1. DERM
1.1. Tinea
1.2. Dermatitis
1.3. Parasites
1.4. HSV
1.5. Acne
1.6. Miscellaneous Skin Drugs
1.6.1. Keratolytic Drugs
1.6.1.1. Retinoic Acid - Vit A acid - Derivatives
1.6.1.1.1. Tretinoin
1.6.1.1.2. Antineoplastic Agents
1.6.1.2. Trichloroacetic Acid
1.6.2. Benzoyl Peroxide
1.6.3. Topical Steroids
1.6.3.1. Hydrocortisone 0.5 - 1% - low potency
1.6.3.2. Hydrocortisone valerate 0.2% - intermediate potency
1.6.3.3. Betamethasone Diproprionate 0.5% - high potency
1.6.4. Hydroxyzine
2. Reumatologic/MSK
2.1. Musculoskeletal Complaints
2.1.1. Shoulder Exam
2.1.1.1. Standing
2.1.1.1.1. Inspect
2.1.1.1.2. Active ROM
2.1.1.1.3. strength
2.1.1.1.4. Reflexes
2.1.1.1.5. palpation
2.1.1.1.6. Sulcus sign
2.1.1.1.7. neer's test - of impingement of supraspinadous tendon
2.1.1.1.8. hawkins test - of impingement of supraspinadous tendon
2.1.1.1.9. acromioclavicular compression test
2.1.1.1.10. test biceps tendon / yurgasons test
2.1.1.1.11. adson's test for thoracic outlet syndrome
2.1.1.1.12. apprehension test
2.1.2. Foot exam
2.1.2.1. Inspect
2.1.2.1.1. inspect from back - look for how many toes you can see. more than 2 is getting too many
2.1.2.2. halux valgus
2.1.2.3. Mortons neuroma
2.1.2.4. achiles tendon rupture
2.1.2.4.1. thompson's test
2.1.2.5. Palpation for tenderness (most important)
2.1.2.5.1. 2nd metatarsal most common for stress #
2.1.2.5.2. Plantar Fasciatis
2.1.2.5.3. chronic heel pain syndrome
2.1.2.5.4. Midfoot - Lisfranc's Joint
2.1.2.5.5. Ottawa Ankle Rules
2.1.2.6. Passive ROM
2.1.3. Joint above/joint below
2.1.3.1. valgus force - applied to lateral side of joint leading to ie: genu Valgum [knock-kneed] distal part angled out)
2.1.3.1.1. Varus force - force applied to medial side of joint (leading to ie: genu VARum[ bow legged] distal part angled in)
2.1.4. Elbow exam
2.1.4.1. inspect
2.1.4.1.1. "carrying angle (greater than women"
2.1.4.1.2. active ROM
2.1.4.1.3. palpation
2.1.4.2. lateral epicondylitis "tennis elbow"
2.1.5. Knee
2.1.5.1. ottawa knee rules
2.2. Sprains
2.3. Strains
2.4. Osteoporosis
2.4.1. full BC Guidline
2.5. Musckuloskeletal Treatment
2.5.1. Back pain
2.5.1.1. acute
2.5.1.2. chronic
2.5.1.3. analgesics
2.5.1.3.1. narcotics
2.5.1.3.2. NSAIDs
2.5.1.3.3. Acetaminophen
2.5.1.4. muscle relaxants
2.5.1.5. non-pharm treatment
2.5.2. Osteoperosis
2.5.2.1. anti catabolic agents - Bisphosphonates 1st line
2.5.2.1.1. alendronate
2.5.3. Rheumatoid Arthritis
2.5.3.1. non biologic DMARDs
2.5.3.1.1. hydroxychloroquine only for mild RA
2.5.4. Gout
2.5.4.1. Acute
2.5.4.1.1. colchicine
2.5.4.1.2. NSAIDs
2.5.4.1.3. glucocorticoids
2.5.4.2. chronic
2.5.4.2.1. allopurinol
2.5.5. fibromyalgia
