AST V3 Lecture 2 Assessment
.webp "AST V3 Lecture 2 Assessment - Quiz")
Questions and Answers
- 1.
The audio recording is based on a real patient visit. Take notes on the information that you think is relevant from the visit. Your notes will not be graded.This audio recording applies to questions 18-23.
- 2.
Type your notes below.
- 3.
The audio recording is based on a real patient visit. Take notes on the information that you think is relevant from the visit. Your notes will not be graded.This audio recording applies to questions 25-30.
- 4.
Type your notes below.
- 5.
The patient is a 45-year-old male who presents for follow up of several symptoms. He complains of mental exhaustion since January 2014 which has been gradually worsening. His symptoms are exacerbated by reading and conversation. He reports episodes 8 hours after any mental activity. He reports that he has been sleeping 10-12 hours per night. He also reports mild cough recently but denies fever and muscle aches. He recently had a spinal tap which the patient reports was normal. Which elements are included in HPI above? (Check all that apply.)
- A.
Location
- B.
Severity
- C.
Onset/Duration
- D.
Context
- E.
Modifying Factors
- F.
Associated Symptoms
Correct Answer(s)
C. Onset/Duration
D. Context
E. Modifying Factors
F. Associated SymptomsExplanation
The given correct answer includes the elements of Onset/Duration, Context, Modifying Factors, and Associated Symptoms. This is evident from the information provided in the question, where the patient complains of mental exhaustion since January 2014 (Onset/Duration), which has been gradually worsening (Context). The symptoms are exacerbated by reading and conversation (Modifying Factors), and the patient also reports mild cough recently (Associated Symptom).Rate this question:
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- 6.
Which of the following are correct matches between HPI element and example? (Check all that apply.)
- A.
Quality: sharp pain
- B.
Associated symptom: relief with Tylenol
- C.
Location: right knee
- D.
Onset/Duration: onset 3 weeks ago
- E.
Context: began after a large greasy meal
Correct Answer(s)
A. Quality: sharp pain
C. Location: right knee
D. Onset/Duration: onset 3 weeks ago
E. Context: began after a large greasy mealExplanation
The correct matches between HPI element and example are as follows: Quality: sharp pain, Location: right knee, Onset/Duration: onset 3 weeks ago, Context: began after a large greasy meal.Rate this question:
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- 7.
He has additional complaint of intermittent chest pain for the last month. He describes the pain as dull and radiating to his left side. The patient's symptoms are not aggravated by laying down, exertion, or eating. He denies associated ear pain, abdominal pain, diarrhea, constipation, or hematochezia but admits to a cough for the last few months.Which elements are NOT included in the HPI above? (Check all that apply.)
- A.
Location
- B.
Quality
- C.
Severity
- D.
Timing
- E.
Context
- F.
Onset/Duration
- G.
Associated Symptoms
Correct Answer(s)
C. Severity
E. ContextExplanation
The given HPI includes information about the location (left side), quality (dull), timing (intermittent for the last month), onset/duration (last month), and associated symptoms (cough). However, it does not mention the severity of the chest pain or the context in which it occurs.Rate this question:
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- 8.
"The patient also reports that she sustained a finger laceration 1 week ago while cutting apples. She has been applying Neosporin to the wound which seems to be helping. She denies swelling or drainage. She states that the apple 'wasn't even worth it.'"All of the information in the HPI above is medically relevant.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
The information in the HPI above is not all medically relevant because the statement about the apple not being worth it does not provide any relevant medical information. The patient's opinion about the apple does not contribute to the understanding or treatment of her finger laceration.Rate this question:
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- 9.
Patient is an 18-year-old female who presents today with complaint of sore throat for the last several months. She initially had a fever which has now resolved. She reports associated cough, nasal congestion, and headache but denies nausea or diarrhea. Patient tested negative for strep throat. Which elements are NOT included in the HPI above? (Check all that apply.)
- A.
Onset/Duration
- B.
Modifying factors
- C.
Timing
- D.
Associated symptoms
Correct Answer(s)
B. Modifying factors
C. TimingExplanation
The HPI above does not include the elements of modifying factors and timing. Modifying factors refer to any factors that make the symptoms better or worse, such as certain activities or medications. The HPI only mentions associated symptoms like cough, nasal congestion, and headache, but does not provide information about any modifying factors. Timing refers to the duration or pattern of the symptoms, such as whether they are constant or intermittent. The HPI mentions that the patient has had a sore throat for several months, but does not provide specific timing information.Rate this question:
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- 10.
