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

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.

• Episode Written By : Patricia Massel MD, CCFP

• Content Reviewer : Natasha White, L&D RN and Breastfeeding Coach

• Hosts : Kyla Freeman, Caitlin Blewett, Patricia Massel

• Artwork : Aikansha Chawla

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

• Written By: Shaila Gunn, FM PGY2, Calgary AB
• Expert Review: Dr Darby Ewashina, ER Psychiatrist, Calgary AB @doc.darbs on Instagram

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

• Episode Written By : Kyla Freeman, FM PGY3
• Episode Reviewed By : Dr. Vanessa Poliquin, OBGYN
• Hosts : Kyla Freeman (FMR3) & Patricia Massel (MD-CCFP)
• Artwork : Aikansha Chawla MS4

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.

• Written By: Timothy Collier, PGY1 FM, Memorial University - Newfoundland
• Peer Review By: Dr Sarah Donnelly, PGY3 IM, University of Alberta - Edmonton

All the CCFP Objectives recommended for Hepatitis!

• Written By: Braedon Paul, FM PGY2, Victoria
• Peer Review: Alysha Thomson, FM PGY2, Victoria BC
• Audio Production: Braedon Paul

Abdominal Aortic Aneurysm, Green Eggs and Ham, Osteoporosis, Diabetes and Hyperlipidaemia screening, updated STI screening,

Immunizations recommendations, and we tidy it up.