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The GenerEhlist - CCFP Exam & Canadian Primary Care Medicine
The GenerEhlist Team
A PodCast by Canadian GPs for Canadian GPs. CCFP Exam Topics, Low Risk Obstetrics, and Primary Care and Family Medicine in Canada. www.thegenerehlist.ca
3 days ago
CCFP 105 Topics: Earache
* Written By: Kajsa Heyes * Peer Review By: Thomsen D'hont A review of acute otitis externa, otitis media with effusion, acute otitis media and the broad differential to consider. We also review worrying complications and the CPS approach to management.
Jan 9, 2022
Low Risk Obstetrics: Diet, Exercise, and Weight Gain
* Episode Written by : Kyla Freeman, Rural Family Medicine PGY2 * Episode Reviewed by : Virginia Clark, FP practicing rural and urban obstetrics * Hosts : Kyla Freeman (FM-PGY2), Patricia Massel (FM-PGY2), Caitlin Blewett (MS4) * Episode Art : Aikansha Chawla In today's episode we explore weight, diet, and exercise. We review the complications of BMIs outside of the normal range, the weight gain recommendations by BMI class, and considerations regarding supplements to reduce the risk of adverse outcomes. When discussing diet we cover everything from "how much should our patient's be eating anyway" to which supplements to be advising and which foods to recommend avoiding. We finish off with a review of the exercise recommendations in pregnancy - what are they and how do we get people to engage safely?
Jan 2, 2022
CCFP 105 Topics: Fatigue
* Written By: Jessica Dawson * Peer Review By: Caleb Dusdal The GenerEhlist team continues the journey through the 105 CCFP Key Topics, with Fatigue, the first episode written by Dr Jessica Dawson from Edmonton, AB.
Dec 19, 2021
CCFP 105 Topics: Elderly
* Written/Researched By: Caleb Dusdal * Peer Review By: Chris Cochrane Join Caleb Dusdal and Chris Cochrane as we review the CCFP Exam Key Topic of Elderly. This includes a discussion of polypharmacy, medications to avoid or stop in the elderly, assessing for frailty, what screening is reasonable in Primary Care, and some conditions that can present atypically in this group of humans.
Nov 28, 2021
Low Risk Obstetrics: ID Screening in Pregnancy - Part 2
* Episode Written by : Patricia Massel Rural Family Medicine PGY2 * Episode Reviewed by : Dr. Maggie Watt (GP) & Dr. Milena Semproni (ID) * Hosts : Kyla Freeman, Patricia Massel, & Caitlin Blewett * Episode Art : Aikansha Chawla In episode one we covered urine cultures, rubella, varicella, chlamydia, and gonorrhoea. Today we tackle HIV, Hepatitis B, and Syphilis - how to screen, how to proceed with a positive screen, and the implications for newborn care. We wrap up our infectious disease discussions with a review of what to order and how to manage the patient who presents in labour without any infectious disease screening whatsoever.
Nov 21, 2021
CCFP 105 Topics: Dyspepsia
* Written By: Chris Cochrane * Peer Review By: Sarah Donnelly Chris and Caleb discuss the ins and outs of Dyspepsia. The broad differential to consider, red flag signs and symptoms, and your overall approach to working these patients up.
Nov 7, 2021
CCFP 105 Topics: Domestic Violence
* Written By: Kajsa Heyes * Peer Review: Sarah Donnelly Join Kajsa and Caleb in quickly reviewing the Key Objectives for another CCFP CFPC Key Topic. Also, the GenerEhlist is one year old!
Oct 31, 2021
Low Risk Obstetrics: Infections in Pregnancy
* Episode Written By : Patricia Massel, Rural Family Medicine PGY2 * Episode Reviewed By : Dr. Maggie Watt (GP) & Dr. Milena Semproni (ID) * Hosts : Kyla Freeman, Patricia Massel, Caitlin Blewett * Episode Art : Aikansha Chawla In the first of this two-part episode we will review some of the basic infectious disease screening tests in pregnancy. In part one we review the key tests to perform during the first prenatal visit that the family doctor should be able to manage themselves (urine cultures, rubella, varicella, chlamydia and gonorrhoea). We will also discuss GBS screening. Then come on back for part two when we review HIV, syphilis, hepatitis B and the patient who presents in labour without any antenatal care including early ID screening.