The patient is a 21-year-old female who presents today with complaint of cold symptoms for the last seven days. Her symptoms include cough, congestion, and body aches. Symptoms began the morning after the patient’s birthday party which included “heavy drinking and very little sleep”. She had a severe headache which gradually improved with fluid intake over the course of the day. She noted onset of dry cough the next day. She has had fatigue and body aches since yesterday. She has taken Advil with moderate relief of body aches. She also complains of subjective fever, worse at night. Patient denies nausea, vomiting, dizziness, shortness of breath, chest pain, leg swelling, confusion, mood swings, hot flashes, dysuria, hematuria, and back pain. “Heavy drinking and very little sleep” represents which HPI element?
- A.
Modifying factor
- B.
Context
- C.
Associated symptom
- D.
This does not represent an HPI element
Correct Answer
B. ContextExplanation
The phrase "heavy drinking and very little sleep" represents the context in which the patient's symptoms began. It provides information about the patient's lifestyle and activities leading up to the onset of symptoms. This context can be important for understanding the potential causes or contributing factors to the patient's cold symptoms.Rate this question:
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- 11.
___________ is the HPI element that describes the symptom (ie, sharp).
- A.
Sensation
- B.
Severity
- C.
Quality
- D.
Modifying factor
Correct Answer
C. QualityExplanation
Quality is the HPI element that describes the symptom (i.e., sharp). When describing a symptom, the quality refers to the specific characteristics or nature of the symptom. In this case, the symptom is described as sharp, indicating a specific type of sensation. Sensation refers to the patient's perception of the symptom, severity refers to the intensity or degree of the symptom, and modifying factor refers to any factors that worsen or alleviate the symptom.Rate this question:
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- 12.
Which of the following are among the Top 10 Most Common Chief Complaints? (Check all that apply.)
- A.
Allergic Reaction
- B.
Urinary Tract Infection (UTI)
- C.
Headache
- D.
Syncope
- E.
Mood Disorders
- F.
Rheumatoid Arthritis
Correct Answer(s)
B. Urinary Tract Infection (UTI)
C. Headache
E. Mood DisordersExplanation
Urinary Tract Infection (UTI), Headache, and Mood Disorders are among the Top 10 Most Common Chief Complaints. This can be inferred from the given options where these three conditions are listed. The other options, Syncope, Rheumatoid Arthritis, and Allergic Reaction, are not mentioned as common chief complaints.Rate this question:
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- 13.
Which of the following Top 10 Common Chief Complaints are chronic conditions? (Check all that apply.)
- A.
Urinary Tract Infection
- B.
Osteoarthritis
- C.
Diabetes Mellitus
- D.
Skin Disorders
- E.
Headache
Correct Answer(s)
B. Osteoarthritis
C. Diabetes Mellitus
D. Skin DisordersExplanation
Osteoarthritis, Diabetes Mellitus, and Skin Disorders are chronic conditions because they are long-term health conditions that typically do not have a cure and require ongoing management and treatment. Chronic conditions are characterized by their persistence and can have a significant impact on a person's quality of life. Urinary Tract Infection and Headache, on the other hand, are acute conditions that are typically short-term and can be resolved with appropriate treatment.Rate this question:
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- 14.
Which of the following is BOTH a Top 10 Chief Complaint AND an acute complaint?
- A.
Skin Disorder
- B.
Scoliosis
- C.
Upper Respiratory Infection (URI)
- D.
Back Pain
Correct Answer
C. Upper Respiratory Infection (URI)Explanation
Upper Respiratory Infection (URI) is both a Top 10 Chief Complaint and an acute complaint. A Top 10 Chief Complaint refers to the most common reasons why patients seek medical attention. URI is one of the most common reasons for patients to visit healthcare providers. Additionally, URI is an acute complaint because it is a sudden onset illness characterized by symptoms such as nasal congestion, sore throat, and coughing.Rate this question:
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- 15.
Which one of the following is NOT a chief complaint?
- A.
Annual physical
- B.
Right lower extremity
- C.
Abdominal pain
- D.
Chest pain
- E.
Medication refill
- F.
Hair loss
- G.
Post-op
- H.
All of the above are examples of chief complaints
Correct Answer
B. Right lower extremityExplanation
A chief complaint refers to the main reason for a patient seeking medical attention. It is typically a symptom or condition that the patient is experiencing. In this case, "Right lower extremity" is not a chief complaint as it refers to a specific body part rather than a symptom or condition. The other options listed, such as "Annual physical," "Post-op," "Abdominal pain," "Chest pain," "Medication refill," and "Hair loss," can all be considered chief complaints as they represent symptoms or conditions that a patient may present with.Rate this question:
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- 16.
