in infants < 6 months old.
  • Sunscreen sprays are flammable.
  • Oxybenzone can cause coral reef bleaching.
Volume 41.2 - Question 5

UV Radiation

Which one of the following statements about ultraviolet (UV) radiation is false?

  • UVA is largely responsible for the erythema of sunburn.
  • Both UVA and UVB radiation can cause skin cancer.
  • UVA unlike UVB is not filtered by clear glass.
  • UVA makes up 95% of terrestrial UV radiation.
Volume 41.2 - Question 4

Intimate Partner Violence

Which one of the following statements regarding intimate partner violence (IPV) is false?

  • Almost three-fourths of women survivors report their first experience of IPV occurred before age 25.
  • Screening of asymptomatic women of reproductive age is not recommended.
  • Transgender people have 2-3 x higher risk of sexual IPV than cisgendered individuals.
  • Homicide is the most common cause of maternal mortality.
Volume 41.1 - Question 7

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

Golf and Risk of Parkinson Disease

Living within 1 to 3 miles of a golf course is associated with an increased risk of parkinson disease.

  • True
  • False
Volume 40.6 - Question 17

Virtual Yoga for Chronic Low Back Pain

Virtual yoga classes may be an effective treatment option for chronic low back pain.

  • True
  • False
Volume 40.6 - Question 16

Prostate Cancer Screening

Performing a biopsy of the prostate only in men with an elevated prostate-specific antigen (PSA) level and visible lesions on MRI could reduce clinically insignificant prostate cancer diagnoses.

  • True
  • False
Volume 40.4 - Question 1

Respiratory Syncytial Virus (RSV) Vaccination in Older Adults

Which one of the following statements regarding RSV vaccination in adults is false?

  • One dose of the RSV vaccine offers protection for at least 2 respiratory virus seasons.
  • There is a small associated increase in the incidence of Guillain-Barre syndrome.
  • There are currently no recommendations regarding booster doses.
  • The National Advisory Committee on Immunization recommends RSV vaccination for all adults aged 65 or older.
Volume 40.3 - Question 7

Effect of Home Exercise on Muscle Mass

A simple home exercise program has no impact on appendicular lean muscle mass among healthy, physically active adults aged 70 years or older.

  • True
  • False
Volume 40.3 - Question 6

Dietary Fats

Consumption of fatty (but not lean) fish is associated with increased risk for coronary heart disease.

  • True
  • False
Volume 40.3 - Question 5

Alzheimer Disease Treatment

Which one of the following statements about the treatment of Alzheimer Disease (AD) is false?

  • Lower dosages of donepezil (10 mg daily) demonstrate comparable effectiveness to higher dosages.
  • Memantine is used in moderate to severe AD.
  • Brexpiprazole may help improve AD-associated agitation.
  • Rivastigmine is associated with lower risk of gastrointestinal adverse effects.
Volume 40.3 - Question 4

Obesity Management

Your next patient is a 38-year-old woman. After several years of struggling with obesity, she wishes to address this issue. The patient is healthy, with no known medical conditions.   You question your patient about her eating habits and physical activity. She has a very healthy lifestyle. You complete a physical examination. In addition to measuring the patient’s body-mass index, you also measure the patient’s waist circumference.
Volume 40.21 - Question 13

Osteoporosis Guidelines

One of your patients comes to see you in the office for a renewal of her hypertension medications. While there, she asks if she should have a bone mineral density test as many of her friends have started getting them.  
Volume 40.21 - Question 4

Prenatal Cannabis Use and Maternal Pregnancy Outcomes

Prenatal cannabis use is associated with a greater risk of all the following except:

  • Excessive gestational weight gain
  • Gestational diabetes
  • Preeclampsia
  • Placental abruption
Volume 40.2 - Question 7

Diet and Cardiovascular Risk

Compared with animal fat intake, plant-based fat intake is associated with a reduction in overall mortality.

  • True
  • False
Volume 40.2 - Question 6

Extreme Heat and Health

Which one of the following statements regarding climate change, extreme heat and health is false?

