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

A 25 year old male, otherwise healthy, comes in with a three-day history of feeling systemically unwell. On physical examination, you note a temperature of 38°C and palpable, enlarged cervical and inguinal lymph nodes. He also reports a large, thick lesion on his penis. He is very anxious that this might be Monkeypox as he has seen it all over the news lately. (8 points)

1. Name three common signs or symptoms that can be seen with Monkeypox. (3 points)

• • Fever
  • Headaches
  • Muscle aches and backache
  • Chills
  • Exhaustion
  • A rash that can look like pimples or blisters (can appear on the face, inside the mouth, hands, feet, chest, genitals, or anus)
  • Lymphadenopathy (usually seen in the prodromal stage of illness and can be a clinical feature to distinguish Monkeypox from Chickenpox or Smallpox)

2. What is the main diagnostic test for Monkeypox? (1 point)

• • Polymerase chain reaction (PCR) testing. Ensure appropriate specimen collection, IPAC considerations, and ability to safely transport the specimen. Best collected through skin lesion – unroof the pustular lesion and use a swab to collect the sample. Alternatives are a blood specimen, NP swab, and urine swab but the yield of an accurate diagnosis is lower with this form of specimen collection
  • Click here for more information about specimen collection and testing

3. True or false: There is a vaccine available for Monkeypox. (1 point)

• • True. At the moment, a vaccine (Imvamune) is available for gay, bisexual, and other MSM meeting risk criteria as well as individuals in close contact with those who have confirmed cases.

4. When does the Monkeypox rash usually occur? (1 point)

• • 2-4 weeks
  • Click here to see photos of a typical Monkeypox rash

5. What is the incubation period for Monkeypox? (1 point)

• • 5-21 days

6. Is infectivity highest during the incubation period, fever stage, rash stage or recovery stage? (1 point)

• • Rash stage
  • Click here to view an excellent Monkeypox fact sheet from the WHO