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PMCH Flashcards

1
Q

Age most vulnerable to lead poisoning

A

< 6 mo

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2
Q

Organisms resistant to chlorine in water?

A

Cryptosporidium
Giardia
HAV
Entamoeba histolytica

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3
Q

Pneumon-Vaccine for elderly

A

At 65 Yr => q5yr

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4
Q 
Abuse in elderly 
M:F
Perpetrator
MC form 
Least common form
A

F>M

90% adult children of elderly (alcoholic / abusers)

Neglect

Sexual

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5
Q

Spouse abuse elderly husband indicate?

A

Hx of violence in relationship

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6
Q

Latex allergy cross-reaction (food)

Latex-fruit syndrome

A

Avocado
Banana
Kiwi
Chestnut

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7
Q

MC nutritional def worldwide

A

Fe

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8
Q

95% CI + OR doesn’t > 1?

A

Significant association

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9
Q

Rx for spinal mets?

A

No Rx increases survival

Best Rx = dexamethasone for Sx + bone pain

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10
Q

Prognostic signs of spinal mets

Bad + good

A

Bad = loss of sphincter tone (irreversible)

Good = ambulation

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11
Q

Features of dexamethasone compared to other steroids

A
  1. Least mineralocorticoid activity
  2. Least to associated w/ cognitive Sx
  3. Least to ass w/ infection
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12
Q

HA1c of 6% = FPG?
HA1c of 7% =

Eqn

A

6% = 7.0

7% = 8.5%

Eqn => FPG = 1.59 x A1c - 2.59

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13
Q

Chloroquine in preg

A

C

Given if plan to travel to high risk

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14
Q

RR equation

A

RR = (A/a+b)/(c/c+d)

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15
Q

What’s relative risk

A

Prob of event to occur in exposed group vs non exposed

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16
Q

Is HepA vaccine imp for immigrants from developing world

A

No

It’s prevalent, chances are they’ve had it and immune to it.

