NAC OSCE Patient Management & Treatment

Question 1

According to Diabetes Canada 2023 guidelines, which medication should be added first-line alongside metformin in a patient with type 2 diabetes and established cardiovascular disease?

Accepted Answer

An SGLT2 inhibitor (e.g., empagliflozin) or GLP-1 receptor agonist with proven CV benefit

Answer

Diabetes Canada 2023 guidelines recommend SGLT2 inhibitors or GLP-1 receptor agonists as preferred second agents in T2DM with established ASCVD due to demonstrated cardiovascular and renal benefits.

Question 2

A 6-year-old child weighing 20 kg presents to a Canadian emergency department with moderate croup (Westley score 3-5). What is the standard treatment?

Accepted Answer

Oral dexamethasone 0.6 mg/kg (single dose) with nebulised epinephrine for moderate cases

Answer

Canadian paediatric guidelines recommend oral or IM dexamethasone 0.6 mg/kg (single dose) for croup; nebulised racemic or L-epinephrine is added for moderate-to-severe cases with stridor at rest.

Question 3

According to the Canadian Hypertension Education Program (CHEP/Hypertension Canada), what is the target blood pressure for a non-diabetic adult with hypertension and no other comorbidities?

Accepted Answer

<130/80 mmHg for most patients, and <120 mmHg systolic in high-risk patients

Answer

Hypertension Canada 2020+ guidelines recommend a target of <130/80 mmHg for most adults and <120 mmHg systolic for high-risk patients (e.g., established CVD, CKD, diabetes with target organ damage).

Question 4

A 35-year-old pregnant woman at 36 weeks has a group B Streptococcus (GBS)-positive vaginal/rectal swab. According to SOGC guidelines, what is the appropriate management during labour?

Accepted Answer

Intrapartum IV penicillin G starting at onset of active labour or rupture of membranes

Answer

SOGC guidelines recommend intrapartum IV penicillin G (or ampicillin) as prophylaxis for GBS-positive mothers to prevent early-onset neonatal GBS disease; antenatal oral antibiotics do not reliably eliminate carriage.

Question 5

A 70-year-old patient with non-valvular atrial fibrillation has a CHA₂DS₂-VASc score of 3. According to CCS guidelines, what anticoagulation is recommended?

Accepted Answer

A direct oral anticoagulant (DOAC), preferably over warfarin

Answer

CCS Atrial Fibrillation guidelines recommend DOACs over warfarin for stroke prevention in non-valvular AF when CHA₂DS₂-VASc ≥2 in males or ≥3 in females due to superior efficacy and safety profiles.

NAC OSCE Practice Test

NAC OSCE Practice Test

NAC OSCE Patient Management & Treatment