Yearly Archives: 2020

Infectious Diseases – ED

Infectious Diseases 1. Given a patient with a suspected severe infection, use empiric antibiotics early, before completing investigations. 2. In a patient with serious systemic infection, look for and recognize septic shock and treat septic shock aggressively when found, using

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Environmental – ED

Environmental 1. Suspect the diagnosis of heat stroke in a patient with altered mental status and fever in a situation of heat stress, and act immediately to reduce the temperature. Prickly heat rash – sweat more than normal leading to

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First-Trimester Bleeding – ED

First-Trimester Bleeding 1. In a patient with acute vaginal bleeding, look for and recognize early signs of shock (e.g., vital signs, orthostatic changes). General Approach – ABC, O2, Monitor, O- blood, cross match 2. Given a patient with vaginal bleeding,

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Suicide Risk – ED

Suicide Risk 1. Given a patient presenting with suicidal ideation or psychiatric complaints, inquire specifically about risk criteria for suicide (e.g., SAD PERSONS scale, hopelessness, lack of supports, impulsivity) to assess the risk of subsequent suicidal behaviour. Suicide note, sex

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Pre-Eclampsia – ED

Preeclampsia: new onset of hypertension and proteinuria or the new onset of hypertension and significant end-organ dysfunction with or without proteinuria after 20 weeks of gestation in a previously normotensive woman Proteinuria ≥0.3 g in a 24-hour urine specimen or

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Decreased Level of Consciousness – ED

Decreased Level of Consciousness Level Of Consciousness – AVPU (Alert, respond to Verbal, respond to Pain, Unresponsive) 1. In a patient presenting with altered level of consciousness (LOC), develop an appropriately broad differential diagnosis (e.g., metabolic, infectious, structural, medications, recreational

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Anaphylaxis – ED

Anaphylaxis 1. In any patient presenting with shock, consider anaphylaxis as a possible diagnosis. 2. In a patient with symptoms and signs suggestive of anaphylaxis, recognize and make the diagnosis even when the presentation is incomplete (e.g., may exhibit only

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Abuse – ED

Abuse (Domestic) 1. In patients who may be at higher risk for undeclared domestic abuse (e.g., the elderly, individuals in same-sex relations, pregnant women, substance abusers, frequent presenters to the ED) look for and recognize discrete indicators of possible abuse

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Asthma – ED

Asthma subtype: Aspirin sensitive asthma prior sensitization to NSAID + chronic rhinosinusitis + nasal polyps + asthma Atopic syndrome: allergic asthma, dermatitis, rhinitis (hay fever) Samter’s triad: asthma, ASA/NSAIDs sensitivity, nasal polyps Type 1: inflammation – female + URI –

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Toxicology – ED

Toxicology 1. In a patient with a suspected toxic exposure, gather available collateral history from the scene (e.g., EMS history, empty pill bottles, recent prescriptions) to better identify the likely toxins. 2. Given a patient with a toxic ingestion: a)

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