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17
Q

Outbreak of Ecoli 0157H7 ass w/

A

Ground beef

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18
Q

Best way to remove ticks

A

Manually by blunt forceps

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19
Q

Responsibilities of public health physician

A

Prevent STD

Prevent dental prob

Infectious disease surveillance

Health promotion activities

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20
Q

Effect of b-carotene supplement

A

Inc risk of lung cancer

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21
Q

MCC of travelers diarrhea

A

Enterotoxigenic E.coli

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22
Q

enterotoxigenic Ecoli mechanism of action

A

Colonization factors

Heat liable enterotoxin

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23
Q

For future, to make effective vaccine against ETEC diarrhea it should contain

A

Colonization factors CS1-6

LT toxoid

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24
Q

Larva migrans transmission

A

Contact with soil contaminated with the cat and dog faeces

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25
Rx of dyspnea + terminal illness (Ca)
Opiates esp Morphine
26
Exercise to burn fat frequency
At least 30 min 5d/wk
27
Why fat burning fat exercise must > 30 min
Glycogen burning fuels body for 20 min Fat fuels it after that
28
Exercise for cardiovascular + fitness
20 min daily Or 10 daily
29
T/F: walking (land/water) + biking = exercise for 10-20 min
T
30
West Neil virus What is it? Transmission? Sx? Risk population?
- Human neuropathogen - Mosquito infected from birds - mostly flu like Rarely Neuro Sx: encephalitis, meningitis, paralysis - elderly at risk - Rx supportive
31
Number needed to Rx Importance? Eqn?
Assess benefit of Rx NNT = 1/ARR
32
What explains population growth in developing countries
Decreased mortality rates
33
Hospice care services
Short term hospitalization Sx Rx of terminal illness Physical/occupational/speech Rx Dietary counseling
34
T/F: curative Rx is covered by hospice care
F
35
Terminally ill + oral secretions Rx | Gurgling/rattling
Anticholinergic Scopolamine Hyoscyamine Glycopyrrolate Atropine
36
MC hospital error ass w/ SE of drug occurs when
Ordering
37
Early detection of cervical cancer by Pap smear survival
90% survival rate
38
WHO def of health
State of complete physical mental and social well-being
39
T/F: transdermal absorption of medication decreases with age
T 2/2 increase ratio of fat to lean body weight
40
T/F: NSAID's should be avoided in liver cirrhosis
T
41
NSAIDs in preg
Safe Should be avoided in last 6wk to prevent inhibition of PG synthesis
42
Sympathomimetic SE in elderly
High BP High ocular pressure Worsen urinary retention Interact w/ BB, methyl dopa, TCA, MAOi
43
Ex of sympathomemtic
Pseudoephrine | Phenylephrine
44
How to make medical decision for incapable pt
1. Follow advanced directive (oral or written) 2. No directives = health care proxy 3. No proxy = family 4. No family or family can't agree = ethics committee
45
What elderly does form heat stroke
``` Living alone Can't care for self CVD or resp disease Mental illness (schizophrenia) +/- alcohol, Hx of heat stroke ```
46
In terminal illness: | Preparatory grief vs depression
Grief = normal self image Sx wax + wane Worry abt separation from family Depression = Poor self esteem Suicidal ideas
47
Rx of depression in terminally ill patient
Expected to live few weeks: stimulants methylphenidate Live longer: SSRIs
48
Chemical exposure associated with leukemia and aplastic anemia and multiple myeloma
Benzene
49
Arsenic exposure is associated with
Skin cancer
50
Best hearing arrange for sounds
400 to 5000 Hz
51
Frequency range for audible sound
20 to 20,000 Hz
52
Who should be screened for HCV
1. Blood transfusion prior to 1992 2. Needle stick with HCV 3. Mucosal exposure to HCV 4. Children born to HCV+ mom
53
Prevent cholera?
Boiling drinking water Chlorinate drinking water Cook vegetables + fish thoroughly
54
When to screen for CRC at 40 and q5 Yrs?
1st degree relative w/ CRC or adenomatous polyps at < 60 > 2 of 1st degree relative with CRC or adenomatous polyps at any age
55
When to screen for CRC at 40 and q5 Yrs?
1st degree relative w/ CRC or adenomatous polyps at < 60 > 2 of 1st degree relative with CRC or adenomatous polyps at any age
56
F patient FU w/ male doc Frequent visits Normal exam + no complaints. What to suspect? Reaction?
Inappropriate relationship Reaction: Pointing your awareness of inappropriate patient-doctor relationship and willingness to help
57
