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CCFP Exam 2021 > Vital FM 3 > Flashcards

Vital FM 3 Flashcards

1
Q

Treatment for alopecia?

A

Steroids

Minoxidil

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2
Q

What are 4 topical treatments for rosacea?

A

Metronidazole
Axelaic acid
Ivermectin
Minocycline

Roasacea MAIMs the face.

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3
Q

What are three oral treatments for rosacea?

A

Doxycycline
Minocycline
Tetracycline

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4
Q

How often should you take height?

A

Annually

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5
Q

How much height loss increases risk for osteoporosis?

A

2 cm.

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6
Q

What are 5 non-pharm management steps for osteoporosis

A 
Calcium
Vitamin D
Exercise
Fall risk
Hip Guards

CDEFG

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7
Q

What are three side effects of bisphosphonates?

A

Esophogeal ulcer
Atypical fractures
Jaw osteonecrosis

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8
Q

When to consider a drug hoidliday?

A

3-5 years in low risk

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9
Q

What are 4 side effects of the medications for HIV?

A

Dyslipidemia
Hyperglycemia
Bone mineral density loss
Renal disease

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10
Q

What chronic diseases to screen for with HIV?

A 
Kidney disease
Cardiovascular
Cervical Cancer
Osteoporosis
Diabetes

KCCO

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11
Q

What are the drugs in Truvada?

A

Emtracitabine/Tenofavir

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12
Q

What drug for HIV in pregnancy/neonate?

A

Zidovudine

Zat mom is fine, zidovudine

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13
Q

What are risk factors for elderly patient?

A 
Roaming
Imminent danger (fires/falls)
Self neglect
Kinship (elder abuse)
Safe driving/Substance use

RISKS

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14
Q

What are 4 aids to help with quality of life in elderly?

A

Hearing aids
Dentures
Glasses
Wheelchair

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15
Q

How much alcohol can a woman over 65 have per week?

A

5 per week.

Max 1 in a day

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16
Q

How do you treat post-phlebitis?

A

Elevation, exercise, vein ablation, horse chestnut oil

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17
Q

What are 5 risk factors for DVT?

A

Stasis
Trauma (central line, pacemaker, surgery)
Hypercoagulability (cancer, pregnancy, OCPs, IBD, CHF, nephrotic)

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18
Q

What are the three points for the CONSTANS (upper arm DVT) score?

A

Central line/pacemaker
Localized pain
Unilateral edema

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19
Q

What do you treat a DVT with?

A

Oral Xa inhibitor (apixaban, rivaroxaban)
or
LMWH

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20
Q

Dabigatran is what class of medication?

A

Thrombin inhibitor.

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21
Q

How long do you treat an unprovoked DVT?

A

Lifelong

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22
Q

How long do you treat a provoked DVT?

A

3 months.

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23
Q

What diseases should you make you screen for CKD?

A

Hypertension
Vascular disease
Diabetes

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24
Q

What populations should you screen for CKD?

A

Indigenous

First degree relative with CKD

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25
Q

What tests do you order if you are screening for CKD?

A

eGFR

Urine ACR

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26
Q

What presentations of CKD would make you want to refer to nephrology?

A 
eGFR <30
ACR>60
Rapid delcline of GFR
BP not at target
Abnormal electrolytes
RBC casts
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27
Q

What is the KFRE?

A

Kidney failure risk equation.

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28
Q

What does the KFRE measure?

A

Risk of progression to ESRD in 5 years.

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29
Q

What are drugs to stop when patients are sick?

A 
Secretagogues
ACE inhibitors
Diuretics
Metformin
Angiotensin Receptor blockers
NSAIDs
SGLT2 inhibitors

SADMANS

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30
Q

What diagnosis should you consider in a peritoneal dialysis and fever?

A

Spontaneous Bacterial Peritonitis

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31
Q

What diagnosis mimics stroke?

List 2

A

Bell’s palsy

Ramsay Hunt Triad

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32
Q

What do you treat bell’s palsy with?

A

Lubricant
Steroids
Antivirals if severe

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33
Q

What are the clinical findings of Ramsay Hunt Type 2

A

Facial paralysis
Ear pain
Vertigo
Vesicles in auditory canal

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34
Q

What increases your risk of stroke after TIA?

A 
Age under 60
Elevated BP
Clinical findings
Duration over 60 minutes
Diabetes

ABCD2

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35
Q

What do you treat an ischemic stroke with?

A

Thrombolytics: Alteplase

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36
Q

What is included in a workup for a stroke etiology?

A

Holter
Carotid Doppler
ECG
Echo

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37
Q

What diseases should you optimize to reduce stroke risk?

A 
A. fib
Blood pressure
Cardiac disease
Diabetes
Ethanol

ABCDE

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38
Q

What are the domains of function with regards to dementia?

