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Review Flashcards

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1
Q

Name 8 investigations for iron deficiency anemia.

A
  • Serum Hemoglobin
  • Mean Cell Volume
  • Serum Ferritin
  • Peripheral blood smear
  • Serum iron
  • Total iron binding capacity
  • Colonoscopy
  • Beta-hCG
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2
Q

Thalassemia risk regions (#6)

A
  • Africa
  • Middle East
  • Mediterranean
  • Caribbean
  • South East Asia
  • South America
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3
Q

Risk factors for vitamin B12 deficiency (#6)

A
  • Gastric surgery
  • Strict vegans
  • Breastfed children of strict vegans
  • Elderly
  • Psychiatric
  • Pernicious anemia
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4
Q

Investigations for Pernicious Anemia (#2)

A
  • Serum vitamin B12
  • Serum anti-intrinsic factor antibody
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5
Q

Forms of iron supplementation (#3)

A
  • Ferrous fumarate (highest iron content)
  • Ferrous sulfate (best for children)
  • IV iron dextran
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6
Q

Severe anemia investigations [#2]

A
  • Colonoscopy
  • Urinalysis
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7
Q

Causes of acute cough (#6)

A
  • Pneumonia
  • Heart failure
  • Neoplasm
  • Foreign body
  • Pneumothorax
  • ACE inhibitors
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8
Q

Causes of subacute cough (#2)

A
  • Post-viral
  • Infectious (bacterial, viral, fungal, mycobacterial)
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9
Q

Causes of chronic cough (#8)

A
  • Asthma
  • GERD
  • Upper airway cough syndrome
  • COPD
  • Parasite
  • Cystic fibrosis
  • Eosinophilic bronchitis
  • Bronchiectasis
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10
Q

PERC rule-out criteria for PE (#8)

A
  • Age < 50
  • Oximetry >94% (RA)
  • Pulse < 100
  • No prior PE or DVT
  • No recent surgery or trauma (< 4 weeks)
  • No hemoptysis
  • No estrogen use
  • No unilateral leg swelling
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11
Q

Well’s Score for PE (#7)

A
  • Clinical signs & symptoms of DVT
  • PE is #1 diagnosis OR equally likely
  • HR > 100
  • Previous, objectively diagnosed PE or DVT
  • Hemoptysis
  • Immobilization at least 3 days or surgery in the previous 4 weeks
  • Malignancy with treatment within 6 months or palliative
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12
Q

YEARS algorithm to rule out PE if pregnant

A
  • Clinical signs of DVT?
  • Hemoptysis?
  • PE most likely diagnosis?

0 = rule out PE with D-dimer < 1000 ng /mL
1-3 = rule out PE with D-dimer < 500 ng/mL

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13
Q

Shortness of breath investigations (#7)

A
  • ECG
  • Echocardiogram
  • Serum Troponin
  • Arterial pO2 / pCO2 / pH / HCO3
  • Chest x-ray
  • Pulmonary function test
  • CT chest
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14
Q

Life-threatening causes of dyspnea (#3)

A
  • Foreign body
  • Anaphylaxis
  • Pneumothorax
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15
Q

Conservative approach to pneumothorax (unilateral, moderate-large, primary spontaneous)

A
  • Observe for 4 hours, discharge if stable on x-ray
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16
Q

Pulmonary / Cardiac zebra causes for dyspnea (#9)

A
  • Recurrent or fungal pneumonia
  • Fibrosis
  • Post-COVID-19 sequelae
  • Pleural effusion
  • Occasional arrhythmia
  • Cardiomyopathy
  • Malignancy
  • Mycobacterial
  • Aortic stenosis
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17
Q

Non-cardiac/pulmonary causes of dyspnea [#8]

A
  • Anxiety
  • Altitude
  • Abnormal thyroid
  • Acid reflux
  • Anemia
  • Abdomen
  • Allergy
  • Anti-aerobic (deconditioning)
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18
Q

Stepwise treatment for mild COPD (#2)

A
  • SABA prn
  • LAMA or LABA
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19
Q

