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CCFP Exam 2021 > Vital FM 1 > Flashcards

Vital FM 1 Flashcards

1
Q

List 5 regions Thalassemia is endemic in.

A 
Africa
Middle East
Caribbean
Mediterranean
South East Asia
South America

Coffee producing regions of the world

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2
Q

What iron formulation has the highest iron content?

A

Ferrous FUmarate

FULL of Fe

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3
Q

What iron formulation is best for children?

A

Ferrous ‘S’ulfate

Best for ‘S’mall

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4
Q

What can you do to aid iron absorption

A

Vitamin C - no Tea

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5
Q

List 5 tests if you are worried about iron deficiency anemia

A 
Hgb
MCV
Serum ferritin
Peripheral Blood Smear
Serum Iron
TIBC
Colonoscopy
HCG
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6
Q

What test do you order to diagnosis Thalassemia

A

Hemoglobin Electrophoresis

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7
Q

Who is at high risk of iron deficiency in anemia?

List 2

A

Women and children

Think women and children FErst

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8
Q

What are risk factors for B12 deficiency?

A 
Gastric surgery (gastric parietal cells make intrinsic factor)
Strict vegans
Breastfed kids of strict vegans
Elderly
Psychiatric
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9
Q

What test do you order if B12 is low to diagnose pernicious anemia?

A

Anti-intrinsic factor antibody

Schilling test is no longer done

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10
Q

What are 5 causes of anemia?

A 
Low intake (dietary - B12/iron)
Loss - menstrual, donations, meds, bleeding disorder
Destruction - Marathon running
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11
Q

How does the Canadian Thoracic society divide up cough?

A

Acute - less than 3 weeks
Sub-acute - 3-8 weeks
Chronic - more than 8 weeks

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12
Q

What can cause acute cough (less than 3 weeks)?

A 
Pneumonia
Heart failure
Neoplasm
Foreign body
Pneumothorax
Medication
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13
Q

What can cause a sub-acute cough (3-8 weeks)?

A

Post-viral
Infectious - bacterial, viral, fungal, mycobacterial
Early chronic (asthma, reflux, upper airway cough syndrome(post-nasal drip))

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14
Q

What can cause chronic cough? (more than 8 weeks)

A 
COPD
Infection
Cystic Fibrosis
Eosinophil bronchitis
Bronchiectasis
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15
Q

What are 4 causes outside the lung?

A

Travel
Occupation
Contacts
Critters

“TOCC” to your patients

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16
Q

What are your first, second and third line treatments for Asthma/COPD overlap syndrome?

A

ICS/LABA (Fluticasone + salmeterol)
LAMA (Tiotropium)
Biologic + Refer

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17
Q

What prophylactic antibiotic will decrease COPD exacerbations?
List 2

A

Azithromycin

Erythromycin

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18
Q

What is the first line treatment for COPD?

A

SABA

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19
Q

What medication do you substitute for a LAMA in COPD with high eosinophilic counts?

A

Inhaled corticosteroid (ICS)

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20
Q

What are 3 other causes of COPD other than smoking?

A

Alpha 1 antitripsyn
Second hand smoke
Biofuels (immigrants)

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21
Q

What is the risk and benefit of adding an ICS for COPD?

A

Fewer exacerbations

More pneumonias

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22
Q

What are two non-pharmacologic interventions for COPD?

A

Quit smoking

Exercise

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23
Q

When do you add antibiotics to steroids for acute exacerbation?

A

CRP>40

or 2 of 3 of
Dyspnea
Sputum purulence
Sputum Volume

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24
Q

What bugs cause COPD?

A

H. Influenza
S. Pneumonia
M. Catarrhalis

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25
Q

What bugs cause complicated COPD exacerbations?

A

Klebisella
Gram -ve’s
Pseudamonas

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26
Q

What can help prevent COPD exacerbations?

A

Flu vaccine
Pneumonia vaccine
Exercise

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27
Q

What can you refer a COPD patient to?

A 
Respiratory therapy
Pulmonary rehab
Respirology
Smoking counsellor
Psychologist
Exercise counsellor
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28
Q

How do you diagnose Asthma in less than 6?

