SAUDI FELLOWSHIP TRAINING PROGRAM. Adult Cardiology. Final Written Examination 2019

Transcription

1 SAUDI FELLOWSHIP TRAINING PROGRAM Adult Cardiology Final Written Examination 2019 Objectives 1. Determine the trainee has sufficient competency related to the required specialty. 2. Determine the eligibility for entering the final clinical examination. General Provisions 1. The final written examination of Saudi board certificates /Diplomas/ Fellowships will be held once each year. 2. The final written examination may not be repeated. 3. Examination dates shall be provided by the Specialty Examination Committee in accordance with the approved annual schedule submitted by the Executive Assessment Administration. 4. The candidate would remain eligible for final written examination for a period not longer than three years after completion of training provided that he/she presents evidence of continuing clinical practice. 5. If the candidate did not pass within the three years, an additional attempt may be granted upon the approval of the Scientific Council, provided evidence of continuing clinical practice. 6. The candidate who failed to pass the final written examination including the additional attempt, has to repeat the final year of training, after which he/she shall be allowed to sit the final written examination twice given the approval of the Scientific Council. 7. After exhausting all the above attempts (maximum 6 attempts) the candidate will not be permitted to sit for the final written examination. Page 1

2 Examination Format: 1. The Saudi subspecialty fellowship and diplomas final written examination shall consist of one of the following: a. One paper with multiple choice questions (includes clinical scenarios with single best answer out of four options). Ten unscored items can be added for pretesting purposes. b. One paper with multiple choice questions (includes clinical scenarios with single best answer out of four options), and short answer questions (model answer for each question must be handed over to the executive assessment administration before the exam date). 2. If any other assessment format is used, the CAC must agree to its implementation (for example Short Answer Question (SAQ) or Modified Essay Question (MEQ) formats). Passing Score: 1. The passing score is 70%. However, if the percentage of candidates passing the examination before final approval is less than 70%, the passing score must be lowered by one mark at a time aiming at achieving 70% passing rate or 65% passing score whichever comes first. 2. Alternatively, to set a passing score using a standard setting method, the specialty examination committee must obtain approval of the process and passing score from the Executive Director for Assessment one month prior to exam administration. 3. To set the passing score a standard setting method that is supported by published scientific evidence can be used, for which the Angoff method is recommended. The process to arrive to the passing score requires prior review and approval. 4. If standard setting is used the above passing score regulation does not apply and a detailed report of the process and the recommended pass score should be forwarded to the Executive Director of Assessment at least two weeks before the examination date. 5. Under no circumstances can the passing score be reduced below 65%. Page 2

3 Suggested References: Heart Disease- A textbook of cardiovascular medicine By Braunwald, Zipes and Libby Cardiology By M. Crawford, J. DiMarco and W. Paulus Textbook of Interventional Cardiology By Topol Textbook of Clinical Echocardiography By C. Otto Feigenbaum's Echocardiography The Echo Manual By J. Oh ASE's Comprehensive Echocardiography Hemodynamic Rounds By M. Kern The Art and Science of bedside diagnosis By Sapira Interventional Cardiology By Singer Mayo Clinic Cardiovascular Board Review By J. Murphy and M. Lloyd Note: This list is intended for use as a study aid only. SCFHS does not intend the list to imply endorsement of these specific references, nor are the exam questions necessarily taken solely from these sources. Blueprint Outlines (MCQs): No. Sections Percentage (%) 1 Basic sciences/htn/cardiac Pathology/Cardiac Physiology 12% 2 Clinical Examination 7% 3 Aortic Disease 8% 4 CAD 23% 5 Cardiomyopathies/Heart Failure /Pregnancy 12% 6 Cardiac Arrhythmia 8% 7 Valvular Diseases 16% 8 Adult Congenital Heart Diseases ACHD 3% 9 Cardiac Pharmacology 2% 10 Pericardial/Systemic Diseases 5% 11 Ethics, Research and Patient Safety 4% Total 100% Page 3

4 Blueprint Outlines (Data Interpretation): No. Sections Percentage (%) 1 Echo Studies 11% 2 Coronary Angiograms 11% 3 Nuclear studies 11% 4 Hemodynamic Tracings 11% 5 EP Tracings 4% 6 CT-angio 2% 7 Cardiac MRI 2% 8 Holter Monitors 3% 9 ECGs 45% Total 100% Note: Blueprint distributions of the examination may differ up to +/-3% in each category Page 4

5 Example Questions EXAMPLE OF K1 QUESTIONS Question 1 Which of the following is a rare side effect of ACE inhibitors? A. Cough B. Hypotension C. Hypokalemia D. Agranulocytosis Question 2 A 56-year-old man is coming for a scheduled clinic follow up. Blood pressure readings have been ranging between 166/90 and 170/100 mmhg for most of the time. His physical activity is limited by shortness of breath, but no other symptoms. He has been receiving incremental doses of antihypertensive medications which currently consist of; Lisinopril 40 mg, Amlodipine 10 mg and carvedilol 25 mg twice daily. Basic laboratory tests are within normal limits. ECG shows voltage criteria for left ventricular hypertrophy with strain pattern. After ensuring adequate adherence with medications and accurate BP measurement technique. Which of the following is the most appropriate next step? A. Doppler renal ultrasound B. Ambulatory BP monitor C. Start hydrochlorothiazide D. Renal denervation therapy Page 5

6 EXAMPLES OF K2: Question 1 A 75-year-old male has 6 months history of increasing dyspnea on effort. He denies orthopnea or PND. He had an episode of dizziness while climbing stairs last year. He also recently noted chest tightness pain when he walks to the mosque. He does not report any palpitation. His medical history includes cholecystectomy 10 years ago for gall stones and recent cataract surgery on the left eye. He has type-2 DM for 10 years on hypoglycemic agents. He has a 40-pack-year smoking history but stopped 10 years ago. Examination revealed that he is overweight and JVP is normal. Brachial pulse is normal in character. The apex beat is difficult to appreciate because the patient is overweight. The first and second heart sounds are distant in intensity and no added sounds are heard. He has a loud ejection systolic murmur at the base which radiates to the neck, but no diastolic murmur. The murmur does not vary with Valsalva maneuver. The patient has a right femoral bruit but no carotid or abdominal bruits. The results of laboratory studies are normal except for increase in serum creatinine (1.3), increase in fasting blood glucose (148) and presence of mild hematuria and proteinuria on urinalysis. Blood Pressure Heart Rate 145/91 mmhg 78 /min Which of the following investigations should be ordered next? A. Doppler study of the carotid arteries B. Exercise nuclear scan C. CT angiogram of coronaries D. Transthoracic echocardiography with Doppler study Question 2 A 55-year-old woman presented to Emergency Medicine Department complaining of progressive dyspnea developing over one week after an episode of febrile illness, and joints pain. She had history of long-standing DM, and HTN, and she was told that her kidney function is deteriorating. Her primary care physician has described her an antibiotic, and analgesia. On auscultation of the heart there was distant heart sounds with no murmurs or added sounds, her chest exam was unremarkable. ECG showed sinus tachycardia. An echo cardiogram was obtained (see image). Blood Pressure Heart Rate 100/60 mmhg 120 /min Page 6

7 The initial differential diagnosis includes which of the following? A. Acute MI with myocardial rupture B. Acute aortic dissection C. Infective endocarditis with acute MR D. Cardiac tamponade Page 7