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116 Cards in this Set
- Front
- Back
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what % of canadians will have polyps by age 50? |
30-40-50% by age 50-60-70 |
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58 yr old male w/ no sx. & Fhx w/ neg. colonoscopy... next screening test? |
10 year interval |
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CA screening with Fhx of CA |
5 year interval |
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CA screening with fhx with benign polyps |
3 year interval |
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sensitivity & specificity |
sens: a / (a+c) |
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PPV & NPV |
PPV: a / (a+b) |
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Gardasil approval for whom? |
Females aged 9-45 & Males aged 9-26 |
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empiric treatment for nursing home acquired pneumonia with no underlying disease? |
levofloxacin |
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Most common illness associated with workplace exposure? |
Asthma |
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MIBI scan |
thallium TI 201 & technetium Tc 99m sestamibi (MIBI) is the most frequently used myocardial perfusion scintigraphy tests. |
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Screening Mammography |
recommended every year after age 50 |
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Which Clinical Trial phase has the highest rate of drug failure? |
Phase 2 |
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Relative Risk |
RR = (a/[a+b]) / (c/[c+d]) |
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If the threshold of a screening test is increased, how will it affect sensitivty and specificity? |
sensitivity decreases, specificity increases |
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Who provides health services to First Nations, Aboriginal peoples, the Canadian military and veterans? |
Health Canada |
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Infectious diseases in Aboriginal Peoples |
Botulism due to ingestion of fermented marine mammal meat, raw fish or salmon eggs. |
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Chronic conditions in Aboriginal Peoples |
heart problems and hypertension are 3x's more prevalant |
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Disability in Aboriginal Peoples |
hearing problems are twice as high |
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Example of fiscal policy |
imposing additional costs (ie. taxes on tabacco and alcohol) |
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Example of legislative policy |
implementing legal deterents (ie. smoking bans, legal alcohol drinking age) |
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Example of social policy |
improving health beyond providing universally funded health care (ie. providing affordable housing) |
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Example of Community-Based Prevention |
Saskatoon's "In Motion" program |
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Precontemplation vs. Contemplation |
The individual is not seriously considering change and is not interested in any kind of intervention vs. the individual begins to seriously consider making the change within the forseeable future |
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Preparation vs. Action |
the individual begins experimenting, making small changes;he/she resolves to make a serious attempt in the future (defined as 30 days) vs. the individual is involved in making the change, using different techniques |
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Top 5 Causes of Mortality in Females |
1) Cancer 2) Heart dx 3) Stroke 4) COPD 5) Alzheimer's |
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Top 5 Causes of Mortality in Males |
1) Cancer 2) heart dx 3) Accidents 4) Stroke 5) COPD |
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Formulating a Research question |
PICO! |
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Cross sectional (prevalence study) |
ex: examine the distribution of BMI by age in Ontario at a particular point in time |
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Case-Control (Retrospective) |
ask cases and controls about exposures, expressed as ODDS RATIO... |
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Cohort (Prospective) |
subjects sampled and classified on the basis of presence or absence of exposure to a particular risk factor... very costly and time consuming! |
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Cost Benefit Analysis |
weighing the total expected costs vs. total expected benefits |
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Cost Effectiveness Analysis (CEA) |
a comparison of the relative expenditure (costs) and outcomes (effects) of two or more courses of action. CEA expressed in terms of a ratio: denominator is a gain in health from a measure and the numerator is the cost of the health gain |
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Endemic |
constant presence of dx in a given geographic area or population subgroup |
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Epidemic |
any dx, infections or chronic, occurring at a greater frequency than usually expected in a defined community or institutional population over a given time period |
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Pandemic |
epidemic over a wide area, crossing international boundaries, and affecting a large number of people |
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Attack Rate |
total # of people who develop clinical dx / population at risk |
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What is Municipal Government responsible for? |
waste disposal, recycling, water and sewage treatment/collections/distribution |