Stepwise treatment for moderate/severe COPD with low risk for AECOPD (#3)

A
  • LAMA or LABA
  • LAMA+LABA
  • Triple
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20
Q

Stepwise treatment for moderate/severe COPD with high risk for AECOPD (#3)

A
  • LAMA+LABA or ICS/LABA
  • Triple
  • Oral
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21
Q

Oral treatments for COPD (#3)

A
  • Roflumilast
  • N-acetyl cysteine (NAC)
  • Daily Azithromycin
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22
Q

Recommended COPD treatment if blood eosinophils ≥ 300 cells/uL

A

Use steroid (ICS+LABA > LAMA+LABA)

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23
Q

Avoid ICS for COPD treatment if (#3)

A
  • Serum eosinophils < 100 cells/uL
  • History of mycobacterium
  • History of repeated pneumonia
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24
Q

Differential for AECOPD [#6]

A
  • Pneumonia
  • Pneumothorax
  • Pleural effusion
  • Pulmonary embolism
  • Pulmonary edema due to heart
  • Problem on ECG
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25
When to add antibiotics for COPD
- 2-3 Winnipeg symptoms (sputum purulence, sputum volume, dyspnea) - CRP > 40
26
Potential bacteria in complicated COPD infections (i.e., empyema, septic, very sick) [#6]
- H. influenza - S. pneumoniae - M. catarrhalis - Klebsiella - Gram negatives - Pseudomonas
27
Non-medical treatments for COPD [#7]
- Smoking cessation - Exercise - Acupuncture - Active mind-body therapy - Yoga - Tai chi - Opioids (palliative)
28
Differential for pediatric asthma [#5]
- Croup - Foreign body - Infection - Cystic fibrosis - Tracheomalacia
29
Features of well controlled asthma [#5]
- Days with symptoms ≤ 2 - Doses of reliever ≤ 2 - Nights with symptoms < 1 - No interference with work/school/exercise - Infrequent, mild exacerbations
30
Asthma diagnosis on spirometry
- FEV1/FVC pre-bronchodilator < 0.75 - FEV1 post-bronchodilator ↑ 12% & reversible
31
PRAM score for severity of airway obstruction [#5]
- O2 saturation - Suprasternal retractions present - Scalene muscle contractions present - Air entry - Wheeze
32
Topics to regularly reassess at asthma visits [#7]
- Control - Risk of exacerbation - Spirometry or PEF - Inhaler technique - Adherence - Triggers - Comorbidities
33
Labs & management of Testicular Cancer
- b-hCG - AFP - Lop it off (surgery)
34
Risk factors for Testicular Cancer
- Cryptorchidism - Family history - Personal history
35
Screening for lung cancer
Low dose CT if age 55-74, 30 pk/yr smoker, current or quit < 15 years ago --> annually up to 3 times
36
Screening for ovarian cancer
No screening indicated if asymptomatic, low risk
37
Screening for cervical cancer
Screen 25-69 every 3 years
38
Screening recommendations for cervical cancer do NOT apply if [#6]
- Never sexually active - Weakened immune system - Symptoms of cervical cancer - Previous abnormal screening results - Does not have cervix - Immunosuppressed
39
Melanoma prevention [#3]
- Sunscreen - Physical UV blocking - Avoid tanning beds
40
High-risk features that should consider referral for 6-monthly fully body examination for melanoma [#7]
- Older, male - Previous skin cancer - Family history - # of Nevi (>15) - Light skin, red hair - Multiple sunburns - Actinic skin damage
41
Screening methods for colorectal cancer [#2]
- FOBT age 50-74 q2 years - Flexible sigmoidoscopy age 50-74 q10 years
42
