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CCFP Exam 2021 > The other 105 topics > Flashcards

The other 105 topics Flashcards

1
Q

What is the skin sloughing sign associated with blisters?

A

Nikolsky’s sign.

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2
Q

What two conditions are associated with Nikolsky’s sign?

A

Toxic Epidermal Necrolysis

Steven’s Johnson’s Syndrome

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3
Q

What are five management steps for SJS/TEN?

A 
Stop offending agent
Pain control
Wound care
Monitor for infection
Fluid balance
Electrolyte balance
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4
Q

What are three risk factors for pityriasis versicolor?

A

Activity in hot climates
Corticosteroids
Changes in activity

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5
Q

List three ways to confirm the diagnosis of pityriasis versicolour.

A

Clinically
Wood’s lamp
Presence of hyphae on KOH prep
Scraping

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6
Q

What are three treatments for pityriasis versicolour?

A

Ketoconazole shampoo
Topical terbinafine
Systemic fluconazole (severe)

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7
Q

What three things would you tell somebody about the natural course of pityriasis versicolour?

A

Fungus goes away after two weeks
Not contagious
Pigment comes back slowly
Triggered by warm/humid environments.

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8
Q

List 5 risk factors for CHF.

A 
Smoking
Previous myocardial infarction
Hypertension
Alcohol consumption
Hyperlipidemia
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9
Q

What are 5 signs and symptoms of CHF?

A 
PND
Orthopnea
Edema
Ascites
Cough
Dyspnea
Hypotension
S3
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10
Q

What are 5 tests you would order to categorize/evaluate CHF?

A 
Chest X-ray
ECG
BNP
Sodium
eGFR
Potassium
Echo
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11
Q

What are 5 investigations you would order if you suspect a flare-up of diverticulitis?

A 
Abdominal CT with oral contrast
Lactate
Blood glucose
White cell count
Hgb
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12
Q

What one test must you order prior to getting a contrast CT?

A

Creatinine

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13
Q

What three diagnoses would you suspect with shortness of breath on a background of wet cough?

A

Pleural effusion
Pneumonia
Heart failure exacerbation
PE

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14
Q

What one cardiac abnormality would you suspect with a high pitched pan-systolic murmur in heart failure?

A

Aortic stenosis

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15
Q

What is your first pharmacologic management step for pleural effusion?

A

Lasix

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16
Q

What are 5 risk factors for DVT?

A 
Smoking
Immobility
Trauma
Surgery
Family history of clotting disorder
Malignancy
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17
Q

What are three tools for assessing risk of PE?

Which is validated during pregnancy?

A

PERC
Wells
YEARS - pregnancy validated

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18
Q

What organism should you suspect in a child with sore throat, fever and rash?

A

Group A beta-hemolytic strep

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19
Q

What are two complications associated with group A strep

A

Post-streptococcal glomerular nephritis

Rheumatic disease

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20
Q

How do you treat Group A strep?

A

Penicillin

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21
Q

What diagnose would you suspect in an individual with ++ NSAID use , fatigue and decreased urine output?

A

Pre-renal AKI

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22
Q

What are 5 physical exam findings associated with pre-renal AKI?

A 
Decreased skin turgor,
Dry mucous membranes
Tachycardia
Orthostasis
Edema
Elevated JVP
S3

Note: kidney failure will have symptoms of both volume deletion and fluid overload

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23
Q

What would cause somebody to scratch in kidney failure?

A

Uremia

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24
Q

What are five lab findings in a pre-renal AKI?

A 
Elevated urea
Elevated creatinine
Elevated urea/cr ratio
Increased urine osmolality
Decreased urine sodium
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25
Q

What are two risk factors for pulmonary hypertension?

A

Scleroderma

Smoking

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26
Q

What three investigations should you order for suspected pulmonary hypertension

A

Cardiac MRI
Echocardiogram
Right heart catheterization

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27
Q

What are three supportive management steps for pulmonary hypertension?

A

Patient education
Cardiology referral
Oxygen
Physical rehabilitation

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28
Q

What are three pathways by which the drugs for pulmonary hypertension work?

A 
Nitric oxide pathway (PDE5i)
Endothelin pathway (endothelia receptor antagonist)
Prostacyclin pathway (soluble guanalate cyclase inhibitors)
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29
Q

What is the lab test to confirm celiac?

A

Anti-tissue transglutaminase

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30
Q

What are five non-pharm treatment options for chronic mechanical back pain?