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Public Health Unit? |
enforcement of water and food safety regulations (including restaurant). Sanitation, assessment of local environmental risks, monitoring and follow-up of reportable diseases |
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Provincial Government? |
water and air quality standards, |
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Best way to measure the quality of health care during pregnancy and delivery in Canada? |
perinatal mortality rates |
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MCC of vision loss in children |
amblyopia - "lazy eye" |
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MCC of vision loss in elderly |
macular degeneration |
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Most effective means of smoking cessation |
1 mg Varenicline |
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most effective doses of vit D and calcium for hip fracture prevention in postmenopausal women |
800 IU Vit D & 1200 mg calcium |
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Causes of increased A-a gradient? |
asthma, pneumonia, pulm. edema. atelectasis, COPD, intracardiac shunt |
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"double effect" for palliative care |
increasing the dosage of morphine knowing it will probably hasten a patient's death |
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autonomy |
patient's ability to direct his or her own care |
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targert LDL in diabetics, CAD pts, ab aortic aneurysm, pv dx, etc. ? |
<2.0 mmol/L |
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hypersensitivity to eggs for vaccines. avoid which? |
yellow fever vaccine (contains highest amount of egg protein out of all) |
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most reliable predictor of survival in breast cancer is: |
cancer stage at the time of diagnosis |
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probability of pregnancy after unprotected sex is highest at which time? |
1 day before ovulation (30% probability) |
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MC infection of CNS in children younger than 1 year? |
aseptic meningitis (echoviruses) |
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causes of neonatal meningitis (<1 month) |
1) GBS 2) e.coli 3) listeria |
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causes of infant meningitis (28 days to 1 year) |
1) s. pneumonia 2) n. meningitidis 3) h. influ |
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best test to assess nutrition status in elderly? |
serum albumin |
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chlorine resistant bugs causing gastroenteritis? |
giardia cysts & cryptosporidium oocysts |
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requirements for hospitalization for PID management |
pregnancy, pelvic abscesses, uncertain diagnosis, compromised immunity & failure to improve after 72 hours of Rx |
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serum hCG peak at which menstrual week of pregnancy? |
8-11 weeks |
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incidental finding of microscopic hematuria - next step? |
U/S kidneys, urine cytology and cystoscopy if >40 yrs to detect trans cell carcinoma |
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prolonged aPPT, normal PT, TT, BT |
hemophilia A! |
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prolonged aPPT, normal PT, TT, prolonged BT |
vWD |
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peak expiratory flow (PEF) <60 |
severe pesistent asthma |
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PEF >60 but <80 |
moderate persistent asthma |
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recommended time duration for dual action antiplatelet therapy after drug-eluting coronary artery stent placement |
1 year (ASA 162-325 mg + clopidogrel 75 mg) |
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flashing of light and visual field defect |
retinal detachment |
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most important management in peripheral arterial disease? |
smoking cessation |
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MCC of overflow tearing (epiphora) in neonates? |
obstruction of the nasolacrimal duct |
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women should be tested for HPV DNA when...?? |
when a Pap smear shows ASCUS |
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most reliable sign of uterine rupture? |
fetal distress |
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which race is at increased risk for prostate CA |
blacks |
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fetus presenting in transverse lie, next step? |
C-section |
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aymptomatic severe hyponatremia? |
fluid restriction |
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symptomatic severe hyponatremia? (ie. seizures) |
IV 3% saline at 100 mL/hr |
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verapamil + statin. increased risk for? |
rhabdomyolysis (verap inhibits CYP 3A4) |
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S1-Q3-T3 pattern change on EKG |
pulmonary embolus |
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anaphylactic shock associated with which spinal tube defect? |
myelomeningocele (due to chronic exposure to latex during repeated urinary catheterization) |
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cervical cap should not be left in for more than how many hours?? |
48 hours! |
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Most common hospital errors associated with preventable adverse drugs effects are in the stage of: |
Ordering |
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chorionic villus sampling |
10-12 weeks |
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amniocentesis |
12-15 weeks |
