99 Topics for the CCFP

This week we talk about fever, which is a super common presenting complaint both in Primary Care and in the Emergency Department. Most of the CCFP exam's focus seems to be on children with fever, but we talk about a few other related conditions as well that can occur in adults.

Links from this week's talk:

* CFPC's Fever in Infants and Children [pdf] (http://www.cfpc.ca/uploadedfiles/resources/resource_items/patients/feverinchildren_en.pdf)

* UpToDate's Patient Information: Fever in Children (Beyond the Basics) (http://www.uptodate.com/contents/fever-in-children-beyond-the-basics)

Arguably, the last of the "core" chronic disease topics this week: Hypertension! The 2015 Canadian Hypertension Education Program (CHEP) has everything you need to know for the exam and for practice; guidelines (http://guidelines.hypertension.ca/) published alongside the paper are a fairly short and recommended read, or even shorter, their highlights (https://guidelines.hypertension.ca/wp-content/uploads/2018/10/Hypertension-Guidelines-English-2018-WEB.pdf) .

Yet another core Family Medicine topic this week, hyperlipidemia. The best reading you can do for the exam around this topic is to read through Dr. Michael Allan et al.'s recent article in the CFP titled Simplified lipid guidelines: prevention and management of cardiovascular disease in primary care (http://www.cfp.ca/content/61/10/857.full) , but of course we'll have a "summary of the summary" up in the study notes very soon!

Links from this week's talk:

* 2013 Cochrane Review, Statins for the primary prevention of cardiovascular disease (http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004816.pub5/abstract)

* iCCS Mobile App from the Canadian Cardiovascular Society (http://www.ccs.ca/en/resources/mobile-apps)

And the second part of our two-parter discussion of Diabetes.

Thanks to Dr. Alain-Philip Gendron (FMR1) for help in developing the study notes for this topic.

The first part of our two part discussion of Diabetes (what a huge topic!), certainly one of the most prevalent diseases in Family Medicine.

Links from this week's talk:

* CANRISK Diabetes Risk Assessment Tool (http://www.pharmacists.ca/index.cfm/education-practice-resources/patient-care/diabetes-practice-tools-and-resources/canrisk-tools/)

* The excellent Canadian Diabetes Association Guidelines (http://guidelines.diabetes.ca/fullguidelines) in full.

Thanks to Dr. Alain-Philip Gendron (FMR1) for help in developing the study notes for this topic.

This week, we discuss depression: one of the most common presentations in Family Medicine. I managed to not record my chat with Mike this time around, so you'll need to take our word for it that it was excellent and highly entertaining.

Some points from our chat:

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Brief, office-based CBT is a great skill to have to help your depressed patients. An example guide is available at A Therapist's Guide to Brief Cognitive Behavioral Therapy (http://www.mirecc.va.gov/visn16/docs/therapists_guide_to_brief_cbtmanual.pdf) . The University of Calgary also offers a distance-learning certificate in CBT (http://ucalgary.ca/pd/CBTCertificate) .

*

The RXFiles offers a very comprehensive comparison of antidepressant (http://www.rxfiles.ca/rxfiles/modules/miscellaneous/search.aspx?for=depression) medications.

Another week, another topic! A favourite topic for GP/Emerg docs everywhere, and Dr. Mike Kirlew is back to talk Chest Pain. The study notes to accompany will be up shortly, and I would highly recommend them: this topic is so large that covering it in one podcast episode is a hopeless task (although we tried our best!). Be sure to look up the new and upcoming chest pain / ACS scoring tools and rule out algorithms (HEART score, TIMI score, etc.), as most Emergency departments are moving to a 1- or 2-hour rule-out for low risk ACS patients.

Erratum:

* We mentioned the ADJUST-PE for age-adjusted D-dimer as being completed in 2012: it's newer than that, completed in 2014.

We have a special treat this week - Dr. Mike Kirlew, of the famous (infamous?) Dr. Mike Kirlew's CCFP Podcasts (http://apple.co/1GaH8lp) has joined us for a special episode on Anaphylaxis!

The study notes have been published alongside the podcast this week - we're still looking for interested residents who would like to work on one of the 99 Topics, if that sounds like you please get in touch with us, we'd love to have you.

And we're back, but dammit, we have a nosebleed this week. Blame it on the dry northern Saskatchewan air.

Key points this week:

* These patients are commonly anxious, which makes everything worse: work on reducing their level of anxiety in the office/ED.

* 90% of nosebleeds will resolve with basic first aid: start with basic first aid when you first see them, and teach it to them to save them the trip in the next time it happens.

* If it's recurrent or you can't get it to stop, consider a posterior bleed: these will usually need help from ENT.

Thanks to FMR2 Dr. Isa Saidu for help in developing this topic!

Exams are over, time to celebrate!

This week, we talk antibiotics.

Probably the most important thing know about antibiotics is having a first-line and second-line antibiotic (and dosing) in mind for common infections.

Two great resources for this:

* RXFiles (the "Common Infections" page) (https://bit.ly/1FKWrE0)

* MUMS Health’s "Anti-infective Guidelines for Community Acquired Infections" (commonly known as the "Orange Book") (https://bit.ly/1E0S17d)