Screening for breast cancer
- Mammogram age 50-74 q2-3 years if average risk
43
Risk factors for pancreatic cancer [#3]
- Family history - Peutz-Jeghers syndrome - BRCA1 with affected relative
44
Serum investigations for unexplained weight loss [#6]
- Serum hemoglobin - Serum Na - Serum K - Serum Cr / eGFR - Serum Urea - Serum PSA
45
Non-lab investigations for unexplained weight loss [#4]
- Weight - Height - Fecal Occult Blood - Chest x-ray
46
Alarm features for abdominal pain [#12]
- Severe pain - Melena - Weight loss - Abnormal labs (Hb, CRP, Na, K) - Age > 55 - Vomiting - Dysphagia - Mass - Family history - Previous history - Bilious vomit - b-HCG (+)
47
Treatment for H. pylori [#4]
Quadruple therapy x 14 days - PPI - Bismuth - Metronidazole - Tetracycline
48
Prevention for esophageal cancer with Barrett's eosphagus
- Lifestyle - High-dose PPI - ASA
49
Non-abdominal causes of abdominal pain [5]
- Pulmonary embolism - Myocardial infarction - Pericarditis - Zoster - Testicular
50
Management of ureteral stone < 5 mm
Conservative management
51
Management of obstructive ureteral stone
Timely decompression
52
First-line imaging for ureteral stone
KUB US
53
Management of ureteral stone 5-10 mm
Medical expulsive therapy
54
Management of distal ureteral stone
Medical expulsive therapy
55
Gallstone risk factors [#5]
- Female - Forty - Fertile - Obese - OCP
56
Pancreatitis risk factors [#6]
- Septra, Flagyl, HCTZ, ACE inhibitors - Progesterone - Atorvastatin - Estrogen - Gallstones - Alcohol
57
Bolus fluids for Peds
20 mL/kg
58
Maintenance fluids for Peds
4-2-1 rule - 4 mL/kg for first 10 kg - +2 mL/kg for kg 11-20 - +1 mL/kg for every kg above 20
59
Objective measurements for treating severe dehydration [#6]
- Weight - Serum glucose - Serum Na - Serum K - Serum Cr - Serum urea
60
Non-gastroenteritis differential for diarrhea in elderly [#5]
- Acute ischemic bowel - Obstruction - Diverticulitis - Appendicitis - Neoplasm
61
Risk factors for C. Difficile [#5]
- Healthcare-associated - Older age - Immunocompromised - Previous C. Diff infection - Recent antibiotics (esp. Fluoroquinolone)
62
Treatments for C. Difficile [#6]
- Vancomycin PO (first-line even if mild) - Fidaxomicin - Metronidazole - Fecal transplant - Rifaximin - Bezlotoxumab (monoclonal)
63
Investigations for chronic diarrhea [#12]
- Serum Hb - Serum ferritin - Serum TSH - Serum ttG - Stool C. Diff NAAT - Stool Ova & parasites - Fecal calprotectin - FIT / Colonoscopy - Hydrogen breath (lactose) - Capsule endoscopy - Fecal elastase (fat malabsorption) - MRI abdomen (chronic pancreatitis)
64
Treatments for Crohn's Disease
- Sulfasalazine - Steroids - Thiopurines - Methotrexate - Anti-TNF therapy
65
IBS investigations
TTG or endomysial IgA
66
Non-medical management for IBS [#5]
- FODMAP diet trial - Psyllium - Peppermint oil, probiotics - CBT, hypnotherapy - Colonoscopy if > 50 years OR alarm features
67
Medical management for IBS [#5]
- Antispasmodics (e.g. Buscopan) - Antidepressants (e.g., TCAs, SSRIs) - Eluxadoline - Lubiprostone - Linaclotide
68
Sleep disorders [#8]
- Narcolepsy - Restless leg syndrome - Sleep terrors - Sleep walking - REM sleep disorder - OSA - Central sleep apnea - Substance/medication-induced
69
PHQ-2
1. Down/depressed/hopeless? 2. Little interest/pleasure?
70
New medications for Insomnia
- Lemborexant (Dayvigo) - Eszopiclone (Lunesta)
71
Non-prescription management for Restless Legs [#5]
