The GenerEhlist - CCFP Exam Prep, Low Risk Obstetrics & Canadian Primary Care Medicine

Written By: Savannah Leigh Bennet and Samantha Kent, FM PGY-2s, Memorial University Expert Review By: Dr Gillian Morrison, Geriatrician, St John's Newfoundland

Hello and welcome to another episode of The GenerEhlist’s CFPC 105 topics podcast. ● Today’s topic is renal failure ● This episode was written by Vaishvi Patel, a third-year medical student from the University of Alberta, and Ronan Noble an MD/PhD student from the UofA as well, and it was reviewed by Dr. Whitney Hung, an internal medicine senior resident in Edmonton, AB.

In today's episode we review the basics of gestational diabetes screening and management. We also briefly discuss the newborn hypoglycemia screening protocol for infants born to gestational parents with diabetes and first steps of management.

Check also the CCFP 105 Topics: Periodic Health Assessment Part One and Two episodes. So, first things first: Who should be assessed for osteoporosis and fracture risk? There are three categories: 1. All women and men aged 65 or more; 2. Adults aged 50-64 who are at high risk of fracture or have already experienced a fragility fracture; 3. Younger adults under the age of 50 who are at high risk of fractures. We know who, let’s see „How?”

We have a bread-and-butter family medicine topic ready for you today – immunizations! This episode was: written by Sean Wang, a third-year Dalhousie medical student out of Halifax, Nova Scotia and peer-reviewed by another East-Coaster, Dr. Melissa Power, Dalhousie Family Medicine Staff and the Faculty Undergraduate Coordinator of South-West Nova. This is a large topic and don’t worry, we won’t just repeat routine vaccine schedules to you the whole time; rather the CCFP objectives focus on the more nuanced details of vaccines – which we all need to have a solid grasp on.

Written By: Andrea Brabant – FM PGY1 - NWT Expert Review By: Dr Katherine Breen, ER Physician NWT Meningitis is defined as inflammation of the meninges, the membranes covering the brain and spinal cord. It is most commonly due to infection, either bacterial or viral. This can happen through hematogenous spread, when bacteria invade the bloodstream (often from the upper airway), and gradually make their way to the subarachnoid space. However, it can also happen through direct contiguous spread. This is when organisms gain entry into the cerebrospinal fluid from adjacent infections (think sinusitis, brain abscess, otitis media) or directly through penetrating traumatic injury, congenital defects, or during neurosurgical procedures.

In today's episode we will review some tips around breastfeeding including how to give the breastfeeding pitch to expectant parents. We will review some common challenges parents face that can contribute to cessation of breastfeeding, such as concerns about breastfeeding logistics and supply. We will cover some breastfeeding norms and norms around infant weight gain. Finally we discuss bottle feeding and breast pumps. Shownotes

Why should a family physician learn about personality disorders? Well, to start, we are the first point of contact with the patients who have them, and often the first to recognize they have a personality disorder. While psychiatrists may have a role in their treatment, most patients do not require a referral, making family doctors the primary provider of care. Even if you do not plan on managing the personality disorder, you WILL have patients with personality disorders and this podcast will help you effectively manage challenging situations. Personality disorders make up over 10% of the general population, and 24% of the population in primary care. They may or may not seek treatment for aspects pertaining to their personality disorder, but they sure as well will have other health concerns.

A new topic added by the CCFP with the recent increase to 105 Key Topics. Written By: Vaishvi Patel, MS3 - University of Alberta Expert Review By: Dr Stephen Yam - Family Physician with expertise in Oncology and Palliative care - Fort McMurray AB

In this episode we dive into the hypertensive diseases of pregnancy. We will review the various hypertensive disorders, but our main focus will be on preeclampsia. We will go over screening, ASA starts, and calcium supplementation. We review the clinical presentation and diagnosis of preeclampsia with a nod to HELLP syndrome (see our Liver Disease episode for more on that one!). Finally we will discuss the first steps in management and some post-partum considerations. We hope you enjoy!