A 
Personality
Language
Visuo-spatial
Judgment
New information
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39
Q

What is the difference between major neurocognitive disorder and Alzheimer’s?

A

1 domain of function in both, but deficit in memory must be present for Alzheimer’s

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40
Q

Give one example from each letter of VINDICATE for a cause of delirium/dementia?

A 
Vascular - stroke
Infection - UTI
Neurologic - Space occupy lesion
Drugs - benzos
Iatrogenic
Congential - Trisomy 21
Autoimmune - 
Trauma - fall
Endocrine - Hypothyroidism
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41
Q

What is the criteria for dementia?

A

Abnormal cognition
Decline in function
Not delirium
2 domains

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42
Q

Mild Cognitive Impairment

A

Abnormal cognition
No deterioration in function
Only need one domain effect

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43
Q

What labwork do you order for dementia?

A

B12, TSH, Calcium, Serum sodium, glucose, hemoglobin

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44
Q

How do you assess competency?

A

Explain treatment options
Explain reasoning
Explain choice

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45
Q

What are red flags for headache?

A 
Systemic symptoms - fevers
Neuro symptoms
Older patient
Onset sudden
Pattern/position change
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46
Q

What tool will help diagnose a migraine and what are the components of it?

A 
Pulsating
Hours
Uniltaeral
Nausea
Disabling

4/5 = 92% migraine

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47
Q

What are 5 lifestyle modifications for headaches?

A 
Caffeine
Relax
Exercise
Avoid irregular sleep
Diary

CREAD of headaches

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48
Q

What are four symptoms of parkinson’s?

A

Tremor
Rigidity
Akinesia
Postural instability

TRAP

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49
Q

What are 5 lab tests to order for Tremor?

A 
Serum TSH
Na
Mg
Ca
B12
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50
Q

What are the 5 types of SALTER-Harris fractures?

A 
Slipped
Above
Lower
Transverse
Rammed
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51
Q

What are 6 complications associated with end of life care?

A 
Hypercalcemia
Massive Bleed
Seizure
SVC Obstruction
Cord Compression
Opioid Toxicity
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52
Q

What are 6 causes of atrial fibrillation?

A 
Hyperthyroid
Alcohol
Ischemic
Valvular
HTN
Pulmonary HTN
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53
Q

What conditions need to be met to consider somebody low risk for clot in a. fib?

A

Non-valvular
Symptoms less than 12 hours
No recent stroke/TIA
12-48 hours and CHADS2<2

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54
Q

What are the elements of CHADS-2?

A 
CHF
HTN
AGE>65
Diabetes
Stroke
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55
Q

What are the elements of the HASBLED score?

A 
Hypertension
Abnormal liver/renal function
Stroke
Bleeding
Labile INR
Elderly > 65
Drugs/Alcohol
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56
Q

What medication do you use for valvular A. Fib?

A

Warfarin

NO DOACS

57
Q

What are 5 risk factors fo infant AOM?

A 
Maternal smoking
Daycare
Pacifier use
Bottle-feeding
Ethnicity
58
Q

What are the 3 most common bugs for AOM?

A

S. pneumoniae
H. Influenzae
H. Catarrhalis

59
Q

What is your first line treatment for AOM in infants?

A

Penicillin

60
Q

What medications would you use if your patient had a rash vs. anaphylaxis to penicillin for AOM?

A

If rash - ceftriaxone

If anaphylaxis - clarithromycin

61
Q

What adjunct to abx do you prescribe for ear infections?

A

Analgesia

62
Q

What are 3 indications for myringotomy?

A

AOM 6/yr or 4/6 months
Chronic otitis media with effusion
Retracted (scarred) tympanic membrane

63
Q

List 5 things that would make you CT a kids head following trauma? CATCH 2 rule

A 
GCS <15 2 hrs post-injury
Open/depressed skull #
Worsening headache
Irritability
Basal skull fracture
Boggy hematoma
Mechanism
>4 episodes of emesis
64
Q

What is part of your neuro exam in ATLS?

A

GCS
Pupils
Sensory/motor 4 extremities

65
Q

List 5 types of shock.

A 
Septic
Hypovolemic
Obstructive
Cardiogenic
AnaphylacticK

“SHOCK”

66
Q

What is the difference between the parkland formula and the Brooke formula? Which is the most current?

A

Parkland says 4 mgTBSAKG

Brooke says 2 mgTBSAKG
Brooke is best

67
Q

When to refer burns? List 5.

A

TBSA > 10
Special burns - electrical, chemical
Special sites - face, hand, foot, genitals, perineum, joint

68
Q

What are 5 management steps in frostbite?

