Question 1

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 2

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 3

A 25-year-old woman presents to the Emergency Department with a 4-hour history of severe left flank pain.

Her vital signs are as follows:

Heart rate: 94/min

Blood pressure: 130/80 mm Hg

Temperature: 37.3 °C

A non-contrast computed tomography shows a 6 mm stone in the distal left ureter with mild associated

hydronephrosis. In addition to appropriate analgesia, which one of the following is the best next step?

Options :

A : Provide reassurance

B : Prescribe antibiotics

C : Administer an alpha blocker

D : Refer for urology consultation

E : Increase intravenous fluids

Answer: C

Question 4

A 34-year-old woman, gravida 3, para 2, aborta 0, presents at 38 weeks' gestation. She is in early labor with ruptured membranes. Her previous pregnancy was complicated by fever during labor. Which one of the following would increase the risk of fever recurrence?

Options :

A : Multiparity

B : Precipitous labor

C : Advanced maternal age

D : Epidural analgesia

Answer: D

Question 5

During an office visit, your 14-year-old patient requests a prescription for oral contraceptives. The province where you are working does not have a statutory age of consent. Which one of the following is the best next step?

Options :

A : Notify child protective services because of the possibility of sexual abuse.

B : Give her the prescription and book a follow-up appointment.

C : Advise her to return with her parents so that legal consent can be obtained.

D : Determine her understanding of the medical issues before prescribing the pills.

E : Refuse to prescribe the pills because she is less than 18 years of age.

Answer: D

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