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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Dimensions of Care | 50% | - Health Promotion and Illness Prevention - Chronic Care - Assessment and Diagnosis - Acute Care |
| Topic 2: Physician Activities | 50% | - Psychosocial Aspects - Communication - Management - Professional Behaviours |
Question 1
An 88-year-old married man is admitted following a cardiac arrest at home. He was not expected to recover, and after 2 weeks, he remains in a coma. His wife states, " I cannot let him go. That would be murder. " As the attending physician looking after her husband, which one of the following is the best next course of action?
A. Emphasize that the duration of his stay in the Intensive Care Unit will be limited
B. Seek advice from the provincial or territorial public guardian
C. Remove him from life support as this would not be murder
D. Encourage her to imagine what her husband would have wanted
E. Say nothing further and wait until she comes around to accepting his state
Question 2
A 72-year-old man presents to your office with reports of a hard lump slowly enlarging in the right inguinal area. He is otherwise healthy. Which one of the following is most likely to reveal the cause of his lump?
A. Sexual history.
B. Palpation of the liver.
C. Palpation of the spleen.
D. Examination of the testicles.
E. Digital rectal examination.
Question 3
You are asked to see a 34-year-old patient at his long-term care facility for a 2-day history of fever. You diagnose a urinary tract infection. He has multiple sclerosis diagnosed 5 years ago and has lived in this long- term care facility for the past 2 years. He is bedbound and has an indwelling urinary catheter. For the past 3 months, he has been non-communicative. Prior to this, he had made it clear that he did not want any life- prolonging measures. Which one of the following is the best next step?
A. Prescribe antipyretics.
B. Change his urinary catheter.
C. Call his family to consider antibiotics.
D. Transfer him to the hospital.
E. Start antibiotics while waiting to contact the family.
Question 4
An 18-year-old woman presents to the Emergency Department with a 3-day history of vomiting and right upper quadrant pain. She is alert but appears unwell and jaundiced. She was previously healthy and has not travelled recently. She has no risk factors for blood-borne pathogens. She denies hematemesis or hematochezia. On further history, she reports that she took a full bottle of pills that she found in her parents' medicine cabinet several hours before she started vomiting. Without intervention, which one of the following is the most likely outcome?
A. Fulminant hepatic failure
B. Rapid-onset cerebral edema
C. Status epilepticus
D. Acute renal failure
E. Ventricular fibrillation
Question 5
A 55-year-old man presents to the Emergency Department with intractable nausea and vomiting. He is diaphoretic, tremulous and tachycardic. In a private conversation with his spouse, you learn that for the last several weeks, he has been drinking 1.2 L of vodka daily. On questioning, he says that since he retired, he has been drinking socially and plans to continue doing so. With respect to his alcohol use, which one of the following best describes the patient's current stage of change?
A. Precontemplation.
B. Preparation.
C. Contemplation.
D. Action.
E. Maintenance.
Solutions:
| Question 1 Answer: D | Question 2 Answer: D | Question 3 Answer: A | Question 4 Answer: A | Question 5 Answer: A |
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