2.5.5.1. TCAs
2.5.5.1.1. TCA type muscle relaxant
2.5.5.1.2. Cyclobenzaprine
2.5.5.2. Amitriptyline
2.5.6. Polymyalgia Rheumatica
2.5.6.1. 1st line high dose corticosteroid
2.6. SEADS
2.6.1. swelling
2.6.2. erythema/echymosis
2.6.3. atrophy/asymetry
2.6.4. deformity
2.6.5. skin changes
2.7. Arthritis & Joint Pain
2.7.1. Infectious Arthritis
2.7.2. Systemic Rheumatic Disease
2.7.2.1. Rheumatoid Arthritis
2.7.2.2. Myopathy
2.7.2.2.1. Polymyositis
2.7.2.2.2. Dermatomyositis
2.7.2.3. Connective Tissue Diseases
2.7.2.3.1. Systemic Lupus Erythmatosis
2.7.2.3.2. sjogrens disease
2.7.2.3.3. scleroderma
2.7.3. Spondyloarthropathies
2.7.4. Crystal Induced Arthropathy
2.7.5. Degenerative
2.7.6. Vasculitis
2.7.7. Endocrine
2.7.8. Neoplasia
2.8. Vitamin D
2.8.1. Patient Handout
3. GU
3.1. STI
3.1.1. STIs
3.1.1.1. Common STIs with genital ulcers
3.1.1.1.1. Syphilis
3.1.1.1.2. Lymphogranuloma venereum (LGV)
3.1.1.1.3. Herpes
3.1.1.2. Genital Warts
3.1.1.2.1. Human Papiloma Virus (HPV)
3.1.1.3. Tx Algorithm for Vaginitis/cervicitis
3.1.1.3.1. common STI causing Vaginal Discharge
3.1.1.3.2. for men
3.1.1.3.3. Common STI causing urethritis and cervicitis
3.1.1.4. Pelvic Inflammatory Disease
3.2. Urinary Conditions
3.2.1. UTI
3.2.1.1. complcated
3.2.1.2. uncomplicated
3.2.1.2.1. first line
3.2.1.2.2. second line
3.2.1.3. Pyelonephritits
3.2.2. BPH
3.2.2.1. Alpha1 adrenergic blockers
3.2.2.1.1. "...osins"
3.2.2.2. 5 - alpha reductase inhibitors
3.2.2.2.1. Finasteride
3.2.2.2.2. best for treating large prostates
3.2.2.2.3. targeted effect to prostate so, low side effects and DDI
3.2.2.2.4. blocks testosterone conversion to dihydrotestosterone --> less stimulation, prostate shrinks
3.2.2.3. Phosphodiesterase Inhibitors
3.2.2.3.1. Tadalafil
3.2.3. urinary incontinence
3.2.3.1. Incontinence in Children
3.2.4. erectile dysfunction
3.2.4.1. Phosphdiesterase inhibitors
3.2.4.1.1. Sildenafil
4. Renal
4.1. Chronic Kidney Disease
4.1.1. CKD BC Guidlines
5. Endocrine
5.1. DM
5.1.1. Diabetes
5.1.1.1. Type I
5.1.1.2. Type II
5.1.1.2.1. what HBA1C do you start treatment?
5.1.1.2.2. Biguanides
5.1.1.2.3. Sulfonylurea
5.1.1.3. Insulins
5.1.1.3.1. bolus/prandial
5.1.1.3.2. basal
5.1.1.3.3. premixed
5.1.1.4. acarbose
5.1.1.5. pioglitazone
5.2. Thyroid Disease
5.2.1. Thyroid
5.2.1.1. Thyroid
5.2.1.1.1. no screening asymptomatic pts
5.2.1.2. Hypothyroid
5.2.1.2.1. levothyroxine
5.2.1.3. hyperthyroid
5.3. Obesity
5.3.1. BC Guidline
6. OSCE PROCESS
6.1. 2 min to write reminders in booklet
6.1.1. 2 min to read instructions
6.1.1.1. 10 min for test
6.1.1.2. Evaluation
6.1.1.2.1. To do for all scenarios
7. HEENT
7.1. Allergies