  • The relative risk of death from myocardial infarction is increased on heat wave days.
  • The risk of suicide is increased with the 93rd percentile warm season temperature compared with the 1st percentile.
  • A 1 degree C increase in temperature is associated with an increase in the risk of stillbirth.
  • Heat action plans have not been shown to reduce deaths per hot day.
Volume 40.2 - Question 5

Precarious Work and Occupational Injury

Workers exposed to precarious employment are more likely to sustain an injury or illness resulting in lost-time compensation.

  • True
  • False
Volume 40.1 - Question 10

Semaglutide and Tobacco Use Disorder in Type 2 Diabetes

Semaglutide was associated with lower risks for Tobacco Use Disorder (TUD)-related health care measures in patients with comorbid type 2 diabetes and TUD compared with other antidiabetes medications.

  • True
  • False
Volume 40.1 - Question 5

Falls

An 85-year-old female patient was brought in by her daughter today to discuss her mother’s recent falls in her current residence. This patient lives alone in a house with 2 staircases for the 2 floors and basement. She has fallen multiple times in her house recently. She is experiencing pains in various parts of her body.
Volume 39.6 - Question 42

Energy and Macronutrients Across the Life Span

Which one of the following statements on energy and macronutrients across the life span is false?

  • Suboptimal diets contribute to one in five deaths worldwide.
  • Reducing intake of sodium to the level of <2300 mg a day is associated with a decreased risk of hypertension.
  • Plant proteins are usually deficient in one more indispensable amino acids.
  • Cholesterol is an essential dietary lipid.
Volume 39.6 - Question 7

Cell Phone Use and Brain Cancer

Long-term or heavy mobile phone use is associated with an increased risk of glioma.

  • True
  • False
Volume 39.6 - Question 6

Ankyloglossia (tongue-tie) in Infants

In infants with ankyloglossia, lingual frenotomy for optimizing later articulation is supported by current evidence.

  • True
  • False
Volume 39.6 - Question 5

Treatment-Resistant Depression

Which one of the following statements about nonpharmacologic treatment strategies for treatment-resistant depression is false?

  • A structured exercise program may reduce the severity of depressive symptoms.
  • When used for years, B12 vitamins have shown some benefit by decreasing the risk of relapse.
  • Bright light therapy does not reduce depressive symptoms for those whose depression is not seasonal.
  • Repetitive transcranial magnetic stimulation may be helpful.
Volume 39.6 - Question 3

Chronic Kidney Disease and Preventing Hospitalization

In patients with chronic kidney disease, type 2 diabetes, and hypertension (the kidney-dysfunction triad) the use of an EHR-based algorithm and practice facilitators embedded in primary care to assist providers in delivering guideline-based interventions reduces hospitalization rate at 1 year. 

  • True
  • False
Volume 39.5 - Question 3

HIV Prevention

Post-exposure prophylaxis-in-pocket is an HIV prevention strategy targeted to those who have lower frequencies (i.e., 0 to 4) of higher-risk, and typically unanticipated, HIV exposures per year.

  • True
  • False
Volume 39.5 - Question 1

Osteoporosis Guidelines

One of your patients comes to see you in the office for a renewal of her hypertension medications. While there, she asks if she should have a bone mineral density test as many of her friends have started getting them.  
Volume 39.4 - Question 42

Chlorhexidene Decolonization

In nursing homes, universal decolonization with chlorhexidine and nasal iodophor leads to a significantly lower risk of transfer to a hospital due to infection than routine care. 

  • True
  • False
Volume 39.4 - Question 24

Transient Atrial Fibrillation in Hospitalized Patients

Among patients who have transient new-onset atrial fibrillation during a hospitalization for noncardiac surgery or medical illness, about 1/3 of patients will have recurrence within 1 year. 

  • True
  • False
Volume 39.4 - Question 7

Twin Study of Vegan Diet

Which one of the following statements about the short-term (8 weeks) cardiometabolic and nutritional effects of omnivorous vs vegan diets in identical twins is false? 

  • Fasting insulin levels are decreased in the omnivorous diet group.   
  • Low-density lipoprotein cholesterol concentrations are higher in the omnivorous diet group.   
  • Body weight decreases in the vegan diet group.  Vitamin B12 levels are comparable in the two groups. 
  • Vitamin B12 levels are comparable in the two groups. 
Volume 39.4 - Question 5

Post-COVID Condition

Unvaccinated individuals have an almost fourfold higher proportion of post-COVID condition diagnoses compared with those who were vaccinated before infection.

