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Extra flash cards - MCCQE1 > PMCH COPY > Flashcards

PMCH COPY Flashcards

1
Q

Age most vulnerable to lead poisoning

A

< 6 mo

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2
Q

Organisms resistant to chlorine in water?

A

Cryptosporidium
Giardia
HAV
Entamoeba histolytica

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3
Q

Pneumon-Vaccine for elderly

A

At 65 Yr => q5yr

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4
Q 
Abuse in elderly 
M:F
Perpetrator
MC form 
Least common form
A

F>M

90% adult children of elderly (alcoholic / abusers)

Neglect

Sexual

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5
Q

Spouse abuse elderly husband indicate?

A

Hx of violence in relationship

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6
Q

Latex allergy cross-reaction (food)

Latex-fruit syndrome

A

Avocado
Banana
Kiwi
Chestnut

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7
Q

MC nutritional def worldwide

A

Fe

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8
Q

95% CI + OR doesn’t > 1?

A

Significant association

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9
Q

Rx for spinal mets?

A

No Rx increases survival

Best Rx = dexamethasone for Sx + bone pain

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10
Q

Prognostic signs of spinal mets

Bad + good

A

Bad = loss of sphincter tone (irreversible)

Good = ambulation

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11
Q

Features of dexamethasone compared to other steroids

A
  1. Least mineralocorticoid activity
  2. Least to associated w/ cognitive Sx
  3. Least to ass w/ infection
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12
Q

HA1c of 6% = FPG?
HA1c of 7% =

Eqn

A

6% = 7.0

7% = 8.5%

Eqn => FPG = 1.59 x A1c - 2.59

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13
Q

Chloroquine in preg

A

C

Given if plan to travel to high risk

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14
Q

RR equation

A

RR = (A/a+b)/(c/c+d)

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15
Q

What’s relative risk

A

Prob of event to occur in exposed group vs non exposed

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16
Q

Is HepA vaccine imp for immigrants from developing world

A

No

It’s prevalent, chances are they’ve had it and immune to it.

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17
Q

Outbreak of Ecoli 0157H7 ass w/

A

Ground beef

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18
Q

Best way to remove ticks

A

Manually by blunt forceps

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19
Q

Responsibilities of public health physician

A

Prevent STD

Prevent dental prob

Infectious disease surveillance

Health promotion activities

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20
Q

Effect of b-carotene supplement

A

Inc risk of lung cancer

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21
Q

MCC of travelers diarrhea

A

Enterotoxigenic E.coli

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22
Q

enterotoxigenic Ecoli mechanism of action

A

Colonization factors

Heat liable enterotoxin

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23
Q

For future, to make effective vaccine against ETEC diarrhea it should contain

A

Colonization factors CS1-6

LT toxoid

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24
Q

Larva migrans transmission

A

Contact with soil contaminated with the cat and dog faeces

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25
Q

Rx of dyspnea + terminal illness (Ca)

A

Opiates esp Morphine

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26
Q

Exercise to burn fat frequency

A

At least 30 min 5d/wk

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27
Q

Why fat burning fat exercise must > 30 min

A

Glycogen burning fuels body for 20 min

Fat fuels it after that

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28
Q

Exercise for cardiovascular + fitness

A

20 min daily

Or

10 daily

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29
Q

T/F: walking (land/water) + biking = exercise for 10-20 min

A

T

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30
Q

West Neil virus

What is it?
Transmission?
Sx?
Risk population?

A
  • Human neuropathogen
  • Mosquito infected from birds
  • mostly flu like
    Rarely Neuro Sx: encephalitis, meningitis, paralysis
  • elderly at risk
  • Rx supportive
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31
Q

Number needed to Rx

Importance?
Eqn?

A

Assess benefit of Rx

NNT = 1/ARR

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32
Q

What explains population growth in developing countries

A

Decreased mortality rates

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33
Q

Hospice care services

A

Short term hospitalization

Sx Rx of terminal illness

Physical/occupational/speech Rx

Dietary counseling

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34
Q

T/F: curative Rx is covered by hospice care

A

F

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35
Q

Terminally ill + oral secretions Rx

Gurgling/rattling

A

Anticholinergic

Scopolamine
Hyoscyamine
Glycopyrrolate
Atropine

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36
Q

MC hospital error ass w/ SE of drug occurs when

A

Ordering

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37
Q

Early detection of cervical cancer by Pap smear survival

A

90% survival rate

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38
Q

WHO def of health

A

State of complete physical mental and social well-being

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39
Q

T/F: transdermal absorption of medication decreases with age

A

T

2/2 increase ratio of fat to lean body weight

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40
Q

T/F: NSAID’s should be avoided in liver cirrhosis

A

T

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41
Q

NSAIDs in preg

A

Safe

Should be avoided in last 6wk to prevent inhibition of PG synthesis

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42
Q

Sympathomimetic SE in elderly

A

High BP
High ocular pressure
Worsen urinary retention

Interact w/ BB, methyl dopa, TCA, MAOi

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43
Q

Ex of sympathomemtic

A

Pseudoephrine

Phenylephrine

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44
Q

How to make medical decision for incapable pt

A
  1. Follow advanced directive (oral or written)
  2. No directives = health care proxy
  3. No proxy = family
  4. No family or family can’t agree = ethics committee
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45
Q

