Question 1

A 23-year-old woman with borderline personality disorder is brought to the Emergency Department having ingested non-lethal substances after her boyfriend broke up with her. The staff tells you that she has consulted 8 times under similar circumstances in the past 3 years. Which one of the following pieces of information would be useful to provide to the staff?

Options :

A : Not much can be done with personality disorders

B : She will never commit suicide

C : Suicidal thoughts must be an indication of major depressive disorder

D : She is overusing health care services

E : Symptoms of borderline personality disorder will likely attenuate over time

Answer: E

Question 2

A 32-year-old woman, gravida 0, comes to your office for contraception counselling, specifically about insertion of a levonorgestrel-releasing intrauterine device. She has a past history of breast cancer and is presently on tamoxifen. Which one of the following is the best advice for your patient?

Options :

A : She has a high risk of irregular bleeding following insertion

B : After consultation with her oncologist, she may choose this option

C : It may increase her risk of breast cancer recurrence

D : She will require pre-procedure antibiotics

E : This device will increase her risk of future infertility

Answer: B

Question 3

A 30-year-old woman presents to the office with her partner and reports that they are planning for her to conceive soon. They visited Mexico recently and are concerned about exposure to the Zika virus. Which one of the following is the best next step?

Options :

A : Refer the couple to an infectious disease specialist

B : Request serologic testing

C : Recommend ceasing conception until 3 months after the couple's return to Canada

D : Explain that condoms are ineffective in preventing sexual transmission of Zika virus

E : Prescribe a prophylactic antiviral medication

Answer: C

Question 4

A 70-year-old woman had a total abdominal hysterectomy with bilateral salpingo-oophorectomy 2 days ago. On examination today, her vital signs are as follows: She has been immobile since her operation. She is fatigued but is tolerating a full diet. Which one of the following is the most likely cause of this patient's fever?

Options :

A : Septic pelvic thrombophlebitis.

B : Pulmonary embolism.

C : Wound infection.

D : Bowel trauma during the operation.

E : Atelectasis

Answer: E

Question 5

A 26-year-old man presents with pain, numbness, and weakness in his right upper extremity. He works as a computer programmer, and his BMI is 32. Symptoms have worsened since he started spending more time on the keyboard. He reports that his right hand feels clumsier while he is typing. Physical examination reveals mild weakness in the intrinsic muscles of that hand, with a positive Tinel sign at the ulnar nerve. Which one of the following is the best next step?

Options :

A : Wrist splint to test for carpal tunnel.

B : Physiotherapy.

C : Elbow extension brace for use during sleep.

D : Magnetic resonance imaging of the cervical spine.

E : Nerve conduction studies to localize the level of the lesion.

Answer: E

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