A 
Rapid wet rewarming
Thrombolysis
Sterile wound care
Analgesia
Tetanus
69
Q

What is your initial treatment for the undifferentiated unconscious patient?

A

Dextrose
Oxygen
Narcan
Thiamine

“DONT” let them die

70
Q

What is your first line treatment for seizure in non-pregnant patient?

A

Benzodiazepines

71
Q

What is your first line treatment for seizure in the pregnancy patient?

A

Magnesium sulfate

72
Q

What is your second line treatment for seizure in the non-pregnant patient?

A

Phenytoin
Valproate
Levetiracetam (Keppra)

73
Q

What is your second line treatment in pregnancy?

A

Benzodiazepines

74
Q

What are 5 causes of seizures?

A 
Hypoglycemia
Hypoxia
HypoCa
Hpyovolemia
Heat
Hponatremia
Hyperopioidemia
Hypodilantinemia
75
Q

What medication reduces recurrence of febrile seizure during the same febrile illness?

A

Acetaminophen

76
Q

What is on your differential for seizure? (DIM FACES)

A

Drugs
Infection (meningitis)
Metabolic

Failure (liver/kidney uremic/hepatic encephalopathy)
Anemia/Alcohol
Cardiac
Electrolyte
Structural/Stroke
77
Q

How can you differentiate between a seizure and pseudo-seizure?

A

Tickle test

Hand drop test

78
Q

What are 3 red flags with red eye?

A

Pain
Decreased acuity
Anisocoria

79
Q

What’s the worst thing to get your eye infected with?

A

Pseudamonas

80
Q

What diagnosis should you suspect with red eye, eye pain and visual disturbance?

A

Acute closed angle glaucoma

81
Q

What management steps do you initiate if you suspect closed angle glaucoma?

A

Measure Intraocular pressure
IV
Oral
Droplet meds

82
Q

What diagnoses should you suspect with pinkeye and diarrhea?

A

IBD
SLE
TB
Syphilis

83
Q

Pink eye and STI symptoms?

A

Chlamydia

Gonorrhea

84
Q

What diagnosis would you suspect with eye symptoms with temple pain?

A

Giant Cell Arteritis

85
Q

What do you treat GCA with?

A

IV steroids

86
Q

List 4 things to do with pre-conception planning?

A

Stop teratogens
Pre-natal vitamins
ASA if BMI>30 and 1 or more risk for preeclampsia

87
Q

What are the cutoffs for GHTN?

A

140/90

88
Q

What two treatments do you give for premature rupture of membranes?

A

Steroids

Antibiotics

89
Q

What 4 management steps do you order if you suspect pre-term labour?

A

Fetal fibronectin
Steroids
Tocolysis
Magnesium

90
Q

What is the definition of dystocia?

A

Less than 2 cm in 4 hours

91
Q

What are 5 questions you should ask with postpartum care?

A 
Breastfeeding
Bottom
Bowels
Bladder
Bleeding
Baby
Blues
Birth control
Boinking
92
Q

What do you need to know before prescribing medical abortion?

A 
Gestational age
Pregnancy location (ectopic)
Contraindications:
Uncontrolled asthma
Chronic adrenal failure
Chronic steroid use
Blood disorders
Remove IUD
93
Q

What are the two drugs in medical abortions?

A

Mifepristone

Misoprostil

94
Q

What are 4 treatments to initiate with acute MI?

A

aspirin
ticegralor
heparin
oxygen

95
Q

What two physical exam findings are specific for heart failure? What are two non-specific?

A

Elevated JVP
S3

Crackles
Leg swelling

96
Q

What 5 medications are you going to prescribe for HFrEF?

A 
ACE/ARB
Beta-blocker
MRA
Diuretic
SGLT2
97
Q

What medication can you add if patients are on optimized heart failure therapy and they are still NYHA 2-4?

A

Entresto

98
Q

What diagnosis should you consider with unexplained heart failure or heart failure with neuropathy or carpal tunnel?

A

Cardiac amyloidosis

99
Q

What are 4 non modifiable risk factors for breast cancer?

A

Age
Sex
Past history
Family history

100
Q

What are 5 modifiable risk factors for breast cancer?

A 
Early menarche
Older menopause
Nulliparity
Postmenopausal HRT
Postmenopausal obesity

Think total cumulative estrogen exposure

101
Q

What are 3 findings of physical exam that are suspicious for breast cancer?

A

Lymph nodes
Peau D’Orange
Inverted nipple

102
Q

What are 5 side effects from breast cancer treatment?

A 
Cardiomyopathy
Valvular disease
Fatigue
Ovarian insufficiency
Lymphedema
103
Q

What are the units for BMI?

A

kg/m^2

104
Q

What are 3 pharmacologic treatments for obesity?

