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CCFP Exam 2021 > Vital FM 4 > Flashcards

Vital FM 4 Flashcards

1
Q

What would make a UTI complicated and what test must you order?

A

Functional or structural abnormality
Male
Pregnancy

You must order and adjust with culture

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2
Q

What are 3 abx choices to treat uncomplicated UTIs?

A

Septra
Nitrofurantoin
Amox/Clav

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3
Q

What are two choices of antibiotics for complicated UTI?

A

Fluorquinolone

3rd generation cephalosporin (ceftriaxone)

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4
Q

What are two choices of antibiotic for severely ill patients with UTI?

A

Piptaz

Ertapenem/Meropenem

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5
Q

Who is at high risk of complications of UTI?

A

Very young
Very old
Pregnant
Pancreatitis

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6
Q

What management if somebody relapses UTI treatment?

A

Culture/re-culture
Re-treat for longer (7-14)
Reconsider diagnosis
Imaging

If determine recurrent - prophylaxis

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7
Q

What do you treat pediatric UTI with?

A

Cefixime 7-10 days PO

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8
Q

What test do you order for febrile UTI in under 2?

A

U/S KUB

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9
Q

What 3 things would make you U/S KUB in pediatric UTI?

A

Fever under age 2
Recurrent
Complicated

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10
Q

What is the only time you treat asymptomatic bacteriuria?

A

Pregnant ladies.

Can also consider upcoming urologic procedure

Increases risk of pre-term labour

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11
Q

What are the three initial steps for mild epistaxis?

A

Blow nose
Oxymetalazone - 2 sprays in both nostril
Pinch for 10 minutes

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12
Q

What is the most common age for croup? Max usual age?

A

6-36 months

6 years

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13
Q

What is your management for mild croup?

A

ABCs

PO fluids

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14
Q

What is the medication and dose of croup in kids?

A

Dexamethasone

0.6 mg/kg

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15
Q

What are 5 other causes of stridor in kids other than croup?

A 
Parainfluenza
Adenovirus
RSV
Foreign body
Tracheomalacia
Foreign body
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16
Q

What diagnosis would you think of a patient treated for croup returns with similar symptoms within a week?

A

Bacterial tracheitis

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17
Q

What are two special tests for Meningitis? Describe them

A

Kernig - extend Knee with hip flexed
Brudzinski - lift Brain off bed

NO negative predictive value

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18
Q

Indications for CT in suspected meningitis?

A 
Focal neurologic deficits
Immunocompromised
History of CNS disease
New seizure
Papillidema
Decreased GCS
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19
Q

What are your treatments in meningitis?

A

Ceftriaxone and
Vancomycin

Ampicllin - Listeria or immunocompromised
Valacyclovir - viral

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20
Q

Acute management mnemonic?

A

Airway
Breathing
Circulation

Monitor
Oxygen
Vitals
Intravenous
ECG
Sugar check
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21
Q

What is the dose for epinephrine for anaphylaxis?

A

0.01 mg/kg IM

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22
Q

What are 9 treatments for anaphylaxis?

A 
Adrenaline - 0.5 mg
Breathing (02) - 5L
Corticosteroid - Methylprednisolone 125 mg
Diphenhydramine - 50 mg
Epi again!
Fluids - 500cc
Glucagon
H2 blocker (ranitidine) 150 mg
Inhaled albutamol

Allergy alphabet
Rule of 5’s

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23
Q

What is a good screening tool for eating disorders?

A 
Made yourself SICK from feeling full
Lost CONTROL over eating
Lost more than ONE stone 14lbs in 3 months
Believed yourself to be FAT
Felt FOOD dominates your life

SCOFF tool

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24
Q

Do you require amenorrhea for diagnosis of anorexia?