7.2. Pharyngitis
7.3. Otitis
7.3.1. Otitis Externa OE
7.3.1.1. Staph Aureus & Psuedomonas most common
7.3.1.2. tender tragus and auricle
7.3.1.2.1. erythema & edema in external canal
7.3.1.3. Malignant Otitis Externa
7.3.1.3.1. Most common in older pts
7.3.1.4. management
7.3.1.4.1. gently remove debri from canal
7.3.2. Otitis Media OM
7.4. Rhinitis
7.4.1. Rhinitis
7.4.1.1. Allergic Rhinitis
7.4.1.2. Infectious Rhinitis
7.4.1.3. Nonallergic/noninfectious Rhinitis
7.4.1.3.1. Occupational Rhinitis
7.4.1.3.2. Drug induced Rhinitis
7.4.1.3.3. Hormonal Rhinitis
7.4.1.3.4. Rhinitis if the elderly (senile)
7.4.1.3.5. NARES (nonallergic rhinitis with nasal eosinophilia syndrome
7.4.1.3.6. smoking rhinitis
7.4.1.3.7. Idiopathic rhinitis (IR)
8. PAIN
8.1. Acute Pain
8.2. Chronic Non Cancer Pain
8.3. Cancer Pain
8.4. Pain
8.4.1. narcotics
8.4.1.1. codeine
8.4.1.2. tramadol
8.4.2. NSAIDs
8.4.2.1. ketorolac
8.4.3. Acetaminophen
8.4.4. GABA
8.4.4.1. gabapentin
8.4.5. Chronic pain
8.4.6. acute pain
9. GI
9.1. GI
9.1.1. Acute Abdomen
9.1.2. Diarrhea
9.1.2.1. Osmotic
9.1.2.2. Secretion
9.1.2.3. Inflammation
9.1.2.4. Motility
9.1.2.5. Anal Sphincter Control
9.1.3. Dyspepsia and peptic ulcers
9.1.4. Appendicitis
9.1.4.1. Mcburney's point tenderness
9.1.4.1.1. RLQ (over appendix)
9.1.4.2. Rovsig's sign
9.1.4.2.1. Press deeply in LLQ and quickly release
9.1.4.3. psoas sign
9.1.4.3.1. Flexion of Psoas muscle
9.1.4.4. obturator sign
9.1.4.4.1. stretch the obturator muscle
9.1.5. Cholecystitis
9.1.5.1. Murphy's Sign
9.1.5.1.1. hook left thumb under right costal margin (where gall bladder is
9.1.5.2. Risk for Cholecystitis
9.1.5.2.1. ABCDEF
9.1.6. Ascites
9.1.6.1. Fluid wave test
9.1.6.2. assess shifting dullness to percussion
9.2. GERD
9.2.1. GERD
9.2.1.1. Treatment
9.2.1.2. lifestyle mods
9.2.1.3. PPI x 4-8 weeks
9.2.1.3.1. Chronic if still symptomatic
9.2.1.3.2. R/O H. Pylori infection
9.3. esophagitis
9.4. Abd Pain
9.4.1. IBS
9.4.1.1. IBS
9.4.1.1.1. ALARM FEATURES
9.5. Dyspepsia
9.5.1. Peptic Ulcer Disease
9.5.1.1. H. Pylori testing/treatment
9.5.1.1.1. Chronic Dyspepsia
9.5.1.1.2. triple therapy
9.5.1.1.3. qudruple therapy
9.5.1.2. must stop ABX 4 weeks, bismuth 2 weeks, PPI and H2 blockers 1 week before Urea Breath Test
9.6. IBD
9.6.1. Crohns Disease
9.6.2. Ulcerative Colitis
9.7. N&V
9.7.1. N&V in Pregnancy
9.8. constipation
9.8.1. non pharm measures
9.8.1.1. increase dietary fibre
9.8.1.1.1. bulk forming agents
9.8.1.1.2. Psylium
9.8.2. reduce and treat causal factors
9.8.3. watch for constipating med
9.9. Diarrhea
9.9.1. acute Diarrhea - ? why
9.9.1.1. Infectious Diarrhea?
9.9.1.1.1. antibiotic associated diarrhea?