A

Contrave
Orlistat
Liraglutide

105
Q

What are 3 surgical treatments for obesity?

A

Gastric Bypass
Sleeve gastrectomy
Adjustable gastric band

106
Q

What is Dressler syndrome?

A

Pericarditis following MI 3-10 days after.

107
Q

What are 5 non-pharmacologic methods for smoking cessation?

A 
Cold turkey
CBT
Counselling
Acupuncture
Hypnosis
108
Q

What are 5 contraindications to bupropion?

A 
Seizure disorder
Eating disorder
Alcohol withdrawal
MAOi use
Allergy
109
Q

What screening tool do you use for alcohol use disorder?

What does it ask?

A

M-SASQ

In the past year how many times have you had more than 8/6 drinks in a single occasion?

+ve = 2 or more

110
Q

Max drinks for men in Day/Week?

A

3/15

111
Q

Max drinks for women in day/week?

A

2/10

112
Q

What are three medications to prescribe for alcohol use disorder?

A

Naltrexone (first line)
Acamprosate
Disulfiram

113
Q

What are 3 side effects of OAT?

A

Constipation
Amenorrhea
Decreased testosterone

114
Q

What are 4 non-pharmacologic approaches to pain?

A

CBT
Exercise
Physiotherapy
Self-management

115
Q

What are 5 indications for cannabis?

A 
Neuropathic pain
Palliative pain
Spasticity from MS
Spasticity from spinal trauma
Chemotherapy N/V
116
Q

What are the rules for not driving with cannabis?

A

4 hours after smoking
6 hours after ingestion
8 hours after euphoria

117
Q

What 3 things according to c-spine rule would automatically qualify somebody for c-spine imaging?

A

Age >65
Dangerous Mechanism
Paresthesia

118
Q

According to Canadian c-spine rule, with these 5 things, no c-spine imaging is necessary.

A

Sitting in ED
Ambulatory
Delayed onset of pain
Absence of midline tenderness

119
Q

What is one benefit of the nexus rule over the canadian c-spine rule?

A

Canadian c-spine rule did not study children under age of 16.

120
Q

What 5 things must be absent to clear the c-spine with nexus rule?

A 
Neurologic deficit
Midline spinal tenderness
Obtunded
Intoxicated
Distracting injury
121
Q

What are 5 unstable c-spine fractures?

A 
Jefferson's fracture
Odontoid fracture
Atlanto-occipital dislociation
Hangman's fracture
Flexion teradrop
122
Q

When should you order imaging for cervical radiculopathy?

A 
Trauma
Persistent symptoms
Sx of malignancy
Sx of myelopathy
Sx of infection
123
Q

What are 5 other things neck pain could be attributed to?

A 
MI
Carotid artery dissection
Mass effect of Cancer
Foreign body
Lymphoma
124
Q

What tests do you order for menopause?

A

None

Clinical diagnosis

125
Q

What 5 lifestyle measures should you offer to all women going through menopause?

A 
Quit smoking
Quit alcohol
Quit caffeine
Start exercise
Start weight loss
126
Q

What are 5 medication classes to treat the vasomotor symptoms of menopause?

A 
HRT
SSRI
Anticonvulsants
TCAs
Progestin
OCPs
127
Q

List 5 contraindications to HRT.

A 
Migraine with aura
Smoker
Uncontrolled HTN
Malignancy
DVT
Stroke
Liver disease
Valvular disease
128
Q

What is the typical pathogen for a cat bite?

A

Pasteurella multocida

129
Q

What antibiotic do you treat cat bites with?

A

Amox/Clav

If allergic Doxy

130
Q

What are two vaccines to consider with cat bites?

A

Tetanus

Rabies

131
Q

What are 4 sedation/analgesia options for kiddos?

A

Intranasal midaz/fentanyl
IV/IM Ketamine
Blanket burrito
LET (lido, epi, tetracaine)

132
Q

What are 4 scenarios where you would not want to close the wound?

A

Deep puncture
High tension
Infected
Smelly Sneaker Syndrome - think osteo

133
Q

What 4 things do you give to the undifferentiated poisoned patient?

A

Dextrose

134
Q

What should you ask the patient with an overdose?

A 
How? - route
What?
When?
Why?
How much?
135
Q

What is the antidote for Sympathomimetic toxidrome?

A

Benzos

136
Q

What is the antidote for anticholinergic toxidrome?

A

Physostigmine

137
Q

What are the two antidotes for cholinergic toxidrome?

SLUDGE

A 
Atropine
Pralidoxime (organophosphate binder)
138
Q

What is one defining feature between anticholinergic and sympathomimetic overdose?

A

Anticholinergic does not sweat

CCFP Exam 2021 (11 decks)

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