PMCH Flashcards
bupropion for smoking cessation
sustained release form = BENEFICIAL at ANY AGE
most common illness related to occupational exposure
asthma
where to refer women with domestic abuse
domestic violence program
occupational hearing loss is worse with—
HIGH frequencies
TB testing recent converters
treated at any age
BCG with TB testing
does NOT interfere with interpretation
two step Tb positive on second, not first
STILL = POSITIVE, can be positive on either first or second, treated as positive
PPD IN HIV PTS.
HIGH FN
HIGH risk of ACTIVE disease
preparatory grief
- terminal illness
- NOT depression– still have self esteem
- WAX and WANE
tx of preparatory grief with short prognosis, and depression
methylphenidate
tx of preparatory grief with LONG prognosis, and depression
SSRI’s
6% HbA1c=
7mmol/L, 120mg/dL
7% HbA1c=
8mmol/L, 150mg/dL
8% HbA1c=
10mmol/L, 180mg/dL
hawthorne study was a type of
experimental study
both experimental and observational studies don’t have
experimental manipulation
2003 internal compliance programs for pharm companies
MUST disclose sponsorship of CME activities
perchloroethylene
- neuropathy
- LIVER– damage, chemical hepatitis
- renal damage
most women with breast cancer —- wrt rf’s
NO RISK FACTORS
if 1 FDR with breast cancer
3-4X increase risk of breast cancer
hereditary breast cancer— maternal/ paternal
BOTH maternal AND PATERNAL SIDE
which month are the most number of RBC’s made?
AUGUST
pseudoephedrine is added to
methampheatmines
albuterol is added to
crack cocaine
self breast examinations
NO DECREASE IN MORTALITY
INCREASE the number of biopsies performed
when to start warfarin with CHADS2V
2+
gadolinium associated nephrogenic systemic fibrosis
using gadolinium with someone with poor renal function
bx of gadolinium associated nephrogenic systemic fibrosis
spindle cells, CD4, fibrocytes, collagen, fibrosis
any tx or predisposition to gadolinium associated nephrogenic systemic fibrosis
NOOOO TX
W/O gender/age/race preference
who is at risk for hyperthermia
- greater than 65, less than 5
- living alone
- schizo’s
- cardiopulmonary disease
use of fans for hyperthermia
NOOOO benefit if temp greater than 32, or humidity greater than 35%
most difficult to prevent which type of disease transmission
AIRBORNE
cumulative incidence rates have differences because of
screening
elder abuse most likely caused by …
CAREGIVER– most often adult children
men or women elder abuse
WOMEN– more reporting and more severe
most common form of elder abuse
NEGLECT
fu colonoscopy with personal hx of colon cancer
1-3-5
fu colonoscopy with personal hx of adenomatous polyps
3-5 years
had sex with someone x days before symptoms– need empiric tx
60 DAYS
economic burden – $ going into
chronic diseases
prophylactic aspirin women
55-79yo
prophylactic aspirin men
45-79yo
5 contraindications to nicotine patches
recent MI severe arrhythmia severe angina pregnant or breast feeding LESS THAN 18YO
why is the life expectancy increasing?
DECREASE INFANT MORTALITY
MCC skin infection in emergency department
MRSA
1 month old vit D levels
400 IU
19-50yo vit D and calcium
200IU/ 1000mg
greater than 50yo male vit D and calcium
400IU/1000mg
greater 51-70yo female vit D and calcium
400IU/1200mg
greater than 70yo female vit D and calcium
600IU/1200mg
vit D and calcium levels to prevent hip fracture in post-menopausal women
800IU/ 1200mg
best way to remove tic
blunt forceps
LDL level 2mmol/L
6
DM/CAD/PVD/AAA/carotid artery symptomatic disease/multiple risk factors greater than 20% risk
LDL level 3.5mmol/L
2 risk factors
less than 20% risk of CAD in 10 yrs
LDL level 4mmol/L
1 risk factor
less than 20% risk of CAD in 10 yrs
black cohosh
menopausal symptoms
best way for direct observational therapy to work
ADD incentives and reminders
obese patients– weight loss
30 minutes a day for 5 days
what DOESN’T hospice cover?
co-morbid illness
what to do if have a new sexual partner?