A

Wheeze
Reversable wheeze
Not anything else

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29
Q

What is the diagnostic cutoff for A5THMA?

A

FEV1/FVC pre < 0.75

Reversible and increase in 12%

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30
Q

What is the diagnostic cutoff for C0PD?

A

FEV1/FVC < 0.70

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31
Q

What are the first, second and third line treatments for pediatric asthma?

A

Salbutamol
ICS
Oral steroid

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32
Q

What is the first line treatment for asthma?

A

As needed ICS-Formoterol combo
slightly better than
ICS whenever SABA is taken

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33
Q

What is the second line treatment for asthma

A

Daily ICS-formoterol + as releiver

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34
Q

What is the third line treatment for asthma?

A

Low dose ICS-LABA

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35
Q

What is the fourth line treatment for asthma?

A

Medium dose ICS-LABA

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36
Q

What is the fifth line treatment for asthma?

A

Maximum dose ICS-LABA
+ refer
+ additional therapy (tiotropium)

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37
Q

What are 5 risk factors for PE?

A 
Age
Prior DVT/PE
Recent Surgery/trauma
Estrogen use
Leg swelling
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38
Q

What intervention do you perform for unilateral spontaneous pneumothorax that does not progress over 4 hours?

A

Nothing.

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39
Q

List 5 non-pulmonary causes of shortness of breath.

A 
Arrhythmia
Cardiomyopathy
Malignancy
Aortic Stenosis
Mycobacterial
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40
Q

List 5 non-pulmonary causes for dyspnea

(5 A’s)

A 
Anemia
Anti-aeriobic (reconditioning)
Altitude
Allergy
Acid Reflux
Abnormal thyroid
Anxiety
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41
Q

How do you diagnose and treat testicular cancer?

A

beta-hcg
Alpha Fetoprotein
Lop it off

BALLLS

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42
Q

What are 3 risk factors for Testicular Cancer

A

Cryptorchidism
Family History
Personal History

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43
Q

What screening test can you offer for lung cancer? What are the criteria?

A

Low Dose CT
55-74
30 pk-yr
Current or quit <15 years

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44
Q

What screening test would you offer for ovarian cancer?

A

Nothing

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45
Q

What 2 screening tests can you offer for colon cancer and what are their intervals?

A

FIT q2years

Flex sig q10years

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46
Q

Who do you screen for pancreatic cancer?

A

Family history

High-risk syndromes (Peutz-Jeghers syndrome)

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47
Q

What are 5 tests you can order for unexplained weight loss

A 
Hemoglboin
Na, K, eGFR, Urea, Creatinine
PSA
FIT
CXR
48
Q

What are four alarm features for abdominal pain?

A

Severe pain
Blood in stool
Melena
Abnormal labs

49
Q

What is the treatment for H.Pylori? How long do you treat them for?

A

PPI
Bismuth
Metronidazole
Tetracycline

14 days

50
Q

What screening test should you order for esophageal cancer?

A

None

51
Q

What is the greater risk factor for Barrett’s esophagus?

A

Reflux

52
Q

List 4 long-term PPI risks?

A

B12, dementia, C. difficile, fractures

53
Q

What is the bolus fluid amount for kids?

A

20 ml/kg

54
Q

What is the maintenance fluid amount for kids?

A

4-2-1 per hour.

55
Q

What are 5 risk factors for C. diff?

A 
Admission
Older age
Immunocompromise
Previous C. diff
Recent antibiotics
56
Q

What is the first line treatment for C. diff?

A

Vancomycin PO

57
Q

What are five tests to order for chronic diarrhea (> 4 weeks)?

A 
CBC
ferritin
TSH
C. Diff
fecal calprotectin
Colonoscopy
58
Q

What test do you order to test for lactose intolerance?

A

Hydrogen breath test.

59
Q

What three agents should you avoid in Crohn’s?

A

5-ASA
Antibiotics
Alternative treatments (probiotics/cannabis)

60
Q

Name 4 medication classes to treat Crohn’s.