What elderly does form heat stroke

A 
Living alone 
Can't care for self 
CVD or resp disease 
Mental illness (schizophrenia)
\+/- alcohol, Hx of heat stroke
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46
Q

In terminal illness:

Preparatory grief vs depression

A

Grief =
normal self image
Sx wax + wane
Worry abt separation from family

Depression =
Poor self esteem
Suicidal ideas

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47
Q

Rx of depression in terminally ill patient

A

Expected to live few weeks: stimulants methylphenidate

Live longer:
SSRIs

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48
Q

Chemical exposure associated with leukemia and aplastic anemia and multiple myeloma

A

Benzene

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49
Q

Arsenic exposure is associated with

A

Skin cancer

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50
Q

Best hearing arrange for sounds

A

400 to 5000 Hz

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51
Q

Frequency range for audible sound

A

20 to 20,000 Hz

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52
Q

Who should be screened for HCV

A
  1. Blood transfusion prior to 1992
  2. Needle stick with HCV
  3. Mucosal exposure to HCV
  4. Children born to HCV+ mom
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53
Q

Prevent cholera?

A

Boiling drinking water

Chlorinate drinking water

Cook vegetables + fish thoroughly

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54
Q

When to screen for CRC at 40 and q5 Yrs?

A

1st degree relative w/ CRC or adenomatous polyps at < 60

> 2 of 1st degree relative with CRC or adenomatous polyps at any age

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55
Q

When to screen for CRC at 40 and q5 Yrs?

A

1st degree relative w/ CRC or adenomatous polyps at < 60

> 2 of 1st degree relative with CRC or adenomatous polyps at any age

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56
Q

F patient FU w/ male doc
Frequent visits
Normal exam + no complaints.

What to suspect?
Reaction?

A

Inappropriate relationship

Reaction:
Pointing your awareness of inappropriate patient-doctor relationship and willingness to help

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57
Q

When does palliative care start?

A

When Dx diagnosed, count through cure or death.

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58
Q

T/F: unit of care in palliative Rx comprises pt and his family as defined by surrogate.

A

T

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59
Q

Who receives palliative care?

A

Pt of all ages w/ chronic illness or injury that impairs daily functioning or reduce life expectancy

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60
Q

Having ER contraception readily available results in

A

Shorter time b/w sex + medication use (15 HR sooner)

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61
Q

Rx of travelers diarrhea

A

ETEC

Rx
Mild = loperamide + diphenoxylate
Safe in kids < 2 yr

Sever =
Adults > cipro
Kids > azithromycin

62
Q

Who shouldn’t receive intranasal vaccine

A
  • Kids < 2yrs
  • Adults > 60
  • Egg allergy
  • long term ASA
  • chronic disease (COPD, asthma, CHF, CKD…) except HTN
  • immune suppression
  • preggos
63
Q

Who should be screened for HCV?

A

IV drug users

64
Q

What’s attack rate

A

ppl sick / ppl

Attack rate = kids w/ Dz / all kids

65
Q

T/F: negative HBsAg + high LFT = r/o sclerosis of liver

A

T

66
Q

MC resp Dz from occupational exposure

A

Asthma

Exposure to gas

67
Q

T/F: early detection of ovarian cancer by CA-125 doesn’t improve mortality

A

T

68
Q

Only DM decreases cardiovascular risks

A

Metformin

69
Q

What led improvement in life expectancy of Canadians?

A

Lower infants death rates
By:
Vaccinations
Surgical Rx of congenital heart disease

70
Q

Hyperplastic polyps on colonoscopy mean?

A

Hyperplastic polyps
Normal
Repeat at 10 yrs

1-2 small adenomas
Low risk
FU 5-10yrs

> 3 adenomas or big adenomas (>1cm$
Remove
Rep 3 yr

Sessile adenomas
Remove
Rep 2-6 mo

71
Q

To qualify for federal contributions, insurance plan must guarantee?

A
  1. Province to province coverage
  2. Universal coverage
  3. Nonprofit basis
  4. Benefits all necessary hospital care + physician service.
72
Q

What are not required for federal assures insurance plan

A

Out of hospital drugs

Dental care

Prosthesis

73
Q

What’s varenicline?

