Table 2 Proportions of correct and incorrect answers for the 28 key feature items, calculated across the two e-seminars, and exit exam and the retention test
Diseases | Key features (Items) | Proportion of correct answers | Frequent or relevant incorrect answers (proportion) |
|---|---|---|---|
Pulmonary embolism | Diagnosis of pulmonary embolism | 58.6% | Acute coronary syndrome (8.0%); aortic dissection (3.9%) |
Wells Score to assess likelihood of PE | 74.0% | Assessment of hemodynamic stability (5.2%) | |
Thorax CT scan to confirm PE in a patient with high clinical probability | 50.0% | Thrombolysis without confirmation (17.7%); other imaging (9.7%); D-dimer testing (9.7%) | |
Right ventricular strain for risk stratification | 51.9% | Â | |
Fibrinolysis for unstable pulmonary embolism | 66.6% | Other medical treatment (10.2%) | |
Arterial hypertension | Diagnosis of secondary hypertension | 49.6% | Essential hypertension (11.5%); cardiac disease (10.4%) |
Diagnosis of diastolic dysfunction | 17.5% | Other myocardial disease (60.8%) | |
Discontinuation of ACE inhibitors due to typical cough | 93.7% | Â | |
Hyponatremia | Hospital admission for chronic symptomatic hyponatremia | 70.5% | Rapid sodium supplementation (11.0%) |
Thiazide diuretics as cause of hyponatremia | 83.0% | Hypovolemia (3.4%) | |
Diagnosis of central pontine myelinolysis following rapid sodium supplementation | 64.9% | Cerebral oedema (13.6%) | |
Atrial fibrillation | Orthostatic challenge after syncope | 72.5% | Tilt testing (22.8%) |
ECG diagnosis of tachyarrhythmia | 61.8% | Conduction blocks (13.7%); myocardial infarction (1.9%) | |
CHA2DS2-VASc score for anticoagulation | 83.6% | Â | |
Lupus erythematosus | Diagnosis of nephrotic syndrome | 80.3% | Nephritic syndrome (8.0%) |
Diagnosis of systemic lupus erythematosus | 83.8% | Non-specific glomerulonephritis (4.3%) | |
Renal biopsy to confirm lupus nephritis | 79.8% | Imaging (4.6%) | |
COPD | Diagnosis of COPD | 91.1% | Â |
Confirmation of COPD by FEV1/VC < 70% | 64.7% | FEV1 (13.6%); FEV1/VC % predicted (15.8%) | |
ABG analysis for suspected CO2 intoxication | 67.2% | Imaging (7.2%) | |
Treatment of CO2 intoxication by non-invasive ventilation | 53.3% | Oxygen (16.9%); CPAP (11.4%); buffering (6.7%) | |
Pneumonia | Diagnosis of left apical pneumonia in a chest X-ray | 72.8% | Incorrect or no localisation (23.3%) |
Decision on hospitalisation based on the CRB-65 score | 75.9% | Decision based on additional laboratory tests (5.6%) | |
Hyperthyroidism | Diagnosis of hyperthyroidism from lab results | 88.8% | Hypothyroidism (4.1%) |
Stopping amiodarone in a pt. with hyperthyroidism | 66.2% | other medical (11.4%) or surgical (5.7%) treatment | |
Pulmonary fibrosis | Diagnosis of pulmonary fibrosis | 53.8% | Pulmonary oedema (12.5%); pneumonia (9.4%) |
Amiodarone as cause of pulmonary fibrosis | 78.9% | Atrial fibrillation (4.8%) | |
Indication for long-term oxygen therapy | 47.6% | Mechanical ventilation (24.2%) |