  • True
  • False
Volume 39.3 - Question 21

Falls

When combined with functional and balance training in older adults, resistance training can reduce the number of falls.

  • True
  • False
Volume 39.3 - Question 18

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

Breast Density

Which one of the following statements about breast density is false?

  • Breast density can be determined by physical examination.
  • Extremely dense breasts confer a risk of breast cancer that is greater than that of having a first-degree relative with breast cancer.
  • Sensitivity of mammogram screening is only 50% for those with the most severe category of breast density.
  • Supplementing mammogram screening with ultrasound screening can improve breast cancer detection in women with dense breasts.
Volume 39.3 - Question 7

Obesity

Time-restricted eating, in the absence of other interventions, results in more weight loss than eating throughout the day. 

  • True
  • False
Volume 36.4 - Question 37

Physical Exercise and Schizophrenia

Which one of the following statements about physical exercise in those with schizophrenia is false? 

  • Guidelines recommend achieving 90–150 minutes of moderate-to-vigorous activity per week.   
  • Supervision by exercise professionals has no effect on dropout rates.   
  • Improvements in aerobic capacity correlate with a better total score on the Positive and Negative Syndrome Scale.    
  • Video games that require physical movement can motivate patients. 
Volume 36.4 - Question 11

HPV Vaccine

Human papillomavirus vaccination is associated with an increased risk of Guillain-Barre syndrome. 

  • True
  • False
Volume 36.4 - Question 3

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

Ulcerative Colitis

Which one of the following statements about ulcerative colitis is false?

  • The most common presenting symptom is bloody diarrhea.
  • Recent campylobacter infection is a risk factor.
  • Active tobacco use is a risk factor.
  • Soda consumption is a risk factor.
Volume 37.6 - Question 4

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

Sunscreen

Which one of the following statements about sunscreen use is false? 

  • It has been shown to reduce the incidence of basal cell carcinomas.   
  • It is effective in preventing the signs of photoaging.   
  • It significantly reduces the rate of actinic keratoses.   
  • It has been shown to reduce the incidence of invasive melanoma. 
Volume 36.3 - Question 4

Weight Loss

Intensive lifestyle promotion including increasing weekly physical activity and meal preparation/portion sizing with help of a health coach at primary care clinics leads to a significantly higher proportion of patients losing 10% body weight at 24 month follow up. 

  • True
  • False
Volume 36.3 - Question 3

Insect Repellents

Which one of the following statements about insect repellents is false?

  • Icaridin is as effective against mosquitoes as N, N-diethyl-m-toluamide (DEET).
  • Icaridin is odorless.
  • Icaridin should not be used in infants <6 months of age.
  • Oil of lemon eucalyptus has been shown to be safe in infants.
Volume 37.2 - Question 27

HIV Pre-Exposure Prophylaxis

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 confirms that he has sex with other men (MSM).   You question the patient’s HIV risk and after careful assessment, you consider that pre-exposure prophylaxis (PrEP) is indicated. The patient has never heard of PrEP and is unsure if it could be useful.
Volume 37.5 - Question 41

Mediterranean vs Low-Fat Diet and CVD

In secondary prevention, the Mediterranean diet is superior to the low-fat diet in preventing major cardiovascular events.

  • True
  • False
Volume 37.5 - Question 16

Treatment of Benign Prostatic Hypertrophy

Which one of the following statements about the treatment of benign prostatic hypertrophy (BPH) is false?

  • Surgery is recommended for patients with recurrent urinary tract infections.
  • Lifestyle modifications such as fluid restriction, frequent bladder emptying, and avoiding bladder irritants are recommended.
  • Used as monotherapy, tadalafil is similar in efficacy to alpha blockers.
  • Saw palmetto has been shown to significantly improve BPH symptoms.
Volume 37.5 - Question 15

Constipation Treatment in Children

Which one of the following statements about the treatment of constipation in children is false?