Oct 17, 2021
CCFP 105 Topics: Dizziness
* Written By: Caleb Dusdal * Peer Review By: Hermeen Dhillon Join Chris Cochrane and Caleb to review the massive and sometimes convoluted CCFP Key Topic of Dizziness. We will discuss some definitions, approach to dizziness, differential for orthostatic hypotension, presyncope, vertigo, symptomatic treatments for vertigo, what scary stuff to rule out, HINTS exam and so much more.
Oct 10, 2021
CCFP 105 Topics: Eating Disorders
* Script by: Eleanor Crawford & Sonja Poole * Expert Reviewer: Clare Whitehead Eleanor Crawford, new PGY1 in Yellowknife NWT, and Caleb Dusdal review the fundamentals of Eating Disorders with a Thanksgiving humour and a sprinkling of clinical pearls along the way.
Oct 3, 2021
Low Risk Obstetrics: MFM Lite
* Written By : Kyla Freeman, Rural Family Medicine PGY2 * Expert Reviewed By : Dr. Megan Cuthbertson * Hosts : Kyla Freeman, Patricia Massel, Catilin Blewett * Episode Art : Aikansha Chawla In this episode we provide a brief overview of a few topics to consider in pre-conception and first pregnancy appointment counselling to help optimize your patients prenatal care. Topics we will explore include which antihypertensives are safe in pregnancy, who to consider starting on ASA early in pregnancy, how long to delay pregnancy post-C-section in patient's wishing to have a TOLAC, interventions to help reduce the risk of preterm birth, and considerations when managing a pregnant patient with a past history of thyroid
Sep 19, 2021
CCFP 105 Topics: Dysuria
Written By: Caitlin Blewett Peer Review By: Chris Cochrane Episode Art By: Aikansha Chawla We cover the five CCFP objectives for the Key Topic of Dysuria.
Sep 12, 2021
CCFP 105 Topics: Diabetes - Part 2
Written By: Dr Samantha Pomroy Expert Review By: Dr Karin Winston (Paeds Endo) Chris Cochrane and Caleb Dusdal review CCFP CFPC Objectives 3-7 for the Key Topic of Diabetes. Lots and lots of info, with much spaced repition.
Sep 5, 2021
CCFP 105 Topics: Diabetes - Part 1
* Written By: Dr. Samantha Pomroy * Expert Review By: Dr Karin Winston - Paediatric Endocrinologist Chris Cochrane and Caleb Dusdal review the first two objective of the CCFP Key Topic of Diabetes. Lots of definitions, screening guidelines, numbers, and a review of the lifestyle and pharmacologic options available to you to help your patient.
Aug 29, 2021
Low Risk Obstetrics: Newborn Sleep
* Episode written by : Caitlin Blewett (MSI 4), with input from Helen van der Kooy (senior MSI) * Episode reviewed by: Dr. Breagh Phipps (Paediatrician) * Hosts: Kyla Freeman, Patricia Massel, Caitlin Blewett In this episode we review some of the common questions around newborn sleep, safe sleep, and sleep training. An area mired with opinions, we have tried to present a balanced approach, with some interesting trivia points too! This episode draws on guiding statements from the Canadian Paediatric Society (CPS) and we also discuss some of the common deviations parents and caregivers may take from these guidelines and how to optimize safety in these situations.
Aug 22, 2021
CCFP 105 Topics: Difficult Patient
Written By: Braedon Paul Peer Review By: Sarah Donnelly Join Caleb Dusdal and Braedon Paul to cover the CCFP Key Topic of Difficult patient via two compelling patient cases. https://thegenerehlist.ca/2021/08/22/episode-thirty-two-difficult-patient/
Aug 15, 2021
CCFP 105 Topics: Dementia Part 2
Written By: Chris Cochrane Peer Review By: Caleb Dusdal Join Chris Cochrane and Caleb Dusdal as we review the rest of the CCFP Objectives for Dementia. As usual with loads of resources available on the shownotes at the GenerEhlist website Episode Art and Infographic by MS-2 Aikansha Chawla of McMaster University!
Aug 8, 2021
CCFP 105 Topics: Dementia Part 1
* written by: Chris Cochrane * peer review: Caleb Dusdal Caleb and Chris discuss the key topic of Dementia including the first three CCFP Board Exam topics.