9.9.1.1.2. Metronizadole
9.9.1.1.3. Vancomycin
9.9.1.2. Viral?
9.9.1.3. Bacterial?
9.9.1.4. O&P?
9.10. antacids
9.10.1. magnesium and aluminum hydroxide
9.11. H2 antagonists
9.11.1. Ranitidine
9.12. PPIs
9.12.1. omeprazole
10. Pediatrics
10.1. Piaget's stages of Development
10.2. Erickson
11. Geriatrics
11.1. Frailty
11.1.1. Full BC Guidline Frailty
12. OB/Gyn/sexuality
12.1. OB / GYN
12.1.1. Contraceptives
12.1.1.1. Combined hormonal contraceptives (COCs)
12.1.1.1.1. ring
12.1.1.1.2. Evra patch
12.1.2. Menopause
12.1.2.1. HRT
12.1.2.1.1. Estrogen
12.1.2.1.2. Progesterone
12.1.3. Primary amenorrhea
12.1.4. Polycystic ovarian syndrome
12.1.5. endometriosis
12.2. Menstruation and Related Problems
12.2.1. Dysmenorrhea
12.2.1.1. NSAIDs
12.2.2. Amenorrhea
12.2.3. oligomenorrhoea
12.2.4. polymenorrhea
12.2.5. hypomenorrhea
12.2.6. Menorrhagia
12.2.7. metrorrhagia
12.2.8. menometrorrhagia
12.2.9. intermenstrual bleeding
12.3. Sexuality
12.3.1. Sexual History 5 P's
13. Diagnostic Testing
13.1. Diagnostic Testing
13.1.1. Laboratory
13.1.1.1. BC Medical Services Plan Payment Schedule
13.1.2. Medical Imaging
13.1.2.1. X- rays
13.1.2.2. ultrasound
13.1.2.3. CT
13.1.2.4. Miscellaneous
13.1.3. Objectives of Diagnostic Tests
13.1.3.1. facilitate diagnosis in a sick pt
13.1.3.2. give prognostic info for pt with a disease
13.1.3.3. screen for sub clinical symptoms in pt with enough risk factors
13.1.3.4. monitor therapy
13.1.4. Questions to ask about each test
13.1.4.1. Why am I considering this test?
13.1.4.2. What question is this test meant to answer?
13.1.4.3. can this test answer my question?
13.1.4.4. do benefits of testing outweigh risks?
13.1.4.5. does the benefit outweigh the cost?
13.1.5. How to decide to use a test?
13.1.5.1. PRE TEST PROBABILITY
13.1.5.1.1. Liklihood Ratios (LR)
13.1.5.2. CLINICAL DECISION RULES (CDR) help set Pre test probabilities for various problems and provide screening tests
13.1.5.2.1. Examples
13.1.5.3. According to Bayesian principles, the pretest odds of disease multiplied by the likelihood ratio gives the post-test odds of disease
13.1.6. Diagnostic and Procedural Codes (ICD9)
14. Oncology
14.1. Oncology Pharm
14.1.1. methotrexate
14.1.2. warfarin
14.1.3. tamoxifen
14.2. Breast CA
14.2.1. BC Guidlines
14.3. Colorectal CA
14.3.1. BC Guidlines Colorectal CA
14.4. Palliative Care
14.4.1. BC Guidline Paliative
15. Respiratory
15.1. Asthma
15.1.1. Asthma BC guidlines Summary
15.2. Pneumonia
15.2.1. 60-80% caused by Strep pneumoniae
15.2.1.1. atypical pneumonia caused by other organisms like influenza, mycoplasma, chlamydia
15.2.1.1.1. young adults more succeptible to atypical pneumonia
15.2.2. LRT infection
15.3. Chronic Cough
15.4. COPD
15.4.1. mild/moderate COPD
15.4.2. Bronchitis
15.4.2.1. Viruses most common cause
15.4.2.1.1. influenza A&B, parainfluenza, RSV, carona, adenovirus
15.4.2.2. usually resolves in <6wks in healthy
15.4.2.3. cough with normal VS and absence of other resp findings of consolidation are very suggestive
15.4.2.4. consider CAP and pertussis
15.4.2.5. treatment
15.4.2.5.1. rest
16. Neuro
16.1. parkinsons disease
16.1.1. levodopa/carbodopa
16.1.2. NMDA receptor blocker