  • Polyethylene glycol is effective for disimpaction.
  • Maintenance therapy should continue for at least 2 months or at least one month after a good response to treatment.
  • Relapses are common.
  • Lactulose is a first-line maintenance treatment.
Volume 37.5 - Question 5

Constipation in Children

Which one of the following statements about constipation in children is false?

  • Increased fiber intake above usual daily recommendations does not improve constipation.
  • Increasing physical activity alleviates constipation.
  • Cow’s milk allergy testing is not recommended.
  • Probiotic supplementation has not been shown to alleviate constipation.
Volume 37.5 - Question 4

Covid-19 Vaccine Effectiveness in Children

Vaccination with the Pfizer vaccine in children 5 to 11 years of age provides moderate protection against symptomatic Covid-19, since the omicron variant became dominant. 

  • True
  • False
Volume 38.1 - Question 7

Covid-19 Vaccination in Pregnancy

Maternal vaccination with two doses of mRNA vaccine against Covid-19 is associated with a reduced risk of hospitalization among infants younger than 6 months of age. 

  • True
  • False
Volume 38.1 - Question 6

Family Meals and Risk of Type 2 Diabetes Mellitus

In families at high risk of type 2 diabetes mellitus, which one of the following statements is false? 

  • After controlling for frequency of family meals, there is no association between parental diet quality and children’s food consumption.
  • Increased family meal frequency is associated with improved parental diet quality. 
  • There is a significant association between family meal frequency and children’s food consumption of selected food items. 
  • Diet quality of parents is negatively associated with the intake of salty snacks in both boys and girls. 
Volume 38.1 - Question 5

Smoking Cessation

Which one of the following statements about the treatment to achieve smoking cessation is false? 

  • Among smokers who use a single smoking-cessation agent, varenicline is superior to other medications in achieving continuous abstinence.  
  • The maximum-strength nicotine patch produces steady-state plasma nicotine concentrations that are equal to smoking 20 cigarettes per day. 
  • A nicotine patch plus a short-acting nicotine-replacement formulation results in cessation success similar to varenicline. 
  • Quit success might be higher with varenicline plus a nicotine patch than with varenicline alone. 
Volume 38.1 - Question 4

Timing of Meals and Weight Loss Trajectory

When counseling patients about weight gain prevention, limiting the frequency of large meals is more beneficial than time-restricted eating.

  • True
  • False
Volume 38.3 - Question 24

E-Cigarettes & MI Risk

Nicotine consumption using only e-cigarettes is associated with a lower risk of myocardial infarction compared with traditional cigarette smoking.

  • True
  • False
Volume 38.3 - Question 22

Recent Updates to Clinical Practice Guidelines

Which one of the following is false regarding recent (since 2021) updates to Canadian clinical practice guidelines?

  • The Canadian Task Force on Preventive Health Care recommends screening of sexually active individuals younger than 30 years for chlamydia and gonorrhea annually.
  • The Canadian Urological Society recommends noncontrast computed tomography as the initial imaging modality for acute ureteral stones.
  • The Society of Obstetricians and Gynecologists of Canada (SOGC) recommends that postmenopausal women with hypoactive sexual desire disorder can consider transdermal testosterone patches as a treatment option.
  • The SOGC recommends consideration of hormone therapy for perimenopausal depression with or without concomitant vasomotor symptoms.
Volume 38.3 - Question 19

Sequelae Associated with SARS-CoV-2 Reinfection

Which one of the following statements regarding SARS-CoV-2 reinfection is false?

  • Compared to those with no reinfection, those with reinfection exhibit an increased risk of all-cause mortality.
  • Compared to those with no reinfection, those with reinfection have an increased risk of gastrointestinal sequelae.
  • There is no increased risk of hospitalization following reinfection in those who have received two or more vaccinations before they are reinfected.
  • The risks of adverse outcomes increase in a graded fashion as the number of reinfections increases.
Volume 38.4 - Question 5

Vaccination for Patients Receiving Cancer Therapy

Which one of the following statements about vaccinations in patients receiving cancer therapy is false?

