When studying for the family medicine exam, you need to be aware of WHAT'S NEW in the guidelines!
This is why The Review Course will cover major points and recent changes from relevant Canadian guidelines.
For example, there are some huge changes in the 2015 CHEP guidelines for Hypertension. The treatment of Hypertension is easy right? Remember the ABCDs and some specific exceptions and side effects…cough…cough…and you’re good to go for the exam?
Probably not, if you want to ACE the exam or answer questions comfortably with time to spare to concentrate on more difficult questions.
EXAM STUDY TIP
When writing the exam it’s easy to forget the simple things and sweat over some details you tried to memorize 3 months ago at a group study session. So to keep your blood pressure down in the exam remember that your patients need to be screened appropriately and confirmed to have HTN, prescribed the right medication AND lifestyle advice (Remember one of The Review Course mantras: Management = More than Medication!), and to the right target, while monitoring for side effects.
PEARLS FOR PRACTICE
A great resource is www.hypertension.ca and the Canadian Hypertension Education Program (CHEP) which produces yearly guidelines and updates in relation to Hypertension in the Canadian context*. They also have resources for patients so don’t forget to educate your patients on their diagnosis.
For example, in 2015 some of the biggest Key Messages included the following:
WHEN & HOW (NEW!!) All Canadian adults should have their blood pressure assessed at all appropriate clinical visits. A huge change: no longer are manual BP measurements recommended. Electronic (oscillometric) measurement methods are preferred to manual measurement.
CONFIRM (NEW!!) Out-of-office measurement (24-hour ambulatory blood pressure or home blood pressure) should be performed to confirm the initial diagnosis in any individual suspected of having hypertension.
TREAT TO TARGET (NEW!!) Another huge change - the targets are different now! Targets to know:
< 140/90 mmHg in most patients, including those with chronic kidney disease.
<130/80 in patients with diabetes
<150 systolic (cautiously!) in patients over 80, and don’t diagnose them with hypertension unless their BP > 160 systolic
Be sure to review the CHEP guidelines before your exam; these will be reviewed during the Hypertension topic at The Review Course as well.
Make sure you are among the first to know when registration begins: click here.
* https://www.hypertension.ca/images/CHEP_2015/2015_CHEPOnePageSummary_EN.pdf