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MCCQE1 ** > PMCH > Flashcards

PMCH Flashcards

1
Q

End of life pt with bone pain. Tx?

A

Steroids

Dexamethasone

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2
Q

PPD test is considered + when?

A

1- >10mm in pts with no known risk factors
2- >10mm in pts with known TB risk factors I.e. immigrants, prisoners, homecare workers
3- >5mm in immunocompromised i.e. HIV, children on chemo, chronic steroid treatment, PLUS household contact with TB pts

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3
Q

Fecal-orally transmitted pathogens:

A

1- Bacteria: C Diff, Cholera, Shigella
2- Virus: Norwalk, Polio, Hep A, Hep E
3- Parasite: Giardia, Cryptosporidium

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4
Q

when should the 1st dose of rotavirus vaccine be given?

A

prior to 14 weeks of age

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5
Q

Asymptomatic patients with family Hx of Colorectal Ca should begin colonoscopy at?

A

age of 50 or 10 yrs younger than the age of their 1st degree relative who had Ca.

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6
Q

screening of 10,000 subjects (160 are +), 8 have the disease.

what is the predictive value of a positive test?

**These 8 survived longer than others suffering from the same type of cancer diagnosed by other means

A

5%

8/160

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7
Q

Disadv of case control studies:

A
  • possibility of recall bias
  • possibility of confounding bias
  • no incidence of the disease
  • control selection can be difficult
  • may be difficult to establish temporality
  • record keeping maybe unreliable
  • only one outcome can be measured
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8
Q

Tx of Pertussis

A

Azithromycin OR clarithromycin

note: they aim at reducing transmissibility not other factors

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9
Q

Environmental health jurisdictions:

A

1- Municipal: waste disposal

2- Provincial:
a- water & air quality
b- regulating industrial emissions
c- toxic waste disposal

3- Federal:
a- designates & regulates toxic substances
b- food regulation
c- pollutants that cross provinces

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10
Q

When are Rotavirus vaccine given?

A

they are given orally starting 6 weeks of age in a 3 dose schedule at ages 2,4 and 6 months or in 2 doses at 2 and 4 months of age.

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11
Q

Most common resevoir of Hantavirus in Canada?

A

Deer mouse

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12
Q

T/F: Men have worse outcomes following MI than women.

A

False

Note: CAD is more common in men than women

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13
Q

Best pharma therapy for reducing craving and smoking cessation

A

Varenicline

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14
Q

T/F: smoking cessation requires only pharma therapy

A

False

it requires both pharma & counselling.

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15
Q

T/F: after menopause, incidence of CAD in women increases and can be equal to men

A

True

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16
Q

T/F: most risk factors for breast Ca are strong risk factors

A

False

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17
Q

Local sanitation, monitoring of reportable diseases, water and food safety enforcement all fall under the jurisdiction of the:

A

Public health unit

18
Q

Relative risk equation?

A

RR = (A/(A+B))/(C/(C+D))

Note: RR can only be calculated in cohort study

19
Q

A group of 50 people are exposed to virus A. 9 develop a mild infection, 10 become seriously ill, 3 die.

What is the attack rate of virus A?

A

22/50

20
Q

Tx for Organophosphates poisoning:

A

Pralodoxime within 48h. Give Atropine at the same time.

21
Q

Adv of case control studies:

A
  • fast and cheap
  • can be used in outbreaks
  • can be used for diseases that are rare in a population
22
Q

Define attack rate:

A

the number of new cases of disease during a specific time period divided by total population at risk during the same time period.

23
Q

Risk of BRCA1 mutation:

A

65% risk for breast Ca and 40% risk for Ovarian Ca

24
Q

T/F: prospective cohort studies provides a stronger evidence of association between health outcomes and exposure to potential risk factors than case control studies.

A

True

25
Q

Main reasons for persistent severe pain after a trial of several different opioids?

A
  • failure of functional improvement
  • failure to comply with monitoring such as urine drug screen
  • failure to comply with pain mgm agreement
  • evidence of diversion and abuse
  • intolerable side effects
26
Q

5 criteria of CHA (Canada health act) provincial govs must meet through their public healthcare insurance plans to qualify for federal cash contribution.

A 
1- Universal
2- Portable
3- Accessible
4- Comprehensive
5- Public administration

note: there is 2 specific provisions and 2 conditions.

27
Q

DTaP (Diphtheria, Tetanus, Acellular Pertussis) + IPV (Inactivated Polio) + Hib vaccine schedule:

A
  • 2 months
  • 4 months
  • 6 months
  • 18 months
    (with Hib)
    then at 4 y/o
28
Q

Public health unit oversees:

A

1- sanitation
2- reportable disease
3- environmental risks
4- enforcing food and water safety

29
Q

Canadian task force on preventive health care (CTFPH)

A

1- screen adults 60-74 for CRC via FIT q2yr OR Flexi Sig. q10yr
2- screen adults 50-59 for CRC via FIT q2yr OR Flexi sig. q10yr
3- NOT screening adults younger than 50
4- NOT screening with colonscopy
5- NOT screening men <55 for prostate Ca w/PSA

30
Q

T/F: Provincial govs are responsible for health insurance either directly or by subsidizing private insurance companies.

A

False

31
Q

Prevention tools of Hep A:

A
  • vaccination
  • immune globulin
  • hygienic practices
32
Q

T/F: diagnostic tests work well in both men and women

A

False

it works better in men

33
Q

Who can LAIV be used for?

A

Healthy children 2-18 y/o and healthy adults 19-59

34
Q

Best measure to prevent Hep A in community:

A

Good hygiene

35
Q

T/F: Federal gov can withhold cash for social programs in provinces that don’t meet the requirements of the Act.

A

True

36
Q

Haemophilus influenza type B containing vaccine is recommended when?

A

Routine immunization beginning at 2 months

37
Q

What does Organophosphates inhibit?

A

AChE. causing increased level of Ach, causing overstimulation of muscarinic and nicotinic receptors

38
Q

What is the most important indication to taper opioids in non cancer pain?

A

Persistent sever pain after different opioids.

39
Q

Pharma therapy for smoking cessation:

A

1- Varenicline
2- Bupropion
3- Nicotine replacement

40
Q

50 y/o man has come for annual checkup. no Sx or Hx.

what screening test to do:

A

Fecal immunochemical test

41
Q

PPD test is + and IGRA is + but no sign of active infection (no symptoms, no CXR signs)
what is Dx?

A

LATENT TB
Note:
Isoniazid for 9 months (add pyridoxine i.e. VitB6 to prevent peripheral neuropathy)

MCCQE1 ** (5 decks)

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