16.1.2.1. amantadine
16.1.3. COMT blocker
16.1.3.1. entacapone
16.1.4. MAOIs
16.1.4.1. Selegiline
16.2. Headache
16.2.1. Migraine
16.2.1.1. abortive agents
16.2.1.1.1. sumatriptan
16.2.1.1.2. ergotamines
16.2.1.1.3. what not to use with peds
16.2.1.1.4. Metoclopramide
16.2.1.2. suppressive/prophylactic agents
16.2.1.2.1. CCBs
16.2.1.2.2. TCAs
16.2.1.2.3. BBs
16.2.1.2.4. what to avoid in peds
16.2.1.3. analgesics
16.2.1.3.1. NSAIDs
16.2.1.3.2. acetaminaphen
16.3. Dizziness
16.4. Bells Palsy
16.4.1. cause of 50% of unilateral LMN facial paralysis
16.4.1.1. some correlation with HSV
16.4.1.1.1. often triggered by something - often URTI
16.4.2. Sparing Forehead muscles suggests UMN lesion instead of Bells Palsy (LMN)
16.4.2.1. quick onset 2-5 days compared to other etiologies
16.4.2.1.1. post auricular pain
16.4.3. Treatment
16.4.3.1. protection of the unclosing eye
16.4.3.1.1. patch at night
16.4.3.2. better prognosis if not full paralysis
16.4.3.2.1. 80-85% recover in 6 months
16.4.3.3. High dose steroids for a week then tapper
16.4.3.3.1. antivirals
16.5. Trigeminal Neuralgia
16.5.1. 2 types of TN
16.5.1.1. TN1/ Primary Classic
16.5.1.1.1. most caused by vascular compression
16.5.1.2. TN2/ Secondary - trigeminal neuropathy
16.5.2. Diagnosed mainly on clinical presentation and lack of other cause
16.5.2.1. immediate referral if ophthalmic involvement
16.5.2.1.1. Usually unilateral
16.5.3. Treatment
16.5.3.1. First Line - Anticonvulsants
16.5.3.1.1. Carbamazepine
16.5.4. Often a symptom of MS
16.5.4.1. Treatment with some success using Misoprostol (NSAID)
16.6. Crancial Nerves
16.6.1. Oh Oh Oh, Tiny Tits Are Fun And Give Virgins Awkward Hips
16.6.1.1. Oh-1
16.6.1.1.1. Olfactory
16.6.1.2. Oh-2
16.6.1.2.1. Optic
16.6.1.3. Oh-3
16.6.1.3.1. oculomotor
16.6.1.4. Tiny-4
16.6.1.4.1. Trochlear
16.6.1.5. Tits-5
16.6.1.5.1. Trigeminal
16.6.1.6. Are-6
16.6.1.6.1. Abductens
16.6.1.7. Fun-7
16.6.1.7.1. Facial
16.6.1.8. And-8
16.6.1.8.1. Auditory
16.6.1.9. Give-9
16.6.1.9.1. glossopharyngeal
16.6.1.10. Virgins-10
16.6.1.10.1. Vagus
16.6.1.11. Awkward-11
16.6.1.11.1. Accessory (spinal accessory)
16.6.1.12. Hips-12
16.6.1.12.1. Hypoglosal
16.6.2. Sensory Nerve
16.6.3. Motor Nerve
16.6.4. Sensory Nerves, Motor Nerves or Both
16.6.4.1. Some Say Marry Money, But My Brother Says Big Brains Matter Most
16.7. Dementia
16.7.1. primary treatment
16.7.2. non pharm treatment
16.7.3. cholinesterase inhibitors
16.7.3.1. Donepezil
16.7.3.2. Galantamine
16.7.4. NMDA receptor blockers
16.7.4.1. mementine
16.8. siezures
16.8.1. non-pharm treatment
16.8.1.1. avoid ETOH, Stimulants, stress
16.8.1.2. get enough sleep
16.8.1.3. yoga
16.8.2. pharm depends on type of seizure
16.8.2.1. phenytoin
16.8.2.2. carbamazepine
16.8.2.3. valproic acid
16.8.2.4. phenobarbitol
16.9. Comparing MS, ALS and Musculo dystrophy
16.10. Temporal/Giant Cell Arteritis
17. Hematologic
17.1. Anemia
17.1.1. Anemias
17.1.1.1. Iron Deficiency Anemia
17.1.1.1.1. patient teaching
17.1.1.2. Megaloblastic Anemias
17.1.1.2.1. Folate deficient
17.1.1.2.2. B12 deficient
17.1.1.3. sickle cell anemia
18. LEGEND
18.1. NP CAN TREAT INDEPENDANTLY
18.2. NO - NP CAN'T TREAT
18.3. NP CAN CO-MANAGE
18.4. NP CAN PRESCRIBE
