2018 Practice exam Flashcards
What are three complications associated with anti-hypertensive polypharmacy?
Falls
Hypotension
Renal abnormalities
What are three downsides of a yearly physical?
Over diagnosis
Increased public cost
Increased patient anxiety
Unnecessary medical interventions
Describe the two shingles shot?
Zostavax - 1
Shingrix - 2
What is the complication of herpes zoster
Post-herpetic neuralgia
What are three acute adverse events associated with short-term corticosteroid use?
AVN of hip
GI bleed
Sepsis
How to reduce spread of infection in organized sports?
Footwear in showers
Clean material
Don’t share hygiene products
Three non-pharmacologic interventions to decrease exacerbations in children with asthma.
Inhaler technique Avoidance of triggers Vacuuming with hepa No smoking in the house Dusting Exercise
List 4 non-inhaler treatments for asthma.
Leukotrine receptor antagonist
Steroids
IV beta agonist
PDE-5 inhibitors
List 5 complications of carotid endarterectomy.
Death Stroke Infection Bleeding MI Pain Anesthetic reaction Damage to nearby structures Transfusion Rejection of stent Re-stenosis
What are 3 options for reducing PPI use?
Reduce dose
Reduce frequency
Switch to H2 receptor antagonist
On demand dosing
List 3 scenarios where you could not de-prescribe PPIs.
Barrett’s esophagus
Chronic NSAIDs
Active ulcer/GI bleed
List 5 possible side effects of PPIs
Hypomagnesemia Pneumonia C. diff Osteoporosis Diarrhea
Three OTC products that can increase bleeding risk on title anti-thrombotic factors.
NSAIDs
Vitamin E
Ginseng
Ginko
8 risk factors for MRSA
Shared living Low SES IVDU Chronic antibiotic use Contact sports Incarceration Military Age younger than 2 Age older than 65
3 medication classes to treat MRSA
Tetracycline (doxycycline) Sulfonamides (TMP/SMX) Lincosamides (clindamycin) Linezolid Lipoglycopeptides (Vancomycin)
List 6 management steps for TB.
Airborne precautions Isolation CXR Sputum TB * 3 Risk factor assessment Contact tracing Consult public test Interfuron gamma release assay HIV serology
What are 5 risk factors for progression to active TB?
Steroids Chemotherapy Biologics HIV Diabetes Alcohol use Malnutrition Smoker
What are three classifications of testes and their descent?
Normal Retractile testis Palpable undescended testis Non-palpable Acquired testis Ectopic testis
What imaging do you order if you suspect undescended testicle?
None
When do you refer an undescended testicle by?
6 months. So they can be operated on before 1 year
List 5 lifestyle interventions for hydradenititis suppuritiva.
Avoid disruption of lesions Smoking cessation Weight loss Low fat diet Shower after exercise/Clean Loose clothing
6 treatments for hydradentitis suppuritiva
Topical clindamycin Oral tetracycline OCP Finasteride Steroid injection Surgical excision
Three complications of blood product resuscitation?
Hemodilution Hypothermia Anaphylaxis Hemolytic reaction TRALI Transfusion reaction circulatory overload Electrolyte abnormalities
List 5 life threatening causes of chest pain.
PE Aortic Dissection Tension pneumothorax Pericardial tamponade MI
What are 4 tests in assessment for ASD.
Hearing test
Visual test
M-CHAT
Developmental paediatrician
List 5 causes of ascites
Heart failure Nephrotic syndrome Peritoneal tumour Cirrhosis TB
5 Complications of cirrhosis
Portal venous hypertension Testiclar shrinkage Gynecomastia Varices SBP HCC Hepatic encephalopathy
What are 5 causes of cirrhosis
Hemochromatosis Hep C Hep B Hep D Alcohol Primary sclerosing cholangitis NASH Wilson disease Alpha-1 antitrypsin
7 vaccines for HIV +ve immigrant
Hep A Hep B Flu COVID Pertussis Tetanus Meningococcal HIB HPV
Headache in HIV. What organisms?
