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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
What tests do you order if you are screening for CKD?
eGFR | Urine ACR
26
What presentations of CKD would make you want to refer to nephrology?
``` eGFR <30 ACR>60 Rapid delcline of GFR BP not at target Abnormal electrolytes RBC casts ```
27
What is the KFRE?
Kidney failure risk equation.
28
What does the KFRE measure?
Risk of progression to ESRD in 5 years.
29
What are drugs to stop when patients are sick?
``` Secretagogues ACE inhibitors Diuretics Metformin Angiotensin Receptor blockers NSAIDs SGLT2 inhibitors ``` SADMANS
30
What diagnosis should you consider in a peritoneal dialysis and fever?
Spontaneous Bacterial Peritonitis
31
What diagnosis mimics stroke? | List 2
Bell's palsy | Ramsay Hunt Triad
32
What do you treat bell's palsy with?
Lubricant Steroids Antivirals if severe
33
What are the clinical findings of Ramsay Hunt Type 2
Facial paralysis Ear pain Vertigo Vesicles in auditory canal
34
What increases your risk of stroke after TIA?
``` Age under 60 Elevated BP Clinical findings Duration over 60 minutes Diabetes ``` ABCD2
35
What do you treat an ischemic stroke with?
Thrombolytics: Alteplase
36
What is included in a workup for a stroke etiology?
Holter Carotid Doppler ECG Echo
37
What diseases should you optimize to reduce stroke risk?
``` A. fib Blood pressure Cardiac disease Diabetes Ethanol ``` ABCDE
38
What are the domains of function with regards to dementia?
``` Personality Language Visuo-spatial Judgment New information ```
39
What is the difference between major neurocognitive disorder and Alzheimer's?
1 domain of function in both, but deficit in memory must be present for Alzheimer's
40
Give one example from each letter of VINDICATE for a cause of delirium/dementia?
``` Vascular - stroke Infection - UTI Neurologic - Space occupy lesion Drugs - benzos Iatrogenic Congential - Trisomy 21 Autoimmune - Trauma - fall Endocrine - Hypothyroidism ```
41
What is the criteria for dementia?
Abnormal cognition Decline in function Not delirium 2 domains
42
Mild Cognitive Impairment
Abnormal cognition No deterioration in function Only need one domain effect
43
What labwork do you order for dementia?
B12, TSH, Calcium, Serum sodium, glucose, hemoglobin
44
How do you assess competency?
Explain treatment options Explain reasoning Explain choice
45
What are red flags for headache?
``` Systemic symptoms - fevers Neuro symptoms Older patient Onset sudden Pattern/position change ```
46
What tool will help diagnose a migraine and what are the components of it?
``` Pulsating Hours Uniltaeral Nausea Disabling ``` 4/5 = 92% migraine
47
What are 5 lifestyle modifications for headaches?
``` Caffeine Relax Exercise Avoid irregular sleep Diary ``` CREAD of headaches
48
What are four symptoms of parkinson's?
Tremor Rigidity Akinesia Postural instability TRAP
49
What are 5 lab tests to order for Tremor?
``` Serum TSH Na Mg Ca B12 ```
50
What are the 5 types of SALTER-Harris fractures?
``` Slipped Above Lower Transverse Rammed ```
51
What are 6 complications associated with end of life care?
``` Hypercalcemia Massive Bleed Seizure SVC Obstruction Cord Compression Opioid Toxicity ```
52
What are 6 causes of atrial fibrillation?
``` Hyperthyroid Alcohol Ischemic Valvular HTN Pulmonary HTN ```
53
What conditions need to be met to consider somebody low risk for clot in a. fib?
Non-valvular Symptoms less than 12 hours No recent stroke/TIA 12-48 hours and CHADS2<2
54
What are the elements of CHADS-2?
``` CHF HTN AGE>65 Diabetes Stroke ```
55
What are the elements of the HASBLED score?
``` Hypertension Abnormal liver/renal function Stroke Bleeding Labile INR Elderly > 65 Drugs/Alcohol ```
56
What medication do you use for valvular A. Fib?
Warfarin | NO DOACS
57
What are 5 risk factors fo infant AOM?
``` Maternal smoking Daycare Pacifier use Bottle-feeding Ethnicity ```
58
What are the 3 most common bugs for AOM?
S. pneumoniae H. Influenzae H. Catarrhalis
59
What is your first line treatment for AOM in infants?
Penicillin
60
What medications would you use if your patient had a rash vs. anaphylaxis to penicillin for AOM?
If rash - ceftriaxone If anaphylaxis - clarithromycin
61
What adjunct to abx do you prescribe for ear infections?