To determine the chief complaint of a visit, you can ask yourself, "What is the reason for the patient's visit today?"
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The statement is true because to determine the chief complaint of a visit, one can ask themselves what the reason for the patient's visit is. This question helps to identify the main issue or concern that the patient wants to address during their visit, allowing healthcare professionals to prioritize and address the patient's needs effectively.Rate this question:
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- 17.
What information was discussed during this information? (Check all that apply.)
- A.
Lab results
- B.
Diet
- C.
Exercise habits
- D.
Leg symptoms
- E.
Headache
- F.
Skin Symptoms
Correct Answer(s)
A. Lab results
B. Diet
C. Exercise habits
D. Leg symptoms
F. Skin SymptomsExplanation
During this discussion, information about lab results, diet, exercise habits, leg symptoms, and skin symptoms was discussed.Rate this question:
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- 18.
Of the following information mentioned in the recording, which do you think is LEAST medically relevant.
- A.
Patient is prediabetic and has a family history of diabetes.
- B.
Patient lost 3lbs since their last visit.
- C.
Patient is doing her best to eat healthy.
- D.
Patient's weakness is tortillas.
Correct Answer
D. Patient's weakness is tortillas.Explanation
The information about the patient's weakness for tortillas is the least medically relevant because it does not provide any direct information about the patient's medical condition or health status. While it may be relevant in terms of dietary preferences or lifestyle choices, it does not have a direct impact on the patient's medical condition or treatment. The other options, such as being prediabetic, having a family history of diabetes, and losing weight since the last visit, are all directly related to the patient's medical condition and are therefore more medically relevant.Rate this question:
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- 19.
Which of the following mentioned in the recording is medically relevant. Check all that apply.
- A.
Patient complains of tingling in her legs.
- B.
Patient describes the tingling as "ants in her pants".
- C.
Patient states that her symptoms her worse with standing.
- D.
Patient denies associated numbness.
Correct Answer(s)
A. Patient complains of tingling in her legs.
B. Patient describes the tingling as "ants in her pants".
C. Patient states that her symptoms her worse with standing.
D. Patient denies associated numbness.Explanation
The answer choices that are medically relevant in the recording are:
- Patient complains of tingling in her legs: Tingling in the legs can be a symptom of various medical conditions and should be taken into consideration for further evaluation and diagnosis.
- Patient states that her symptoms are worse with standing: This information suggests that there may be a vascular or neurological component to the symptoms, as they worsen with a change in position.
- Patient denies associated numbness: This information rules out a common symptom often associated with tingling, which can help narrow down the possible causes.
- Patient describes the tingling as "ants in her pants": This description can provide additional insight into the quality or nature of the tingling sensation, potentially aiding in diagnosis.Rate this question:
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- 20.
Which of the quotes from the recording contain information that belongs in the HPI? (Check all that apply.)
- A.
Provider: Yes as we get older we see more people with diabetes.
- B.
Provider: Numbness in feet at all? Patient: No.
- C.
Provider speaking to scribe: She has good motion in her ankles and her knees, and good dorsal pedal pulses, and trace edema.
- D.
Provider: Try to avoid standing. If something gets worse let me know.
- E.
Provider: How long have you had that funny feeling in your legs? Patient: For 1 year now.
Correct Answer(s)
B. Provider: Numbness in feet at all? Patient: No.
E. Provider: How long have you had that funny feeling in your legs? Patient: For 1 year now.Explanation
The quotes from the recording that contain information that belongs in the HPI are "Provider: Numbness in feet at all?" and "Provider: How long have you had that funny feeling in your legs? Patient: For 1 year now." These quotes provide information about the patient's symptoms and their duration, which are important factors to consider in the history of present illness.Rate this question:
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- 21.
Which of the quotes from the recording contain information that is SUBJECTIVE? (Check all that apply.)
- A.
Patient: No, I feel like I have ants inside my pants. When I am ironing clothes I feel something in my legs when I am standing.
- B.
Provider: Numbness in feet at all? Patient: No.
- C.
Provider speaking to scribe: She has good motion in her ankles and her knees, and good dorsal pedal pulses, and trace edema.
- D.
Provider: Try to avoid standing. If something gets worse let me know.
- E.
Provider: How long have you had that funny feeling in your legs? Patient: For 1 year now.
Correct Answer(s)
A. Patient: No, I feel like I have ants inside my pants. When I am ironing clothes I feel something in my legs when I am standing.
