“Doc, Help Me Manage My Pain!”: Let’s Talk About Fibromyalgia

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A woman holding her neck in pain.

“Doc, Help Me Manage My Pain!”: Let’s Talk About Fibromyalgia

April 22, 2023 | Family Medicine Exam Prep Course | CCFP

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.



Sharon Cohen is a 52 year old female who has been in your practice for 10 years. She was previously diagnosed with Fibromyalgia, COPD, Type 2 Diabetes, Anxiety, and Depression. She has been reluctant to start medication. She comes to your office today to discuss her pain and fatigue. She smoked a pack per day for the past 40 years. She controls her Diabetes with diet and lifestyle measures and takes St. John Wort for Anxiety and Depression. She lives with her three cats and a parrot who are protective factors for her. She has no allergies. (8 points)

1. How is Fibromyalgia diagnosed? (1 point)

    • Fibromyalgia is diagnosed as 4 out of 5 regions of the body having generalized pain associated with fatigue, sleep, mood, and memory disturbances that last at least three months and cannot be explained by an organic condition
    • Note: the previous guidelines have been updated and no longer include “pain pointsâ€

2. True or false: Fibromyalgia affects more males than females. (1 point)

    • False

3. List three classes of medications that can help patients with Fibromyalgia. (3 points)

    • Analgesics
    • NSAIDs
    • SSRI
    • SNRI
    • TCA
    • Gabapentinoids

4. What non-pharmacologic interventions could be helpful for patients with Fibromyalgia? (3 points)

    • Physical therapy
    • Occupational therapy
    • Meditative movement therapies (e.g., Tai Chi)
    • Acupuncture
    • Exercise
    • Good Sleep Hygiene
    • CBT