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CCFP Exam 2021 > Practice Exam Questions! > Flashcards

Practice Exam Questions! Flashcards

1
Q

Side effects of antipsychotics in elderly?

A 
BLACK BOX: ALL cause mortality!
Adverse cardiac events
Gait
UTIs
Edema
Somnolence
Falls
Anticholinergic side effects
Orthostatic hypotension
Weight gain
Diabetes
Dyslipidemia
Sedation
EPS
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2
Q

How long is AP trial in geris?

A

Deprescribe if for insomnia!

Also deprescribe if had adequate trial (3 mo) or if unresponsive/stabilized!

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3
Q

BASELINE BLOODWORK FOR ANTIPSYCHOTIC MED INITIATION?

A 
Fasting blood glucose
HDL, LDL, TChol/triglycerides (lipid panel is INCORRECT)
AST, ALT
Prolactin
Amylase
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4
Q

Clinic physical exam for initiation of antipsychotics?

A

Height
Weight
Waist circumference
Blood pressure

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5
Q

45 yo F with neck lump. What are RF’s for Thyroid CA on history?

A

Constitutional symptoms
Rapid growth
Radiation (head/neck OR total body for Bone Marrow transplant)
Familial thyroid carcinoma
Thyroid cancer syndromes (MEN 2, Cowden’s dz, familial adenomatous polyposis)

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6
Q

Physical exam findings in neck mass are concerning for malignancy?

A 
Lymphadenopathy
Fixated to surrounding tissue
Dysphonia
Dysphagia
Dyspnea
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7
Q

You find a SINGLE FIXED nodule on the thyroid. What is the SINGLE MOST important blood test to order now?

A

serum TSH

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8
Q

What are the four steps to trauma informed care?

A
  1. Bear witness to patient’s trauma experience
  2. Create a safe space
  3. Include patient in healing process
  4. Believe in the patient’s strength and resilience
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9
Q

What do you call when patient’s hurt themselves but don’t want to kill themselves?

A

Nonsuicidal self-injury (NSSI)

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10
Q

What conditions are associated with nonsuicidal self-injury?

A

Depression
Borderline Personality Disorder
Higher risk of suicidal behaviour
Childhood sexual abuse

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11
Q

What are three things on your differential when somebody presents with restless legs at bed?

A 
Periodic limb movement disorder
Leg pain
Akathisia
Nocturnal leg cramps
Volitional movements
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12
Q

What are 4 risk factors for restless leg syndrome

A 
Iron deficiency
Pregnancy
Uremia
Neuropathy
Multiple sclerosis
Parkinsons
Medications (antiemetics, antihistmines, antidepressants and anticonvulsants)
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13
Q

How do you treat restless leg syndrome?

List 3

A 
Iron replacement
Dopamine agonist (pramipexole)
Gabapentin, pregabalin
Benzodiazepines
Exercise/stretching
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14
Q

What are three ways to remove a cast safely?

A 
Use a guard
Cut from both sides
Stop patient if patient says stop
Mark the cast prior to cutting
Display that the cast does not cut skin
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15
Q

What diagnosis are you worried about with pain in cast?

A

Compartment syndrome

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16
Q

Does early introduction of allergens increase the risk of allergy?

A

No. It lowers it. Introduce allergens no earlier than 4 months.

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17
Q

What two conditions put children at higher risk for having a peanut allergy?

A

Severe eczema

Egg allergy

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18
Q

List 6 conditions that would be associated with intellectual disabilities

A 
Dementia/Diabetes
Infectious conditions
Menopause
Addictions
Psychiatric conditions
Epilepsy
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19
Q

What are additional psychosocial steps in caring for developmentally disabled?

A 
Support in community
Educating family
Ensuring follow-up
Engaging with inter professional services
Monitoring for drug reactions
Monitoring for abuse
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20
Q

What are three of the essential eligibility requirements for MAID?

A

Capacity
18 years old
Irremediable medical condition that causes suffering
Ab advanced state of irreversible decline and death is reasonably foreseeable
Decision not made as a result of external pressure

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21
Q

If patient’s are having difficulty with BGMs, what management do you offer?

A

Reduce BGMs or Stop daily monitoring.

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22
Q

What diet is prescribed for IBS?