B. Provider: Numbness in feet at all? Patient: No.
E. Provider: How long have you had that funny feeling in your legs? Patient: For 1 year now.Explanation
The quotes from the recording that contain subjective information are the ones where the patient describes their sensations and feelings in their legs. The patient's statement "I feel like I have ants inside my pants" and "When I am ironing clothes I feel something in my legs when I am standing" are subjective because they are based on the patient's personal perception and cannot be objectively measured or observed. Similarly, the patient's response to the provider's question about the duration of the funny feeling in their legs is also subjective as it is based on the patient's own recollection and perception of time.Rate this question:
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- 22.
Of the following information mentioned during the recording, which do you think is the LEAST appropriate to include in the HPI?
- A.
Patient: "Yeah... its been raining so much so I’ve been coughing more"
- B.
Patient: "Yeah, only when I’m kneeling down it hurts not even when I apply pressure."
- C.
Patient: "Last time i was here, the pharmacy gave me a Zyrtec."
- D.
Provider: "You know, allergies can predispose you to a cold" Patient: "Oh I know. Been there, done that. "
Correct Answer
D. Provider: "You know, allergies can predispose you to a cold" Patient: "Oh I know. Been there, done that. "Explanation
The least appropriate information to include in the HPI is the provider's statement about allergies predisposing the patient to a cold and the patient's response. This exchange does not provide any relevant information about the patient's current symptoms, medical history, or any other details that would be important for the healthcare provider to know. It does not contribute to the assessment of the patient's condition and would not be useful in formulating a diagnosis or treatment plan.Rate this question:
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- 23.
Which of the following were discussed in the visit above? (Check all that apply.)
- A.
The patient denies fever and chills.
- B.
The patient takes Motrin with no side effects.
- C.
The patient complains of a sharp knee pain with kneeling.
- D.
The patient complains of sneezing and cough but denies significant congestion.
Correct Answer(s)
B. The patient takes Motrin with no side effects.
C. The patient complains of a sharp knee pain with kneeling.
D. The patient complains of sneezing and cough but denies significant congestion.Explanation
The visit above discussed the patient's use of Motrin with no side effects, the patient's complaint of sharp knee pain with kneeling, and the patient's complaint of sneezing and cough but denies significant congestion.Rate this question:
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- 24.
When considering the recording, which of the following statements IS medically relevant? (Check all that apply.)
- A.
Patient: "I’ve noticed every time I kneel down there is a sharp pain."
- B.
Patient: "Oh I also gargle salt in the morning and night."
- C.
Patient: "Yeah... its been raining so much so I’ve been coughing more."
- D.
Patient: "I’m not that congested but I am sneezing."
Correct Answer(s)
A. Patient: "I’ve noticed every time I kneel down there is a sharp pain."
B. Patient: "Oh I also gargle salt in the morning and night."
C. Patient: "Yeah... its been raining so much so I’ve been coughing more."
D. Patient: "I’m not that congested but I am sneezing."Explanation
The given answer is correct because all of the statements made by the patient are medically relevant. The first statement indicates a specific symptom of sharp pain when kneeling down, which could be indicative of an underlying condition. The second statement about gargling salt could be relevant to the patient's oral health or respiratory symptoms. The third statement suggests a correlation between rain and increased coughing, which could be related to allergies or respiratory conditions. The fourth statement mentions sneezing, which could be a symptom of a respiratory infection or allergies.Rate this question:
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- 25.
When the patient says, "The other day, I went to kneel down in the garden and I’ve noticed every time I kneel down there is a sharp pain," what HPI elements are discussed? (Check all that apply.)
- A.
Context
- B.
Severity
- C.
Quality
- D.
Onset/Duration
- E.
Location
Correct Answer(s)
A. Context
C. Quality
D. Onset/DurationExplanation
The patient's statement about experiencing a sharp pain every time they kneel down in the garden provides information about the context in which the pain occurs. This helps to understand the specific situation in which the pain is triggered. The mention of a sharp pain indicates the quality of the pain. The patient also mentions that they have noticed this pain every time they kneel down, which provides information about the onset and duration of the pain. Therefore, the elements of context, quality, and onset/duration are discussed in the patient's statement.Rate this question:
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- 26.
What information does NOT belong in the HPI?
- A.
Patient: "Yeah.. its been raining so much so I’ve been coughing more"
- B.
Provider: "You don't have ulcers?" Patient: "Nope, but I don't think I’ve taken any type of pain pill since"
- C.
Patient: "I’m not that congested but I am sneezing."
- D.