A 
Stretching
Heat
Ice
Massage
Yoga
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31
Q

What three things should you document prior to starting opiates?

A 
Pain history
Medical history
Substance use history
Previous analgesia use
Opioid treatment agreement
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32
Q

What is the one best tool for assessing risk with opiates?

A

Opioid Risk Tool

Think OAT/ORT

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33
Q

What three things must you discuss with patients prior to starting opiates?

A

Benefits
Harms
Risks

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34
Q

What are two other diagnoses you should consider if you are thinking aortic dissection?

A

Intramural hematoma
Penetrating atherosclerotic ulcer

Think Acute aortic syndrome

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35
Q

What imaging do you order for acute aortic syndrome

A

ECG gated CT aorta with contrast

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36
Q

By what two metrics do you determine that chronic non-cancer opiates are working?

A

Improved function

Reduction in pain by 30%

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37
Q

List 5 side effects of opiates.

A 
Nausea
Somnolence
Pruritus
Vomiting
Vertigo
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38
Q

What are two medical complications associated with opioid therapy

A

Sleep apnea

Opioid-induced hyperalgesia

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39
Q

What are three risk factors specific to upper arm DVT?

A

IV catheters
Pacemaker/ICD
Overhead arm activity

40
Q

What is the syndrome associated called for upper arm DVT?

A

Paget-Schroetter

41
Q

What test should you order if you suspect upper extremity DVT

A

Arm venous duplex doppler U/S

42
Q

What is the difference between primary and secondary erythrocytosis?

A

Primary is when RBCs are produced from an RBC secreting tumour like polycythemia vera

Secondary is when RBCs are elevated due to something else that stimulates RBC production such as EPO secreting tumours

43
Q

What are 5 tests you would order to distinguish between primary and secondary causes of erythrocytosis?

A 
Hgb
Peripheral blood smear
Creatinine
K
Na
GGT
ALT
AST
Ferritin
44
Q

What is the name of the gene mutation associated with the primary form of erythrocytosis (Polycythemia vera)

A

JAK2

45
Q

What are 2 conditions that would predispose somebody to erythrocytosis?

A

COPD

OSA

46
Q

What are three treatments for erythrocytosis?

A

Phlebotomy
ASA
Treat underlying cause

47
Q

What are two definitions of chronic kidney failure?

A

eGFR < 60
ACR > 3

Either must be present3 months

48
Q

What is the target BP for CKD?

A

120/90

49
Q

How often should somebody with CKD have physical exam and labwork?

A

q6months

50
Q

What labwork should be done at CKD checkups?

A 
U/A
K
Na
eGFR
Creatinine
ACR
51
Q

What are 5 lifestyle modifications for CKD?

A 
Exercise
Weight loss
Decrease salt intake
Protein restriction
Smoking cessation
Decrease alcohol intake
52
Q

What are 5 signs/symptoms that suggest testicular torsion?

What is the screening tool?

A

TWIST

Absent cremasteric reflex
Hard testicle
Swollen testicle
High riding testicle
Nausea/Emesis
53
Q

What are 5 things to consider on diffential with testicular pain?

A 
Torsion
Orchitis
Tumour
Epidimytis
Nephrolithiasis

TOTEN = german for kill

54
Q

What is a three treatments for fibromyalgia?

A

TCA’s
SNRI
Gabapentin/Pregabalin

55
Q

What tool could you utilize to mitigate aberrant drug behaviours when starting opioids?

A

Opioid contract

56
Q

What are three ways you can titrate the dosage of opioids for patients who are at increase risk of opioid misuse?

A

Frequent dispensing
Frequent follow-up
Lower dose/increase frequency

57
Q

List one long-term complication of endocarditis.

A

Congestive Heart Failure

58
Q

What organism is most responsible for endocarditis in IVDU?

A

S. aureus.

59
Q

What are four signs of physical exam associated with heart failure.

A

Elevated JVP
Ascites
Pitting edema
Hepatomegaly

60
Q

What is the numerical echocardiogram cutoff for heartfailure with reduced EF?

A

<40%

61
Q

List 5 conditions associated with high output heart failure.

A 
Hyperthyroidism
Obesity
Liver disease
Lung disease
Pregnancy

Think that blood flow forward is HOLLuP

62
Q

What is one necessary treatment step in all of beriberi, Wernicke’s encephalopathy and Korsikoff syndrome?

A

Thiamine for two weeks

63
Q

What are two risk factors and one genetic predisposition for ankylosing spondylitis?

