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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
Q

How many binge/purge cycles do you need for diagnosis of bulimia?

A

Once weekly

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26
Q

What are 5 things to screen for with eating disorders?

A 
Anxiety
Depression
OCD
Personality Disorder
Bullying
Poverty
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27
Q

What diagnose to you attribute to athletes who cannot consume as many calories as they burn?

A

Relative Energy Deficiency in Sport

RED-S

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28
Q

Who should you refer to eating disorders to?

A 
Dietician
Psychiatrist
Group counselling
Individual counselling
Psychologist
CBT
School counsellor
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29
Q

What are the three main parts of sexual assault management?

A

Pregnancy prevention
STI post exposure prophylaxis
Trauma informed care

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30
Q

What are three treatments for pregnancy prevention following rape?

A

Copper IUD
Levonorgestrel
Ullipristal
Combined OCP

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31
Q

What are the treatments for post-exposure prophylaxis?

A

PrEP
Hepatitis B immunoglobulin

TEST @ 6/12 weeks

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32
Q

Treatment of Gonorrhea

A

Azithromycin 1g PO AND ONE OF
Cetriaxone 250mg IM
OR
Cefixime 800 mg PO

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33
Q

Abx treatment for Chlamydia?

A

Azithromycin or Doxy 100 mg PO BID * 7 days

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34
Q

When do you have to report sexual assault/rape?

A

Under the age of 18.

Otherwise it is voluntary.

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35
Q

Who is at high risk of domestic violence?

A

Kids
Elderly
Pregnant
Immigrants

36
Q

What is the age of onset for ADHD?

A

12

37
Q

What are 4 treatments for ADHD?

A

Amphetamine
Methylphenidate
Atomoxetine (SNRI)
Guanfacine (Alpha 2a receptor agonist) - good if diverting

38
Q

What are things to consider before changing to 2nd or 3rd line ADHD medication such as atomoxetine or guanfacine?

A 
Dosage/Duration
All - trial all 1st line
Time for response
Examine targets
Review - comorbidities
39
Q

What are some risks associated with ADHD?

How do you fix this?

A

2-4X as many motor vehicle collisions

Recommend standard vehicle

40
Q

What two management steps do you order for 1st trimester bleeding?

A

Serial ultrasound

Serial bHCG

41
Q

What four things are on your differential for 1st trimester bleeds? Which of these is life threatening?

A

Threatened abortion
Missed abortion
Complete abortion
Ectopic

42
Q

What are 5 risk factors for ectopic pregnancy?

A 
Previous ectopic pregnancy
Abnormal fallopian tubes
Endometriosis
History of tubal surgery
STI
Smoking
Advanced maternal age
43
Q

What are risk factors for AUB?

A

Estrogen exposure

Hyperandrogenism

44
Q

What are three tests you would consider for AUB?

A

Endometrial biopsy
Pap
Colposcopy

45
Q

What are three hormonal managements for AUB?

A

IUS
OCP
Progestin

46
Q

What are two non-hormonal treatments for AUB?

A

NSAID

TXA

47
Q

What are 4 surgical treatments for AUB?

A

Ablation
Hysterectomy
Polypectomy
Myomectomy

48
Q

What are four tests or exams for post-menopausal bleeding?

A

Pelvic
PAP
Ultrasound
Endometrial biopsy

49
Q

What are 4 tests to do for vaginitis?

A

Swabs
Wet mount
KOH
pH test

50
Q

What are 5 things that could cause vaginal itch other than STIs?

A 
Eczema
Psoriasis
Lichen sclerosis
Lichen simplex chronicus
Vulvar cancer
Genitourinary syndrome of menopause
Contact dermatitis
51
Q

What are 4 infectious things that can cause vaginal itch?

A

Herpes
Trichomonas
Pelvic inflammatory disease
Bacterial vaginosis

52
Q

What are three things to think about with pediatric vaginal itch?

A

Foreign body
Irritant (soaps/clothes)
STI (REPORTABLE)

Unlikely to be yeast

53
Q

When can you consider PSA screening? At what age?

A

If patient has > 10 years of life expectancy. Age 50.

54
Q

What is the next step after finding an elevated PSA?

A

If less than 10 low risk
If 10-20 medium risk
If greater than 20 high risk

Refer to urology for prostate biopsy

55
Q

How does physical exam findings on DRE effect referrals for prostate CA?

A

If PSA < 10 and abnormal prostate, non-urgent

If PSA > 10 and abnormal prostate, urgent

56
Q

What are risk factors for prostate cancer?