Written By: Christopher Clarke, FM PGY2, Victoria BC Expert Review: Dr Jaques De Jager, GP, CFB Edmonton AB We are talking Low Back Pain. Amanda is a 32 year old Search and Rescue Technician with the Royal Canadian Airforce based out of Canadian Forces Base - Comox here on the island. Two days ago, she was on a mission med-evacing a patient from a fishing vessel of the coast. She and her fellow SAR - Tech were able to stabilize the patient for transport. However, upon bending over to lift the stretcher, Amanda felt an immediate sharp pain her in lumbar spine. Upon returning home for her days off, despite taking Tylenol, which offered little relief, she stayed mainly in bed because the pain was so intense. She presents to sick parade on Monday at the base clinic, because the pain has not resolved and now she is having some pain radiate down her right leg. When it comes to back pain, I find it useful to consider timelines as this can help to guide our differential and management. Definitions ● Acute back pain: 4 weeks ● Subacute back pain: 4-12 weeks ● Chronic back pain: >12 weeks

Written By: Jessica Dawson , FM PGY2 in Edmonton Expert Review By: Dr. Brent Crawford, an Emergency Medicine physician at Westview Health Center in Stony Plain Alberta. Lacerations come in many shapes and flavours - big ones, little ones, simple ones, dirty ones, bloody ones, complicated ones - . . .you get it. As family physicians we tend to encounter accidental lacerations (as opposed to incisions of our own making) most often in emergency medicine or urgent care, but we will also see a lot of lacerations in follow up. Lacerations are one of those topics where art, science and personal preference tend to collide. There is enormous practice variation between physicians - probably in part because there is an absence of evidence for and lot of dogma behind many common practices. We will focus on the fundamentals for the CCFP exam – the things you need to know to put back together the most common lacerations you’ll encounter, and to identify those situations where referral might be necessary or when it’s best not to close things up at all! There are some great links in the show notes you can reference with tips and tricks for repairing different types of lacerations and deep dives into the evidence.

In this episode we review some of the liver diseases of pregnancy including cholestasis, HELLP syndrome, Acute Fatty Liver Disease of Pregnancy, Cholecystitis, and Hepatitis B and C. We hope this episode helps you broaden your differential when it comes to these patients as well as think about and recognize some rare, but serious liver disorders in pregnancy.

All the CCFP Objectives recommended for Hepatitis!

Abdominal Aortic Aneurysm, Green Eggs and Ham, Osteoporosis, Diabetes and Hyperlipidaemia screening, updated STI screening, Immunizations recommendations, and we tidy it up.

CCFP 105 Topics: Periodic Health Assessment Author: Braedon Paul (FM R2, Victoria) Peer Review: Alysha Thomson (FM R2, Victoria) Audio Production: Braedon Paul BACKGROUND AND RATIONALE FOR PERIODIC EXAM Let’s read off those objectives, right up front, so you know what you’re getting yourself into: 1. Do a periodic health assessment in a proactive or opportunistic manner (i.e., address health maintenance even when patients present with unrelated concerns). 2. In any given patient, selectively adapt the periodic health examination to that patient’s specific circumstances (i.e., adhere to inclusion and exclusion criteria of each manoeuvre/intervention, such as the criteria for mammography and prostate-specific antigen [PSA] testing). 3. In a patient requesting a test (e.g., PSA testing, mammography) that may or may not be recommended: 1. Inform the patient about limitations of the screening test (i.e., sensitivity and specificity). 2. Counsel the patient about the implications of proceeding with the test. 4. Keep up to date with new recommendations for the periodic health examination, and critically evaluate their usefulness and application to your practice.

This episode was written by Two incredible Family medicine residents out of Memorial University in Newfoundland, Sarah Vincent and Kelly Mitchelmore. It was expert review by Dr Sean Hamilton, Divisional Chief of Rheumatology for Eastern Health, in Newfoundland. As well as Ian Parsons, FM and Sports Medicine physician, Newfoundland. In Part Two of Joint Disorders we continued with the remaining objectives and finish it off with ten Rheumatology clinical pearls from Dr Sean Hamilton

Written By: Sarah Vincent (PGY1 FM, Memorial University) and Kelly Mitchelmore (also PGY1 FM, Memorial University) Expert Review By: Dr Sean Hamilton, Head of Rheumatology for Eastern Health in St Johns Newfoundland.