Aug 1, 2021
Low Risk Obstetrics: Post Partum Hemorrhage
Kyla Freeman, Patricia Massel and Caitlin Blewett review some of the key principles of postpartum hemorrhage, with an emphasis on medical management options. This episode was expert reviewed by Dr. Nicole Ebert, an OSS trained family physician. Join us to review your 4 T's : Tone, Tissue, Trauma, and Thrombin
Jul 25, 2021
CCFP 105 Topics: Diarrhea
Braedon Paul and Caleb Dusdal tackle the CCFP Key Topic Diarrhea Written by Braedon Paul, the topics are covered in the form of three cases.
Jul 18, 2021
Low Risk Obstetrics: Introduction
Caleb Dusdal introduces some new team members and a whole new podcast to the Generehlist line up! The GenerEhlist: Low risk obstetrics with: * Kyla Freeman, * Patricia Massel, and * Caitlin Blewett
Jul 11, 2021
CCFP 105 Topics: Deep Vein Thrombosis
Written By: Caleb Dusdal Peer Review By: Sarah Donnelly https://thegenerehlist.ca/ccfp-exam-105-topics-podcast/ Objective One: In patients complaining of leg pain and/or swelling, evaluate the likelihood of deep venous thrombosis (DVT) as investigation and treatment should differ according to the risk. Objective Two: In patients with high probability for thrombotic disease (e.g., extensive leg clot, suspected pulmonary embolism) start anticoagulant therapy if tests will be delayed. Objective Three: Identify patients likely to benefit from DVT prophylaxis. Objective Four: Utilize investigations for DVT allowing for their limitations (e.g., Ultrasound and D-dimer). Objective Five: In patients with established DVT, use oral anticoagulation appropriately, (e.g., start promptly, watch for drug interactions, monitor lab values and adjust dose when appropriate, stop warfarin when appropriate, provide patient teaching). Objective Six: Consider the possibility of an underlying coa…
Jun 27, 2021
CCFP 105 Topics: Depression
Written By: Dr. Vishalini Sivarajah Expert Review By: Dr. Darby Ewashina https://thegenerehlist.ca/ccfp-exam-105-topics-podcast/ Objective One: In a patient with a diagnosis of depression: Assess the patient for the risk of suicide. Decide on appropriate management (i.e., hospitalization or close follow-up, which will depend, for example, on severity of symptoms, psychotic features, and suicide risk) Objective Two: Identify patients who may be at a higher risk for depression (e.g., certain socio-economic groups, those who suffer from substance abuse, postpartum women, people with chronic pain) and assess appropriately. Objective Three: In patients who have medically unexplained symptoms consider and assess for depression. Objective Four: After a diagnosis of depression is made look for and diagnose other comorbid psychiatric conditions (e.g., anxiety, bipolar disorder, personality disorder). Objective Five: In a patient diagnosed with depression: Manage appropriately (e.g.,…
Jun 20, 2021
CCFP 105 Topics: Dehydration
* Written By: Darrell Vandenbrink * Peer Review By: Chris Cochrane * Expert Review By: Dr. Adrienne Stedford Objective One: When assessing the acutely ill patient, look for signs and symptoms of dehydration. (e.g., look for dehydration in the patient with a debilitating pneumonia). Objective Two: In the dehydrated patient, assess the degree of dehydration using reliable indicators (e.g., vital signs) as some patients' hydration status may be more difficult to assess (e.g., elderly, very young, pregnant). Objective Three: In a dehydrated patient, Determine the appropriate volume of fluid for replacement of deficiency and ongoing needs Use the appropriate route (oral if the patient is able; IV when necessary). Objective Four: When treating severe dehydration, use objective measures (e.g., lab values) to direct ongoing management. Objective Five: In a dehydrated patient Identify the precipitating illness or cause, especially looking for non-gastro-intestinal, including dr…
Jun 6, 2021
CCFP 105 Topics: Croup
Written By: Chris Cochrane Expert Review By: Dr. Nabeela Waja (Paediatrician) https://thegenerehlist.ca/2021/06/06/ccfp-key-topic-croup/ Objective 1: In patients with croup, Identify the need for respiratory assistance (e.g., assess ABCs, fatigue, somnolence, paradoxical breathing, in drawing) and provide that assistance when indicated. Objective 2: Before attributing stridor to croup, consider other possible causes (e.g., anaphylaxis, foreign body (airway or esophagus), retropharyngeal abscess, epiglottitis). Objective 3: In any patient presenting with respiratory symptoms, look specifically for the signs and symptoms that differentiate upper from lower respiratory disease (e.g., stridor vs. wheeze vs. whoop). Objective 4: In a child presenting with a clear history and physical examination compatible with mild to moderate croup, make the clinical diagnosis without further testing (e.g., do not routinely X-ray). Objective 5: In patients with a diagnosis of croup, use steroid…
