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CCFP Exam > Review > Flashcards

Review Flashcards

1
Q

Name 8 investigations for iron deficiency anemia.

A
  • Serum Hemoglobin
  • Mean Cell Volume
  • Serum Ferritin
  • Peripheral blood smear
  • Serum iron
  • Total iron binding capacity
  • Colonoscopy
  • Beta-hCG
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2
Q

Thalassemia risk regions (#6)

A
  • Africa
  • Middle East
  • Mediterranean
  • Caribbean
  • South East Asia
  • South America
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3
Q

Risk factors for vitamin B12 deficiency (#6)

A
  • Gastric surgery
  • Strict vegans
  • Breastfed children of strict vegans
  • Elderly
  • Psychiatric
  • Pernicious anemia
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4
Q

Investigations for Pernicious Anemia (#2)

A
  • Serum vitamin B12
  • Serum anti-intrinsic factor antibody
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5
Q

Forms of iron supplementation (#3)

A
  • Ferrous fumarate (highest iron content)
  • Ferrous sulfate (best for children)
  • IV iron dextran
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6
Q

Severe anemia investigations [#2]

A
  • Colonoscopy
  • Urinalysis
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7
Q

Causes of acute cough (#6)

A
  • Pneumonia
  • Heart failure
  • Neoplasm
  • Foreign body
  • Pneumothorax
  • ACE inhibitors
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8
Q

Causes of subacute cough (#2)

A
  • Post-viral
  • Infectious (bacterial, viral, fungal, mycobacterial)
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9
Q

Causes of chronic cough (#8)

A
  • Asthma
  • GERD
  • Upper airway cough syndrome
  • COPD
  • Parasite
  • Cystic fibrosis
  • Eosinophilic bronchitis
  • Bronchiectasis
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10
Q

PERC rule-out criteria for PE (#8)

A
  • Age < 50
  • Oximetry >94% (RA)
  • Pulse < 100
  • No prior PE or DVT
  • No recent surgery or trauma (< 4 weeks)
  • No hemoptysis
  • No estrogen use
  • No unilateral leg swelling
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11
Q

Well’s Score for PE (#7)

A
  • Clinical signs & symptoms of DVT
  • PE is #1 diagnosis OR equally likely
  • HR > 100
  • Previous, objectively diagnosed PE or DVT
  • Hemoptysis
  • Immobilization at least 3 days or surgery in the previous 4 weeks
  • Malignancy with treatment within 6 months or palliative
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12
Q

YEARS algorithm to rule out PE if pregnant

A
  • Clinical signs of DVT?
  • Hemoptysis?
  • PE most likely diagnosis?

0 = rule out PE with D-dimer < 1000 ng /mL
1-3 = rule out PE with D-dimer < 500 ng/mL

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13
Q

Shortness of breath investigations (#7)

A
  • ECG
  • Echocardiogram
  • Serum Troponin
  • Arterial pO2 / pCO2 / pH / HCO3
  • Chest x-ray
  • Pulmonary function test
  • CT chest
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14
Q

Life-threatening causes of dyspnea (#3)

A
  • Foreign body
  • Anaphylaxis
  • Pneumothorax
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15
Q

Conservative approach to pneumothorax (unilateral, moderate-large, primary spontaneous)

A
  • Observe for 4 hours, discharge if stable on x-ray
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16
Q

Pulmonary / Cardiac zebra causes for dyspnea (#9)

A
  • Recurrent or fungal pneumonia
  • Fibrosis
  • Post-COVID-19 sequelae
  • Pleural effusion
  • Occasional arrhythmia
  • Cardiomyopathy
  • Malignancy
  • Mycobacterial
  • Aortic stenosis
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17
Q

Non-cardiac/pulmonary causes of dyspnea [#8]

A
  • Anxiety
  • Altitude
  • Abnormal thyroid
  • Acid reflux
  • Anemia
  • Abdomen
  • Allergy
  • Anti-aerobic (deconditioning)
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18
Q

Stepwise treatment for mild COPD (#2)

A
  • SABA prn
  • LAMA or LABA
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19
Q

Stepwise treatment for moderate/severe COPD with low risk for AECOPD (#3)

A
  • LAMA or LABA
  • LAMA+LABA
  • Triple
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20
Q

Stepwise treatment for moderate/severe COPD with high risk for AECOPD (#3)

A
  • LAMA+LABA or ICS/LABA
  • Triple
  • Oral
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21
Q

Oral treatments for COPD (#3)

A
  • Roflumilast
  • N-acetyl cysteine (NAC)
  • Daily Azithromycin
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22
Q

