CCFP Flashcards
Jill Brien, age 20, is a university student. She is a non-smoker who has asthma. She has had infrequent asthma symptoms over the years, and uses her medication once or twice a week. You consider her to have mild asthma.
- What class of medication should be the mainstay of her pharmacological therapy? Be specific.
State ONE.
A short-acting beta-agonist
Jill Brien, age 20, is a university student. She is a non-smoker who has asthma. She has had infrequent asthma symptoms over the years, and uses her medication once or twice a week. You consider her to have mild asthma.
- Ms. Brien starts a part-time job at a construction site. Over the next few weeks she notices that her asthma symptoms are occurring more frequently, and require her to use the medication in question 1 at least once daily. What is the most likely cause of her asthma exacerbation?
State ONE.
Dust/An environmental allergen
Jill Brien, age 20, is a university student. She is a non-smoker who has asthma. She has had infrequent asthma symptoms over the years, and uses her medication once or twice a week. You consider her to have mild asthma.
- What class of medication should be the mainstay of Ms. Brien’s pharmacological therapy at this point?
State ONE.
An anti-inflammatory/A steroidal metered-dose inhaler (MDI)/A nonsteroidal metered-dose inhaler (MDI)/Long-acting
An inhaled glucocorticoid
An inhaled glucocorticoid combined with a long-acting beta-agonist
Jill Brien, age 20, is a university student. She is a non-smoker who has asthma. She has had infrequent asthma symptoms over the years, and uses her medication once or twice a week. You consider her to have mild asthma.
- Ms. Brien would like to be able to manage her own asthma therapy. What device would you recommend she purchase?
State ONE.
A peak-flow meter
Anne Sullivan, age 29, is a schoolteacher who comes to your office complaining of 10 to 12 loose bowel movements a day for the past three to four weeks. The stools are sometimes bloody and often contain mucus.
Ms. Sullivan feels fatigued and has lost about 3 kg in weight. She has not been febrile. She has no history of previous similar episodes.
You examine Ms. Sullivan. She has a few small, ulcerated lesions on her buccal mucosa; her abdomen is diffusely tender, with no guarding or rebound and no masses. The rectal examination is very painful. She has some small ulcerations just inside the anal canal, and there is fresh blood on your glove.
- What is the most likely diagnosis?
State ONE.
Crohn’s disease/Inflammatory bowel disease (IBD)/Ulcerative colitis/Colitis *Do NOT accept “irritable bowel syndrome (IBS)”
Anne Sullivan, age 29, is a schoolteacher who comes to your office complaining of 10 to 12 loose bowel movements a day for the past three to four weeks. The stools are sometimes bloody and often contain mucus.
Ms. Sullivan feels fatigued and has lost about 3 kg in weight. She has not been febrile. She has no history of previous similar episodes.
You examine Ms. Sullivan. She has a few small, ulcerated lesions on her buccal mucosa; her abdomen is diffusely tender, with no guarding or rebound and no masses. The rectal examination is very painful. She has some small ulcerations just inside the anal canal, and there is fresh blood on your glove.
- What initial laboratory investigations would you order?
List FOUR.
Question 2 – 4 points (1 point each – any 4)
Stool culture testing
Stool testing for ova and parasites (O&P)
Hemoglobin testing/Hematocrit testing
White blood cell count (WBC)
Erythrocyte sedimentation rate (ESR) testing
C-reactive protein (CRP) testing
Albumin testing
Anne Sullivan, age 29, is a schoolteacher who comes to your office complaining of 10 to 12 loose bowel movements a day for the past three to four weeks. The stools are sometimes bloody and often contain mucus.
Ms. Sullivan feels fatigued and has lost about 3 kg in weight. She has not been febrile. She has no history of previous similar episodes.
You examine Ms. Sullivan. She has a few small, ulcerated lesions on her buccal mucosa; her abdomen is diffusely tender, with no guarding or rebound and no masses. The rectal examination is very painful. She has some small ulcerations just inside the anal canal, and there is fresh blood on your glove.
- What is the most appropriate diagnostic investigation to do next? Be specific.
State ONE.
Question 3 – 1 point (either)
Colonoscopy/Sigmoidoscopy
Endoscopy with biopsy testing
Do NOT accept “barium enema”
Anne Sullivan, age 29, is a schoolteacher who comes to your office complaining of 10 to 12 loose bowel movements a day for the past three to four weeks. The stools are sometimes bloody and often contain mucus.
Ms. Sullivan feels fatigued and has lost about 3 kg in weight. She has not been febrile. She has no history of previous similar episodes.
You examine Ms. Sullivan. She has a few small, ulcerated lesions on her buccal mucosa; her abdomen is diffusely tender, with no guarding or rebound and no masses. The rectal examination is very painful. She has some small ulcerations just inside the anal canal, and there is fresh blood on your glove.
- The investigation in question 3 confirms the diagnosis in question 1. What are the possible future gastrointestinal complications of Ms. Sullivan’s condition?
List THREE.
QUESTION 4 – 3 points (1 point each – any 3)
Strictures
Abscesses
Fistulae
Bowel obstruction
Toxic megacolon
Malabsorption/Malnutrition
Intestinal malignancy
Bile malabsorption