A

No

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25
How many binge/purge cycles do you need for diagnosis of bulimia?
Once weekly
26
What are 5 things to screen for with eating disorders?
``` Anxiety Depression OCD Personality Disorder Bullying Poverty ```
27
What diagnose to you attribute to athletes who cannot consume as many calories as they burn?
Relative Energy Deficiency in Sport RED-S
28
Who should you refer to eating disorders to?
``` Dietician Psychiatrist Group counselling Individual counselling Psychologist CBT School counsellor ```
29
What are the three main parts of sexual assault management?
Pregnancy prevention STI post exposure prophylaxis Trauma informed care
30
What are three treatments for pregnancy prevention following rape?
Copper IUD Levonorgestrel Ullipristal Combined OCP
31
What are the treatments for post-exposure prophylaxis?
PrEP Hepatitis B immunoglobulin TEST @ 6/12 weeks
32
Treatment of Gonorrhea
Azithromycin 1g PO AND ONE OF Cetriaxone 250mg IM OR Cefixime 800 mg PO
33
Abx treatment for Chlamydia?
Azithromycin or Doxy 100 mg PO BID * 7 days
34
When do you have to report sexual assault/rape?
Under the age of 18. Otherwise it is voluntary.
35
Who is at high risk of domestic violence?
Kids Elderly Pregnant Immigrants
36
What is the age of onset for ADHD?
12
37
What are 4 treatments for ADHD?
Amphetamine Methylphenidate Atomoxetine (SNRI) Guanfacine (Alpha 2a receptor agonist) - good if diverting
38
What are things to consider before changing to 2nd or 3rd line ADHD medication such as atomoxetine or guanfacine?
``` Dosage/Duration All - trial all 1st line Time for response Examine targets Review - comorbidities ```
39
What are some risks associated with ADHD? | How do you fix this?
2-4X as many motor vehicle collisions Recommend standard vehicle
40
What two management steps do you order for 1st trimester bleeding?
Serial ultrasound | Serial bHCG
41
What four things are on your differential for 1st trimester bleeds? Which of these is life threatening?
Threatened abortion Missed abortion Complete abortion Ectopic
42
What are 5 risk factors for ectopic pregnancy?
``` Previous ectopic pregnancy Abnormal fallopian tubes Endometriosis History of tubal surgery STI Smoking Advanced maternal age ```
43
What are risk factors for AUB?
Estrogen exposure | Hyperandrogenism
44
What are three tests you would consider for AUB?
Endometrial biopsy Pap Colposcopy
45
What are three hormonal managements for AUB?
IUS OCP Progestin
46
What are two non-hormonal treatments for AUB?
NSAID | TXA
47
What are 4 surgical treatments for AUB?
Ablation Hysterectomy Polypectomy Myomectomy
48
What are four tests or exams for post-menopausal bleeding?
Pelvic PAP Ultrasound Endometrial biopsy
49
What are 4 tests to do for vaginitis?
Swabs Wet mount KOH pH test
50
What are 5 things that could cause vaginal itch other than STIs?
``` Eczema Psoriasis Lichen sclerosis Lichen simplex chronicus Vulvar cancer Genitourinary syndrome of menopause Contact dermatitis ```
51
What are 4 infectious things that can cause vaginal itch?
Herpes Trichomonas Pelvic inflammatory disease Bacterial vaginosis
52
What are three things to think about with pediatric vaginal itch?
Foreign body Irritant (soaps/clothes) STI (REPORTABLE) Unlikely to be yeast
53
When can you consider PSA screening? At what age?
If patient has > 10 years of life expectancy. Age 50.
54
What is the next step after finding an elevated PSA?
If less than 10 low risk If 10-20 medium risk If greater than 20 high risk Refer to urology for prostate biopsy
55
How does physical exam findings on DRE effect referrals for prostate CA?
If PSA < 10 and abnormal prostate, non-urgent If PSA > 10 and abnormal prostate, urgent
56
What are risk factors for prostate cancer?
``` Age Family Hx Smoking Obesity Hi risk race ```
57
What tests do you order for suspected BPH?
Urinalysis and Midstream culture & sensitivity PSA if life expectancy > 10 years