- Iron, Magnesium - Stretch calves - Avoid caffeine - Massage, heat - Exercise
72
Prescriptions for Restless Legs [#4]
- Pramipexole - Ropinirole - Gabapentin - Pregabalin
73
STOP-BANG for OSA [#8]
- Snore loudly - Tired - Observed apnea - high blood Pressure - BMI >35 - Age >50 - Neck circumference > 40 cm - male Gender
74
Caregiver burnout management [#4]
CALM - Counselling - Appointment (next visit) - Lifestyle advice - Mental health support
75
Thyroid storm management [#5]
Block B's: - Block synthesis = Thionamides (Methimazole, Propylthiouracil) - Block T4 --> T3 = Propranolol, Propylthiouracil - Block release = Iodine - Beta Blocker = Propranolol - Bile acid sequestrant = Cholestyramine
76
Risk factors for hypothyroidism [#5]
- Age - Pregnancy - Personal history - Thyroidectomy - Radiation
77
Treatment for hyperthyroidism
- Propranolol if symptomatic for 6-8 weeks - RAIU unless 100% sure it's Graves
78
Contraindications for RAIU [#2]
- Obvious Grave's disease - Pregnant or breastfeeding
79
Indications for biopsy for thyroid nodule
- >1 cm - Irregular surface - Taller than wide - Calcifications within
80
Criteria for Myalgic Encephalomyelitis-Chronic Fatigue Syndrome (ME-CFS) [2]
- Fatigue profound & not improved by rest - Post-exertional malaise
81
Criteria for Environmental Sensitivity (ES-MCS) [2]
- Provoked by chemical, biological agents & removal relieves - Neurocognitive, respiratory symptoms
82
Criteria for Fibromyalgia [2]
- Diffuse body pain x 3 months with no other explanation - Fatigue (in 90%), sleep, mood, cognitive symptoms
83
Treatment for Diabetic Ketoacidosis [#5]
- Insulin - Saline - Potassium - Bicarbonate if overacidic - D5W once appropriate
84
5 classes of medications for diabetes besides insulin
- Biguanide - SGLT-2 inhibitors - GLP-1 receptor agonists - Sulfonylureas - DPP-4 inhibitors - Thiazolidinediones
85
Differential for Dyscopia [#6]
SAD-CSS: - Somatic symptom disorder - Anxiety - Depression - Chronic pain - Sleeping disorder - Substance use
86
Tests to check infectivity for Hepatitis B [#3]
- Serum HBV DNA - Serum HBeAg - Anti-HBe
87
Hepatitis C tests [#3]
- Serum anti-HCV (unless known previous HCV) - Serum HCV RNA - Genotype & subtype
88
Hepatitis A management [#2]
- Supportive - Report
89
Treatment indications for severe Hepatitis B [#3]
- Cirrhosis - Fibrosis - HBV DNA >2000 IU/mL & ALT elevated for 3-6 months
90
Medications for Hepatitis B [#2]
- Tenofovir - Entecavir
91
Treatment for Hepatitis C [#2]
- Interferon, Peginterferon, Ribavirin - New regimens (i.e., Sofosbuvir with Ledipasvir, Daclatasvir, Velpatasvir) [Mavyret, Harvoni)
92
Monitoring for Hepatitis B & C [#4]
- HCC = liver U/S q6-12 months - Varices = scope q1-3 years - Alcohol = history - Cirrrhosis/fibrosis = Fibroscan
93
Features of non-inflammatory low back pain [#2]
- AM stiffness < 30 mins - Worse @ end of day
94
Features of inflammatory back pain [#2]
- AM stiffness > 30 mins - Better @ end of day
95
Myotome for L1/2
Hip flexion
96
Myotome for L3/4
Knee extension
97
Dermatome for L4
Knees to first toe
98
Dermatome for L5
Middle toes
99
Dermatome for S1
Pinky toe
100
Non-medical management for low back pain [#4]
- Yoga - Acupuncture - Osteopathy - CBT
101
Alarm features for joints [#4]
- Hot (fever; warm joint) - Bog (soft & boggy joint) - AM stiffness > 30 mins - PM pain (night pain)

CCFP Exam (1 decks)

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