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CCFP Exam 2021 > 2021 Practice Exam > Flashcards

2021 Practice Exam Flashcards

1
Q

List two point-of-care tests for group A strep.

A

Rapid antigen testing

Nucleic acid detection

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2
Q

List 5 symptoms of hypothyroidism.

A 
Brittle hair/nails
Weight gain
Depression
Cold intolerance
Dry skin
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3
Q

What are three limitations of point of care group A strep tests?

A

Cannot distinguish between carrier and active infection
Cannot determine virulence
Cannot determine abx sensitivity

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4
Q

What are three benefits of antibiotic treatment for group A strep?

A

Reduced symptoms and reduced duration
Decrease instance of secondary infections (AOM, Peritonsillar abscess, sinusitis)
Decreased incidence of rheumatic fever

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5
Q

List 5 symptoms of hypothyroidism.

A 
Brittle hair/nails
Weight gain
Depression
Cold intolerance
Dry skin
Constipation
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6
Q

What is the definition of sub-clinical HTN? 4 items.

A

TSH 4-10
Normal T3
Normal T4
Asymptomatic

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7
Q

In what 4 cases should acupuncture be avoided?

A

Radicular back pain
Local infection
Non-licensed
Non-sterile

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8
Q

What are five non-drug therapies for low back pain?

A 
Stretching
Heat
Ice
Massage
Yoga
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9
Q

What percentage of patients with ASD suffer from sleep abnormalities?

A

75%

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10
Q

What are five common sleep abnormalities associated with ASD?

A 
Onset latency
Poor sleep efficiency
Early waking
Prolonged sleep
Somnambulism
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11
Q

What two treatments are effective for improving sleep in ASD?

A

CBT

Melatonin

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12
Q

What are 5 risk factors for social isolation, social vulnerability and loneliness?

A 
Increased age
Living alone
Female sex
Sensory loss
Low income
Living far from family
LTC
Few friends
No transport
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13
Q

What effect might social isolation have on a patient’s health?

A

Increased morbidity and mortality

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14
Q

What are the four geriatric giants?

A

Immobility
Incontinence
Instability
Impaired memory/intellect

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15
Q

What are three signs of Wernicke’s encephalopathy?

A

Confusion
Ataxia
Opthalmoplegia

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16
Q

What is the management for Wernicke’s encephalopathy?

A

Thiamine

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17
Q

Why do we give thiamine prophylactically to EtOH patients?

A

To prevent Wernicke’s encephalopathy.

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18
Q

What three conditions are associated with thiamine deficiency?

A

Wernicke’s encephalopathy
Beriberi
Korsakoff’s syndrome

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19
Q

What two non-pharm substances should be avoided in patients taking opioids?

A

Cannabis

Alcohol

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20
Q

What two OTC should all heavy smokers take?

A

Vit D

Calcium

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21
Q

New 65 year old male heavy smoker comes to office. What non-lab screening tests do you order?

A

Flex sig
Low dose CT thorax
U/S abdo for AAA

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22
Q

What 4 vaccinations do you offer 65+ male

A

PSV-13
PPSV-23
Flu
Tdap

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23
Q

What are 4 teratogenic effects associated with anti-seizure medications?

A 
Neural tube defects
Lower IQ scores
Heart malformation
Cleft lip and palate
Low birth weight
Urogenital defects
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24
Q

What is the recommended dose of folic acid supplementation during pregnancy for women at high risk of defects?

A

4 mg

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25
Q

What effect does estrogen have on valproate?

A

Estrogen increases the breakdown of valproate.

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26
Q

How long does somebody need to be seizure free before getting pregnant?

A

9 months

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27
Q

What are 5 things to do before the start of every pregnancy?

A 
Cannabis cessation
Smoking cessation
Alcohol cessation
Medication review
Folic acid
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28
Q

List 5 causes of alternating diarrhea and constipation.

A 
IBS
Crohn's
UC
Celiac disease
Gastroenteritis
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29
Q

What test is best to differentiate IBS from IBD?

A

Fecal calprotectin.

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30
Q

What are two medications to treat IBS?