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antidepressant to exacerbate hypertension? |
venlafaxine |
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% formula for burns |
Rule of 9's for Adults: 9% for each arm, 18% for each leg, 9% for head,18% for front torso, 18% for back torso. |
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Parkland formula |
4 x Mass(kg) x (burn% x 100) |
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rear facing position for child seat safety should be used until: |
12 months of age AND weights 10 kg (22 lbs) |
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booster seat for children: |
at least 18 kg (40 lbs) |
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requirements for seatbelt |
at least 36 kg (80 lbs) AND 145 cm |
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mild persistant asthma |
symptoms occurring more than 2 days per week, but not daily, and use of albuterol more than 2 days/week, but not daily |
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NNT |
NNT=1/absolute relative risk |
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healthy weight gained for neonate daily (weekly) |
20-30 grams/day OR 150-200 grams/week |
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which suture materials decreases both wound dehiscence and postpartum perineal pain? |
polyglactin 910 (Vicryl) |
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doctor's privilege to practice medicine following rehab for narcotics is determined by? |
provincial medical board |
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MC risk factor for frozen shoulder? |
DM |
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most accurate measurement with sono for estimating gestational age? |
crown rump length at 10 weeks |
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ex of primary prevention |
-giving immunizations to kids |
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ex of secondary prevention |
- intervening pts with high blood pressure |
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ex of tertiary prevention |
-performing heart surgery on pt with advanced dx |
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murmur(s) accentuated by valsalva |
MVP + HOCM |
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best treatment option for the MC type of skin cancer? |
Mohs micrographic surgery for basal cell carcinoma |
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The doctrine of informed consent requires that the physician recommending a surgical procedure to a patient: |
must explain all material risks |
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A 57-year-old woman with known Addison disease, maintained on fludrocortisone 0.1 mg/day and dexamethasone 0.5 mg/day, attends the Emergency Room after having experienced five days of nausea, weakness and lethargy. She is found to have a blood pressure of 105/65 and a pulse of 110. Serum sodium is 123 and potassium 5.9. Which of the following would be the most appropriate treatment? |
Normal saline IVat 250cc/hr, hydrocortisone 100 mg iv q six hours for 24 hours |
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A 16-year old girl is brought to the Emergency Department approximately 1 hour after ingesting 20 diazepam 5 mg tablets. She is slightly drowsy and said she took them because her boyfriend left her. After initial medical management, which one of the following is proper treatment? |
psych consult to assess suicide risk! |
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concerns for pt not competent to drive anymore... next step? |
notify provincial motor vehicle licensing authority |
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You are a physician who stops at a serious motor vehicle collision. There is an elderly gentleman who is in severe respiratory distress from a flail chest, and hemorrhagic shock. You should provide medical care: |
if the circumstances of providing treatment are within your skills and capability. |
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osteoporosis screening? |
begin universal screening at age 65 of both men and women |
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contraindication for nicotine patch |
under 18, pregnant, post MI period, severe arrhythmia, severe angina pectoris |
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one time screening test in male 65-75 yrs who have ever smoked |
abdominal u/s ------ AAA |
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recommendation for influenza vaccination |
recommend vaccine to everyone 6 months of age and older |
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Rx/ latent TB |
isoniazid for 9 months (with vit. b6) |
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PPD test criteria |
- greater than 15mm (no known risk factors) |
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vaccine recommended for all international travelers |
hep A vaccine |
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likelihood ratio |
indicates how a positive or negative test correlates with the likelihood of disease |
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pt with small (less than 1 cm) tubular adenomas, including those with the only low-grade dysplasia, should have their next colonoscopy when? |
5 years |
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the incidence of a particular dx is greater in men than in women, but the prevalence shows no sex difference. the most probably explanation is that: |
the duration of the dx is longer in women |
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h.influ B prophylaxis for family contacts? |
Rifampin |
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chance-corrected proportional agreement |
KAPPA= (observed agreement - Chance agreement)/(1 - Chance agreement) |
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Framingham Risk Score |
calculate 10 year risk of CAD |
