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

Emily McSmith is a lovely 56 year old female, with a history of Diabetes and Hypertension who presented to your office with a small erythematous pruritic rash on her abdomen. You suspected atopic dermatitis and prescribed a low dose topical steroid. She comes back a week later with the rash spreading more extensively to her breasts, chest, neck, arms and legs. Her face is spared. She has tried over-the-counter antihistamines and the steroid cream you had prescribed but has not had any relief. (13 points)

1. List four dermatologic causes of pruritus. (4 points)

• • Atopic dermatitis
  • Contact dermatitis
  • Lichen Planus
  • Urticaria
  • Scabies
  • Insect bite reaction
  • Psoriasis
  • Xerosis

2. True or false: Pruritus can be associated with liver disease. (1 point)

• • True.

3. List three stigmata of liver disease you would assess for on a physical exam. (3 points)

• • Jaundice
  • Hepatosplenomegaly
  • Clubbing
  • Telangiectasia
  • Palmar erythema
  • Ascites
  • Gynecomastia
  • Hair loss
  • Bruising

4. List two different classes of oral prescription medication that can be offered to patients with pruritic dermatoses. (4 points)

• • Corticosteroids
  • Calcineurin inhibitors
  • Antihistamines
  • Anticonvulsants
  • Antidepressants
  • μ-opioid receptor agonists

5. What blood tests would you consider ordering for a patient presenting with a three day history of a localized, erythematous rash on the flexural surface of their elbows? (1 point)

• • None is an acceptable answer here – this is a case that suggests atopic dermatitis and can be managed with topical corticosteroids and/or moisturizers before any further workup is required

Reference:

https://members.fmpe.org/