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1. You are caring for a 17-year-old girl who has end-stage renal disease. She is receiving dialysis at the hospital
3 times a week. She requests medical assistance in dying (MAID). Which of the following is the best next step?

A) Suggest a trial of home dialysis.
B) Explain to the patient that she is not terminally ill.
C) Explore the reasons for the patient's request for MAID.
D) Inform the patient that she will need parental consent to be assessed for MAID.
E) Refer the patient to a psychiatrist.

2. A 58-year-old woman presents to your office with heavy vaginal bleeding. She has a history of type 2 diabetes and hypertension. Some active bleeding is visible on speculum examination. Ultrasound reveals an endometrial thickness of 12 mm. Endometrial biopsy shows complex hyperplasia with atypia. Which one of the following is the best next step?

A) Arrange endometrial ablation
B) Refer for hysterectomy and bilateral salpingo-oophorectomy
C) Prescribe topical progesterone
D) Obtain consent for dilatation and curettage
E) Organize hysteroscopy

3. A 76-year-old man is brought by his family to your clinic with new-onset urinary incontinence. They state that the patient is experiencing a slowly progressing cognitive decline marked by memory disturbance, apathy, and attentional problems. Examination reveals that the patient has a stooped, forward-leaning posture and a wide-based gait. Which one of the following is the most likely diagnosis?

A) Normal pressure hydrocephalus
B) Lewy body dementia
C) Parkinson disease
D) Frontotemporal dementia
E) Alzheimer disease

4. An 18-month-old boy is brought to the office by his guardians for a well-child visit. His guardians are concerned that his eyes do not look the same. On examination, his eyes appear as shown in the referenced photo.
Which one of the following best represents the patient's condition?

A) Strabismus
B) Ptosis
C) Pseudostrabismus
D) Cataract

5. A 42-year-old businessman known to have type 2 diabetes and ischemic heart disease is admitted to hospital with acute coronary syndrome. He admits to drinking 4 beers a day for the last 6 years and to binge drinking twice a year when his school buddies are in town. Your chart review reveals that he had a seizure secondary to alcohol withdrawal during his last admission. Which one of the following elements of his history puts him at highest risk of having another such seizure?

A) His medical comorbidities.
B) His previous episode of alcohol withdrawal.
C) The quantity of alcohol he consumes daily.
D) The number of years he has consumed alcohol.
E) His binge drinking.

問題與答案：