Analgesia
62
What are 3 indications for myringotomy?
AOM 6/yr or 4/6 months Chronic otitis media with effusion Retracted (scarred) tympanic membrane
63
List 5 things that would make you CT a kids head following trauma? CATCH 2 rule
``` GCS <15 2 hrs post-injury Open/depressed skull # Worsening headache Irritability Basal skull fracture Boggy hematoma Mechanism >4 episodes of emesis ```
64
What is part of your neuro exam in ATLS?
GCS Pupils Sensory/motor 4 extremities
65
List 5 types of shock.
``` Septic Hypovolemic Obstructive Cardiogenic AnaphylacticK ``` "SHOCK"
66
What is the difference between the parkland formula and the Brooke formula? Which is the most current?
Parkland says 4 mg*TBSA*KG Brooke says 2 mg*TBSA*KG Brooke is best
67
When to refer burns? List 5.
TBSA > 10 Special burns - electrical, chemical Special sites - face, hand, foot, genitals, perineum, joint
68
What are 5 management steps in frostbite?
``` Rapid wet rewarming Thrombolysis Sterile wound care Analgesia Tetanus ```
69
What is your initial treatment for the undifferentiated unconscious patient?
Dextrose Oxygen Narcan Thiamine "DONT" let them die
70
What is your first line treatment for seizure in non-pregnant patient?
Benzodiazepines
71
What is your first line treatment for seizure in the pregnancy patient?
Magnesium sulfate
72
What is your second line treatment for seizure in the non-pregnant patient?
Phenytoin Valproate Levetiracetam (Keppra)
73
What is your second line treatment in pregnancy?
Benzodiazepines
74
What are 5 causes of seizures?
``` Hypoglycemia Hypoxia HypoCa Hpyovolemia Heat Hponatremia Hyperopioidemia Hypodilantinemia ```
75
What medication reduces recurrence of febrile seizure during the same febrile illness?
Acetaminophen
76
What is on your differential for seizure? (DIM FACES)
Drugs Infection (meningitis) Metabolic ``` Failure (liver/kidney uremic/hepatic encephalopathy) Anemia/Alcohol Cardiac Electrolyte Structural/Stroke ```
77
How can you differentiate between a seizure and pseudo-seizure?
Tickle test | Hand drop test
78
What are 3 red flags with red eye?
Pain Decreased acuity Anisocoria
79
What's the worst thing to get your eye infected with?
Pseudamonas
80
What diagnosis should you suspect with red eye, eye pain and visual disturbance?
Acute closed angle glaucoma
81
What management steps do you initiate if you suspect closed angle glaucoma?
Measure Intraocular pressure IV Oral Droplet meds
82
What diagnoses should you suspect with pinkeye and diarrhea?
IBD SLE TB Syphilis
83
Pink eye and STI symptoms?
Chlamydia | Gonorrhea
84
What diagnosis would you suspect with eye symptoms with temple pain?
Giant Cell Arteritis
85
What do you treat GCA with?
IV steroids
86
List 4 things to do with pre-conception planning?
Stop teratogens Pre-natal vitamins ASA if BMI>30 and 1 or more risk for preeclampsia
87
What are the cutoffs for GHTN?
140/90
88
What two treatments do you give for premature rupture of membranes?
Steroids | Antibiotics
89
What 4 management steps do you order if you suspect pre-term labour?
Fetal fibronectin Steroids Tocolysis Magnesium
90
What is the definition of dystocia?
Less than 2 cm in 4 hours
91
What are 5 questions you should ask with postpartum care?
``` Breastfeeding Bottom Bowels Bladder Bleeding Baby Blues Birth control Boinking ```
92
What do you need to know before prescribing medical abortion?
``` Gestational age Pregnancy location (ectopic) Contraindications: Uncontrolled asthma Chronic adrenal failure Chronic steroid use Blood disorders Remove IUD ```
93
What are the two drugs in medical abortions?
Mifepristone | Misoprostil
94
What are 4 treatments to initiate with acute MI?
aspirin ticegralor heparin oxygen
95
What two physical exam findings are specific for heart failure? What are two non-specific?
Elevated JVP S3 Crackles Leg swelling
96
What 5 medications are you going to prescribe for HFrEF?
``` ACE/ARB Beta-blocker MRA Diuretic SGLT2 ```
97
What medication can you add if patients are on optimized heart failure therapy and they are still NYHA 2-4?
Entresto
98
What diagnosis should you consider with unexplained heart failure or heart failure with neuropathy or carpal tunnel?
Cardiac amyloidosis
99
What are 4 non modifiable risk factors for breast cancer?
Age Sex Past history Family history
100
What are 5 modifiable risk factors for breast cancer?
