We are excited to see so many of you join our 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
(5 points)

1. Which of the following best describes the main pathophysiology of Eustachian tube dysfunction (ETD)? (1 point)

• 1. Overproduction of cerumen in the external canal
     
  2. Inflammation or narrowing of the Eustachian tube causing impaired middle ear ventilation
     
  3. Ossicular chain fixation causing conductive hearing loss
     
  4. Tympanic membrane perforation with middle ear effusion
     
• Answer: B

2. Which condition is most commonly associated with secondary Eustachian tube dysfunction? (1 point)

• 1. Temporomandibular joint dysfunction
     
  2. Allergic rhinitis and gastroesophageal reflux disease
     
  3. Ménière’s disease
     
  4. Otosclerosis
     
• Answer: B

3. What tympanometry pattern is most consistent with obstructive Eustachian tube dysfunction? (1 point)

• 1. Type A
     
  2. Type As
     
  3. Type B or Type C
     
  4. Type Ad
• Answer: C

4. Which of the following is an appropriate first-line treatment for chronic Eustachian tube dysfunction due to allergic rhinitis? (1 point)

• 1. Oral antibiotics for 10 days
     
  2. Intranasal corticosteroids and second-generation antihistamines
     
  3. Tympanostomy tube placement
     
  4. Daily pseudoephedrine
     
• Answer: B

5. A 42-year-old diver has persistent barotrauma symptoms despite conservative measures for 3 months. What is the next best management step? (1 point)

• 1. Continue intranasal steroids indefinitely
     
  2. Refer for tympanic membrane patching
     
  3. Consider referral for balloon dilation of the Eustachian tube
     
  4. Begin oral corticosteroids
     
• Answer: C