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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
What bugs cause complicated COPD exacerbations?
Klebisella Gram -ve's Pseudamonas
26
What can help prevent COPD exacerbations?
Flu vaccine Pneumonia vaccine Exercise
27
What can you refer a COPD patient to?
``` Respiratory therapy Pulmonary rehab Respirology Smoking counsellor Psychologist Exercise counsellor ```
28
How do you diagnose Asthma in less than 6?
Wheeze Reversable wheeze Not anything else
29
What is the diagnostic cutoff for A5THMA?
FEV1/FVC pre < 0.75 | Reversible and increase in 12%
30
What is the diagnostic cutoff for C0PD?
FEV1/FVC < 0.70
31
What are the first, second and third line treatments for pediatric asthma?
Salbutamol ICS Oral steroid
32
What is the first line treatment for asthma?
As needed ICS-Formoterol combo slightly better than ICS whenever SABA is taken
33
What is the second line treatment for asthma
Daily ICS-formoterol + as releiver
34
What is the third line treatment for asthma?
Low dose ICS-LABA
35
What is the fourth line treatment for asthma?
Medium dose ICS-LABA
36
What is the fifth line treatment for asthma?
Maximum dose ICS-LABA + refer + additional therapy (tiotropium)
37
What are 5 risk factors for PE?
``` Age Prior DVT/PE Recent Surgery/trauma Estrogen use Leg swelling ```
38
What intervention do you perform for unilateral spontaneous pneumothorax that does not progress over 4 hours?
Nothing.
39
List 5 non-pulmonary causes of shortness of breath.
``` Arrhythmia Cardiomyopathy Malignancy Aortic Stenosis Mycobacterial ```
40
List 5 non-pulmonary causes for dyspnea | (5 A's)
``` Anemia Anti-aeriobic (reconditioning) Altitude Allergy Acid Reflux Abnormal thyroid Anxiety ```
41
How do you diagnose and treat testicular cancer?
beta-hcg Alpha Fetoprotein Lop it off BALLLS
42
What are 3 risk factors for Testicular Cancer
Cryptorchidism Family History Personal History
43
What screening test can you offer for lung cancer? What are the criteria?
Low Dose CT 55-74 30 pk-yr Current or quit <15 years
44
What screening test would you offer for ovarian cancer?
Nothing
45
What 2 screening tests can you offer for colon cancer and what are their intervals?
FIT q2years Flex sig q10years
46
Who do you screen for pancreatic cancer?
Family history | High-risk syndromes (Peutz-Jeghers syndrome)
47
What are 5 tests you can order for unexplained weight loss
``` Hemoglboin Na, K, eGFR, Urea, Creatinine PSA FIT CXR ```
48
What are four alarm features for abdominal pain?
Severe pain Blood in stool Melena Abnormal labs
49
What is the treatment for H.Pylori? How long do you treat them for?
PPI Bismuth Metronidazole Tetracycline 14 days
50
What screening test should you order for esophageal cancer?
None
51
What is the greater risk factor for Barrett's esophagus?
Reflux
52
List 4 long-term PPI risks?
B12, dementia, C. difficile, fractures
53
What is the bolus fluid amount for kids?
20 ml/kg
54
What is the maintenance fluid amount for kids?
4-2-1 per hour.
55
What are 5 risk factors for C. diff?
``` Admission Older age Immunocompromise Previous C. diff Recent antibiotics ```
56
What is the first line treatment for C. diff?
Vancomycin PO
57
What are five tests to order for chronic diarrhea (> 4 weeks)?
``` CBC ferritin TSH C. Diff fecal calprotectin Colonoscopy ```
58
What test do you order to test for lactose intolerance?
Hydrogen breath test.
59
What three agents should you avoid in Crohn's?
5-ASA Antibiotics Alternative treatments (probiotics/cannabis)
60
Name 4 medication classes to treat Crohn's.
Sulfasalazine Thiopurines Methotrexate Biologics
61
What are 5 things you can refer for insomnia?
``` Sleep Medicine Sleep study Psychiatry Auricular Accupuncture CBT-I ```
62
What are 5 non-pharm treatments for restless legs?
``` Iron Magnesium Stretch Massage Heat Exercise ```
63
What are 4 pharm treatments for restless legs?
Pramipexole Gabapentin Pregabalin Benzos
64
What are the 4 steps of trauma informed care?
1. Bear witness 2. Create safe space 3. Collaborate 4. Believe in resilience
65
What is your first treatment class of medications for hyperthyroidism?
Beta-blocker
66
What 2 tests are you ordering for a thyroid nodule?
TSH | Thyroid ultrasound
67
What are 4 suspicious features on U/S of thyroid warrant biopsy?
1 cm Irregular surface Taller than wide Calcifications Think goitre the hedgehog.
68
What two treatments can you use for pharmacology resistant Grave's disease?
Radiation | Surgery
69
What are 5 things common to ME-CFS, fibre and ES-MCS?
``` Fatigue Pain Sleep Neuro symptoms Cognitive symptoms ```
70
What symptoms are specific to ME-CFS?
Chronic, profound fatigue Not improved by rest Post-exertional malaise
71
What symptoms are specific to fibromyalgia?
Diffuse body pain (3 months)
72
What symptoms are specific to multiple chemical sensitivity?
Provoked by chemical agents Removal relieves Respiratory symptoms
73
What are the 5 steps in pharmacotherapy for diabetes?