A 
Age
Family Hx
Smoking
Obesity
Hi risk race
57
Q

What tests do you order for suspected BPH?

A

Urinalysis and
Midstream culture & sensitivity
PSA if life expectancy > 10 years

58
Q

What are 5 non-pharmacologic interventions for BPH?

A 
Antihistamines
Decongestants
NSAIDs
Saw palmetto
Caffeine
Alcohol
59
Q

What are 2 classes of medication for BPH?

A 
Alpha blocker (tamsulosin)
5 alpha-reductase inhibitors (finasteride)
60
Q

What are 2 second line treatments for BPH?

A

Antimuscarinics

PDE5 inhibitors

61
Q

What 4 symptoms would you associate with prostatitis that would not be present with UTI or STI?

A

Systemic symptoms of illness such as:

Fevers, chills myalgia, malaise

62
Q

What is the most common bug for prostatitis?

A

E. coli.

63
Q

Define hypertensive emergency

A

180/120

Asymptomatic

64
Q

Define hypertensive emergency

A 
Elevated BP
WITH
Generalized neurological symptoms (agitation, delirium, seizure, visual disturbances)
Focal neurological symptoms
Nausea/Vomiting
Chest discomfort
Dyspnea
Pregnancy
Recreational drugs
65
Q

What are five causes of tubal dysfunction that may lead to infertility?

A 
Endometriosis
Ectopic pregnancy
Surgery
Crohn's
PID
Chlamydia
Ruptured appendix
66
Q

What are 4 structural uterine problems that may lead to infertility?

A

Surgery/Instrumentation
Septate uterus
Arcuate uterus
Intracavitary fibroids

67
Q

What are 5 things that may lead to infertility in men?

A 
Trauma
Torsion
Surgery
Infection
Tobacco
Cannabis
Cycling
Laptops
68
Q

What are 5 tests you will order for infertility in relation to ovulation?

A 
Day 3 FSH
Estrogen
TSH
Prolactin
Midluteal progesterone
69
Q

What are 3 tests you would order with suspected hyperaandrogenism?

A

DHEA-S
17 OH Progesterone
Total testosterone

70
Q

What are two imaging tests to look for structural causes of infertility in women?

A

Pelvic ultrasound

Hysterosalpingogram

71
Q

What are three indications for referral with infertility?

A

12 months if no risk factors
6 months if risk factors and over 35
Immediately if over 40

72
Q

What % of healthy individuals conceive by 12 months?

A

90%

73
Q

What 5 things would make you consider intrauterine insemination?

A 
No pregnancy after 12 months
Regular intercourse
Normal ovulary function
Normal semen analysis
1 patent Fallopian tube
74
Q

What two abx do you treat PID with?

A

Cefoxitin + Doxycycline (Foxy Doxy)
or
Clindamycin + Gentamicin (in hospital)

75
Q

What are three things you are doing in addition to treating an STI?

A

Treat partner
Contact tracing
Abstinence * 7 days

76
Q

When and why should you start on OCP?

A

Start your pills on a Sunday. That way you will never get period on weekend.

77
Q

List 5 contraindications to OCPs

A 
Migraine with aura
Smoker >65 or >15 cigs/day
Uncontrolled HTN
Malignancy
DVT
Stroke
Valvular disease
Diabetes with end organ damage
Liver disease
78
Q

What is the age of consent in Canada?

A

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
Q

What cancer consideration do you have with sexually active individuals? How do you manage and prevent this?

A

Cervical/Anal cancer
Pap smear
HPV vaccination

80
Q

What do we do for priapism?

A

Doppler ultrasound

Cavernosal blood gas (Ischemic vs. Non-ischemic)

81
Q

If we have non-ischemic priapism what are the management steps?

A

Watch & Wait

5a-reductase inhibitors (finasteride)

82
Q

What are the management steps for ischemic priapism?

A

Needle drainage
Intracavernosal phenylephrine
Surgical shunt if > 48 hours

83
Q

What 5 investigations should you offer for erectile dysfunction?

A 
Glucose
Cholesterol
Hdl
Ldl
Triglycerides
Testosterone
84
Q

What 5 places could you refer somebody with erectile dysfunction?

A 
Counseling
Urology
Sexual medicine
Endocrinology
Psychiatry
85
Q

Who gets PrEP?

A

MSM
Anyone having sex with somebody with a detectable viral load
Anybody sharing needles for IVDU

86
Q

What labs do you order for somebody starting PrEP?

A 
HIV test
b-HCG
Hepatitis labs
Renal function
STI screening q3months

CCFP Exam 2021 (11 decks)

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