Major SE?

A

Smoking-cessation drug

Suicide

74
Q

Why Rx pertussis w/ azithromycin

A

Decrease infectivity + severity of Sx.

Doesn’t change course of illness

75
Q

What’s direct observational Rx

A

Provide medication directly to patient and watch them swallow

76
Q

The benefit of direct observational therapy

A

As your highest treatment completion rate

77
Q

A freshman heading to college should receive what vaccine

A

Meningococcal glad to stay in the dome

78
Q

3 situations in which that things are contraindicated

A
  1. Live vaccine for a pregnant
  2. Anaphylaxis to a component
  3. Immune suppression
79
Q

NNT

2 eqn

A

NNT= 1/ARR

ARR = (c/c+b) - (a/a+b)
ARR = control event rate - experiment event rate.
80
Q

Vaccine recommended for homosexuals

A

Hepatitis a vaccine

81
Q

Who is responsible for our local sanitation, water and food safety, monitoring reportable disease, local environmental risk assessment

A

Public health unit

82
Q

What is the job of the federal government

A

Regulate toxic substance

regulate food product

set policies for pollutant

83
Q

Provincial government

A

Maintaining water and Eire quality standards

regulated and industrial

emission and toxic waste disposal

84
Q

Characteristic of occupational hearing loss

A

Hearing Loss at the high frequency

85
Q

Who should be screen for lung cancer and when

A
  1. Adults
    Smoked 30 pack-year
    Currently smokers
    Exsmoker < 15 yrs
  2. Start at 55-75 then yearly for 3 yrs
  3. Low dose CT
86
Q

T/F: most women with breast cancer had no identifiable rest factors

A

T

87
Q

The woman has a 1st° relative with the breast cancer what’s her Risk of developing the disease

A

There is 3 to 4 fold increased risk

88
Q

What do you do with a patient requires oxygen on the planes

A

Arranged through home airline for oxygen to be available on board + airport 24-48 hr prior to flight

89
Q

Can you patient who requires continuous oxygen to bring their own supply to the airport/flight

A

No

90
Q

T/F: people with PaO2 <68-70 shouldn’t go on plane unless on plane oxygen is arranged

A

T

91
Q

Daily use of ASA recommend for what age group (M + F)

A

M: 45-79

F: 55-79

92
Q

When is breach of confidentiality justified (3)

A
  1. Abuse of vulnerable person child or elder
  2. Public health risk like in communicable disease
  3. Danger to patient or others
93
Q

Eqn of kappa (chance-corrected agreement)

A

Kappa = (observed agreement - chance agreement) / (1-chance agreement).

94
Q

Viruses transmitted fecorally

A

Norwalk virus
Hepatitis a + e
Poliovirus

95
Q

Perinatal mortality

A

Write up a stillbirth and early neonatal deaths

96
Q

Decreased perinatal mortality rates indicates

A

Improve the quality of health care during pregnancy and delivery

97
Q

Is asbestos removal mandated by the Environmental Protection Agency

A

No

98
Q

Are asthmatics at increased risk of cancer from asbestos exposure

A

No

99
Q

MCC of a cute aseptic meningitis

A

Echovirus

Coxsackievirus

100
Q

In case of airborne bioterrorism use respirator maybe harmful in what conditions

A

COPD
Asthma
CAS
Anxiety disorders

101
Q

A doctor convicted of narcotic abuse and completed drug Rehabilitation program

Who decides if he can go back to work

A

provincial medical board

102
Q

Anaesthesiologist convicted of narcotic abuse can he ever go back to work

A

Not this speciality

I different to speciality that is not anaesthesiology

103
Q

What each of the following herbs ass w/

Ginkgo

Kava

Yohimbine

A

Ginkgo = intracerebral bleed in pt w/ anticoagulant

Kava = GI side effects + rash

Yohimbine = HTN

104
Q

What animals get you salmonella

A

Iguana

105
Q

Can physicians be compensated for attending a CME activity

A

No it’s against the law

106
Q

Can monosodium glutamate cause cancer

A

Nope

Its of Flavor enhancer

107
Q

Can fat cause cancer

A

Yes CRC

108
Q

Can alcohol cause cancer

A

Pancreatic cancer

109
Q

How to use the walking cane

A

Place the cane in the hand opposite to the most affected leg

Movement of the cane tracks the movement of the affected leg

110
Q

Exposure to pesticides causes?