A

Sulfasalazine
Thiopurines
Methotrexate
Biologics

61
Q

What are 5 things you can refer for insomnia?

A 
Sleep Medicine
Sleep study
Psychiatry
Auricular Accupuncture
CBT-I
62
Q

What are 5 non-pharm treatments for restless legs?

A 
Iron
Magnesium
Stretch
Massage
Heat
Exercise
63
Q

What are 4 pharm treatments for restless legs?

A

Pramipexole
Gabapentin
Pregabalin
Benzos

64
Q

What are the 4 steps of trauma informed care?

A
  1. Bear witness
  2. Create safe space
  3. Collaborate
  4. Believe in resilience
65
Q

What is your first treatment class of medications for hyperthyroidism?

A

Beta-blocker

66
Q

What 2 tests are you ordering for a thyroid nodule?

A

TSH

Thyroid ultrasound

67
Q

What are 4 suspicious features on U/S of thyroid warrant biopsy?

A

1 cm
Irregular surface
Taller than wide
Calcifications

Think goitre the hedgehog.

68
Q

What two treatments can you use for pharmacology resistant Grave’s disease?

A

Radiation

Surgery

69
Q

What are 5 things common to ME-CFS, fibre and ES-MCS?

A 
Fatigue
Pain
Sleep
Neuro symptoms
Cognitive symptoms
70
Q

What symptoms are specific to ME-CFS?

A

Chronic, profound fatigue
Not improved by rest
Post-exertional malaise

71
Q

What symptoms are specific to fibromyalgia?

A

Diffuse body pain (3 months)

72
Q

What symptoms are specific to multiple chemical sensitivity?

A

Provoked by chemical agents
Removal relieves
Respiratory symptoms

73
Q

What are the 5 steps in pharmacotherapy for diabetes?

A 
Metformin
2nd line OHA
qhs basal insulin
qam basal insulin
bolus insulin
74
Q

What two oral hypoglycemic agents have cardioprotective effects?

A 
SGLT2 inhibitors (empagliflozin)
GLP-1 receptor agonists (liraglutide)
75
Q

Driving guidelines for diabetes?

A

Check sugar q2h if symptomatic
Check sugar q4h if asymptomatic
Have 6 lifesavers in the car.

2-4-6 rule

76
Q

What 5 things should you screen for in somebody with suspected somatization?

A 
Substance use
Anxiety
IPV
Depression
Sleeping disorder

THINK SAIDS - like dummies who are on income assistance will have somatization

77
Q

What are the 5 stages of change?

A 
Pre-contemplation
Contemplation
Preparation
Action
Maintenance
78
Q

List 5 causes of hepatitis.

A 
Infections
Medication
Alcohol
Iron overload
Autoimmune
79
Q

What are four treatments for non-alcohol fatty liver disease?

A

Exercise
Diet
Weight Loss
EtOH reduction

80
Q

What test do you order to confirm active HCV infection?

A

HCV RNA

81
Q

What are four complications of hepatitis to screen for?

A

HCC
Varices
Alcohol
Cirrhosis

82
Q

What are two parts of low back pain history that suggest a non-inflammatory cause?

A

Less than 30 minutes of morning stiffness

Worse at the end of the day.

83
Q

What are two parts of low back pain history that suggest an inflammatory cause?

A

More than 30 minutes of morning stiffness

Better at the end of the day

84
Q

What are four alarm features for joints?

A

Hot
Boggy
AM (Stiff > 30 min)
PM (Night pain)

85
Q

What four diseases should you screen for before starting DMARD/Immune suppressants

A

HIV
TB
HCV
HBV

86
Q

What are 5 non-pharm options for treating bedwetting?

A 
Use toilet before bed
No fluids before bed
No caffeine
Training pants
Bedwetting alarms
87
Q

What two drugs can you use to treat bedwetting?

A

Desmopressin

Imipramine

88
Q

What are 5 things you can refer for autism?

A 
Hearing assessment
Visual assessment
Pediatrics
Autism support group
SLP
89
Q

What are three co-morbid conditions to screen for in Autism spectrum disorder?