  • Vaccination rates are low.
  • Live vaccines are contraindicated in immunosuppressed patients.
  • Non-live vaccines are contraindicated in patients receiving cancer treatment with immunotherapy.
  • Patients are no longer considered immunosuppressed 3 months after cessation of treatment for cancer.
Volume 38.4 - Question 4

Fruit and Vegetable Prescriptions

Fruit and vegetable prescription programs provided to individuals at metabolic risk who are from low-income neighborhoods or are food insecure, improves all of the following except:

  • Blood pressure in hypertensive adults.
  • HbA1C in individuals with HbA1C ≥ 6.5%.
  • BMI in overweight and obese adults.
  • BMI in children.
Volume 39.2 - Question 37

Exercise Training and Blood Pressure

Isometric exercise training is more effective than aerobic exercise training in reducing systolic blood pressure.

  • True
  • False
Volume 39.2 - Question 5

Time-Restricted Eating

In patients with a BMI between 30 and 50 kg/m2, time-restricted eating without calorie counting is as effective as a weight loss strategy as calorie counting.

  • True
  • False
Volume 39.2 - Question 4

Consumption of Coffee

Moderate consumption of coffee is associated with a reduced risk of cognitive disorders.

  • True
  • False
Volume 39.2 - Question 3

Occupational Lung Disease

More than 10% of all lung diseases are attributed to occupational exposures. 

  • True
  • False
Volume 39.1 - Question 6

Varenicline and Vaping

Varenicline is effective for increasing the vaping cessation rate in adults who use electronic cigarettes.   

  • True
  • False
Volume 39.1 - Question 5

Cannabis and Alcohol Use Among Smokers

Among current cigarette smokers in Canada, cannabis use is associated with high-risk alcohol consumption. 

  • True
  • False
Volume 39.1 - Question 4

Emergency Department Treatment of Smoking

The treatment of tobacco dependence with a brief negotiation interview in the emergency department can increase the rate of abstinence at 3 months.

  • True
  • False
Volume 38.6 - Question 23

Parkinson Disease and Trichloroethylene

Remote occupational exposure to trichloroethylene in drinking water may increase the risk of Parkinson disease.

  • True
  • False
Volume 38.6 - Question 9

PCOS Comorbidities

Patients with polycystic ovary syndrome have routine screening for the following comorbidities except:

  • Depression
  • Hypertension
  • Obstructive sleep apnea
  • Endometrial cancer
Volume 38.6 - Question 6

Prevention of Fragility Fractures

Which one of the following statements about the Canadian Task on Preventive Health care guideline regarding the prevention of fragility fractures by screening in people of average risk is false?

  • Women over 65 years old should be screened.
  • Men 40 years old and older should not be screened.
  • Women 40-65 years old should be screened.
  • Risk assessment-first screening using the Canadian clinical fracture risk assessment tool (FRAX) without bone mineral density is the recommended screening method.
Volume 38.6 - Question 4

RSV and Childhood Asthma

Among healthy children born at term, not being infected with RSV in the first year of life was associated with a substantially reduced risk of developing childhood asthma.

  • True
  • False
Volume 38.6 - Question 3

Vitamin D and Pre-Diabetes

In adults with prediabetes, vitamin D supplementation reduces the risk of progression to type 2 diabetes.

  • True
  • False
Volume 38.5 - Question 15

Antenatal Care in Refugee Patients

Among resettled refugees in Canada, those in the government-assisted pathway were more likely to receive adequate prenatal care than privately sponsored refugees.

  • True
  • False
Volume 38.5 - Question 14

Postexposure Doxycycline to Reduce STIs

Doxycycline postexposure prophylaxis taken within 72 hours after condomless sex decreases incident gonorrhea, chlamydia, and early syphilis among men who have sex with men and transgender women who have had bacterial STI in the previous year.

  • True
  • False
Volume 38.5 - Question 10

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.
Volume 38.5 - Question 9

Aerobic Exercise During Pregnancy

Aerobic exercise intervention reduces the incidence of gestational hypertension among pregnant women.

  • True
  • False
Volume 38.5 - Question 8

Long-term Health Risks of Childhood Cancer

Which one of the following statements about long-term health risks in adult survivors of childhood cancer is false?

  • All cause mortality is increased.
  • Risk of cardiovascular mortality is increased.
  • Risk of mortality from other cancers is similar to the general population
  • Absence of diabetes is associated with a significant reduction in health-related mortality.
Volume 38.5 - Question 6

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