18.5. NP CAN CONTINUE PRESCRIPTION ONLY
18.6. NP CAN NOT PRESCRIBE
18.7. Not safe in pregnancy
18.8. probably not safe in pregnancy
18.9. probably safe in pregnancy
19. Infectious Disease
19.1. Pharmacology of ID
19.1.1. Infectious Diseases
19.1.1.1. Antiviral Drugs
19.1.1.1.1. Acyclovir
19.1.1.2. Anti parasitic drugs
19.1.1.2.1. Permethrin
19.1.1.3. Antifungals
19.1.1.3.1. Clotrimazole - Canesten
19.1.1.3.2. Ketoconazole
19.1.1.3.3. fluconazole
19.1.1.4. Mechanisms for antibiotic resistance
19.1.1.5. Antibiotic Toxicities
19.1.1.6. Interactions with warfarin
19.1.1.7. Allergic Reactions
19.1.1.8. Atypical Bacteria and their diseases
19.1.1.9. Antibiotics for Atypical Bacteria
19.1.1.10. Infections
19.1.1.10.1. Respiratory Infections
19.1.1.10.2. Skin Infections
19.1.1.10.3. Eye Infections
19.1.1.10.4. Ear infections
19.1.1.10.5. Nasal Infections
19.1.1.10.6. Throat infections
19.1.1.10.7. Eye infections
19.1.1.11. Anaerobic Bacteria
19.1.1.12. Mechanisms of Antibiotics
19.1.1.13. add these to the map: Gentamicin (opthalmic anti-infective) Timolol (beta blocker antiglaucoma agent) Ciprofloxacin otic solution (otic anti-infective) Benzocaine antipyrine-glycerine (otic analgesic) Acetic acid otic solutions Loratadine (2nd generation antihistamine) Chlorpheneramine Diphenhydramine Pseudoephedrine (decongestant, look also at phenylephrine) Codeine phosphate (antitussive) Guaifenesin (expectorant) Intranasal steroids (Fluticosone and betamethasone) Cromolyn (mast cell stabilizer) Ketotifen (opthalmic antihistamine + mast cell stabilizer) Ketorolac (ophthalmic NSAID)
19.1.1.14. Highly Resistant Gram Neg Bacteria
19.1.1.14.1. Antibiotics for highly resistant Gram Neg Bacteria
19.1.1.15. Oral Antibiotics against CA - MRSA
19.1.1.16. Preferred Antibiotic for serious Gram + Infections
19.1.1.17. Antibiotic Classes
19.1.1.17.1. Miscellaneous Antibiotics
19.1.1.17.2. macrolides
19.1.1.17.3. penicillins
19.1.1.17.4. cephalosporins
19.1.1.17.5. flouroquinolones
19.1.1.17.6. sulpha
19.1.1.17.7. Tetracyclines
19.1.1.17.8. aminoglycosides
19.1.1.17.9. Metronidazole
19.1.1.18. Infectious Disease Common Etiologies
19.2. Immunization
19.2.1. Which are live attenuated vaccines?
19.2.2. Basic immunization schedule first year of life
19.2.3. Schedule and reccomendations
19.2.3.1. MMR
19.2.3.2. Hep A
19.2.3.3. Hep B
19.2.3.4. Varicella
19.2.3.5. HPV
19.2.3.6. tetanus
19.2.3.7. influenza
19.2.3.7.1. antivirals
19.3. HIV
19.3.1. drugs in pregnancy?
19.3.2. Protease Inhibitors (PI)
19.3.2.1. ritonavir
19.3.3. nucleoside Reverse transcriptase inhibitor (NRTI)
19.3.3.1. 1st Generation
19.3.3.1.1. zodovudine / AZT
19.3.3.1.2. NON-nucleoside REverse Transcriptase Inhibitors (NNRTI)
20. Cardiovascular
20.1. HTN
20.1.1. HTN Guidlines
20.1.1.1. Primary HTN
20.1.1.1.1. treat to <140/90
20.1.1.1.2. diabetic treat to <130/80
20.1.1.1.3. 80yr+ treat carefully SBP 150 is ok
20.1.2. hepatojugular reflux sign
20.2. Dyslipidemia
20.3. CV Disease
20.4. PVD
20.4.1. Peripheral Vascular Tests
20.4.1.1. Allens Test
20.4.1.1.1. occlude both ulnar and radial arteries till hand goes white
20.4.1.2. Pallor Leg Raise Test
20.4.1.2.1. raise both legs to 60deg x 1 minute