58
What are 5 non-pharmacologic interventions for BPH?
``` Antihistamines Decongestants NSAIDs Saw palmetto Caffeine Alcohol ```
59
What are 2 classes of medication for BPH?
``` Alpha blocker (tamsulosin) 5 alpha-reductase inhibitors (finasteride) ```
60
What are 2 second line treatments for BPH?
Antimuscarinics | PDE5 inhibitors
61
What 4 symptoms would you associate with prostatitis that would not be present with UTI or STI?
Systemic symptoms of illness such as: Fevers, chills myalgia, malaise
62
What is the most common bug for prostatitis?
E. coli.
63
Define hypertensive emergency
180/120 | Asymptomatic
64
Define hypertensive emergency
``` Elevated BP WITH Generalized neurological symptoms (agitation, delirium, seizure, visual disturbances) Focal neurological symptoms Nausea/Vomiting Chest discomfort Dyspnea Pregnancy Recreational drugs ```
65
What are five causes of tubal dysfunction that may lead to infertility?
``` Endometriosis Ectopic pregnancy Surgery Crohn's PID Chlamydia Ruptured appendix ```
66
What are 4 structural uterine problems that may lead to infertility?
Surgery/Instrumentation Septate uterus Arcuate uterus Intracavitary fibroids
67
What are 5 things that may lead to infertility in men?
``` Trauma Torsion Surgery Infection Tobacco Cannabis Cycling Laptops ```
68
What are 5 tests you will order for infertility in relation to ovulation?
``` Day 3 FSH Estrogen TSH Prolactin Midluteal progesterone ```
69
What are 3 tests you would order with suspected hyperaandrogenism?
DHEA-S 17 OH Progesterone Total testosterone
70
What are two imaging tests to look for structural causes of infertility in women?
Pelvic ultrasound | Hysterosalpingogram
71
What are three indications for referral with infertility?
12 months if no risk factors 6 months if risk factors and over 35 Immediately if over 40
72
What % of healthy individuals conceive by 12 months?
90%
73
What 5 things would make you consider intrauterine insemination?
``` No pregnancy after 12 months Regular intercourse Normal ovulary function Normal semen analysis 1 patent Fallopian tube ```
74
What two abx do you treat PID with?
Cefoxitin + Doxycycline (Foxy Doxy) or Clindamycin + Gentamicin (in hospital)
75
What are three things you are doing in addition to treating an STI?
Treat partner Contact tracing Abstinence * 7 days
76
When and why should you start on OCP?
Start your pills on a Sunday. That way you will never get period on weekend.
77
List 5 contraindications to OCPs
``` Migraine with aura Smoker >65 or >15 cigs/day Uncontrolled HTN Malignancy DVT Stroke Valvular disease Diabetes with end organ damage Liver disease ```
78
What is the age of consent in Canada?
16 if non-exploitative (i.e. no power differential) 18 if exploitative 12-13 Up to 2 years older 14-15 Up to 5 years older
79
What cancer consideration do you have with sexually active individuals? How do you manage and prevent this?
Cervical/Anal cancer Pap smear HPV vaccination
80
What do we do for priapism?
Doppler ultrasound | Cavernosal blood gas (Ischemic vs. Non-ischemic)
81
If we have non-ischemic priapism what are the management steps?
Watch & Wait | 5a-reductase inhibitors (finasteride)
82
What are the management steps for ischemic priapism?
Needle drainage Intracavernosal phenylephrine Surgical shunt if > 48 hours
83
What 5 investigations should you offer for erectile dysfunction?
``` Glucose Cholesterol Hdl Ldl Triglycerides Testosterone ```
84
What 5 places could you refer somebody with erectile dysfunction?
``` Counseling Urology Sexual medicine Endocrinology Psychiatry ```
85
Who gets PrEP?
MSM Anyone having sex with somebody with a detectable viral load Anybody sharing needles for IVDU
86
What labs do you order for somebody starting PrEP?
``` HIV test b-HCG Hepatitis labs Renal function STI screening q3months ```

CCFP Exam 2021 (11 decks)

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