A

TCA’s - diarrhea

SSRI’s - constipation

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31
Q

What are the four categories of fecal incontinence?

A

Urge
Passive
Involuntary
Seepage

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32
Q

What are two non-pharmacologic strategies to treat fecal incontinence?

A

Dietary changes

Reduce barriers

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33
Q

What are 4 classes of medications that may cause diarrhea?

A 
Biguanides
Magnesium
Antibioitcs
PPI
Calcium channel blockers
Antifungals
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34
Q

What diagnosis would you suspect with a rash that starts in between the toes and progresses to the dorm of the foot with scale?

A

Tinea pedis.

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35
Q

What are three complications of tinea pedis?

A

Secondary infection
Asthma flares
Eczema flares

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36
Q

What is the most effective treatment for tinea pedis?

A

Topical terbinafine

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37
Q

What are three times you should you use an oral agent for tinea pedis?

A

Immunosuppressed
Failed topical
Severe disease

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38
Q

What are four side effects with the ketogenic diet?

A 
Gastrointestinal discomfort
GERD
Nausea
Vomiting
Diarrhea
Constipation
Dyslipidemia
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39
Q

What are 3 benefits of the ketogenic diet

A

Decreased HbA1c
Decreased need for insulin
Weight loss

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40
Q

What one condition benefits from the ketogenic diet?

A

Epilepsy

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41
Q

What one test do you order if you suspect lithium toxicity?

A

Serum lithium level

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42
Q

What 3 things may effect lithium level?

A

Treatment adherence
Drug interactions
Age
Comorbid conditions

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43
Q

What are four occasions where you check lithium levels?

A

3-6 days after initiation
If there is a dosage change
If you suspect toxicity
q3-6 months regardless

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44
Q

What are 5 parameters you would follow for a patient on lithium?

A 
Lithium level
Serum sodium
Serum urea
Serum creatinine
Calcium level
TSH
Weight
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45
Q

What two conditions are associated with pediatric atopic dermatitis?

A

Asthma

Allergies

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46
Q

What are two recommendations you would make regarding diet for a 5 month old child?

A

Introduce allergens
Introduce allergens one food at a time
Introduce iron containing foods

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47
Q

List four foods you would want to introduce to a 5 month child.

A

Eggs
Milk
Peanuts
Wheat

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48
Q

What is the ideal age range to introduce allergens?

A

4-6 months

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49
Q

What is the most concerning side effect with aromatase inhibitors (breast cancer chemo)?

A

Osteoporosis

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50
Q

What drug class reduces the risk of breast cancer recurrence in bone as well as mortality in menopausal women?

A

Bisphosphonates

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51
Q

What four things should you screen a patient with cancer for?

A

Depression
Fatigue
Anxiety
Pain

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52
Q

How often should a post breast cancer patient be reviewed?

A

q6months

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53
Q

What three things should be done post breast cancer at each visit?

A

Clinical exam
Screen for mental health
Side effects of therapy

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54
Q

When should a post-breast cancer patient have a mammogram?

A

q12 months

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55
Q

What five lifestyle recommendation should you make for a post-breast cancer patient?

A 
Exercise
Smoking cessation
Alcohol reduction
Maintain healthy weight
Monthly self breast exam
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56
Q

What two medications are most associated with a hypoglycemic event?

A

Sulfonureas

Insulin

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57
Q

What is the biggest risk for a hypoglycemic event in a diabetic?

A

Age

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58
Q

What indication must you have for chronic non-cancer opiate use?

A

All other therapies have failed

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59
Q

If a patient has almost constant pain (day and night) what formulation of narcotic analgesia is appropriate?

A

Sustained release

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60
Q

What diagnosis do you suspect with repetitive strain injury worse with wrist extension?

A

Lateral epicondylitis

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61
Q

What recommendation do you have for PRP injections?

A

Don’t

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62
Q

What treatment is associated with a reduction in pain in lateral epicondylitis?

A

Physiotherapy

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63
Q

What is the prognosis for lateral epicondylitis if left untreated?