A

Low FODMAP

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23
Q

What does FODMAP stand for and give two examples of each

A

Fermented Oligosaccharides - Wheat, rye, onions, garlic
Disaccharides - Milk, yogurt, soft cheese
Monosaccharides - mangos, honey
Polyols - Blackberries, lychie and sugar alcohols

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24
Q

What are the physical exam findings of Leprosy?

A

Painless pale or red lesions without loss of sensation
Extensive sensory loss
Thickening of nerves

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25
Q

List four countries where Leprosy is endemic?

A

India
Indonesia
Brazil
Congo

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26
Q

What are 3 risk factors for leprosy?

A

Exposure (Droplet/contact)
Low - SES
Genetic

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27
Q

What are three risks of bento receptor agonist (BZRA) in elderly?

A

Falls
Physical dependence
Psychological dependence

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28
Q

What should you do for elderly patients on benzodiazepines?

A

Taper.

Not applicable with co-morbid psych disease.

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29
Q

Can patients swab themselves for STI screening?

A

Yes. More sensitive than health care providers.

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30
Q

What are three types of urinary incontenence?

A

Giggle micturition
Stress incontenance
Urge Incontenance

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31
Q

List 4 diseases for abnormal uterine bleeding?

A 
Leiomyoma
Leiomyosarcoma
Clotting disorders - Hemophilia, Von willebrands
Endometrial polyp
Endometrial carcinoma
Endometriosis
Endometrial hyperplasia
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32
Q

Elbow pain in kid following trauma?

A

Subluxation of the radial head (nursemaid’s elbow)

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33
Q

What imaging would you order for Nursemaid’s elbow?

A

None.

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34
Q

How do you treat nursemaid’s elbow?

A

Hyperpronation maneuver.

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35
Q

What is on your differential for a suspected nursemaid’s elbow?

A

Non-accidental injury

Supracondylar fracture of humerous

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36
Q

What 5 things do fibromyalgia, myalgic encephalitis-chronic fatigue syndrome and environmental sensitivities have in common?

A 
Allodynia
Fatigue
Sleep disturbance
Cognitive symptoms
Neurologic symptoms
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37
Q

What is distinctive about myalgic encephalitis (chronic fatigue syndrome) fatigue?

A

It does not get better with rest
Chronic and profound fatigue
Post-exertional malaise

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38
Q

What does environmental sensitivity suffer from after exposure? List 3.

A

Fatigue
Neurocognitive depression
Relief when inciting agents removed.

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39
Q

What tests do you order for somebody with celiac disease?

A

Vitamin D annually

BMD

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40
Q

What do you recommend to celiacs for bone health?

A 
Calcium and Vit D supplementation
Weight bearing exercises
Don't smoke
Don't drink
Gluten free diet
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41
Q

What are red flag of back pain?

List 6.

A 
Fecal incontenance
Urinary retention
Saddle anesthesia
Fever
Weight loss
Night sweats
Loss of rectal tone
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42
Q

What imaging do you order for back pain with no red flags?

A

None.

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43
Q

What on history, physical exam or labwork would lead you to believe a patient has appendicitis.

A

History - migratory pain, nausea
Physical exam - Fever, Rosving’s, Obturator, Psoas, Cough tenderness
Labwork - Leukocytosis with neutrophilia

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44
Q

What is one thing you must check in peds patients with suspected appendicitis

A

Check balls for torsion

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45
Q

What organism causes whooping cough?

A

Bortadella Pertussis

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46
Q

How long is whooping cough contagious?

A

3 weeks

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47
Q

How long is an individual contagious of pertussis after receiving antibiotics?

A

5 days

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48
Q

Who do you prioritize vaccines for whooping cough if there is an outbreak?

A

Pregnant women >26

Infants

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49
Q

What are red flags for tinnitus

A

Unilateral
Pulsatile
Abnormal autoscope findings

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50
Q

What is best for ruling out a vascular cause for tinnitus?

A

MRA venogram of brain and neck

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51
Q

What are 6 risk factors for plantar fasciitis?

A 
Obesity
Deconditioning
Smoking
Male gender
Excessive running
Flat footed (pes planus)
Extra arch in foot
Reduced ankle dorsiflexion
Leg length discrepancy
Foot and calf muscle tightness
Occupations requiring prolonged standing or walking.
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52
Q

How do you treat plantar fasciitis? Name 6

A 
NSAIDs
Heel padding
Stretching
Ice
Activity modification
Massage
Weight loss
Glucocorticoid injection
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53
Q

What are 5 things on your differential for heel pain?