May 30, 2021
CCFP 105 Topics: Crisis
Written/Researched By: Braedon Paul Peer Review By: Caleb Dusdal STEP 1. [Objectives 1a/b/c, 8a] Provide reassurance and develop rapport through validation of the problem and use of active listening skills. STEP 2. [Objective 3a] Evaluate the severity of the crisis and assess the patient’s mental, psychiatric, suicidal or homicidal, and medical statuses. STEP 3. [Objective 3a/b/c, 6] Ensure the safety of the patient and others through voluntary hospitalization, involuntary commitment, securing close monitoring by family and friends, or helping to remove the patient from a dangerous situation. STEP 4. [Objective 2a/b/ , 4, 5] Stabilize the patient’s emotional status, explore options for dealing with the crisis, develop a specific action plan, and obtain commitment from the patient to follow through. STEP 5. [Objectives 2c/d] Follow up with the patient to provide ongoing support and to reinforce appropriate action.
May 23, 2021
CCFP 105 Topics: Chronic Disease
Objective One: In a patient with a diagnosed chronic disease who presents with acute symptoms, diagnose: acute complications of the chronic disease acute exacerbations of the disease Objective Two: Regularly reassess adherence (compliance) to the treatment plan (including medications) Objective Three: In patients with chronic disease a) Actively inquire about pain. b) Treat appropriately by: titrating medication to the patient's pain, taking into account other treatments and conditions, considering non-pharmacologic treatment and adjuvant therapies Objective Four: Patients with chronic disease, actively inquire about: the psychological impact of diagnosis and treatment, functional impairment, underlying depression or risk of suicide or underlying substance abuse. Objective Five: Given a non-compliant patient, explore the reasons why, with a view to improving future adherence to the treatment plan.
May 16, 2021
CCFP 105 Topics: Chronic Pain
Written & Researched By: Caleb Dusdal and Thomsen D'hont The first of the new 105 CCFP Topics https://thegenerehlist.ca/2021/05/16/ccfp-key-topic-chronic-pain/ Objective One: In a patient with chronic pain: Establish the etiology, Reassess and periodically review the etiology and Periodically look for potential comorbidities or complications, particularly mental illness and addictions. Objective Two: In a patient with chronic pain who complains of significantly increased pain, search for an alternative etiology as you cannot assume that the original cause of the pain is the reason for the exacerbation. Objective Three: In a patient in whom you did not make the initial diagnosis of chronic pain: Establish an effective relationship, Verify the diagnosis, and clarify goals of treatment and plans for management Objective Four: In managing a patient with chronic pain: Use shared decision-making, and engage other professionals in this care when appropriate Objective Five: In a pat…
Apr 25, 2021
CCFP 105 Topics: Seizure
Written By: Chris Cochrane, FM Resident in Medicine Hat Peer Review By: Kevin Duncan, EM Resident in Kelowna Objective One: a) In a patient having a seizure: Ensure proper airway control (e.g., oropharyngeal airway or nasal trumpet, lateral decubitus to prevent aspiration). b) Use drugs (e.g., benzodiazepines, phenytoin) promptly to stop the seizure, even before the etiology is confirmed. c) Rule out reversible metabolic causes in a timely fashion (e.g., hypoglycemia, hypoxia, heat stroke, electrolytes abnormalities). Objective Two: In a patient presenting with an ill-defined episode (e.g., fits, spells, turns), take a history to distinguish a seizure from other events. Objective Three: In a patient presenting with a seizure, take an appropriate history to direct the investigation (e.g., do not over investigate; a stable known disorder may require only a drug-level measurement, while new or changing seizures may require an extensive work-up). Objective Four: In all patients…
Apr 18, 2021
CCFP 105 Topics: Counseling
Researched By: Caleb Dusdal Expert Review By: Dr Todd Hill Objective One: When counselling a patient: - Set clear therapeutic goals with the patient, - Allow adequate time, - Evaluate your own skills, - Recognize when you are approaching or exceeding boundaries, - Recognize when your beliefs or biases may interfere with counselling. - Remain aware of the risks of offering advice versus providing options and - Pay close attention to the quality of the therapeutic relationship and alliance. Objective Two: For a patient who is considering or requesting referral for counselling/psychotherapy, clarify concerns and provide realistic information about the process and available resources (e.g., expectations, timing, frequency, costs, duration, homework, starting/ending the relationship if ineffective). Plus some bonus counseling tools, resources and a review of motivational interviewing!
