CCFP Exam questions and answers
1. Name 3 signs of estrogen excess 1. breast tenderness, increased size 2. dysmenorrhea 3. VTE
Name 3 signs of progesterone excess 1. breast tenderness 2. fatigue, 3. weight gain 4 mood
swings depression 5, decreased libido
What are drawbacks to Micronor? decreased efficacy for contraception, need adherence. if late
taking Micronor by 3 hours, need backup contraception
What are contraindications to IUD insertion? Name 3. active infection/ STI/ endometritis, known
pregnancy, unexplained vaginal bleeding
Name 3 risks of IUD use? 1) uterine perforatio 2. PID 3. device expulsion ( but uncommon after 3
months)
Name 2 forms of emergency contraception and their time periods 1. copper IUD within 7 days. 2.
Plan B within 3 days
in menstruation period what phase is the same, and which phase can fluctuate? follicular phase
can change, but luteal phase is always 14. calculate ovulation from period time - 14.
How do you deal with missed pills and what is the reasoning? takes 7 days to build hormonal
levels to suppress ovulation. therefore in weeks 2 and 3 if you miss one pill, no need to back-up. during
first week, need backup.
Name 5 risk factors for breast cancer 1. family history first degree relative 2. alcohol 3. obesity 4.
hx of radiation on chest 5. prev hx of breast ca.
What is the gene associated with Breast Cancer and what should you do ? BRCA 1 and 2. Earlier
or more frequent br ca screening
,Name 5 differentials for breast lump 1. fibroadenoma 2. fibrocystoma 3. intraductal papilloma 4.
breast Ca 5. abscess , but could be inflammatory breast Ca
What should you always rule out with breast abscess? inflammatory breast cancer
What imaging modaility is prefered in young females? u/s due to dense breasts, density can look
at calcifications give false positive on mammogram
What is the primary use of HRT in menopausal women? to reduce autonomic symptoms include
night sweats and hot flashes
how would you treat other vasomotor symptoms, including night sweats, besides HRT consider
SSRI, clonidine gabapentin
When can you initiate HRT? 1. < 60 and not more than 10 years since symptoms, as hot flashes
are usually new onset
If patient have a uterus, what should you give as HRT? both estrogen and PROGESTERONe ( for 12
days)
What test should you use to confirm diagnosis of COPD? FEV1/FVC pulmonary function test
What three recommendations should you give to those with COPD for prevention? 1. smoking
cessation
2. pneumonia Pneumovax vaccine
3. Influenza
Write down the step wise approach for COPD management 1. Saba/saac then laac or laba alone,
laac + laba , then triple tx laac plus laba plus steroid
what would benefit COPD patients with allied health? pulmonary rehab protocol
,what should you rule out when someone presents with COPDe? COPEe likely caused by acute
bacterial or viral infections, but also must rule out MI, CHFe, systemic infections ( blood cultures), PE
What is the diagnostic criteria for COPD e? increase in sputum, cough or SOB
What should all patients with croup get? And what is the dose? Dexamethasone 0.6mg/kg po X
one dose. and then if needed epi.
Name 3 things you should be assessing for resuscitation appropriateness 1. code status
2. pre code diagnosis
3. long code times
4. asystole What test should you use to confirm diagnosis of COPD? FEV1/FVC pulmonary
function test
what should you do post miscarriage? always do Rh status
ultrasound
grief counselling
If patient only has vulvovaginal symptoms, what route should you give estrogen vaginal
How long should HRT be? most clinicains do 5 or 6 years, but therapy is individualized. some can
do 10 years, if they have severe sleep disturbances
What are 3 ways to manage aborption? expectant, medical and surgical, success rates depend on
type of abortion
In children with vaginal discharge, besides treating, what else should you do? r/o STI, abuse, and
foreign body
, do you have to treat unpregnant women with BV or candidiasis? no, BV if symptomatic, metro
500mg bid X 7
16 yo female presents with change in her vaginal bleeding, more heavier than usual. What should you
order first? bhcg, r/o ectopic pregnancy
What are indications for endometrial biospy? 1. postmenopausal, any uterine bleeding 2. age 40
to menopause, more frequent bleeding, heavier bleeding, or prolonged. 3. < 40 yrs, obese women, or
persistent in healthy women
what are basic investigations to do in a healthy 16 yo female for AUB? bhcg! hgb, TSH, ferritin,
coags, PT, PTT and VWF.
what are basic investigations to do in a healthy 41 yo female for AUB? bhcg, cbc, tsh, pelvic u/s
+/- endometrial biopsy
What is the diagnostic criteria for PCOS? 1. ovulatory dysfunction-oligomenorrhea or amenorrhea
( 3 mo without menses), 2. hyperandrogenism 3. u/s >= 12 follicles
What should you make sure of in a patient with PCOS? they have a bleed q3 months, because of
anovulation, the estrogen can build their endometrium up, hyperplasia. can give provera for w/d bleed.
In a patient with postmenopausal bleeding, what investigations should you do? 1. pap smear,
pelvic u/s, endometrial biopsy, pelvic exam
when should bhcg double during early pregnancy? every 2-3 days
how should you monitor medical miscarriages? serial wkly bhcgs and pelvic u/s at 4 weeks.
What substances can affect male fertility? Opioids, alcohol, marijuana, spirnolactone, smoking