Treponema Pallidum
Cough in HIV. What organisms?
Mycobacterium avian complex
PJP
Do you reduce DOACs for renal disease?
Yes if eGFR less than 60
If dialysis switch to warfarin
What medication must you use in valvular a. fib?
Warfarin.
What are 4 non-genital areas to look for STIs?
Throat Eyes Skin Abdomen MSK
Treatment for syphillis
Azithromycin 1 g PO
Ceftriaxone 250 mg IM
or
Doxy 100 mg BID * 7 days
What are complications of urogenital gonorrhoea and chlamydia?
Epididimytis Infertility Fournier's gangrene Prostatitis Orchitis
5 contraindications to OCP
Migraine with aura Breast cancer Smoker > 35 DVT Liver disease Uncontrolled HTN PE Active malignancy
What population do you screen for AAA?
Men 65-80 once
What is the range of opiates for chronic non-cancer pain?
50-90 MDE
What objects can cause toxic shock syndrome?
Diva cup
Female condom
Sexual aids
Physical exam findings suggestive of thyroid malignancy
Lymphadenopathy Fixated Irregular borders Dysphonia Dysphagia Dyspnea
History suggestive of thyroid malignancy
Head and neck radiation
MEN 2
Total body radiation for bone
Four non-pharmacological treatments for pruritus?
Moisturizer after bathing Avoid scented soaps Identify allergens Cleaning bedding Limit bathing Cut fingernails
5 psychological causes of itch.
Delusional parsitosis Formication OCD Psychosis Anxiety
What is the target sign associated with on U/S?
Intessuception.
What are 3 surgical emergencies in kiddo with abdominal pain?
Volvulus
Intussueception
Pyloric stenosis
What are 5 conditions that a patient may have had that would make they high risk and ineligible for colon cancer screening?
Colon cancer Prior polyps Lynch Syndrome Familial adenomatous popyposis IBD
Other than colonoscopy what other investigation can be used for colorectal screening?
Flex sig q10years
What two conditions would put the patient at high risk for peanut allergy?
Egg allergy
Eczema
What are three conditions associated with non-suicidal self-injury?
Depression
Borderline
Sexual abuse
What medications can be used in treatment of C. difficile
Vancomycin
Fidaxomycin
Metronidazole
Rifampin
What are 5 complications with C. diff?
AKI Toxic megacolon Hypokalemia Sepsis Dehydration
What is an infectious agent concerning with diarrhea in HIV positive.
Mycobacterium Avian Complex
What are three red flags associated with diarrhea?
Pain
Febrile
Bloody
Is loperamide safe in pregnancy?
Yes.
Metronidazole in pregnancy and breastfeeding?
Safe in pregnancy. No good in breastfeeding
5 non-pharmacologic treatments for fibromyalgia
CBT Patient education Accupuncture Massage Group support Treat co-morbid disease
List 5 live attenuated vaccines?
MMR Shingles (Zostavax) Varicella Polio Rotavirus
What are 5 advanced treatments for RF?
Methotrexate Sulfasalazine Azathioprine Cyclosporin Adalimumab
What are 5 physical exam findings associated with dyslipidemia?
Arcus cinillicus Xanthelasmas Xanthomas Weight Waist circumference Hepatosplenomegaly
List three classes of medications that can cause hyperlipidemia.
Anti-psychotics HRT OCP Thiazide diuretics Beta-blockers
List 6 dietary recommendations for dyslipidemia.
Alcohol reduction Caloric reduction Mediterranean diet Increase fresh fruit and vegetable Omega 3 supplementation Soluble fibre supplementation
What do you do to the Framingham if there are first degree relatives with CV disease?
You double it.
5 therapies other than ARVs for HSV
Topical abreva Acetaminophen NSAIDs Topical lidocaine Topical hydrocortisone