``` Early menarche Older menopause Nulliparity Postmenopausal HRT Postmenopausal obesity ``` Think total cumulative estrogen exposure
101
What are 3 findings of physical exam that are suspicious for breast cancer?
Lymph nodes Peau D'Orange Inverted nipple
102
What are 5 side effects from breast cancer treatment?
``` Cardiomyopathy Valvular disease Fatigue Ovarian insufficiency Lymphedema ```
103
What are the units for BMI?
kg/m^2
104
What are 3 pharmacologic treatments for obesity?
Contrave Orlistat Liraglutide
105
What are 3 surgical treatments for obesity?
Gastric Bypass Sleeve gastrectomy Adjustable gastric band
106
What is Dressler syndrome?
Pericarditis following MI 3-10 days after.
107
What are 5 non-pharmacologic methods for smoking cessation?
``` Cold turkey CBT Counselling Acupuncture Hypnosis ```
108
What are 5 contraindications to bupropion?
``` Seizure disorder Eating disorder Alcohol withdrawal MAOi use Allergy ```
109
What screening tool do you use for alcohol use disorder? | What does it ask?
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
Max drinks for men in Day/Week?
3/15
111
Max drinks for women in day/week?
2/10
112
What are three medications to prescribe for alcohol use disorder?
Naltrexone (first line) Acamprosate Disulfiram
113
What are 3 side effects of OAT?
Constipation Amenorrhea Decreased testosterone
114
What are 4 non-pharmacologic approaches to pain?
CBT Exercise Physiotherapy Self-management
115
What are 5 indications for cannabis?
``` Neuropathic pain Palliative pain Spasticity from MS Spasticity from spinal trauma Chemotherapy N/V ```
116
What are the rules for not driving with cannabis?
4 hours after smoking 6 hours after ingestion 8 hours after euphoria
117
What 3 things according to c-spine rule would automatically qualify somebody for c-spine imaging?
Age >65 Dangerous Mechanism Paresthesia
118
According to Canadian c-spine rule, with these 5 things, no c-spine imaging is necessary.
Sitting in ED Ambulatory Delayed onset of pain Absence of midline tenderness
119
What is one benefit of the nexus rule over the canadian c-spine rule?
Canadian c-spine rule did not study children under age of 16.
120
What 5 things must be absent to clear the c-spine with nexus rule?
``` Neurologic deficit Midline spinal tenderness Obtunded Intoxicated Distracting injury ```
121
What are 5 unstable c-spine fractures?
``` Jefferson's fracture Odontoid fracture Atlanto-occipital dislociation Hangman's fracture Flexion teradrop ```
122
When should you order imaging for cervical radiculopathy?
``` Trauma Persistent symptoms Sx of malignancy Sx of myelopathy Sx of infection ```
123
What are 5 other things neck pain could be attributed to?
``` MI Carotid artery dissection Mass effect of Cancer Foreign body Lymphoma ```
124
What tests do you order for menopause?
None | Clinical diagnosis
125
What 5 lifestyle measures should you offer to all women going through menopause?
``` Quit smoking Quit alcohol Quit caffeine Start exercise Start weight loss ```
126
What are 5 medication classes to treat the vasomotor symptoms of menopause?
``` HRT SSRI Anticonvulsants TCAs Progestin OCPs ```
127
List 5 contraindications to HRT.
``` Migraine with aura Smoker Uncontrolled HTN Malignancy DVT Stroke Liver disease Valvular disease ```
128
What is the typical pathogen for a cat bite?
Pasteurella multocida
129
What antibiotic do you treat cat bites with?
Amox/Clav | If allergic Doxy
130
What are two vaccines to consider with cat bites?
Tetanus | Rabies
131
What are 4 sedation/analgesia options for kiddos?
Intranasal midaz/fentanyl IV/IM Ketamine Blanket burrito LET (lido, epi, tetracaine)
132
What are 4 scenarios where you would not want to close the wound?
Deep puncture High tension Infected Smelly Sneaker Syndrome - think osteo
133
What 4 things do you give to the undifferentiated poisoned patient?
Dextrose
134
What should you ask the patient with an overdose?
``` How? - route What? When? Why? How much? ```
135
What is the antidote for Sympathomimetic toxidrome?
Benzos
136
What is the antidote for anticholinergic toxidrome?
Physostigmine
137
What are the two antidotes for cholinergic toxidrome? | SLUDGE
``` Atropine Pralidoxime (organophosphate binder) ```
138
What is one defining feature between anticholinergic and sympathomimetic overdose?
Anticholinergic does not sweat

CCFP Exam 2021 (11 decks)

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