Provider: "So the bone itself has a very thin layer called the periosteum. It is very sensitive. Sometimes by just laying down you can injure the top layer"
Correct Answer
D. Provider: "So the bone itself has a very thin layer called the periosteum. It is very sensitive. Sometimes by just laying down you can injure the top layer" -
- 27.
What HPI element is contained in the following piece of dialogue from the visit" Provider: "Are you able to take Motrin?"Patient: "As far as I know"Provider: "You don't have ulcers?"Patient: "Nope, but I don't think I’ve taken any type of pain pill since"
- A.
Context
- B.
Modifying Factors
- C.
Associated Symptoms
- D.
No HPI element is contained in this piece of dialogue.
Correct Answer
D. No HPI element is contained in this piece of dialogue.Explanation
There is no description of how the medication is related to the complaint, therefore this is not a modifying factor.Rate this question:
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- 28.
If information is NOT an HPI element, it should NOT be included in the HPI.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
This statement is false. In the context of medical documentation, the HPI (History of Present Illness) is a crucial component of a patient's medical history. It includes information about the patient's symptoms, the duration and severity of the illness, any previous treatments, and other relevant details. However, it is important to note that the HPI is not the only element of a patient's medical record. Other information such as the patient's medical history, physical examination findings, and laboratory test results may also be included in the overall documentation.Rate this question:
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- 29.
If information from the visit IS an HPI element, it SHOULD be included in the HPI.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The statement is true because the HPI (History of Present Illness) is a crucial component of a patient's medical record. It includes information about the patient's symptoms, their onset, duration, severity, and any factors that may have triggered or worsened the symptoms. Therefore, if information obtained from the visit is relevant to the patient's current symptoms or medical condition, it should be included in the HPI to provide a comprehensive and accurate description of the patient's history.Rate this question:
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- 30.
Which of the following questions are you LEAST likely to hear during a follow-up visit?
- A.
Have your symptoms worsened or improved since the last visit?
- B.
When was the patient last seen?
- C.
What are your chronic conditions?
- D.
How effective was the treatment?
Correct Answer
C. What are your chronic conditions?Explanation
During a follow-up visit, the healthcare provider is typically more focused on assessing the progress of the patient's symptoms and the effectiveness of the treatment. Asking about chronic conditions is less likely because it is a question more commonly asked during the initial visit to gather comprehensive medical history.Rate this question:
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- 31.
Which of the following information is important during a pre-operative visit? (Check all that apply.)
- A.
Date of surgery
- B.
Underlying illnesses
- C.
Type of Surgery
- D.
Name of Surgeon
Correct Answer(s)
A. Date of surgery
B. Underlying illnesses
C. Type of Surgery
D. Name of SurgeonExplanation
During a pre-operative visit, it is important to gather information such as the date of surgery to ensure proper scheduling and preparation. Knowledge of underlying illnesses is crucial as it helps the medical team understand any potential complications or risks. The type of surgery is essential for the medical staff to plan and carry out the procedure correctly. Lastly, knowing the name of the surgeon is important for communication and coordination between the patient, surgeon, and other healthcare professionals involved in the operation.Rate this question:
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- 32.
In what order should the following topics be presented in the HPI?
- A.
1. Most recent colonoscopy which was unremarkable. 2. Frequent episodes of chest pain. 3. Recent fall with minor injuries.
- B.
1. Recent fall with minor injuries. 2. Most recent colonoscopy which was unremarkable. 3. Frequent episodes of chest pain.
- C.
1. Frequent episodes of chest pain. 2. Recent fall with minor injuries. 3. Most recent colonoscopy which was unremarkable.
- D.
1. Frequent episodes of chest pain with associated shortness of breath. 2. Recent fall with minor injuries. 3. Most recent colonoscopy which was unremarkable.
Correct Answer
D. 1. Frequent episodes of chest pain with associated shortness of breath. 2. Recent fall with minor injuries. 3. Most recent colonoscopy which was unremarkable.Explanation
The correct answer is 1. Frequent episodes of chest pain with associated shortness of breath. 2. Recent fall with minor injuries. 3. Most recent colonoscopy which was unremarkable. This order is based on the principle of presenting the most concerning and potentially urgent symptoms first. Chest pain with associated shortness of breath is a symptom that could indicate a serious underlying condition, such as a heart problem. It is important to address this symptom first to rule out any immediate life-threatening issues. The recent fall with minor injuries can be addressed next, as it may provide context for any potential injuries or complications. The most recent colonoscopy, which was unremarkable, can be discussed last as it is not immediately concerning compared to the other symptoms.Rate this question:
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Aug 11, 2023Quiz Edited by
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Jun 27, 2016Quiz Created by
Firstsourcetrain
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