A

Sleep
Constipation
Anxiety/Depression

90
Q

What are 5 things on your differential for Autism Spectrum Disorder

A 
Global development delay
Hearing impairment
Epilepsy
OCD
ODD
Conduct disorder
Trisomy 21
Cerebral Palsy
91
Q

What are 5 things to look for in conduct disorder?

A 
Persistent
Violating rights of others
Rule breaking
Violence against people/animals
Running away from home/school
92
Q

How do you separate ODD from conduct disorder?

A

ODD does not
Damage people or animals
Damage property
Deceive or thieve

93
Q

What is one treatment for button battery injection?

A

Honey

94
Q

List 5 things to counsel for in safety around the home in kids.

A 
Guns
Carbon monoxide
Electric plugs
Hot water heater
Car Seats
Pools
95
Q

What is the most common poisoning to occur in the household?

A

Shampoo/Soap

96
Q

What are 4 pros of circumcision?

A

Phimosis
UTI
Penile cancer
HPV/HIV/HSV

97
Q

What do you treat phimosis with?

A

Betamethasone at age 8-10.

98
Q

What vaccine is given in every pregnancy?

A

TdaP

99
Q

What are 5 tips to reduce vaccine pain for children?

A 
Most painful last
Breastfeed
Skin to skin
Topical anesthetic
Sugars
100
Q

What are 4 risk factors for sinusitis?

A

Smoking
Anatomy (deviated septum etc.)
Allergic rhinitis
Asthma

101
Q

What are 3 bugs found in sinusitis?

A

H. flu
S. Pneumonia
M. Catarrhalis

Same as ear bugs
Same as COPD bugs

102
Q

What are 5 alarm features of sinusitis?

A 
Persistent fever
Periorbital edema
Cranial nerve palsies
Abnormal extra ocular movements
Proptosis
Vision changes
Sever headache
Altered mental status
Meningismus
103
Q

What are four features that will point to bacterial sinusitis?

A

Pain
Obstruction
Discharge
Smell

Greater than 7 days - treat

104
Q

What is your first line antibiotic treatment for sinusitis?

A

Amox

105
Q

What are two second line treatments for sinusitis?

A

TMP/SMX

Macrolide

106
Q

What are 5 additional treatments to abx for sinusitis?

A 
Nasal rinse
Intranasal steroids
Decongestants
Analgesics
Anti-inflammatories
107
Q

What is the treatment for strep throat?

A

Pen V 800 mg QID * 5 days

108
Q

What are 5 risk factors for neonatal sepsis?

A 
Chorioamniotinits
Maternal fever
< 37 weeks
Rupture > 18 hours
GBS +ve
109
Q

What are the three bugs that cause sepsis?

A

Listeria
E. Coli
GBS

LEGS

110
Q

What is the treatment for infant hypoglycemia?

A

D10W

111
Q

What are 5 symptoms of hypoglycemia in the neonate?

A 
Jittery
Lethargic
Hypotonic
Sweating
Weak cry
Tachypnea
Seizures
112
Q

How long is jaundice possible for in neonates?

A

2 weeks

113
Q

What is the workup for neonate hypobilirubinemia?

A 
Hemoglobin
Group and Screen
Conjugated bilirubin
Coomb's
Peripheral smear
114
Q

What does a Coomb’s test in neonates?

A

Looks for maternal antibodies on baby’s red blood cells.

115
Q

What are 5 risk factors for hip dysplasia

A 
Firstborn
Female
Family history
Fluid (oligo)
Feet (breech)

5 F’s

116
Q

What are 5 thinks to look for with pediatric limp?

A 
Legg-Calve-Perthes
Infection
Malignancy (Ewing's Sarcoma)
Pain from abuse
Slipped Capital Femoral Epiphysis

“LIMPS”

117
Q

Causes of altered mental status?

A 
Drugs
Infection
Metabolic
Failure
Anemia/Alcohol
Cardiac
Electrolyte
Structural

DIM FACES

CCFP Exam 2021 (11 decks)

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