Family Medicine Flashcards
(69 cards)
Name the 3 groups that you screen for diabetes and how often
1) Age <40, low-mod risk –> no screening
2) Age >40 or high-risk –> screen q3 years
3) Very high risk, specific RFs –> screen q6-12 mo
What FPG is impaired, what is diabetes
6.1-6.9 = impaired
7+ = diabetes
What A1C is prediabetes, what is diabetes?
6.0-6.4% = prediabetes
6.5%+ = diabetes
Target for glycemic control in most patients?
7 or less
In what populations would you have an increased A1C target and what would it be
7.1-8.5% in people with
- recurrent severe hypoglycemia/hypoglycemia unawareness
- limited life expectancy
- frail/elderly with dementia
What antihyperglycemic drug class has evidence for improving outcomes in patients with HFpEF?
SGLT2i
In what diabetic patients are Statin + ACEi/ARB + ASA indicated?
CV disease (cardiac ischemia, PAD, CVD)
In what diabetic patients are Statin + ACEi/ARB indicated?
Microvascular disease (neuropathy, retinopathy, kidney disease (ACR 2+))
OR
Age >55 with additional CV risk factors (e.g. hypertension, smoking, albuminuria, low HDL)
In what diabetic patients is Statin-only indicated?
Age 40+
Age 30+ and diabetes >15 years
Other indications based on lipid guidelines
What meds should diabetic patients hold when at risk of dehydration (vomiting/diarrhea)
Sulfonylureas
ACEi
Diuretics/direct renin inhibitors
Metformin
ARBs
NSAIDs
SGLT2 inhibitors
Breast cancer screening mammography is recommended to whom in Ontario? How often?
Women aged 50-74, q2 years
Cervical cancer screening is recommended to whom in Ontario? How often?
Every 3 years in women >21 (or >25) who has ever been sexually active.
Stop after age 70 if 3+ normal paps
Colon cancer screening for people with average risk?
FIT q2 years
or flexible sigmoidoscopy q10 years
Define “average risk” for colorectal cancer?
50-74 years old
No first-degree relative diagnosed with CRC
No personal hx of pre-cancerous polyps requiring surveillance or IBD
Colon cancer screening for patient with 1 first-degree relative with CRC or an advanced adenoma
Colonoscopy q5-10 years started at age 40-50 or 10 years younger than diagnosis of FDR (or could use FIT q1-2 yrs)
Who should get lung cancer screening? What method? How often?
Current/former smokers ages 55-74 if smoked cigarettes daily for at least 20 years cumulative
Low-dose CT
Every year up to 3 years in a row
At what age is DEXA indicated for osteoporosis screening?
65+ years for both men and women
Name RFs for fracture that would indicate DEXA screening in men/women >50yo
Fragility fracture
Use of high-risk meds (e.g. glucocorticoids)
Fracture/osteopenia seen on XR
Current smoking
++Drinking
Low body weight (<60kg) or major weight loss (>10% of body weight @ 25yo)
RA
Parental hip fracture
Other diseases that increase risk
At what age should lipid testing as part of CVD risk estimation be performed?
Frequency?
Men >40
Women >50 (conflicting, other resource says >40 or post-menopausal)
Until age 75
q5 years for FRS <5%, q1yr for FRS >5%
Primary prevention based on 10-year CVD risk:
Risk <10%
Risk 10-19%
Risk >20%
Risk <10% - Retest q5 years
Risk 10-19% - Mod-intensity statins
Risk > 20% - high-intensity statins
Antibiotic for strep throat in adults
Oral Penicillin V 500mg BID-TID for 10 days
Antibiotic for strep throat in children
Penicillin V or Amoxicillin (latter tastes better in suspension so preferred for young kiddos)
What are the components of the centor score
Cough absent = +1
Exudate = +1
Nodes (anterior) = +1
Temp >38 = +1
Old (>45) = SUBTRACT 1
Really young (3-14) = +1
Describe the scoring of CENTOR score
0-1 (1-7% chance)–> no culture or AB
2-3 (8-34%) –> culture all, treat only if +
4+ –> culture all, treat with AB clinically