When does palliative care start?
When Dx diagnosed, count through cure or death.
58
T/F: unit of care in palliative Rx comprises pt and his family as defined by surrogate.
T
59
Who receives palliative care?
Pt of all ages w/ chronic illness or injury that impairs daily functioning or reduce life expectancy
60
Having ER contraception readily available results in
Shorter time b/w sex + medication use (15 HR sooner)
61
Rx of travelers diarrhea
ETEC Rx Mild = loperamide + diphenoxylate Safe in kids < 2 yr Sever = Adults > cipro Kids > azithromycin
62
Who shouldn't receive intranasal vaccine
- Kids < 2yrs - Adults > 60 - Egg allergy - long term ASA - chronic disease (COPD, asthma, CHF, CKD...) except HTN - immune suppression - preggos
63
Who should be screened for HCV?
IV drug users
64
What's attack rate
#ppl sick / ppl Attack rate = kids w/ Dz / all kids
65
T/F: negative HBsAg + high LFT = r/o sclerosis of liver
T
66
MC resp Dz from occupational exposure
Asthma Exposure to gas
67
T/F: early detection of ovarian cancer by CA-125 doesn't improve mortality
T
68
Only DM decreases cardiovascular risks
Metformin
69
What led improvement in life expectancy of Canadians?
Lower infants death rates By: Vaccinations Surgical Rx of congenital heart disease
70
Hyperplastic polyps on colonoscopy mean?
Hyperplastic polyps Normal Repeat at 10 yrs 1-2 small adenomas Low risk FU 5-10yrs >3 adenomas or big adenomas (>1cm$ Remove Rep 3 yr Sessile adenomas Remove Rep 2-6 mo
71
To qualify for federal contributions, insurance plan must guarantee?
1. Province to province coverage 2. Universal coverage 3. Nonprofit basis 4. Benefits all necessary hospital care + physician service.
72
What are not required for federal assures insurance plan
Out of hospital drugs Dental care Prosthesis
73
What's varenicline? | Major SE?
Smoking-cessation drug Suicide
74
Why Rx pertussis w/ azithromycin
Decrease infectivity + severity of Sx. Doesn't change course of illness
75
What's direct observational Rx
Provide medication directly to patient and watch them swallow
76
The benefit of direct observational therapy
As your highest treatment completion rate
77
A freshman heading to college should receive what vaccine
Meningococcal glad to stay in the dome
78
3 situations in which that things are contraindicated
1. Live vaccine for a pregnant 2. Anaphylaxis to a component 3. Immune suppression
79
NNT | 2 eqn
NNT= 1/ARR ``` ARR = (c/c+b) - (a/a+b) ARR = control event rate - experiment event rate. ```
80
Vaccine recommended for homosexuals
Hepatitis a vaccine
81
Who is responsible for our local sanitation, water and food safety, monitoring reportable disease, local environmental risk assessment
Public health unit
82
What is the job of the federal government
Regulate toxic substance regulate food product set policies for pollutant
83
Provincial government
Maintaining water and Eire quality standards regulated and industrial emission and toxic waste disposal
84
Characteristic of occupational hearing loss
Hearing Loss at the high frequency
85
Who should be screen for lung cancer and when
1. Adults Smoked 30 pack-year Currently smokers Exsmoker < 15 yrs 2. Start at 55-75 then yearly for 3 yrs 3. Low dose CT
86
T/F: most women with breast cancer had no identifiable rest factors
T
87
The woman has a 1st° relative with the breast cancer what's her Risk of developing the disease
There is 3 to 4 fold increased risk
88
What do you do with a patient requires oxygen on the planes
Arranged through home airline for oxygen to be available on board + airport 24-48 hr prior to flight
89
Can you patient who requires continuous oxygen to bring their own supply to the airport/flight
No
90
T/F: people with PaO2 <68-70 shouldn't go on plane unless on plane oxygen is arranged
T
91
Daily use of ASA recommend for what age group (M + F)
M: 45-79 F: 55-79
92
When is breach of confidentiality justified (3)
1. Abuse of vulnerable person child or elder 2. Public health risk like in communicable disease 3. Danger to patient or others
93
Eqn of kappa (chance-corrected agreement)
Kappa = (observed agreement - chance agreement) / (1-chance agreement).
94
Viruses transmitted fecorally
Norwalk virus Hepatitis a + e Poliovirus
95
Perinatal mortality
Write up a stillbirth and early neonatal deaths
96
Decreased perinatal mortality rates indicates
Improve the quality of health care during pregnancy and delivery
97
Is asbestos removal mandated by the Environmental Protection Agency
No
98
Are asthmatics at increased risk of cancer from asbestos exposure
No
99
MCC of a cute aseptic meningitis
Echovirus | Coxsackievirus
100