A

90% self resolve by 12 months

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64
Q

What three things are diagnostic for familial hypercholesterolemia?

A

Tendon xanthomas
LDL-C < 8.5
Known DNA mutation

65
Q

What lab finding would make you suspicious for familial hypercholesterolemia?

A

LDL-C > 5 in patients over 40

LDL-C > 4 in patients under 18

66
Q

What are three things on personal history/physical exam that would make you suspicious for colon cancer?

A 
Melena
Hematochezia
Constitutional symptoms
Abdominal mass
Rectal mass
67
Q

What are 5 treatments (pharm/non-pharm) for IBS?

A 
Low-FODMAP
Increase fluid
Soluble fibre
Anti-spasmodics
TCA's
SSRIs
68
Q

What 5 medications would you expect a patient with diabetes and a history of MI to be on?

A 
ACE
beta-blocker
Statin
Metformin
SGLT2i
69
Q

What are 5 classes of medications you would stop on a sick day?

A 
Sulfonureas
ACE
Diuretics
Biguanide
ARB
NSAIDs
SGLT2i
70
Q

What two diabetic medications have cardioprotective effects?

A

GLP1 agonists

SGLT2 inhibitors

71
Q

What are 5 benefits of GLP1 agonists/SGLT2i?

A 
Decreased CV complication
Decreased CV mortatliy
Weight loss
BP lowering
Nephroprotective
72
Q

What are 5 side effects associated with SGLT2i?

A 
Increased urinary frequency
Increased urinary volume
Orthostasis
Genital candidiasis
UTIs
Decreased GFR
73
Q

What two parameters should be assessed after initiation of an SGLT2i at 2-4 weeks?

A

eGFR

Potassium

74
Q

What therapy should be initiated in pregnancy to reduce pre-eclampsia?

A

Low dose ASA

75
Q

When is the optimal time to initiate aspirin to reduce pre-eclampsia?

A

< 16 weeks

76
Q

What are three risk factors for pre-eclampsia?

A

Obesity
Previous gestational diabetes
Older age

77
Q

When is the best time to deliver a patient who is pregnant and obese?

A

Before 39 weeks

78
Q

When should a c-section be considered in an obese patient?

A

If projected birthweight is > 5kg

79
Q

What additional imaging tests should be done in an obese patient?

A

U/S @ 28, 32, 36 weeks

Weekly after 37

80
Q

What are 5 causes of tremor?

A 
Beta-agonist use
Corticosteroid use
Essential tremor
Physiological tremor
Alcohol withdrawal
Caffeine intake
81
Q

What are three symptoms of Parkinson’s?

A

Pill rolling tremor
Bradykinesia
Rigidity

82
Q

What is one treatment you wouldn’t use for Parkinson’s?

What is one you would?

A

Don’t use amantadine

DO use carbodopa/levopoda.

83
Q

What are 5 causes of Kussmal breathing in children?

A 
Metabolic acidosis
Heart failure
Croup
Bronchitis
Pneumonia
Uncontrolled asthma
Renal failure
Sepsis
Anxiety
84
Q

What is the causative agent for Molluscum?

A

Poxvirus

85
Q

How does one continue to get infected by molluscum?

A

Autoinnoculation

86
Q

What is the one best treatment for molluscum?

What are two others

A

Cantharidin
Curettage
Cryo
Observation

87
Q

What are three adjustments you can make to help with absorption of medications following bariatric surgery?

A

Switch solid to liquid
Switch XR to IR
Non-oral formulations
Less first pass metabolism

88
Q

How frequently do you review a bariatric patient post surgery?

A

q2-4 weeks until weight stabilizes

89
Q

What are three features of sensorineural hearing loss?

A

Gradually progressive
Worse at high frequencies
Worse in noisy environments

90
Q

What diagnosis would you suspect with patchy circular hair loss?

A

Alopecia areata

91
Q

What age range is alopecia aerate most prevalent?

A

1-17 years

92
Q

What are 3 treatments for alopecia areata?

A 
Steroids
Topical midoxinil
Topical bimatoprost
Cyclosporine
Azathiprine
PRP
93
Q

Which four routes are effective for steroid use for alopecia aerata?

