We are excited to see so many of you join our spring 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. Pres Sure is a 68 year old male who comes to your office for a blood pressure check. He recently had a headache and went to a local pharmacy to measure his blood pressure. He cannot recall the numbers but says “the numbers seemed highâ€. His medical history is significant for hyperlipidemia and diabetes. His medications: Rosuvastatin 10 mg administered orally once daily, Metformin 500 mg BID. He smokes 9 cigarettes a day. He drinks 2-5 beers per day. (13 points)

1. You use an automated office blood pressure monitor. At what minimum threshold would you diagnose hypertension in Mr. Pres Sure? (1 point)

• • >130/80

2. You diagnose hypertension. What are three investigations you would like to order to assess end-organ damage? (3 points)

• • Urinalysis
  • K+, Na+, eGFR, Cr
  • FBG/HBA1c
  • Total Cholesterol, HDL, LDL, TG, non-HDL
  • ECG
  • ACR (if the patient is diabetic)

3. What are three first-line classes of medications you could start for Mr. Pres Sure’s high blood pressure? (3 points)

• • Thiazide/thiazide-like
  • ACEI
  • ARB
  • CCB
  • Beta blocker
  • Single pill combination

4. What are three lifestyle changes you would recommend for Mr. Pres Sure? (3 points)

• • Physical exercise
  • Weight reduction
  • Moderate alcohol consumption
  • Diet modification (should be specific)
  • Stress management
  • Smoking cessation

5. What are three causes of secondary hypertension? (3 points)

• • Renal artery stenosis (CCFP specific!- check out the objective)
  • Chronic kidney disease
  • Primary hyperaldosteronism (CCFP specific!- check out the objective)
  • Thyroid disorder
  • Pheochromocytoma
  • Obstructive sleep apnea
  • Coarctation of aorta
  • Cushing’s syndrome