20.4.1.3. Trendelenberg Test
20.4.1.3.1. lay supine, raise legs to 90 deg for to empty venous system
20.5. Cardiovascular drug classes
20.5.1. Diuretics
20.5.1.1. Thiazide Diuretics
20.5.1.2. Loop Diuretics
20.5.1.3. Potassium Sparing Diuretics
20.5.2. Vasodilators
20.5.2.1. Renin Angiotensin System Blockers
20.5.2.1.1. ACE inhibitors
20.5.2.1.2. Angiotensin Receptor Blockers
20.5.3. Antiplatelet Drugs
20.5.3.1. ASA
20.5.3.2. Clopidogrel
20.5.4. antithrombotic
20.5.4.1. Warfarin - Coumadin
20.5.4.2. Dabigatran
20.5.5. Cardioinhibitory Drugs
20.5.5.1. Alpha bockers
20.5.5.1.1. Clonidine
20.5.5.1.2. Methydopa
20.5.5.2. Calcium Channel Blockers
20.5.5.2.1. Dihydropyridine CCB - for HTN not ischemic disease
20.5.5.2.2. Non-Dihydropyridine CCB
20.5.5.3. Beta Blockers
20.5.5.3.1. Cardioselective Beta Blockers
20.5.5.3.2. non-cardioselective Beta Blocker
21. Mental Health
21.1. Anxiety
21.1.1. anxiety Pharm
21.1.1.1. First line
21.1.1.1.1. SNRI
21.1.1.1.2. SSRI
21.1.1.2. second line/ adjunct
21.1.1.2.1. TCA
21.1.1.2.2. Benzodiazepines
21.1.1.2.3. MOAI
21.2. Depression
21.2.1. Depression Pharm
21.2.1.1. SSRIs
21.2.1.1.1. Citalopram
21.2.1.2. SNRIs
21.2.1.2.1. venlafaxine
21.2.1.3. single vs Dual action
21.2.1.4. TCAs 2nd line
21.2.1.4.1. amatriptyline
21.2.1.5. MAOIs - 3rd line
21.2.1.5.1. phenelzine
21.2.1.5.2. meclobemide
21.2.1.6. atypical antidepressants
21.2.1.6.1. bupropion
21.2.1.6.2. Trazodone
21.2.1.7. which are safer
21.2.1.7.1. citalopram for SSRIs
21.2.1.7.2. Bupropion for atypicals and TCAs
21.2.1.7.3. venlafaxine for SNRIs because it has been around longer
21.2.1.7.4. NO MAOs, too many DDI and small therapeutic window.
21.2.1.8. which are less sedating
21.2.1.8.1. most of the SSRIs, SNRIs and bupropion
21.2.1.9. SIGECAPS - for depression
21.2.1.9.1. Sleep
21.2.1.9.2. Interest
21.2.1.9.3. Guilt
21.2.1.9.4. Energy
21.2.1.9.5. Concentration
21.2.1.9.6. Appetite
21.2.1.9.7. Psychomotor
21.2.1.9.8. Suicide
21.2.1.10. DIG FAST - for mania
21.2.1.10.1. Distractable
21.3. Suicide
21.3.1. SADPERSONS
21.3.1.1. sex (male)
21.3.1.1.1. age (>60yrs)
21.4. Pharmacologics
21.4.1. Psychiatric disorders
21.4.1.1. Bipolar Depression
21.4.1.1.1. Mood Stabilizers
21.4.1.1.2. Bipolar I - manic
21.4.1.1.3. Bipolar II - depression with no full mania
21.4.1.1.4. Bipolar not otherwise specified
21.4.1.2. Depression
21.4.1.2.1. SSRIs
21.4.1.2.2. SNRIs
21.4.1.2.3. single vs Dual action
21.4.1.2.4. TCAs 2nd line
21.4.1.2.5. MAOIs - 3rd line
21.4.1.2.6. atypical antidepressants
21.4.1.2.7. which are safer
21.4.1.2.8. which are less sedating
21.4.1.3. anxiety
21.4.1.3.1. First line
21.4.1.3.2. second line/ adjunct
21.4.1.4. what drugs are worse to overdose on?
21.4.1.4.1. TCAs because of narrow therapuetic window
21.4.1.5. what drugs are worse to withdraw from?
21.4.1.5.1. Benzodiazepines
21.4.1.5.2. SNRIs
21.4.1.5.3. ETOH
21.4.1.6. antipsychotics
21.4.1.6.1. First Generation
21.4.1.6.2. second generation / atypical
21.4.1.7. ADHD
21.4.1.7.1. methylphenidate
21.5. Sleep Disturbances
21.5.1. BC Guidline on insomnia/hypersomnia/parsomnias
21.5.1.1. Sleep Hygiene/diary handout
21.6. Addictions
21.6.1. Alcohol Abuse
21.6.1.1. BC Guidlines