NAC OSCE Patient Management & Treatment 2

Question 1

A 2-year-old child presents with a first febrile seizure lasting 3 minutes that has now resolved. The child is alert and examination is normal. According to CPS guidelines, what is the MOST appropriate next step?

Accepted Answer

Reassure parents, educate about fever management, and discharge — routine EEG and neuroimaging are NOT indicated for simple febrile seizures

Answer

CPS guidelines state that simple febrile seizures (brief, generalised, no recurrence within 24 hours) do not require EEG, neuroimaging, or prophylactic anticonvulsants; parental education and fever management are sufficient.

Question 2

According to the SOGC, at what gestational age is the combined first-trimester prenatal screening (nuchal translucency + PAPP-A + free β-hCG) performed?

Accepted Answer

11+0 to 13+6 weeks gestation

Answer

SOGC guidelines specify combined first-trimester screening is performed between 11+0 and 13+6 weeks when nuchal translucency measurement is technically optimal.

Question 3

A 72-year-old patient is discharged after an acute STEMI treated with primary PCI. According to CCS guidelines, which medications should be prescribed at discharge?

Accepted Answer

Dual antiplatelet therapy (aspirin + P2Y12 inhibitor), high-intensity statin, ACE inhibitor or ARB, and beta-blocker

Answer

CCS post-MI guidelines recommend DAPT (aspirin + ticagrelor or prasugrel), high-intensity statin, ACE inhibitor/ARB (especially if EF <40%), and beta-blocker as standard post-STEMI secondary prevention.

Question 4

A 55-year-old woman is newly diagnosed with stage 2 breast cancer (ER+/PR+/HER2-). She undergoes lumpectomy. According to Canadian Cancer Society standards, which adjuvant therapy is indicated?

Accepted Answer

Adjuvant radiotherapy to the breast plus 5-10 years of endocrine therapy (tamoxifen or aromatase inhibitor)

Answer

For hormone receptor-positive early breast cancer after breast-conserving surgery, adjuvant breast radiotherapy reduces local recurrence and endocrine therapy for 5-10 years reduces systemic recurrence, per Cancer Care Ontario and Canadian guidelines.

Question 5

According to the Canadian Immunization Guide, which vaccine is recommended at 2, 4, and 6 months of age in the standard Ontario childhood immunization schedule?

Accepted Answer

DTaP-IPV-Hib-HB (hexavalent vaccine) plus PCV13 and Rotavirus

Answer

Ontario's immunization schedule at 2, 4, and 6 months includes the hexavalent vaccine (DTaP-IPV-Hib-HB), pneumococcal conjugate (PCV13), and rotavirus oral vaccine, consistent with the Canadian Immunization Guide.

NAC OSCE Practice Test

NAC OSCE Practice Test

NAC OSCE Patient Management & Treatment 2