Recommended COPD treatment if blood eosinophils ≥ 300 cells/uL

A

Use steroid (ICS+LABA > LAMA+LABA)

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23
Q

Avoid ICS for COPD treatment if (#3)

A
  • Serum eosinophils < 100 cells/uL
  • History of mycobacterium
  • History of repeated pneumonia
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24
Q

Differential for AECOPD [#6]

A
  • Pneumonia
  • Pneumothorax
  • Pleural effusion
  • Pulmonary embolism
  • Pulmonary edema due to heart
  • Problem on ECG
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25
Q

When to add antibiotics for COPD

A
  • 2-3 Winnipeg symptoms (sputum purulence, sputum volume, dyspnea)
  • CRP > 40
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26
Q

Potential bacteria in complicated COPD infections (i.e., empyema, septic, very sick) [#6]

A
  • H. influenza
  • S. pneumoniae
  • M. catarrhalis
  • Klebsiella
  • Gram negatives
  • Pseudomonas
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27
Q

Non-medical treatments for COPD [#7]

A
  • Smoking cessation
  • Exercise
  • Acupuncture
  • Active mind-body therapy
  • Yoga
  • Tai chi
  • Opioids (palliative)
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28
Q

Differential for pediatric asthma [#5]

A
  • Croup
  • Foreign body
  • Infection
  • Cystic fibrosis
  • Tracheomalacia
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29
Q

Features of well controlled asthma [#5]

A
  • Days with symptoms ≤ 2
  • Doses of reliever ≤ 2
  • Nights with symptoms < 1
  • No interference with work/school/exercise
  • Infrequent, mild exacerbations
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30
Q

Asthma diagnosis on spirometry

A
  • FEV1/FVC pre-bronchodilator < 0.75
  • FEV1 post-bronchodilator ↑ 12% & reversible
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31
Q

PRAM score for severity of airway obstruction [#5]

A
  • O2 saturation
  • Suprasternal retractions present
  • Scalene muscle contractions present
  • Air entry
  • Wheeze
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32
Q

Topics to regularly reassess at asthma visits [#7]

A
  • Control
  • Risk of exacerbation
  • Spirometry or PEF
  • Inhaler technique
  • Adherence
  • Triggers
  • Comorbidities
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33
Q

Labs & management of Testicular Cancer

A
  • b-hCG
  • AFP
  • Lop it off (surgery)
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34
Q

Risk factors for Testicular Cancer

A
  • Cryptorchidism
  • Family history
  • Personal history
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35
Q

Screening for lung cancer

A

Low dose CT if age 55-74, 30 pk/yr smoker, current or quit < 15 years ago –> annually up to 3 times

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36
Q

Screening for ovarian cancer

A

No screening indicated if asymptomatic, low risk

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37
Q

Screening for cervical cancer

A

Screen 25-69 every 3 years

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38
Q

Screening recommendations for cervical cancer do NOT apply if [#6]

A
  • Never sexually active
  • Weakened immune system
  • Symptoms of cervical cancer
  • Previous abnormal screening results
  • Does not have cervix
  • Immunosuppressed
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39
Q

Melanoma prevention [#3]

A
  • Sunscreen
  • Physical UV blocking
  • Avoid tanning beds
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40
Q

High-risk features that should consider referral for 6-monthly fully body examination for melanoma [#7]

A
  • Older, male
  • Previous skin cancer
  • Family history
  • # of Nevi (>15)
  • Light skin, red hair
  • Multiple sunburns
  • Actinic skin damage
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41
Q

Screening methods for colorectal cancer [#2]

A
  • FOBT age 50-74 q2 years
  • Flexible sigmoidoscopy age 50-74 q10 years
42
Q

Screening for breast cancer

A
  • Mammogram age 50-74 q2-3 years if average risk
43
Q

Risk factors for pancreatic cancer [#3]

A
  • Family history
  • Peutz-Jeghers syndrome
  • BRCA1 with affected relative
44
Q

Serum investigations for unexplained weight loss [#6]

A
  • Serum hemoglobin
  • Serum Na
  • Serum K
  • Serum Cr / eGFR
  • Serum Urea
  • Serum PSA
45
Q

Non-lab investigations for unexplained weight loss [#4]

A
  • Weight
  • Height
  • Fecal Occult Blood
  • Chest x-ray
46
Q

Alarm features for abdominal pain [#12]

A
  • Severe pain
  • Melena
  • Weight loss
  • Abnormal labs (Hb, CRP, Na, K)
  • Age > 55
  • Vomiting
  • Dysphagia
  • Mass
  • Family history
  • Previous history
  • Bilious vomit
  • b-HCG (+)
47
Q

