SNAP SAMP:
Let's review the criteria for diagnosis and management of something we all see every day: uncomplicated urinary tract infection. I want to show you a few ways the SAMP can trip you up even on something you know inside out and backwards.
I want you to grab a piece of paper and answer these SNAP SAMP questions before you read on.
Joss, 23, presents with dysuria. What are the findings of an uncomplicated urinary tract infection? Name FOUR.
You determine Joss has an uncomplicated urinary tract infection. What is the most appropriate investigation?
Name 2 first-line classes of antibiotics for uncomplicated urinary tract infection.
Now, let's go over the answers.
Joss, 23, presents with dysuria. What are the findings of an uncomplicated urinary tract infection? Name FOUR.
Pyuria or nitrites on dipstick
No fever
No vaginal discharge
No CVA tenderness
Did you name any FEATURES instead of FINDINGS? Though dysuria and frequency are characteristic of uncomplicated UTI, they are not physical findings. Tricky SAMP!
You determine Joss has an uncomplicated urinary tract infection. What is the most appropriate investigation?
Nothing
Did you say urine culture? I bet you thought about it. If no investigation is required, the answer is nothing. Tricky SAMP!
Get comfortable with the fact that you will sometimes need to write that no investigation is required - and know when these instances are! This is a classic one. The 99 topics will often specifically state where the CFPC believes no investigation is required -- for example, see the discussion around FSH in the menopause topic.
Name 2 first-line classes of antibiotics for uncomplicated urinary tract infection.
Sulfonamides
Nitrofurantoin
Did you say TMP-SMX or Septra? Look out for this tricky SAMP trick, I bet you will see it at least once on your exam. There's a difference between asking for 2 first line antibiotics and 2 CLASSES of antibiotics.
(In case you were wondering, Nitrofurantoin is both a drug and a class as it's the only drug in the class!)