Apr 11, 2021
CCFP 105 Topics: Cough
CCFP 105 Key Topic: Cough Written & Researched By: Kajsa Heyes Peer Review By: Hermeen Dhillon Objective One: In patients presenting with an acute cough: a) Include serious causes in the differential diagnosis. b) Diagnose a viral infection clinically, principally by taking an appropriate history. c) Do not treat viral infections with ant Objective Two: In pediatric patients with a persistent (or recurrent) cough, generate a broad differential diagnosis Objective Three: In patients with a persistent (e.g., for weeks) cough: a) Consider non-pulmonary causes, as well as other serious causes in the differential diagnosis. b) Investigate appropriately. Objective Four: Do not ascribe a persistent cough to an adverse drug effect without first considering other causes. Objective Five: In smokers with persistent cough, assess for chronic bronchitis and make a positive diagnosis when it is present.
Mar 21, 2021
CCFP 105 Topics: Chronic Obstructive Pulmonary Disease (COPD)
Written/Researched By: Khash Farzam Peer Review By: Caleb Dusdal Objective One: In all patients presenting with symptoms of prolonged or recurrent cough, dyspnea, or decreased exercise tolerance, especially those who also have a significant smoking history, suspect the diagnosis of chronic obstructive pulmonary disease (COPD). Objective Two: When the diagnosis of COPD is suspected, seek confirmation with pulmonary function studies (e.g., FEV1). Objective Three: In patients with COPD, use pulmonary function tests periodically to document disease progression. Objective Four: Encourage smoking cessation in all patients diagnosed with COPD. Objective Five: Offer appropriate vaccinations to patients diagnosed with COPD (e.g., influenza/pneumococcal vaccination). Objective Six: In an apparently stable patient with COPD, offer appropriate inhaled medication for treatment (e.g., anticholinergics/bronchodilators if condition is reversible, steroid trial). Objective Seven: Refer a…
Mar 14, 2021
CCFP 105 Topics: Contraception - Part 2
Mar 7, 2021
CCFP 105 Topics: Contraception - Part I
Written By: Kyla Freeman Peer Review By: Thomsen D'hont Expert Review By: Dr. Vanessa Rogers Objective One: With all patients, especially adolescents, young men, postpartum women, and perimenopausal women, advise about adequate contraception when opportunities arise. Objective Two: In patients using specific contraceptives, advise of specific factors that may reduce efficacy (e.g. delayed initiation of method, illness, medications, specific lubricants) Objective Three: In aiding decision-making to ensure adequate contraception: - Look for and identify risks (relative and absolute contraindications) - Assess (look for) STI exposure - Identify barriers to specific methods (e.g. cost, cultural concerns) - Advise of efficacy and side effects, especially short-term side effects that may result in discontinuation Objective Four: In patients using hormonal contraceptives, manage side effects appropriately (i.e. recommend an appropriate length of trial, discuss estrogens in medro…
Feb 21, 2021
CCFP 105 Topics: Chest Pain - Part 2
Written By: Caleb Dusdal - PGY-1 FM Calgary Reviewed By: Chris Cochrane - PGY-1 FM Medicine Hat Objective Four: Given an appropriate history of chest pain suggestive of herpes zoster infection, hiatal hernia, reflux, esophageal spasm, infections, or peptic ulcer disease: a) Propose the diagnosis. b) Do an appropriate work-up/follow-up to confirm the suspected diagnosis. Objective Five: Given a suspected diagnosis of pulmonary embolism: a) Do not rule out the diagnosis solely on the basis of a test with low sensitivity and specificity
Feb 14, 2021
CCFP 105 Topics: Chest Pain - Part I
Written and Researched By: Caleb Dusdal Peer Review By: Chris Cochrane https://thegenerehlist.ca/ccfp-exam-105-topics-podcast/ Objective One Given a patient with undefined chest pain, take an adequate history to make a specific diagnosis (e.g., determine risk factors, whether the pain is pleuritic or sharp, pressure, etc.). Objective Two Given a clinical scenario suggestive of life-threatening conditions (e.g., pulmonary embolism, tamponade, dissection, pneumothorax), begin timely treatment (before the diagnosis is confirmed, while doing an appropriate work-up). Objective Three In a patient with unexplained chest pain, rule out ischemic heart disease