STI screen
biggest risk factor for STI’s
sexual activity at a young age
definition latent TB
positive PPD
no symptoms
no CXR findings
rabies prophylaxis for symptomatic pet
VET– if yes–> PEP
which vitamin was proven NOT TO WORK against CV disease
VITAMIN E
latex is cross reactive with
avocados
AAA screening first time
65-75yo in males who have EVER smoked
best measure of health quality during pregnancy and delivery
perinatal mortality rate
influenza vaccine
ALL PATIENTS 6mos and older
- adults with chronic conditions
- aboriginals
- elderly in nursing homes
- older than 65
- healthy pregnant women
- kids 6mos- 59mos
tx of travellers diarrhea
LOPERAMIDE or diphenoxylate
and fluids
most common adverse hospital event in those older than 60
surgical related events
ETEC vaccine
DOES NOT EXIST, but would consist of:
CS1, CS6, LT toxoid
how to kill botox spores
120 degrees for 30minutes
how to kill botox toxin
80 degrees for 30 minutes
scoliosis random ass facts
- those requiring more aggressive tx, are UNLIKELY to be detected with community screenings
- forward bend test has variable detection ability
- poor follow up once detected
- only a small portion of those treated from scoliosis actually get health benefits from tx
physical exams in young adults–40yo
every 3-5years
feeding tubes in patients with AZD
NOOOO specific benefit has been shown
effects of VZV vaccine
- decreases outbreaks
- decreases severity
- decreases duration
- MAINTAINS EFFICACY >70yo
only 2 infections= CONTRAINDICATIONS to breast feeding
HIV
HTLV-1
info on nicotine replacement tx
- 2X more likely to quit
- NO difference between suddenly stopping and tapering off
- 8 weeks= effective
- NO 1 NRT is more beneficial than the other
- increase likely to quit if add several types of NRT
all sexually activity women less than or equal to 25
CHLAMYDIA CHECK
number one risk factor for pancreatic cancer
SMOKING
hep A vaccine– random indication
amphetamine addict
melanoma screening
NOOOOPE– does NOT decrease mortality
who is most at risk for melanoma
men > 50yo
is it ok to give influenza, PCV, steroids all at same time
yessssss
what drug to avoid in elderly
1ST GEN ANTI-HIS– diphenhydramine
cause of death part 1
IMMEDIATE cause of death, and underneath including the leading up events
cause of death part 2
contributory PAST MEDICAL HX
most common STI in elderly
GENITAL HERPES
where can genital herpes present in elderly
SACRUM
whats a random fact about genital herpes
MOST PEOPLE DON’T NOTICE
AEDs beneficial in….
full and functional neurorecovery
what can be used to express the chances of a diagnostic procedure giving a positive/negative test– with likelihood of disease
LIKELIHOOD RATIO
what has the highest content of omega 3 fatty acids
FLAX SEEDS
mc population HIV in kids before 1994
male haemophiliacs
bit by someone with HIV
DO HIV TEST
cardiac rehab program for elderly
safe and effective
amount of exercise elderly need
30 minutes a week,
beneficial even with just 6 minutes
what pressure of oxygen would you need to arrange an O2 tank for the plane
if O2
aboriginals at increased risk for
TB
RA
suicide
DMT2
does MSG cause cancer?