A

Adolescent
Male
HLA-B27

64
Q

What diagnosis would you suspect in an adolescent male with A.M. back pain relieved with exercise?

A

Ankylosing spondylitis

65
Q

What are three medications to treat ankylosing spondylitis?

A

NSAIDs
TNF blockers
Methotrexate

66
Q

Pretibial myxedema (edema with overlying hyperkeratosis) is associated with what disease?

A

Grave’s disease

67
Q

What is the pathophysiology of Grave’s disease?

A

TSH receptor antibodies cause ++ over production of TSH.

68
Q

What are two treatments for pretibial myxoedema?

A

Topical steroids

Compression stockings

69
Q

What is one scoring tool to be able to determine somebody’s chance of organ failure outside of ICU?

A

qSOFA

70
Q

What are the three elements of qSOFA?

A

Altered mental status (GCS <15)
Resp rate > 22
SBP < 100

71
Q

What are 5 investigations you should order for the sick patient?

A 
Hgb
WBC
Glucose
Blood cultures
Chest x-ray
ECG
U/A
72
Q

What is the one most likely bug in community acquired pneumonia?

A

S. pneumonia

73
Q

What are 5 symptoms associated with anaphylaxis?

A 
Angioedema
Wheeze
Drooling
Emesis
Drowsiness
Hypotension
74
Q

What is the dose of epinephrine for ananphylaxis?

A

0.01 mg/kg

75
Q

What are 5 other adjuncts to epinephrine?

A 
Antihistamines
Steroids
Dopamine
IV fluids
Oxygen
76
Q

What most you look out for after an anaphylactic reaction?

How do you manage this?

A

Bi-phasic reaction

Monitor for up to 8 hours.

77
Q

What are the cutoffs for the stages of kidney disease?

A 
> 90 with kidney damage = stage 1
60-89 = stage 2
30-59 = stage 3
15-29 = stage 4
< 15 = stage 5
78
Q

What is the target hgb level for somebody with CKD?

A

110

79
Q

What are 6 complications of CKD?

A 
Anemia
Osteoporosis
HTN
Hyperkalemia
Depression
Restless legs
80
Q

How do you treat anemia associated from CKD?

A

EPO

Iron supplementation

81
Q

What might you suspect in a patient with kidney disease and restless legs?

A

Uremia

82
Q

What are three indications for referral to nephrologist?

A

GFR < 30
Rapidly decreasing GFR
ACR > 60

83
Q

List 5 organs to look at when suspecting sarcoidosis.

A 
Lung
Liver
Spleen
Eyes
Skin
Lymph nodes
Joints
Heart
Kidneys
84
Q

What is your second line treatment for otitis media in a child?

A

Ceftriaxone IM

85
Q

What three investigations do you order if you suspect sarcoidosis?

A 
Chest X-ray
PFTs
ECG
Creatinine
Calcium
AST/ALT/GGT
Hgb
86
Q

What key finding would you expect in stage 1 of sarcoidosis?

A

Bilateral hilar lymphadenopathy

87
Q

What pulmonary condition are patients with sarcoidosis at risk of developing?

A

Pulmonary fibrosis

88
Q

What form of dysfunction does HOCM cause?

A

Diastolic

89
Q

What maneuvers will increase a HOCM murmur?

Decrease?

A

Increase: Valsalva/standing

Decrease: Hand grip, leg raise, squatting

90
Q

What are 3 complications with HOCM?

A 
Ventricular arrythmias
CHF
Infective endocarditis
Atrial fibrillation
Embolic phenomenon
91
Q

What are 5 diagnoses to consider in LLQ with rebound tenderness and fever

A 
Diverticulitis
Bowel obstruction
Colorectal cancer
Gastroenteritis
IBD
92
Q

What are 4 associated features with diverticulitis?

A

Anorexia
Nausea
Vomiting
Constipation

93
Q

What would categorize diverticulitis as complicated?

A 
Abscess
Phlegmon
Fistula
Obstruction
Perforation
94
Q

What are three symptoms associated with endometriosis?

A

Pain with defecation
Pain with urination
Pain with intercourse

95
Q

What are 5 classes of medications for endometriosis?

A 
NSAIDs
Combined OCPs
Progestins
IUS
Aromatase inhibitors
96
Q

What are 3 tests to confirm endometriosis?

A

Physical exam
MRI pelvis
Laparosocpy

CCFP Exam 2021 (11 decks)

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