A 
Plantar fasciitis
Bone spur
Calcaneal fracture (acute or stress)
Spondyloarthropathies
Tumour
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54
Q

What are 5 pregnancy conditions linked to future cardiovascular disease risk?

A 
GDM
GHTN
Pre-term birth
Delivery of IUGR
Abruption placental
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55
Q

What are 4 medications safe to use in treatment of hypertension while breastfeeding?

A

Captopril
Enalapril
Labetalol
Nifedipine

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56
Q

What are features of mono on history (4) and physical exam (2)?

A 
Fever
Pharyngitis
Chest pain
Fatigue
splenomegaly
Head and neck lymphadenopathy
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57
Q

What is the causative organism of mono?

A

Epstein-Barr Virus

58
Q

What advice do you give to patient’s with enlarged spleens?

A

No contact sports for 3-6 weeks.

59
Q

What is the chance of curing fungal toe infections with topical treatment alone?

A

Less than 6-23%

60
Q

What is the oral medication for fungal toe infection?

A

Terbinafine

61
Q

What is the chance of livery injury with terbinafine?

A

1 in 50,000 to 120,000

62
Q

What are relevant questions for cannabis history?

A 
How much?
How frequently?
Before noon?
Smoke and drive?
Smoked alone?
Friends or family asking to cut down?
Attempts to reduce are unsuccessful?
Problems due to cannabis?
Type and Delivery method?
63
Q

What screening test is good for cannabis risk?

A 
Cannabis 
Abuse
Screening
Test
93% sensitivity 81% specificity in low EtOH cannabis users
64
Q

What are the two screening tests for colon cancer?

A

FIT q1-2 years

Colonoscopy 10 years earlier than first degree relative diagnosis

65
Q

What are the modifiable risk factors for colon cancer?

A 
Smoking
Processed meats
Soluble fibre
Alcohol
Weight loss
Diabetes
66
Q

What are the genetic risk factors for CRC?

A 
Familial adenomatous polyposis
Lynch Syndrome (HNPCC)
67
Q

What are three topical treatments for topical rosacea?

A

Azelic acid
Topical ivermectin
Metronidazole

68
Q

What is the definition of pathological weight loss?

A

10% in 6 months or >5% in 1 month

69
Q

What are 10 modifiable causes of weight loss in elderly patients?

A 
Side of Medication
Treatment effects (chemos, rads)
Other Malignancy
Pain control
Wandering or repetative behaviour of psychiatric disease
Emotional or Psychological problems
Impaired condition
GI disease
Hyperparythyroidism
Hypo/hyperthyroidism
Hypoadrenalism
Taste and Texture
Loss of appetite
Oral health
Swallowing disorders
Social factors (low-SES)
70
Q

What are you concerned about with professional athletes and excess exercise?

A

Rhabdomyolysis

71
Q

What are 4 symptoms and 4 complications of rhabdomyolysis?

A 
Oliguria
Dark urine
Back pain
Myalgias
Renal failure
Compartment syndrome
End organ failure
Death
72
Q

What lab test to confirm rhabdomyolysis and what is the cutoff?

A

CK 5X Upper limit of normal or above 5000.

73
Q

What treatment steps for rhabdo?

A

IV fluids
Rest
Restrict exercise
Sleep

74
Q

What are 4 side effects of PPI use?

A 
Pneumonia
CKD
Hypomagnesium
B12 deficiency
Fractures
Dementia
C. Diff
75
Q

What would cause a secondary spasticity?

A

Spinal cord injury (trauma)
M.S.
Stroke
Cerebral Palsy

76
Q

List 10 causes of increased spasticity in elderly.

A 
Discontinuing medications
UTI
Bladder retention
Constipation
Pregnancy
Post-partum 
Anxiety
Improper wheelchair
Temperature
Pressure ulcer
Tight clothes
Ingrown toenails
DVT
Infection
77
Q

When do you introduce allergens? When is the earliest you can do it?

A

6 months.

Not before 4 months.

78
Q

How do you incorporate breast milk with allergenic foods?

A

Breastfeed after allergenic foods.

79
Q

Over 65 gets what vaccines?

A

PPSV - 23 and PSV-13

80
Q

What at-risk or high-risk conditions would you vaccinate with PPSV-23 and PSV-13?