Treatment for H. pylori [#4]

A

Quadruple therapy x 14 days
- PPI
- Bismuth
- Metronidazole
- Tetracycline

48
Q

Prevention for esophageal cancer with Barrett’s eosphagus

A
  • Lifestyle
  • High-dose PPI
  • ASA
49
Q

Non-abdominal causes of abdominal pain [5]

A
  • Pulmonary embolism
  • Myocardial infarction
  • Pericarditis
  • Zoster
  • Testicular
50
Q

Management of ureteral stone < 5 mm

A

Conservative management

51
Q

Management of obstructive ureteral stone

A

Timely decompression

52
Q

First-line imaging for ureteral stone

A

KUB US

53
Q

Management of ureteral stone 5-10 mm

A

Medical expulsive therapy

54
Q

Management of distal ureteral stone

A

Medical expulsive therapy

55
Q

Gallstone risk factors [#5]

A
  • Female
  • Forty
  • Fertile
  • Obese
  • OCP
56
Q

Pancreatitis risk factors [#6]

A
  • Septra, Flagyl, HCTZ, ACE inhibitors
  • Progesterone
  • Atorvastatin
  • Estrogen
  • Gallstones
  • Alcohol
57
Q

Bolus fluids for Peds

A

20 mL/kg

58
Q

Maintenance fluids for Peds

A

4-2-1 rule
- 4 mL/kg for first 10 kg
- +2 mL/kg for kg 11-20
- +1 mL/kg for every kg above 20

59
Q

Objective measurements for treating severe dehydration [#6]

A
  • Weight
  • Serum glucose
  • Serum Na
  • Serum K
  • Serum Cr
  • Serum urea
60
Q

Non-gastroenteritis differential for diarrhea in elderly [#5]

A
  • Acute ischemic bowel
  • Obstruction
  • Diverticulitis
  • Appendicitis
  • Neoplasm
61
Q

Risk factors for C. Difficile [#5]

A
  • Healthcare-associated
  • Older age
  • Immunocompromised
  • Previous C. Diff infection
  • Recent antibiotics (esp. Fluoroquinolone)
62
Q

Treatments for C. Difficile [#6]

A
  • Vancomycin PO (first-line even if mild)
  • Fidaxomicin
  • Metronidazole
  • Fecal transplant
  • Rifaximin
  • Bezlotoxumab (monoclonal)
63
Q

Investigations for chronic diarrhea [#12]

A
  • Serum Hb
  • Serum ferritin
  • Serum TSH
  • Serum ttG
  • Stool C. Diff NAAT
  • Stool Ova & parasites
  • Fecal calprotectin
  • FIT / Colonoscopy
  • Hydrogen breath (lactose)
  • Capsule endoscopy
  • Fecal elastase (fat malabsorption)
  • MRI abdomen (chronic pancreatitis)
64
Q

Treatments for Crohn’s Disease

A
  • Sulfasalazine
  • Steroids
  • Thiopurines
  • Methotrexate
  • Anti-TNF therapy
65
Q

IBS investigations

A

TTG or endomysial IgA

66
Q

Non-medical management for IBS [#5]

A
  • FODMAP diet trial
  • Psyllium
  • Peppermint oil, probiotics
  • CBT, hypnotherapy
  • Colonoscopy if > 50 years OR alarm features
67
Q

Medical management for IBS [#5]

A
  • Antispasmodics (e.g. Buscopan)
  • Antidepressants (e.g., TCAs, SSRIs)
  • Eluxadoline
  • Lubiprostone
  • Linaclotide
68
Q

Sleep disorders [#8]

A
  • Narcolepsy
  • Restless leg syndrome
  • Sleep terrors
  • Sleep walking
  • REM sleep disorder
  • OSA
  • Central sleep apnea
  • Substance/medication-induced
69
Q

PHQ-2

A
  1. Down/depressed/hopeless?
  2. Little interest/pleasure?
70
Q

New medications for Insomnia

A
  • Lemborexant (Dayvigo)
  • Eszopiclone (Lunesta)
71
Q

Non-prescription management for Restless Legs [#5]

A
  • Iron, Magnesium
  • Stretch calves
  • Avoid caffeine
  • Massage, heat
  • Exercise
72
Q

Prescriptions for Restless Legs [#4]

A
  • Pramipexole
  • Ropinirole
  • Gabapentin
  • Pregabalin
73
Q

STOP-BANG for OSA [#8]