Feb 7, 2021
CCFP 105 Topics: Cancer
CCFP Key Topic "Cancer" https://thegenerehlist.ca/ccfp-exam-105-topics-podcast/ Written & Researched By: Sarah Donnelly IM PGY-1 University of Alberta Objective One In all patients, be opportunistic in giving cancer prevention advice even when it is not the primary reason for the encounter. Objective Two In all patients, provide the indicated evidence-based screening (according to age group, risk factors, etc.) to detect cancer at an early stage (e.g., with Pap tests, mammography, colonoscopy, digital rectal examinations, prostate-specific antigen testing). Objective Three In patients diagnosed with cancer, offer ongoing follow-up and support and remain involved in the treatment plan, in collaboration with the specialist cancer treatment system. (Don’t lose track of your patient during cancer care.) Objective Four In a patient diagnosed with cancer, actively inquire, with compassion and empathy, about the personal and social consequences of the illness (e.g., family issues,…
Jan 31, 2021
CCFP 105 Topics: Breast Lump
https://thegenerehlist.ca/ccfp-exam-105-topics-podcast/ 1 Given a well woman with concerns about breast disease, during a clinical encounter (annual or not): a) Identify high-risk patients by assessing modifiable and non- modifiable risk factors b) Advise regarding screening (mammography, breast self- examination) and its limitations. c) Advise concerning the woman’s role in preventing or detecting breast disease (breast self-examination, lifestyle changes). 2 Given a woman presenting with a breast lump: a) Use the history, features of the lump, and the patient’s age to determine if aggressive work-up or watchful waiting is indicated. b) Ensure adequate support throughout investigation of the breast lump by availability of a contact resource. c) Use diagnostic tools (e.g., needle aspiration, imaging, core biopsy , referral) in an appropriate manner (i.e., avoid over- or under-investigation, misuse) for managing the breast lump. 3 In a woman who presents with a malignant b…
Jan 17, 2021
CCFP 105 Topics: Behavioural Problems
CCFP Key Topic 11 - Behavioural Problems https://thegenerehlist.ca/2021/01/17/ccfp-exam-key-topic-eleven-behavioural-problems/(opens in a new tab) Written By: Chris Cochrane Reviewed By: Kajsa Heyes Objective One: In all patients, when working up a behavioural problem: a) Ensure a thorough assessment of medical and mental health conditions and psychosocial factors before offering a diagnosis or definitive advice b) Use a validated assessment tool if available c) Use multiple sources of information (e.g., workplace, family, school) with consent d) Explore the patient’s own perspective, not just that of the caregiver Objective Two: In assessing behavioural problems in adolescents specifically look for substance use, peer issues, abuse, and other stressors. Objective Three: While assessing behavioural problems in a patient, a) Evaluate the impact of the behaviour b) Explore any underlying emotional distress with the patient c) Destigmatize embarrassing behaviours Objective Fo…
Jan 10, 2021
CCFP 105 Topics: Bad News
Written and Researched: Kajsa Heyes Reviewed by: Chris Cochrane https://thegenerehlist.ca/ccfp-topics-page/ Step 1: “S” for Setting up the interview Step 2: “P” is for Perception of patient Step 3: “I” is for Invitation from the patient Step 4: “K” is for Knowledge and information for the patient Step 5: “E” is for Empathy and responding to patient emotions Step 6:”S” is for Strategy and Summary
Jan 3, 2021
CCFP 105 Topics: Anxiety
Written/Researched: Caleb Dusdal Peer Review: Sophia Park https://thegenerehlist.ca/ccfp-topics-page/episode-nine-anxiety Objective One For a patient with multiple unexplained symptoms or behaviours, look for anxiety as a primary or contributing cause. Objective Two When a patient presents with symptoms of anxiety, clearly distinguish between distress (e.g. fear, nervousness, worry) and an anxiety disorder. Objective Three In a patient presenting with acute symptoms of panic (e.g., shortness of breath, palpitations, hyperventilation), do not attribute the symptoms to anxiety without first excluding serious medical pathology (e.g., pulmonary embolism, myocardial infarction) from the differential diagnosis, especially in patients with established anxiety disorder. Objective Four When working up a patient with symptoms of anxiety, and before making the diagnosis of an anxiety disorder, a) Exclude serious medical pathology b) Identify - other co-morbid psychiatric conditio…