``` Metformin 2nd line OHA qhs basal insulin qam basal insulin bolus insulin ```
74
What two oral hypoglycemic agents have cardioprotective effects?
``` SGLT2 inhibitors (empagliflozin) GLP-1 receptor agonists (liraglutide) ```
75
Driving guidelines for diabetes?
Check sugar q2h if symptomatic Check sugar q4h if asymptomatic Have 6 lifesavers in the car. 2-4-6 rule
76
What 5 things should you screen for in somebody with suspected somatization?
``` Substance use Anxiety IPV Depression Sleeping disorder ``` THINK SAIDS - like dummies who are on income assistance will have somatization
77
What are the 5 stages of change?
``` Pre-contemplation Contemplation Preparation Action Maintenance ```
78
List 5 causes of hepatitis.
``` Infections Medication Alcohol Iron overload Autoimmune ```
79
What are four treatments for non-alcohol fatty liver disease?
Exercise Diet Weight Loss EtOH reduction
80
What test do you order to confirm active HCV infection?
HCV RNA
81
What are four complications of hepatitis to screen for?
HCC Varices Alcohol Cirrhosis
82
What are two parts of low back pain history that suggest a non-inflammatory cause?
Less than 30 minutes of morning stiffness | Worse at the end of the day.
83
What are two parts of low back pain history that suggest an inflammatory cause?
More than 30 minutes of morning stiffness | Better at the end of the day
84
What are four alarm features for joints?
Hot Boggy AM (Stiff > 30 min) PM (Night pain)
85
What four diseases should you screen for before starting DMARD/Immune suppressants
HIV TB HCV HBV
86
What are 5 non-pharm options for treating bedwetting?
``` Use toilet before bed No fluids before bed No caffeine Training pants Bedwetting alarms ```
87
What two drugs can you use to treat bedwetting?
Desmopressin | Imipramine
88
What are 5 things you can refer for autism?
``` Hearing assessment Visual assessment Pediatrics Autism support group SLP ```
89
What are three co-morbid conditions to screen for in Autism spectrum disorder?
Sleep Constipation Anxiety/Depression
90
What are 5 things on your differential for Autism Spectrum Disorder
``` Global development delay Hearing impairment Epilepsy OCD ODD Conduct disorder Trisomy 21 Cerebral Palsy ```
91
What are 5 things to look for in conduct disorder?
``` Persistent Violating rights of others Rule breaking Violence against people/animals Running away from home/school ```
92
How do you separate ODD from conduct disorder?
ODD does not Damage people or animals Damage property Deceive or thieve
93
What is one treatment for button battery injection?
Honey
94
List 5 things to counsel for in safety around the home in kids.
``` Guns Carbon monoxide Electric plugs Hot water heater Car Seats Pools ```
95
What is the most common poisoning to occur in the household?
Shampoo/Soap
96
What are 4 pros of circumcision?
Phimosis UTI Penile cancer HPV/HIV/HSV
97
What do you treat phimosis with?
Betamethasone at age 8-10.
98
What vaccine is given in every pregnancy?
TdaP
99
What are 5 tips to reduce vaccine pain for children?
``` Most painful last Breastfeed Skin to skin Topical anesthetic Sugars ```
100
What are 4 risk factors for sinusitis?
Smoking Anatomy (deviated septum etc.) Allergic rhinitis Asthma
101
What are 3 bugs found in sinusitis?
H. flu S. Pneumonia M. Catarrhalis Same as ear bugs Same as COPD bugs
102
What are 5 alarm features of sinusitis?
``` Persistent fever Periorbital edema Cranial nerve palsies Abnormal extra ocular movements Proptosis Vision changes Sever headache Altered mental status Meningismus ```
103
What are four features that will point to bacterial sinusitis?
Pain Obstruction Discharge Smell Greater than 7 days - treat
104
What is your first line antibiotic treatment for sinusitis?
Amox
105
What are two second line treatments for sinusitis?
TMP/SMX | Macrolide
106
What are 5 additional treatments to abx for sinusitis?
``` Nasal rinse Intranasal steroids Decongestants Analgesics Anti-inflammatories ```
107
What is the treatment for strep throat?
Pen V 800 mg QID * 5 days
108
What are 5 risk factors for neonatal sepsis?
``` Chorioamniotinits Maternal fever < 37 weeks Rupture > 18 hours GBS +ve ```
109
What are the three bugs that cause sepsis?
Listeria E. Coli GBS LEGS
110
What is the treatment for infant hypoglycemia?
D10W
111
What are 5 symptoms of hypoglycemia in the neonate?
``` Jittery Lethargic Hypotonic Sweating Weak cry Tachypnea Seizures ```
112
How long is jaundice possible for in neonates?
2 weeks
113
What is the workup for neonate hypobilirubinemia?
``` Hemoglobin Group and Screen Conjugated bilirubin Coomb's Peripheral smear ```
114
What does a Coomb's test in neonates?
Looks for maternal antibodies on baby's red blood cells.
115
What are 5 risk factors for hip dysplasia
``` Firstborn Female Family history Fluid (oligo) Feet (breech) ``` 5 F's
116
What are 5 thinks to look for with pediatric limp?
``` Legg-Calve-Perthes Infection Malignancy (Ewing's Sarcoma) Pain from abuse Slipped Capital Femoral Epiphysis ``` "LIMPS"
117
Causes of altered mental status?
``` Drugs Infection Metabolic Failure Anemia/Alcohol Cardiac Electrolyte Structural ``` DIM FACES

CCFP Exam 2021 (11 decks)

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