A

Topically
Intralesionally
Orally
IV

94
Q

What tool could you use to assess disease burden of OA severity?

A

Lequesne index

95
Q

What is one non-parenteral medication for OA?

A

Intra-articular steroid injection

96
Q

In decreasing order of severity, what are 4 types of homelessness?

A

Unsheltered
Emergency sheltered (Sal’s army)
Provisionally accommodated
Precariously housed (couch surfing)

97
Q

What are 3 reasons somebody may not be able to make it to an appointment?

A 
Hours of operation
Transport
Child care
Mental barriers
Lack of phone
98
Q

What are 4 things to help the homeless?

A 
Income assistance
Access to housing
Social worker
Substance use programming
Mental health services
99
Q

What are 6 symptoms of Kawasaki disease?

A 
Fever
Conjunctivitis
Rash
Adenopathy
Oral changes (strawberry tongue)
Hand/Foot involvement
100
Q

What complication do you look out for in Kawasaki disease?

A

Coronary Artery Aneurysm

101
Q

How do you treat Kawasaki disease?

A

ASA

IVIG

102
Q

In a child who you suspect Kawasaki disease, but they don’t have 4/5 symptoms, what would you call the diagnosis?

A

Incomplete Kawasaki disease

103
Q

What two antibody screening should be done at the first pre-natal visit?

A

ABO

Rh

104
Q

What antibodies are most commonly associated with hemolytic disease of the fetus and newborn?

A

Anti-C,D,E Kell

105
Q

What are three circumstances that increase risk of the mother developing antibodies?

A

Blood transfusion
Pregnancy
Maternal fetal hemorrhage

106
Q

What test should you order if a pre-natal patient has weak RhD antibodies?

A

RhD genotyping

107
Q

What are three tests if you suspected hemolytic disease of the newborn?

A

Hemoglobin
Reticulocyte count
Blood film
Indirect bilirubin

108
Q

What test is unsuitable for screening of neonatal jaundice?

A

Coomb’s test

109
Q

If there is an elevated unconjugated bili, what tests need to be normal to rule out hemolytic disease of the newborn?

A

Normal hgb
Normal reticulocyte
Normal blood film

110
Q

What one condition are you worried about if there is fetal-maternal incompatibility

A

Hemolytic disease of the newborn

111
Q

What process do we try and prevent with winRho?

A

Alloimmunization

112
Q

List 5 causes of maternal fetal hemorrhage.

A 
Abdominal trauma
Delivery
Spontaneous abortion
Therapeutic abortion
Crodocentesis
Chorionic villous sampling
Amniocentesis
External Cephalic Version
113
Q

What is the dose of WinRho?

A

300 micrograms

114
Q

What test do you order if you suspect varicella zoster or herpes zoster?

A

Viral PCR

115
Q

What complication do you worry about in elderly with herpes zoster or varicella zoster?

A

AKI

116
Q

What precautions should somebody infected with varicella zoster be placed under?

A

Airborne

117
Q

When is somebody with varicella zoster no longer contagious?

A

When the lesions have crusted over

118
Q

What is the active ingredient in the IUS?

A

levonorgestrel

119
Q

What two treatments can reduce the pain of IUD insertion?

A

4% topical lidocaine
600 micrograms of misoprostol
Lidocaine-prilocaine cream

120
Q

What are the two first line treatments for alcohol use disorder? Which is better for cravings? Which is better for abstinence?

A

Acamprosate - abstience

Naltrexone - cravings

121
Q

What are two second line treatments for alcohol use disorder?

A

Gabapentin

Topiramate

122
Q

What are two indications for multi-vitamins?

A

Alcohol use disorder
Compromised nutritional status
Macular degeneration

123
Q

Which three OTC do not have great evidence in otherwise healthy elderly?

A

ASA
B12
Multivitamin

124
Q

What happens when you give amoxicillin to mononucleosis?

A

Amoxicillin rash

125
Q

List 5 side effects of antibiotics

A 
Nausea
Vomiting
Bloating
Abdominal pain
Diarrhea
C. diff
Allergy
126
Q

List 3 antibiotics that are most likely to cause C. difficile infections.

