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

CCFP 105 Topics: Periodic Health Assessment

Author: Braedon Paul (FM R2, Victoria)

Peer Review: Alysha Thomson (FM R2, Victoria)

Audio Production: Braedon Paul

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.

• Episode Written by : Cadence MacPherson, Family Medicine PGY2
• Episode Reviewed by : Dr. Farrukh, Family Doctor
• Hosts : Kyla Freeman FMR3 in obstetrics & Cadence MacPherson FMR2
• Episode Art : Aikansha Chawla MS4

Today we are making a splash! We will review premature rupture of membranes, both at term (Term PROM) and premature rupture (PPROM) as well as pre-term labour. We are going to talk about when to give steroids, who you should induce, and who you should try to slow things down in. We hope you find it useful!

• Written By: Shaila Gunn - PGY , Calgary AB

• Expert Review: Dr Darby Ewashina, ER Psychiatrist, Calgary AB @doc.darbs

It is important that as family physicians, we learn to not only diagnose insomnia but learn to counsel patients in the management, both behavioral and pharmacological.

Insomnia is a common problem, impacting 35-50% of adults. However, only 12-20% of patient with symptoms of insomnia meet the criteria for insomnia disorder.

Many other factors including other sleep related conditions, mental health concerns, and organic health problems may present with symptoms of insomnia.

Knowing what is causing the insomnia is an important step, as this will guide the most effective treatment strategies. Common, non-modifiable risk factors for insomnia include female gender and middle aged to older adults.

However, most patients with insomnia will have another treatable condition. It is important to note that the MOST COMMON CAUSE OF SLEEPINESS IS INADEQUATE SLEEP WITH LACK OF TIME SPENT IN BED AND POOR SLEEP QUALITY

Regardless of the cause of insomnia, there are some important, non-pharmacologic treatments that we will talk about that can be beneficial for all patients struggling (or not!) with sleep. The two main treatments are sleep hygiene techniques and Cognitive Behavioral therapy for insomnia (or CBT-I for short). We will get into this later in the episode.

Written by: third-year medical student, Kim Papp, and

Expert Review By: Dr. Meghan Smith, PGY-5 in Ophthalmology, University of Alberta

• Episode Written By : Kyla Freeman, FM-PGY3
• Episode Reviewed By : Jillian Gilroy, OBGYN-PGY3
• Hosts : Kyla Freeman PGY3, Patricia Massel MD-CCFP, Caitlen Blewett PGY1
• Art : Aikansha Chawla

In today's episode we sloooow it right down and go back to basics to review "what is labour" and when is labour prolonged or arrested? We will review the stages of labour as well as how to recognize and manage prolonged or obstructed labour in the first or second stage. We will also very briefly talk about cesarean sections and assisted vaginal deliveries. We hope you enjoy!

• Written By: Sonja Poole, PGY2 FM - Yellowknife NWT
• Reviewed By: Dr Andrew Kotaska OBGYN, - Yellowknife NWT

Some definitions:

• Infertility = inability to conceive or carry to term after 1 year of regular, unprotected intercourse
• Primary infertility = infertility in the context of no prior pregnancies
• Secondary infertility = infertility in the context of a prior conception

As a disclaimer, we are going to be heteronormative with our language to simplify referring to the person providing the sperm as the male partner and the person providing the ovum as the female partner, and using cis-gendered pronouns. This is because those are the two essential ingredients for producing an embryo and they both have specific health considerations.

People who are non-binary, trans, or in queer relationships may also struggle with infertility. Referring to people by their preferred pronouns is extremely important and separating our ideas of sex and gender identity is crucial to providing excellent care. Keep this in mind as you listen to this episode.

Today's episode is a little unique - Dr. Patricia Massel interviews Nicole Schmitt, a pelvic floor physio to get a whole bunch of tips and pearls about how to support your patient in pregnancy and post-partum with their pelvic floor concerns.

They said they'd be 30 minutes, but you know of course it's longer to hopefully enhance your knowledge in this important, yet under-discussed area of pregnancy care! We hope you enjoy.

• Written By: Karkirat Singh, FM PGY1 - Vancouver BC
• Review By: Dr Hermeen Dhillon
• Hosted By: Braedon Paul and Caleb Dusdal