Dec 20, 2020
CCFP 105 Topics: Asthma
Written By: Hermeen Dhillon Reviewed By: Dr. Brandie Walker Objective 1: In patients of all ages with respiratory symptoms (acute, chronic, recurrent): - Include asthma in the differential diagnosis. - Confirm the diagnosis of asthma by appropriate use of: - History - Physical examination - Spirometry Objective 2: In a child with acute respiratory distress, distinguish asthma or bronchiolitis from croup and foreign body aspiration by taking an appropriate history and doing a physical examination. Objective 3: In a known asthmatic, presenting either because of an acute exacerbation or for ongoing care, objectively determine the severity of the condition physical examination, spirometry. Do not underestimate severity. Objective Four: In a known asthmatic with an acute exacerbation: - Treat the acute episode - Rule out co-morbid disease - Determine the need for hospitalization or discharge Objective Five: For the ongoing (chronic) treatment of an asthmatic, propose a stepw…
Dec 13, 2020
CCFP 105 Topics: Atrial Fibrillation
Written By: Caleb Dusdal, FM PGY1 Calgary Reviewed By: Kirstin Dawson, IM PGY1 - Ottawa https://thegenerehlist.ca/2020/12/13/episode-seven-atrial-fibrillation/ Objective One: In a patient who presents with new onset atrial fibrillation, look for an underlying cause Objective Two: In a patient presenting with atrial fibrillation, look for haemodynamic instability, and intervene rapidly and appropriately to stabilize the patient. Objective Three: In an individual presenting with chronic or paroxysmal atrial fibrillation, a. Explore the need for anticoagulation based on the risk of stroke with the patient and b. Periodically reassess the need for anticoagulation. Objective Four: In patients with atrial fibrillation, when the decision has been made to use anticoagulation, institute the appropriate therapy and patient education, with a comprehensive follow-up plan. Objective Five: In a stable patient with atrial fibrillation, identify the need for rate control. Objective Six…
Dec 6, 2020
CCFP 105 Topics: Antibiotics
Written and Researched by: Chris Cochrane Reviewed by: Sarah Donnelly Objective 1a. In patients requiring antibiotic therapy, make rational choices first-line therapies for common bacterial infections: - Simple Cystitis - Complicated Cystitis/Pyelonephritis - STI: Gonorrhea/Chlamydia - Cellulitis and Erysipelas (non-purulent skin infections) - Abscess (purulent skin infection) - Impetigo - Bacterial Community Acquired - Pneumonia - Sinusitis - Acute Otitis Media - Acute Conjunctivitis - Hyper-Acute Conjunctivitis Objective 1b. Make rational choices regarding knowledge of local resistance patterns: Objective 1c. Make rational choices with respect to patient’s medical and drug history: Objective 1d. Make rational choices regarding patient’s context: Objective 2. In patients with a clinical presentation suggestive of a viral infection, avoid prescribing antibiotics. Objective 3. In a patient with a purported antibiotic allergy, rule out other causes (e.g., into…
Nov 29, 2020
CCFP 105 Topics: Anaemia
The GenerEhlist CCFP Exam 105 Topics Podcast Episode Written By: Sarah Donnelly - IM UofA, and Hermeen Dhillon FM UBC Episode Reviewed by: Chris Cochrane - FM UofC Medicine Hat * Objective One: Assess the risk of decompensation of anemic patients to decide if prompt transfusion or volume replacement is necessary. * Objective Two: In a patient with anemia, classify the anemia as microcytic, normocytic, or macrocytic by using the MCV or smear test result, to direct further assessment and treatment. * Objective Three In all patients with anemia, determine the iron status before initiating treatment. * Objective Four In a patient with iron deficiency, investigate further to find the cause. * Objective Five Consider and look for anemia in appropriate patients. Such as those at risk for blood loss or in patients with hemolysis whether they are symptomatic or not, and in those with new or worsening symptoms of angina or CHF. * Objective Six Look for other manifestations o…