NOOOOO
elderly and changes
increase % body fat
transdermal absorption–varies the LEAST
intra-nasal influenza vaccine
2-59yo
contraindications to intra-nasal influenza vaccine
immunosuppressed chronic immune condition pregnant asthmatic chronic aspirin use
who requires 2 doses of influenza vaccine
kids 6 months- 9 yo
kappa
observed agreement- chance agreement/ 1-chance agreement
what two diabetic drugs decrease CV mortality
- metformin
2. glucosidase inhibitors *** with impaired glucose control
why use pertussis tx
decrease secondary attack rate,
since even with vaccine have epidemic and sporadic forms
HCV most common causes
- blood transfusions before 1994
- NSI
- mucosal exposure
- vertical
HIV most common causes
- sharing needles
- sex
- vertical
LEAST LIKELY= BLOOD TRANSFUSIONS
PSA indications
for men with >10year life expectancy
- prostate on DRE
- secondary mets searching
what is more sensitivity for prostate cancer PSA or DRE
PSA
decreasing falls in elderly
safe living environment
AEROBIC EXERCSE
what steroid to treat spinal mets
DEXAMETHASONE
what things can cause a false positive urine toxicology
POPPY SEED MUFFINS Fluorquinolones Rifampin Oxaprozin NSAID's Dextromethorphan Selegiline Venlafaxine Vicks
audible sound Hz
20-20,000Hz
understanding speech Hz
400-5000Hz
what % of autopsies of men have microscopic carcinoma of prostate
70%
3 big risk factors for prostate cancer
family history
black
greater than 50yo
how many more times are black men likely to get prostate cancer
1.5X
ovarian screening—
NOT warranted, but…
- annual pap smears
- pelvic exams
if Dr. is a heroin addict– who should we report it to?
PROVINCIAL MEDICAL BOARD
they can go back to being a doctor– but if anaesthesiologist– can’t become it again– can do something else
what artery to take in child less than 1 yo
brachial artery
ginko biloba
stroke
tinnitus
yohimibine
hypertension
kava
GI
rash
rules for colonic polyps
30-40-50
50-60-70
someone with terminal illness, has congestion, gurgling, retaining secretions
scopolamine
glycopyrrolate
atropine
when to use opiates in patients with terminal illness
PAIN
FATIGUE
SOB
what two parasites are chloride resistant
cryptosporidium
giardia
IFN gamma
cannot tell difference between latent and active;
12hrs to incubate and test antigens
what parameters in framingham score– 5
- age
- smoking status
- sbp
- TOTAL CH
- HDL
smokers taking LARGE AMOUNTS OF WHAT… can increase risk of lung cancer
beta carotene
epidemiology triad
host/ agent/ environment
OCP decreases which two types of cancer
ovarian
endometrial
hyperplastic polyps
NORMAL COLONOSCOPY
any poison mishaps– send to…
PCC: poison control centre
public health physician looks after
- STI’S
- infection diseases
- dental programs in kids
- health promotion
legal negligence is the same as…
malpractice– error occurs when doing something OUTSIDE the standard accepted practice
positive PPD what next
CXR
positive CXR what next
sputum culture
most common deficiency worldwife
IRON
relapses in stages of change
NORMAL aspect of change, can be recurrent
most of the health care budget goes into…
HOSPITALS
medical records
- only released by written consent from patient
- property- physically= DR, info= patient
- CANNOT WITHHOLD FROM: third party, unpaid bills, doctor is concerned
most common adverse drug event
ordering
biofeedback for
migraines
oxygen for
cluster headaches
ma huang for
rhinitis– ephedrine like
epley monitor for
positional vertigo
CT SCANS CAUSE CANCER– risk factors include
abdo/chest> brain
neonates
women– increases risk for lung cancer, breast cancer
TdAP okay in pregnant women
YESSS
who can take away licence from patient
MINISTRY OF TRANSPORT
most common cause of emergency admission in elderly
FALLS
what phase of drug trials has the highest rate of drug failure
PHASE 2
H5N1 avian influenza small number of ppl infected because
human-human transmission
precautions when outbreak of hep A
- give hep A Ig to close contacts
- MUST REPORT TO MOH
- contact tracing
- locate primary source
NOOOOOOOOOO benefit with hand washing/disinfecting
hep C screening is NOTTTTTTT indicated for
HCM
Prague women
public safety workers
what causes occupational asthma
PVC
isocyanate
anhydride
NOT NOT NOT NOT NOT NOT NOT radiation
osteoporosis screening
NOO proven efficacy
men and women at 65yo; younger if history…
