We are excited to see so many of you join our fall FMEP courses. Several of you have requested we continue to post more practice SAMPs, so here you go!

Just a reminder… pay attention to the questions. Here are our general tips one more time:

1. Pay attention to the questions. Look carefully at how many items you are being asked to list. If the question asks for five items, you will not get more marks if you list eight items; the examiner will look at the first five and allocate marks only for the first five answers so be careful. On a SAMP, if it is not clearly stated how many items you should list, look at the amount of points/marks being allocated for the question to get an idea of how many answers the examiner may be anticipating you write down.

2. Do not write lengthy answers. Most questions can be answered in 10 words or less!

3. Be specific when writing down investigations (hemoglobin instead of CBC; CT abdomen instead of CT).

4. Remember that trade names and generic names are both acceptable when writing down medications.

5. For more helpful tips, you can refer to CCFP’s SAMP instructions by clicking here.

SAMP

Mr. Beef comes to your office for a preventative health visit. He has a history of renal stones. He is on no medication. He is a non-smoker and drinks 1-2 glasses of wine per week. He is quite active. He tells you his diet is unbalanced and he consumes a lot of red meat. He has no allergies. (6 points)

1. What is Hemochromatosis? (1 point)

• • Hemochromatosis are inherited disorders that can cause iron overload. Iron overload can affect various joints in the body and results in a failure in the regulation of liver-derived hormone hepcidin

2. Should you be screening for Hemochromatosis in the general population? (1 point)

• • No. At this time it has not been recommended to screen as there is no evidence of a survival advantage

3. What two laboratory abnormalities could you see in Hemochromatosis? (2 points)

• • Elevation in Serum Transferrin Saturation
  • Elevation in Mean Red-cell Hemoglobin level
  • Elevation in Ferritin
  • Elevation in Red-cell Volume
  • Unexplained liver function test abnormalities

4. True or false: Arthritis can be seen in patients with Hemochromatosis after successful therapeutic phlebotomy. (1 point)

• • True

5. True or false: Iron elevation is a risk factor for breast cancer. (1 point)

• • True. Epidemiologic observations indicate that iron elevation is a risk factor for breast cancer.

Helpful NEJM Resource:
https://www.nejm.org/doi/full/10.1056/NEJMra2119758