A 
Diseases of white blood cells
Asplenia
Immunosuppressants
HIV
Renal failure
Cochlear implants
Asthma
COPD
EtOH
Steroids
Liver disease
Lung disease
Oral steroids
Reumatoid arthritis
Seizure
Lupus
Chrohn's
Smokers
81
Q

Rheumatoid arthritis is a risk factor for?

List 2.

A

Atherosclerosis
CV disease
Lymphoma
Infection

82
Q

List 8 side effects of steroids

A 
Weight gain
Osteoporosis
Avascular necrosis
Cataracts
Infection
Bruising
Acne
HTN
Hyperlipidemia
Hypokalemia
Hyperglycemia
Mood Swings
83
Q

Diagnostic Criteria for SLE

A 
Malar rash
Discoid rash
Serositis
Oral ulcers
ANA
Photosensitivity
Blood
Renal
Arthritis
Immune
Neurologic
84
Q

Describe the Spurling test

A

Neck extension, lateral flexion, axial loading.

85
Q

What is the treatment for anogenital gonorrhoea?

A

Cefixime PO 800 mg

Ceftriaxone IM 250 mg PLUS Axithromycin PO 1 g

86
Q

What test do you order for resistant strains of gonorrhoea?

A

Urine/swab culture.

87
Q

What medication would you prescribe for ceftriazone -resistant gonorrhoea, anaphylactic penicillin allergy and allergy to cephalosporins?

A

Gentamicin IM 240 mg PLUS

Azithromycin PO 2 g

88
Q

What is on your differential for chronic, non-bloody diarrhea without travel?

A 
IBS
IBD
Celiac
Lactose intolerance
Bacterial
Parasitic
89
Q

What agent does gum contain in it that causes diarrhea?

A

Sorbitol (sugar alcohol)

90
Q

What is the role of loperamide for travellers diarrhea?

A

Fine with non-bloody diarrhea.

91
Q

What one OTC agent can be taken to prevent traveler’s diarrhea?

A

Pepto bismol

92
Q

What are 4 side effects of pepto bismol?

A

Black tongue
Black stool
Tinnitus
Constipation

93
Q

What antibiotic do you treat traveler’s diarrhea with?

A

Azithromycin

94
Q

What are 5 indicators of advance heart failure?

A 
Symptoms at rest
Multiple hospitalizations in a year
Weight loss
Frequent ICD shock
SBP < 90 mm Hg
Inability to walk 1 block
Decrease in serum sodium
95
Q

What are four symptoms of Meniere disease?

A

Vertigo
Aurul fullness
Tinnitus
Unilateral hearing loss

96
Q

What conservative measures can you treat Meniere disease with? List 4

A

Dietary salt restriction
Stress reduction
Betahistine
Diuretics

97
Q

Can you drive with Meniere disease?

A

Yes

98
Q

Red flags for melanoma. List 5

A 
Assymetry
Irregular borders
Multiple colours
Diameter > 6mm
Evolution of appearance
99
Q

What descriptors would you use for seborrheic keratosis?

A

Verrucous
Well defined borders
Dull-brown plaque/papule

100
Q

What descriptors would you use for a benign nevus?

A

Structural symmetry in all axes
Light or dark brown
No blue or white (scar) areas
Gradual fading and thinning towards edges

101
Q

What organism causes warts?

A

Human papillomavirus

102
Q

Can warts spontaneously resolve in healthy individuals?

A

Yes

103
Q

What are the elements of using duct tape for warts?

6 steps

A 
Apply directly to the wart
Stay on for 4-7 days
Remove tape
Remove dead skin with emery board
Re-apply after 12 hours
Repeat for 6 weeks
104
Q

What percentage of elderly patients will have side effects with SSRI’s?

A

20%

105
Q

How do falls risk compare in SSRIs vs benzos.

A

Same

106
Q

How quickly to see changes in mood with SSRIs in elderly?

A

10-12 weeks

107
Q

What are the two most common treatments for opioid addiction?

A

Suboxone

Methadone

108
Q

What medication is the cure for opiate overdose?

A

Naloxone

109
Q

What resources should be provided to those undergoing opioid agonist therapy?

A

Individual counselling
Group support
Safe storage
Work safety

110
Q

How frequently should individuals with intellectual disabilities have periodic health examinations?

A

Annually

111
Q

What should be screened for in a periodic health examination in individuals with intellectual disabilities or slowing?

A 
Hearing impairments
Thyroid disorder
Cardiac disorders
Vision impairments
Respiratory disease
Obesity
Osteoporosis
Mental health
112
Q

What conditions could cause behavioural changes in individuals with intellectual disabilities?