A 
Clindamycin
Ampicillin
Amoxicillin
Levofloxacin
Moxifloxacin

Think CALM the gut

127
Q

Broad spectrum antibiotics are associated with overgrowth of what organism?

A

Candida

128
Q

What is called when somebody is pathologically scared of getting cancer again?

A

Fear of cancer recurrence (FCR)

129
Q

What is the scale for measuring patient worry about cancer recurrence?

A

Fear of Cancer Recurrence inventory

130
Q

List 5 antibiotics that can be used for oral treatment of cystic acne

A 
Doxycycline
Tetracycline
Clindamycin
Keflex
Azithromycin
Erythromycin
SMP-TMX
131
Q

What drug class for cystic acne is most associated with hypersensitive reactions and autoimmune disorders?

A

Tetracyclines

132
Q

What two populations should not get tetracyclines?

A

Pregnant persons

Children under 8 years

133
Q

List 5 symptoms of ADHD

A 
Inattention
Impulsiveness
Hyperactivity
Forgetfulness
Distractibility
Poor academic performance
Behavioural problems
134
Q

What are 5 other diagnoses that should be on your differential when considering a diagnosis of ADHD?

A 
ODD
tic disorder
Substance use disorder
Anxiety
Depression
Autism spectrum disorder
Learning disorder
Intelectual disability
135
Q

What are three gestational risk factors for ADHD?

A

Low birth weight
Maternal alcohol use
Maternal smoking

136
Q

What are two first-line treatments for ADHD?

A

Methylphenidate

Amphetamine

137
Q

What is the number one risk factor for ADHD?

A

Family history

138
Q

What should you screen for before prescribing a stimulant for ADHD?

A

Risk factors for sudden cardiac death

139
Q

List 5 risk factors for pneumothorax.

A 
Previous pneumothorax
Asthma
Emphysematous bleb
Tobacco use
Congenital abnormalities
140
Q

What is the definitive management for pneumothorax?

A

Chest tube

141
Q

What is the most common complication following pneumothorax?

A

Recurrence

142
Q

What are three risk factors for developing OA?

A

Occupation
BMI
Previous injury

143
Q

What is the most effective treatment for OA pain?

A

Exercise

144
Q

What are 3 side effects of BZRAs?

A

Physical dependence
Falls
Memory
Sleep quality

145
Q

How much sleep do the elderly need?

A

7-8 hours

146
Q

What are 3 interventions to improve sleep hygiene?

A

Avoid caffeine before bed
Avoid alcohol before bed
Avoid electronics before bed

147
Q

In a child with a swollen joint what are 4 diagnoses you should consider?

A

Septic arthritis
Juvenile idiopathic arthritis
Acute reactive arthritis
Lyme disease

148
Q

What is the treatment for lyme disease?

A

Doxycycline

149
Q

What is the complication associated with missed DKA?

A

Cerebral injury

150
Q

What are four parameters for diagnosing DKA?

A

Elevated BGM
Low pH
Ketonemia or Ketonuria
Low Bicarb

151
Q

What are 5 precipitants for DKA?

A 
Febrile illness
Gastro
Eating disorder
Alcohol
Cannabis
152
Q

What is the first step in management in pediatric DKA?

A

Bolus normal saline 10 mg/kg

153
Q

What are four side effects of hearing loss in elderly?

A

Falls
Social isolation
Mental illness
Cognitive decline

154
Q

If a patient exhibits improvement with hearing aids, what second device could you offer?

A

Cochlear implants

155
Q

What are red flags of hearing loss?

A

Sudden onset
Head trauma
Neurologic findings

156
Q

What diagnosis would you suspect if you saw a rash in a 6 year old as well as abdominal pain and fever?

A

Henoch Schonlein purpura

157
Q

What is the pathophysiology of Henoch Schonlein purpura?

A

IgA mediated vasculitis

158
Q

What is one long term complications associated with henloch schonlein purpura?

A

Renal injury

CCFP Exam 2021 (11 decks)

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