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MCCQE 1 > Family Medicine > Flashcards

Family Medicine Flashcards

1
Q

Breast Cancer Screening

A

Mammography to 50-74 yo q/2-3 years (Conditional recommendation, very low certainty evidence)

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2
Q

Lung Cancer Screening

A

LDCT q/ year, 55-74 yo with smoking history currently of >30 pack/year or quit <= 15 years ago, up to 3 consecutive times

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3
Q

Colorectal Cancer Screening

A 
60-74 yo: 
FOBT or FIT q/2 years
Or
Flexible Sigmoidoscopy q/10 years
(Strong recommendation, moderate quality evidence)
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4
Q

Cervical Cancer Screening

A

30-69 yo: Pap Smear or liquid bases cytology q/3 years.

> 70 yo with not proper screening: continued screening until 3 negatives.

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5
Q

Next step if Cervical cancer screening Normal

A

Routine screening in 3 years

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6
Q

Next step if Cervical Cancer Screening: Inadequate sample

A

Repeat cytology in 3 months

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7
Q

Next step if Cervical Cancer Screening: Adequate sample, no TZ

A

Routine screening in 3 years

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8
Q

Next step if Cervical Cancer Screening: ASCUS, <30 yo or not HPV testing available

A

Repeat cytology in 6 months.
And then If
Negative: repeat in 6 months
ASCUS: Colposcopy

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9
Q

Next step if cervical cancer screening ASCUS, >30yo

A

HPV-DNA testing.
If negative: repeat cytology in 1 year.
If positive: Colposcopy.

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10
Q

Next step if cervical screening ASC-H (Abnormal squamous cells cannot rule out HSIL)

A

Colposcopy

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11
Q

Next p if cervical cancer screening AGUS/atypical endocervical cells/ atypical endometrial cells

A

Colposcopy + endometrial sampling

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12
Q

Next step if cervical cancer screening LSIL

A

Colposcopy or repeat cytology in 6 months

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13
Q

Next step if cervical cancer screening HSIL

A

Colposcopy

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14
Q

Next step if cervical cancer screening squamous carcinoma / other malignant changes

A

Colposcopy

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15
Q

Prostate cancer screening

A

55-69yo, inconsistent evidence of small benefit of PSA test. There is no evidence that screening with PSA test reduces mortality at other ages.

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16
Q

Obesity Definition

A

Prevalent,
Complex,
Progressive,
Relapsing chronic disease that is characterized by abnormal/excessive body fat (adiposity)

17
Q

BMI formula

A

Weight (kg) / height2 (m2)
Or
Weight (lbs) / height2 (inches2) x703

18
Q

Normal BMI

A

18.5 - 24.9

19
Q

Management

Canadian Adult Obesity Clinical Practice Guidelines (Obesity Canada, 2020)

A
  • Step 1: recognize obesity as a chronic disease and obtain patient permission to treat
    • Step 2:
    -assess the patient using appropriate measures (i.e. height, weight, WC, and BMI calculation)
  • identify root causes
    complications, and barriers to treatment
    • Step 3: discuss treatment options
  • Step 4: agree on goals of therapy with the patient
  • Step 5: follow-up and reassess
20
Q

Obesity Treatment Options

A 
Nutrition
Physical activity
Psychological and behavioral interventions
Pharmacotherapy
Bariatric surgery
21
Q

Pharmacological treatment indication in obesity

A

BMI >27 kg/m2 and risk factors
or
BMI ≥30 kg/m2

Adjunct to lifestyle modifications:
consider if patient has not lost
0.5-1 kg (1-2 lb) per wk by
3-6 mo after lifestyle changes

22
Q

Bariatric surgery indication in obesity

A 
BMI ≥35 kg/m2 and risk factors
or
BMI >40 kg/m2
Consider if other weight loss
attempts have failed. Requires
lifelong medical monitoring
23
Q

Dyslipidemia Screening

A

full lipid profile every 1-3 yr
in:
- males and females ≥40 yo or menopausal
- Any age adults with additional dyslipidemia risk factors

24
Q

Risk Factors for screening for dyslipidemiA

A 
-Men and women ages ≥40 (or
postmenopausal)
-First Nations or
individuals of South Asian ancestry
-Current cigarette smoking
-T2DM
-Arterial HTN
-Family history of premature CVD (men
<55, women <65 in 1st-degree relative)
-Family history of dyslipidemia
-Erectile dysfunction
-Chronic kidney disease
-Inflammatory disease (lupus, rheumatoid
arthritis, psoriatic arthritis, IBD)
-HIV infection
-COPD
-Clinical evidence of atherosclerosis or
abdominal aortic aneurysm
-Stigmata of dyslipidemia (arcus cornea,
xanthelasma, or xanthoma)
Obesity (BMI 230 kg/m?)
-Hypertensive diseases of pregnancy
25
Q

Dyslipidemia Assesment

A

-Dyslipidemia screening
-physical examination
-Glucose
-eGFR
-4, 1G, calculated HDL-C), glucose, and eGFR
(optional: apolipoprotein B, urine ACR)
-screen for secondary causes: hypothyroidism, chronic kidney disease, DM. nephrotic sundrome liver
disease
-Estimate risk category (FRS)

26
Q

Dyslipidemia Treatment

A

Intensity and type of treatment is guided by “risk category” :

  1. Health behaviour interventions
  2. Pharmacologic therapy
27
Q

Pharmacologic therapy Dyslipidemia

A

(If patient is not a high risk, employ consistent lifestyle modifications for at least 3 mo before considering drug therapy.)

  • 1st line mono therapy: Statins
  • If severe side effects: Ezetimibe
  • Post acute coronary syndrome: Cholesterol absorption inhibitors + Simvastatin (reduces mortality)
28
Q

Monitoring of pharmacologic treatment of dyslipidemia

A
  • ALT, CK, creatinine at baseline and 6 wk later

- Fasting lipids every 6-12 mo

MCCQE 1 (1 decks)

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