A
  • Snore loudly
  • Tired
  • Observed apnea
  • high blood Pressure
  • BMI >35
  • Age >50
  • Neck circumference > 40 cm
  • male Gender
74
Q

Caregiver burnout management [#4]

A

CALM
- Counselling
- Appointment (next visit)
- Lifestyle advice
- Mental health support

75
Q

Thyroid storm management [#5]

A

Block B’s:
- Block synthesis = Thionamides (Methimazole, Propylthiouracil)
- Block T4 –> T3 = Propranolol, Propylthiouracil
- Block release = Iodine
- Beta Blocker = Propranolol
- Bile acid sequestrant = Cholestyramine

76
Q

Risk factors for hypothyroidism [#5]

A
  • Age
  • Pregnancy
  • Personal history
  • Thyroidectomy
  • Radiation
77
Q

Treatment for hyperthyroidism

A
  • Propranolol if symptomatic for 6-8 weeks
  • RAIU unless 100% sure it’s Graves
78
Q

Contraindications for RAIU [#2]

A
  • Obvious Grave’s disease
  • Pregnant or breastfeeding
79
Q

Indications for biopsy for thyroid nodule

A
  • > 1 cm
  • Irregular surface
  • Taller than wide
  • Calcifications within
80
Q

Criteria for Myalgic Encephalomyelitis-Chronic Fatigue Syndrome (ME-CFS) [2]

A
  • Fatigue profound & not improved by rest
  • Post-exertional malaise
81
Q

Criteria for Environmental Sensitivity (ES-MCS) [2]

A
  • Provoked by chemical, biological agents & removal relieves
  • Neurocognitive, respiratory symptoms
82
Q

Criteria for Fibromyalgia [2]

A
  • Diffuse body pain x 3 months with no other explanation
  • Fatigue (in 90%), sleep, mood, cognitive symptoms
83
Q

Treatment for Diabetic Ketoacidosis [#5]

A
  • Insulin
  • Saline
  • Potassium
  • Bicarbonate if overacidic
  • D5W once appropriate
84
Q

5 classes of medications for diabetes besides insulin

A
  • Biguanide
  • SGLT-2 inhibitors
  • GLP-1 receptor agonists
  • Sulfonylureas
  • DPP-4 inhibitors
  • Thiazolidinediones
85
Q

Differential for Dyscopia [#6]

A

SAD-CSS:
- Somatic symptom disorder
- Anxiety
- Depression
- Chronic pain
- Sleeping disorder
- Substance use

86
Q

Tests to check infectivity for Hepatitis B [#3]

A
  • Serum HBV DNA
  • Serum HBeAg
  • Anti-HBe
87
Q

Hepatitis C tests [#3]

A
  • Serum anti-HCV (unless known previous HCV)
  • Serum HCV RNA
  • Genotype & subtype
88
Q

Hepatitis A management [#2]

A
  • Supportive
  • Report
89
Q

Treatment indications for severe Hepatitis B [#3]

A
  • Cirrhosis
  • Fibrosis
  • HBV DNA >2000 IU/mL & ALT elevated for 3-6 months
90
Q

Medications for Hepatitis B [#2]

A
  • Tenofovir
  • Entecavir
91
Q

Treatment for Hepatitis C [#2]

A
  • Interferon, Peginterferon, Ribavirin
  • New regimens (i.e., Sofosbuvir with Ledipasvir, Daclatasvir, Velpatasvir) [Mavyret, Harvoni)
92
Q

Monitoring for Hepatitis B & C [#4]

A
  • HCC = liver U/S q6-12 months
  • Varices = scope q1-3 years
  • Alcohol = history
  • Cirrrhosis/fibrosis = Fibroscan
93
Q

Features of non-inflammatory low back pain [#2]

A
  • AM stiffness < 30 mins
  • Worse @ end of day
94
Q

Features of inflammatory back pain [#2]

A
  • AM stiffness > 30 mins
  • Better @ end of day
95
Q

Myotome for L1/2

A

Hip flexion

96
Q

Myotome for L3/4

A

Knee extension

97
Q

Dermatome for L4

A

Knees to first toe

98
Q

Dermatome for L5

A

Middle toes

99
Q

Dermatome for S1

A

Pinky toe

100
Q

Non-medical management for low back pain [#4]

A
  • Yoga
  • Acupuncture
  • Osteopathy
  • CBT
101
Q

Alarm features for joints [#4]

A
  • Hot (fever; warm joint)
  • Bog (soft & boggy joint)
  • AM stiffness > 30 mins
  • PM pain (night pain)

CCFP Exam (1 decks)

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