A

Dementia
Depression
Hypothyroidism

113
Q

What are the upper limits of QTC in men and women

A

Men 450

Women 460

114
Q

What are risk factors for Torsade de pointes? List four.

A 
Low K
Low Mg
Low Ca
Old age
Female
Bradycardia
Prior TdP
115
Q

List 4 medications that are linked to Torsade de Pointes.

A

Domperidone
Citalopram/Escitalopram
Macrolides
Quinolones

116
Q

What is one conservative measure to reduce the incidence of UTI’s?

A

Increase fluid intake by 1.5 L/day.

117
Q

What treatment do you prescribe for pre-menopausal vaginal dryness?

A

Vaginal estrogens

Vaginal moisturizers

118
Q

What one treatment can you give for simple febrile seizure?

A

Tylenol

119
Q

What condition causes nervelike distribution of discolouration in fingers in response to the cold?

A

Raynaud’s.

120
Q

What conditions are associated with Raynaud’s?

A

SLE
Secondary Raynaud’s
Systemic sclerosis
Sjogren sundrome

121
Q

Who do patient’s with Raynaud’s get referred to?

A

Pediatric rheumatology.

122
Q

What is one alarm feature for Raynaud’s disease?

A

Nail fold capillary changes.

123
Q

What is your first line antibiotic for purulent cellulitis in MRSA +ve patients?

A

SMP/TMX

Clindamycin added increases cure rate.

124
Q

What are risk factors for community acquired MRSA?

List 4

A 
Recent abx
Contact sports
Group housing
Low SES
IVDU
125
Q

Who is PrEP indicated for?

List 3

A

MSM
IVDU
Individuals having sex with somebody with detectable virus load

126
Q

What drugs are in PrEP?

A

Emtricitabine/Tenofovir

127
Q

When is PrEP taken?

A

Daily

Around the time of sex

128
Q

When can you stop PrEP?

A

2-28 days after exposure

129
Q

When do you prescribe Dukoral for Traveler’s Diarrhea?

A

Never.

130
Q

What percentage of people who are infected by hepatitis C clear the virus spontaneously?

A

25-35%

131
Q

What are FOUR risk factors for hepatitis C infection?

A 
Low SES
IVDU
Intra-nasal drugs
MSM
Sex-workers
Prisoners
Tattoos
Travel or emmigration from endemic nation (China)
132
Q

What is the inflammatory reaction associated with treating spirochetes (syphillis)?

A

Jarisch-Herxheimer reaction

133
Q

How long does the Jarish-Herxheimer reaction take to resolve?

A

24 hours

134
Q

How do you treat the Jarisch-Herxheimer reaction?

A

Anti-pyretics

135
Q

What clinical tool do you use to assess concussions?

A

SCAT-5

136
Q

What are important elements of history to determine readiness for return to play?

A

Are all symptoms resolved?
Has there been unrestricted return to cognitive normal activity without symptoms?
Has there been return to physical activities without symptoms?
Are there any abnormal neurologic findings?

137
Q

What conditions may be co-morbid with concussion or delay return to normal?

A 
Migraines
Anxiety
Depression
Autonomic dysfunction
Sleep Dysfunction
C-spine trauma
138
Q

What are indications for inpatient treatment of anorexia?

A 
HR < 45
Weight < 75% ideal
Temp <35.5
SBP < 80
Orthostatic change in pulse is >20 BPM
Orthostatic change in BP is greater than 10 mm Hg
139
Q

What should be screened for with diabetic patients?

A

Retinopathy
Nephropathy
Neuropathy

140
Q

Why do patients have different Hgb A1c targets?

List 4

A 
Age
Comorbidities
Cardiac risk
Medication cost
Frailty
Hypertension
Side Effects
141
Q

What nutrition advice is appropriate for new mothers?

A

Discourage homemade formula
Vit D supplementation
Start solids at 6 months (containing iron)
Avoid hard, small round, smooth and sticky foods until 3 years of age
Promote family meals
Avoid all sweetened drinks or juices
Early and repeated introduction of allergens at 6 months of age is associated with reduction in risk of food allergies

142
Q

What three injury prevention advice should you give to new parents?

A

Use rear facing child seat until 2 years of age.
Swaddling is not recommended for the first 2 months of life
Infants should sleep in a crab without soft objects or loose bedding

CCFP Exam 2021 (11 decks)

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