Nov 15, 2020
CCFP 105 Topics: Allergy and Anaphylaxis
Script By: Thomsen D'hont Peer-Review By: Hermeen Dhillon Hosts: Caleb Dusdal, Thomsen D'hont, AND Christ Cochrane! https://thegenerehlist.ca/2020/11/15/episode-four-allergy-anaphylaxis/https://thegenerehlist.ca/ccfp-topics-page/ Objective One: In all patients, always inquire about any allergy and clearly document it in the chart. Re-evaluate this periodically. Objective Two: Clarify the manifestations of a reaction in order to try to diagnose a true allergic reaction Objective Three: In a patient reporting allergy, ensure that the patient has the appropriate medication to control symptoms Objective Four: Prescribe an EpiPen to every patient who has a history of, or is at risk for, anaphylaxis. Objective Five: Educate appropriate patients with allergy and their families about the symptoms of anaphylaxis and the self-administration of the EpiPen, and advise them to return for immediate reassessment and treatment if those symptoms develop or if the EpiPen has been used. Ob…
Nov 7, 2020
CCFP 105 Topics: ACLS Part II
Script By: Caleb Dusdal Peer Review By: Thomsen D'hont https://thegenerehlist.ca/2020/11/08/episode-three-acls-part-ii/ * Objective Four: Suspect and promptly treat some specific reversible causes of arrhythmias even before confirmation of the diagnosis. * Objective Five: Ensure adequate ventilation and secure the airway in a timely manner. Know how and when to ensure adequate ventilation, and secure the airway in a timely manner * Objective Six: In patients requiring resuscitation, assess their circumstances to help you decide when to stop * Objective Seven: In patients with serious medical problems or end-stage disease, discuss code status and end-of-life decisions and readdress these issues periodically. * Objective Eight: Attend to family members during and after resuscitating a patient. * Objective Nine: In paediatric resuscitation, use appropriate resources to determine the correct drug doses and tube sizes. In paediatric resuscitation, know what resources y…
Nov 1, 2020
CCFP 105 Topics: ACLS - Part I
Written By: Caleb Dusdal Peer Review: Thomsen D'hont https://thegenerehlist.ca/2020/11/01/episode-two-acls-part-i/www.thegenerehlist.ca 1. Keep up to date with ACLS recommendations 2. Know how to recognize and defibrillate a patient with Ventricular Fibrillation, or ventricular tachycardia that is either pulseless or symptomatic. 3. Be able to diagnose worrysome arrhythmias such as: a. Ventricular tachycardia b. Ventricular fibrillation c. Supraventricular tachycardia d. Atrial fibrillation e. Second and third-degree heart block 4. Know when to suspect a few specific causes of arrhythmias, even before confirmatory testing. a. Hyperkalemia b. Digoxin toxicity c. Cocaine intoxication 5. Know how and when to ensure adequate ventilation and secure the airway in a timely manner 6. In patients who do require resuscitation, you want to be able to assess the context to help decide when stopping resuscitation is the most appropriate decision. 7. Patients who arrest or are at ri…
Oct 24, 2020
CCFP 105 Topics: Abdominal Pain
Written by: Kajsa Heyes, PGY-1 Yellowknife https://thegenerehlist.ca/2020/10/11/abdo-pain/ There are eight objectives for the exam, via which we are going to cover: * localization and the massive differential for abdominal pain, * investigations depending on suspicions, * management of a few specific conditions, * abdo pain in young women, * what is a surgical abdomen, * how your differential should shift based on age of the patient, * immediate management of life-threatening causes, and * extraintestinal signs of IBD. Reach out to us at email@example.com
Oct 1, 2020
CCFP 105 Topics - Meet the Team
https://thegenerehlist.ca/2020/07/13/episode-zero-meet-the-team/ A quick introduction to what this project is all about, and a chance for the incredible team members to introduce themselves.