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* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
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: • • • • 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) 1 Communicationofinformation: grammar,spelling,mechanics,conformancetoconventionsofabbreviations • Legibilitymatters.WRITEORPRINTCLEARLY.Youwillreceivenocreditforananswerthatcannot beread. • 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. • • 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 2