In case of airborne bioterrorism use respirator maybe harmful in what conditions
COPD Asthma CAS Anxiety disorders
101
A doctor convicted of narcotic abuse and completed drug Rehabilitation program Who decides if he can go back to work
provincial medical board
102
Anaesthesiologist convicted of narcotic abuse can he ever go back to work
Not this speciality I different to speciality that is not anaesthesiology
103
What each of the following herbs ass w/ Ginkgo Kava Yohimbine
Ginkgo = intracerebral bleed in pt w/ anticoagulant Kava = GI side effects + rash Yohimbine = HTN
104
What animals get you salmonella
Iguana
105
Can physicians be compensated for attending a CME activity
No it's against the law
106
Can monosodium glutamate cause cancer
Nope Its of Flavor enhancer
107
Can fat cause cancer
Yes CRC
108
Can alcohol cause cancer
Pancreatic cancer
109
How to use the walking cane
Place the cane in the hand opposite to the most affected leg Movement of the cane tracks the movement of the affected leg
110
Exposure to pesticides causes?
Organophosphate toxicity
111
Path of organophosphate Rx
Inhibit AChase Few hours = pralidoxime + atropine
112
Alcohol rub vs hand soap
Alcohol rub is better - microbiologically more effective - less irritating - less time
113
When is hand soap a preferred over alcohol rub
Of the hands are visibly soiled or exposed to spore forming organism After use of bathroom
114
Which woman should be screened for ovarian cancer
No woman
115
Best screening test for hemochromatosis
Transferrin
116
Why should smokers use nicotine patches
Double chances of quitting
117
How long should the smokers use nicotine patch to give result
8 wks
118
T/F: tapering nicotine patch is better than abrupt D/C
F | Same
119
MCC of blindness in > 65
Macular degeneration
120
Should I help you I want to be screened for hepatitis C
No need
121
Who should be screened for hepatitis C
Persistent abnormal ALT
122
When to Rx influenza even if it's > 48 hrs?
Patient is deteriorating Rx oseltamivir or zanamivir
123
Contraindication to zanamivir
COPD Asthma Resp distress
124
High INR + on warfarin
• 5-9 + no bleeding Hold warfarin for 48 hrs • 5-9 + risk of bleeding Vit K • 5-9 + bleeding Vit K FFP
125
MCC of retinal detachment
Posterior detachment of vitreous
126
Most fatal cancer in Canada
Lung
127
Coagulation profile in vW
High PTT | High BT
128
What's otosclerosis
Normal eardrum + conductive hearing loss
129
Ms affected in otosclerosis
Stapes
130
Rx of rotator cuff tear | RICE or physio
RICE
131
What does low appetite in seasonal affective mean
Endocrine path
132
Recurrent pain + swelling of salivary gland
Sialolithiasis
133
Dextromethorphan + SSRI
It's a cold drug Cause serotonin syndrome
134
How much vitamin D a post menopausal woman need
800
135
pregnant gets parvovirus b19 happens to her baby
Hydrops
136
Antabiotics for dog bite
Amoxicillin-clave
137
Ginseng
Herb Should be stopped 7 days pre-op Causes Hypoglycaemia and interferes with anticoagulant
138
Fiscal policy
Additional taxes on unhealthy behaviors
139
Tetrad of Menier's
Vertigo Hearing loss Tinnitus Aural fullness
140
Risks for claudication
DM Smoking HTN Dyslipidemia
141
T/F: raloxifene helps menopause Sx
F
142
Someone tests + for HBsAg + HBcAg
Repeat test in 8 weeks to see if it progresses to chronic. Stop all things hurt liver (alcohol)
143
T/F: PPV influenced by prevalence
T High prevalence = high PPV
144
WPW arrhythmia ECG Rx
Delta wave Wide QRS Short PR Its SVT Procainamide or amiodrone Sync cardioversion Ablation No BB, CCB, adenosine!
145
1st heart block ECG Rx
Prolonged PR No Rx
146
2nd heart block ECG Rx
Mobitz 1: Progressive increase in PR until drop No Rx stop drug causing it. ``` Mobitz 2: Fixed drop (no progressive prolongation) ``` Pacemaker
147
3rd heart block
No relation b/w p + QRS Pacemaker
148
Afib A flutter ECG Rx
AFib Irregular irregular No P wave ``` Unstable = sync cardio version Stable = BB or CCB Chronic: Add anticoagulant CHADS2 0-1 = ASA > 2 = no renal = dabigtran Or warfarin if renal or prosthetic valve INR 2-3 ``` Flutter: Saw tooth < 48 HR => drug version: procainamide, amiodrone Or electrical version >48 HR => warfarin then 3-4 wk electrical cardio version. TEecho to r/o thrombi 1st Cont warfarin for 4wks Anticoagulant Rate (BB, CCB, digoxin)
149
SVT ECG Rx
Narrow QRS 1st Valsalva Massage 2nd Rate (BB, CCB, adenosine) Electrical cardioversion
150
T/F: Nicotine replacement is safe in stable angina
Yes
151
Ethnic group at risk of prostate ca
Black
152
How long after Sx of sore throat can u start Abx to prevent rheumatic fever
9 day

CanQB (16 decks)

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