CCFP Review 2021 Questions and
Answers|Latest Update
Treatment for actinic keratosis -Imiquimod 5% 2 times per week, for 16 weeks
Hypothyroid symptoms Hypoventilation
Intolerance to cold
Slow HR
tongue swelling
Infertility
Menorrhagia
memory impairment
Mood change: (depression)
Constipation
dry, thickened skin (previously, this answer said cold, clammy skin, which is more likely for
hyperthyroid rather than hypo)
course hair
brittle nail
Paresthesia
,periorbital edema
goitre
myalgias
delayed reaction phase of deep tendon reflexes
low TSH and low T4 indicates Central hypothyroidism
High TSH, low T4 primary hypothyroidism
Blood test to monitor progression from subclinical hypothyroid to overt? Anti-TPO (anti
thyroid peroxidase antibody)
when to treat subclinical hypothyroidism (TSH <10) 1. antithyroid antibodies
2. abnormal lipid profile
3. symptoms of hypothyroidism
4. Pregnant or trying to become pregnany
5. Goitre
6. Strong family history of autoimmune disease
,-> Otherwise if likely subacute granulomatous thyroiditis, (preceding viral infection, painful
thyroid), usually self resolving, tx with NSAIDs
Counseling re: how to take thyroxine -take on empty stomach 30 minutes before
breakfast
-some foods affect absorption of thyroixine: high fibre, soy, coffee and medications -> PPI,
anticonvulsants, iron, antacids, calcium, cholestyramine
Hypothyroidism in pregnancy dosing? -Increase by 2 doses/week by ~6 weeks GA
-Take prenatal vitamins at different time from thyroixine
-Will need to decrease dose postpartum
Pediatric dose of epinephrine in anaphylaxis, including dilution 0.01 mg/kg, up to max of
0.5 mg per dose , 1:1000, IM
Most common etiology of croup? Parainfluenza
Treatment of severe croup in hospital
, - humidified O2
- nebulized racemic epinephrine (FYI: 0.5cc in 3mL NS)
heliox
IV rehydration
repeat steroid dose (usual dose is dexamethasone 0.6 mg/kg PO, up to max of 10 mg)
Signs and symptoms of croup Abrupt onset barking cough, usually at night, inspiratory
stridor, hoarseness, respiratory distress, fever. Usually lasting 3 to 7 days.
Signs/symptoms of bacterial tracheitis -toxic appearance, high fever, poor response to
epinephrine, ragged edge or membrane spanning the trachea on x-ray
Signs/sx of epiglottis Toxic appearance, sudden onset, high fever, no barky cough,
dysphasia, drooling, sitting forward in sitting position, thickening on x-ray, caused by H. flu
Signs and Sx of Retropharyngeal Abscess High fever, neck pain, sore throat and a seizure
followed by torticollis, drooling, respiratory distress and strider, bulging posterior pharynx on x-
ray
Answers|Latest Update
Treatment for actinic keratosis -Imiquimod 5% 2 times per week, for 16 weeks
Hypothyroid symptoms Hypoventilation
Intolerance to cold
Slow HR
tongue swelling
Infertility
Menorrhagia
memory impairment
Mood change: (depression)
Constipation
dry, thickened skin (previously, this answer said cold, clammy skin, which is more likely for
hyperthyroid rather than hypo)
course hair
brittle nail
Paresthesia
,periorbital edema
goitre
myalgias
delayed reaction phase of deep tendon reflexes
low TSH and low T4 indicates Central hypothyroidism
High TSH, low T4 primary hypothyroidism
Blood test to monitor progression from subclinical hypothyroid to overt? Anti-TPO (anti
thyroid peroxidase antibody)
when to treat subclinical hypothyroidism (TSH <10) 1. antithyroid antibodies
2. abnormal lipid profile
3. symptoms of hypothyroidism
4. Pregnant or trying to become pregnany
5. Goitre
6. Strong family history of autoimmune disease
,-> Otherwise if likely subacute granulomatous thyroiditis, (preceding viral infection, painful
thyroid), usually self resolving, tx with NSAIDs
Counseling re: how to take thyroxine -take on empty stomach 30 minutes before
breakfast
-some foods affect absorption of thyroixine: high fibre, soy, coffee and medications -> PPI,
anticonvulsants, iron, antacids, calcium, cholestyramine
Hypothyroidism in pregnancy dosing? -Increase by 2 doses/week by ~6 weeks GA
-Take prenatal vitamins at different time from thyroixine
-Will need to decrease dose postpartum
Pediatric dose of epinephrine in anaphylaxis, including dilution 0.01 mg/kg, up to max of
0.5 mg per dose , 1:1000, IM
Most common etiology of croup? Parainfluenza
Treatment of severe croup in hospital
, - humidified O2
- nebulized racemic epinephrine (FYI: 0.5cc in 3mL NS)
heliox
IV rehydration
repeat steroid dose (usual dose is dexamethasone 0.6 mg/kg PO, up to max of 10 mg)
Signs and symptoms of croup Abrupt onset barking cough, usually at night, inspiratory
stridor, hoarseness, respiratory distress, fever. Usually lasting 3 to 7 days.
Signs/symptoms of bacterial tracheitis -toxic appearance, high fever, poor response to
epinephrine, ragged edge or membrane spanning the trachea on x-ray
Signs/sx of epiglottis Toxic appearance, sudden onset, high fever, no barky cough,
dysphasia, drooling, sitting forward in sitting position, thickening on x-ray, caused by H. flu
Signs and Sx of Retropharyngeal Abscess High fever, neck pain, sore throat and a seizure
followed by torticollis, drooling, respiratory distress and strider, bulging posterior pharynx on x-
ray
