Download Therapeutic Decision Making Exam information sheet for candidates

Youhave3hourstocompletetheexamination.
YoumustuseONLYthepencilsprovidedforyou.
YOUMUSTRETURNTHISEXAMINATIONBOOKINTACTATTHEENDOFTHEEXAMINATION:DONOT
REMOVEANYPAGES.YOUMAYNOTCOPYAND/ORREMOVETHEQUESTIONSINANYWAY.
INSTRUCTIONS Thisassessmentisbasedonclinicaltherapeuticsituationsrelevanttofamilypractice.Eachcasedescribesa
specificclinicalconditionorsituation.
Objectives:
TheobjectiveoftheTHERAPEUTICDECISIONMAKINGASSESSMENTistoexamineyourabilitytointegrate,
evaluateandapplyknowledgeofeverydaytherapeutics.Responseswillbemarkedaccordingtoyour
understandingofclinicalissues,relevanceandappropriatenessofyourdecisions.
FormatandMarking:
Thereare40cases,andeachcaseisequallyimportanttothetotalscore,regardlessofthenumberof
questionsforthecase.Readtheclinicalinformationcarefullyandthendocumentthe
therapeutic/managementoption(s)youconsidertobeoptimal.Therearenonegativemarks,butyou
shouldreadthequestionscarefully.Whenaspecifiednumberofoptionsisrequested,answerswillbe
markedintheorderwritten:additionalresponseswillnotbemarked.
Managementofinformation:
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Focusandcoherence
o Beasbriefaspossible,makinguseofthespaceprovidedaftereachquestion.
§ Wordyourresponsescarefully.Correctanswersareusuallyasingleword,afew
wordsorashortphrase.
§ Partialmarkswillbegivenforpartialinformation.
o Beasspecificaspossible.
§ Forexample,‘thyroiddisease’isanunacceptableresponsewhen‘hyperthyroidism’
isthecorrectresponse.
Organization
o Listonlythenumberofresponsesasked.Youwillreceivecreditforonlythenumberasked
intheorderwritten.
o Useaseparatelineforeachresponse.Youranswersmustbelistedverticallyinthespace
provided.
Drugnomenclature
o Somequestionsaskaboutaclassortypeofdrug(e.g.beta-blocker)ratherthanaspecific
drug.Thiswillbeclearlynotedinthequestion.
o Whenaskedtolistorprescribedrugsormedicationsusegenericnames,whenever
possible.
Drugdosage,routeofadministration,frequencyanddurationoftreatment
o Readquestionscarefullytodetermineifthedrugdosage,routeofadministration,
frequencyanddurationoftreatmentneedtobespecifiedinyouranswer.
o Donotprovidearange(e.g.5-10daysor10-20mg)unlessspecificallyaskedtodoso.
o Whenaskedtoprovideadrugdoseyoushouldbereasonablyconfidentabouttheproper
dose.Nocreditisgivenforanincorrectdose;howevernopenaltyisassignedforan
incorrectdose.
o Drugdosemaybeexpressedasanactualdose(e.g.200mg)orinmg/kgofbodyweight.
(somequestionswillprovidethepatient’sweightintheclinicalscenario)
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Communicationofinformation:
grammar,spelling,mechanics,conformancetoconventionsofabbreviations
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Legibilitymatters.WRITEORPRINTCLEARLY.Youwillreceivenocreditforananswerthatcannot
beread.
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Whenaskedtofillaprescriptionform,dosoasyouwouldtobefilledbyapharmacist.Besureto
completeallnecessarypartsoftheprescription.Whenaskedtowriteaprescription…
Abbreviations:
o Onlyuseverycommonshortformsandacronyms;e.g.,CBCforcompletebloodcount,and
IVforintravenousareacceptable.Otherabbreviationsmaynotbeclearevenforaspecific
context,andshouldbewrittenout.
o Generallydrugnamesshouldbespelledcompletelyratherthanusingabbreviationsor
acronyms.However,someverycommonabbreviationsareacceptable(e.g.ASA,NSAID,
SSRI)
Spelling:
o Accuratespellingofdrugnamesisimportant.
o Spellingerrorswillnothurtyourscoresolongastheerrordoesnotinterferewiththe
markerunderstandingyouranswer.
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Examples:
A23yearoldwomanisseeninclinicwithahistoryofmildasthmasymptoms,oftenexacerbatedby
exercise.
1) Whatclassandtypeofmedicationisrecommendedasfirstlinemanagementforthispatient?Give
yourrationaleforthischoice.
AcceptableAnswer:Short-actingbeta2agonist;inhaler
Rationale:mildasthmamostlytriggeredbyexercise
2) Youprescribethismedication.Listthreepatientbehaviorsoractionsthatmayadverselyaffectthe
intendedoutcomeofthetreatmentthatyouhaveprescribed.
AcceptableAnswers:
1. Notgettingtheprescriptionfilled
2. Takingthedrugattheincorrecttime(notusinginhalerbeforeexercise)
3. Forgettingtousemedication
4. Incorrectinhalertechnique
3) Listthreemeasuresthispatientcantaketominimizeasthmasymptoms.
AcceptableAnswers:
1. Avoidknownallergensand/orirritants
2. Avoidsmoking
3. Learnaboutasthmatriggers,symptomsandtherapy(patienteducation/selfmanagement)
4. RegularlyuseaBeta2agonistpriortoexercise
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