A

Organophosphate toxicity

111
Q

Path of organophosphate

Rx

A

Inhibit AChase

Few hours = pralidoxime + atropine

112
Q

Alcohol rub vs hand soap

A

Alcohol rub is better

  • microbiologically more effective
  • less irritating
  • less time
113
Q

When is hand soap a preferred over alcohol rub

A

Of the hands are visibly soiled or exposed to spore forming organism

After use of bathroom

114
Q

Which woman should be screened for ovarian cancer

A

No woman

115
Q

Best screening test for hemochromatosis

A

Transferrin

116
Q

Why should smokers use nicotine patches

A

Double chances of quitting

117
Q

How long should the smokers use nicotine patch to give result

A

8 wks

118
Q

T/F: tapering nicotine patch is better than abrupt D/C

A

F

Same

119
Q

MCC of blindness in > 65

A

Macular degeneration

120
Q

Should I help you I want to be screened for hepatitis C

A

No need

121
Q

Who should be screened for hepatitis C

A

Persistent abnormal ALT

122
Q

When to Rx influenza even if it’s > 48 hrs?

A

Patient is deteriorating

Rx oseltamivir or zanamivir

123
Q

Contraindication to zanamivir

A

COPD
Asthma
Resp distress

124
Q

High INR + on warfarin

A

• 5-9 + no bleeding
Hold warfarin for 48 hrs

• 5-9 + risk of bleeding
Vit K

• 5-9 + bleeding
Vit K
FFP

125
Q

MCC of retinal detachment

A

Posterior detachment of vitreous

126
Q

Most fatal cancer in Canada

A

Lung

127
Q

Coagulation profile in vW

A

High PTT

High BT

128
Q

What’s otosclerosis

A

Normal eardrum + conductive hearing loss

129
Q

Ms affected in otosclerosis

A

Stapes

130
Q

Rx of rotator cuff tear

RICE or physio

A

RICE

131
Q

What does low appetite in seasonal affective mean

A

Endocrine path

132
Q

Recurrent pain + swelling of salivary gland

A

Sialolithiasis

133
Q

Dextromethorphan + SSRI

A

It’s a cold drug

Cause serotonin syndrome

134
Q

How much vitamin D a post menopausal woman need

A

800

135
Q

pregnant gets parvovirus b19 happens to her baby

A

Hydrops

136
Q

Antabiotics for dog bite

A

Amoxicillin-clave

137
Q

Ginseng

A

Herb
Should be stopped 7 days pre-op

Causes Hypoglycaemia and interferes with anticoagulant

138
Q

Fiscal policy

A

Additional taxes on unhealthy behaviors

139
Q

Tetrad of Menier’s

A

Vertigo
Hearing loss
Tinnitus
Aural fullness

140
Q

Risks for claudication

A

DM
Smoking
HTN
Dyslipidemia

141
Q

T/F: raloxifene helps menopause Sx

A

F

142
Q

Someone tests + for HBsAg + HBcAg

A

Repeat test in 8 weeks to see if it progresses to chronic.

Stop all things hurt liver (alcohol)

143
Q

T/F: PPV influenced by prevalence

A

T

High prevalence = high PPV

144
Q

WPW arrhythmia

ECG
Rx

A

Delta wave
Wide QRS
Short PR

Its SVT
Procainamide or amiodrone
Sync cardioversion
Ablation

No BB, CCB, adenosine!

145
Q

1st heart block

ECG
Rx

A

Prolonged PR

No Rx

146
Q

2nd heart block

ECG
Rx

A

Mobitz 1:
Progressive increase in PR until drop

No Rx stop drug causing it.

Mobitz 2:
Fixed drop (no progressive prolongation)

Pacemaker

147
Q

3rd heart block

A

No relation b/w p + QRS

Pacemaker

148
Q

Afib
A flutter

ECG
Rx

A

AFib
Irregular irregular
No P wave

Unstable = sync cardio version
Stable = BB or CCB 
Chronic:
Add anticoagulant CHADS2 
0-1 = ASA
> 2 = no renal = dabigtran 
Or warfarin if renal or prosthetic valve INR 2-3

Flutter:
Saw tooth

< 48 HR => drug version: procainamide, amiodrone
Or electrical version

> 48 HR => warfarin then 3-4 wk electrical cardio version.
TEecho to r/o thrombi 1st
Cont warfarin for 4wks

Anticoagulant
Rate (BB, CCB, digoxin)

149
Q

SVT

ECG
Rx

A

Narrow QRS

1st
Valsalva
Massage

2nd
Rate (BB, CCB, adenosine)
Electrical cardioversion

150
Q

T/F: Nicotine replacement is safe in stable angina

A

Yes

151
Q

Ethnic group at risk of prostate ca

A

Black

152
Q

How long after Sx of sore throat can u start Abx to prevent rheumatic fever

A

9 day

Extra flash cards - MCCQE1 (12 decks)

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