Core TDM Examination topics

Allergy and Immunology

• Allergic reaction (e.g., rash)
• Anaphylaxis
• Seasonal allergies

Breast Health

• Breastfeeding
• Breast lump (e.g., breast cancer, fibroadenoma)
• Mastitis

Cardiovascular

• Advanced cardiac life support
• Arrhythmias (e.g., atrial fibrillation, heart block)
• Chest pain (e.g., myocardial infarction, pericarditis)
• Heart failure
• Hypertension
• Vascular disease (e.g., abdominal aortic aneurysm, peripheral vascular disease)

Communication and Professionalism

• Counselling and education (e.g., medication adherence)
• Establishing goals of care
• Managing challenging clinical encounters (e.g., delivering bad news, de-escalation of aggression, boundary setting)
• Obtaining informed consent (e.g., capacity assessment)
• Providing culturally appropriate care
• Upholding professional standards (e.g., confidentiality)

Dermatologic

• Alopecia
• Burns
• Eczematous rash (e.g., atopic dermatitis)
• Macular rash (e.g., drug reaction, viral exanthem)
• Papular and/or pustular dermatoses (e.g., acne, folliculitis)
• Plaque dermatoses (e.g., psoriasis)
• Skin cancer
• Skin trauma (e.g., lacerations, bites)
• Ulcers (e.g., decubitus ulcers)
• Vesicular and/or bullous conditions
• Wheals (e.g., urticaria)

Drug Prescribing and Monitoring

• Absolute and relative contraindications
• Adverse drug effects (e.g., long QT, rash)
• Dosage adjustment (e.g., age, renal function)
• Drug interactions
• Pain management (e.g., acute pain, chronic pain)
• Prescribing controlled substances (e.g., opioids, benzodiazepines)
• Prescribing in pregnancy and lactation (e.g., avoiding known teratogens)
• Prescribing to older adults (≥ 65 years) (e.g., fall risk, polypharmacy)
• Therapeutic drug monitoring (e.g., lithium levels, renal function)

Endocrine and Metabolic

• Adrenal disease
• Diabetes mellitus (e.g., type 1, type 2)
• Dyslipidemia
• Gender-affirming care
• Obesity
• Thyroid disorders

Gastrointestinal and Hepatic

• Abdominal pain (e.g., gastroesophageal reflux disease, peptic ulcer disease, dyspepsia)
• Abnormal liver enzymes (e.g., hepatitis, steatotic liver disease)
• Cirrhosis complications (e.g., hepatic encephalopathy)
• Constipation
• Diarrhea (e.g., Celiac disease, irritable bowel syndrome)
• Dysphagia (e.g., esophagitis, esophageal cancer)
• Gastrointestinal bleeding (e.g., hemorrhoids, Mallory-Weiss tear)
• Inflammatory bowel disease
• Jaundice
• Nausea and vomiting

Geriatric

• Delirium
• Dementia
• Fall prevention
• Frailty

Gynecologic

• Abnormal vaginal bleeding (e.g., postmenopausal bleeding)
• Amenorrhea (e.g., ovarian insufficiency)
• Menopause-related symptoms (e.g., hot flashes, sleep disturbance)
• Menstruation-related symptoms (e.g., dysmenorrhea, menorrhagia)
• Pelvic organ prolapse
• Pelvic pain (e.g., endometriosis, ovarian torsion, pain management during procedures)
• Vaginal atrophy
• Vulvar pruritus (e.g., lichen sclerosus)

Head and Neck

• Epistaxis
• Tinnitus
• Vertigo (e.g., Meniere disease, benign paroxysmal positional vertigo)

Hematologic

• Abnormal bleeding (e.g., thrombocytopenia, von Willebrand disease)
• Anemia (e.g., iron deficiency, B12 deficiency, myeloproliferative disorders)
• Hematologic emergencies (e.g., febrile neutropenia, sickle cell crisis)
• Venous thromboembolism

Illness Prevention, Health Promotion, and Integrated Care

• Abuse and assault (e.g., elder abuse, child abuse, intimate partner violence)
• Cancer screening (e.g., mammography, fecal immunochemical test)
• Immunization
• Infection control practices (e.g., hand hygiene)
• Lifestyle recommendations (e.g., smoking cessation, sun protection, exercise)
• Metabolic and environmental screening (e.g., lipid profile)
• Occupational health (e.g., needlestick injury)
• Periodic health assessment
• Primary and secondary prevention for cardiovascular disorders
• Prophylaxis (e.g., HIV, malaria)
• Travel health

Infectious

• Central nervous system (e.g., meningitis)
• Ear, nose, and throat (e.g., pharyngitis, otitis media)
• Gastrointestinal (e.g., Clostridiodes difficile infection, gastroenteritis)
• Gynecologic and obstetric (e.g., vaginitis, endometritis)
• Hepatobiliary (e.g., cholangitis, cholecystitis)
• Multisystem (e.g., Lyme disease, HIV)
• Musculoskeletal (e.g., septic arthritis)
• Ophthalmologic (e.g., conjunctivitis)
• Oral (e.g., thrush)
• Respiratory tract (e.g., pneumonia, viral upper respiratory tract infections)
• Sepsis
• Sexually transmitted (e.g., chlamydia, gonorrhea)
• Skin (e.g., abscess, impetigo, tinea versicolor)
• Urogenital (e.g., cystitis, pyelonephritis)

Mental Health

• Anxiety disorders (e.g., panic disorder, specific phobia, social anxiety disorder)
• Depressive disorders (e.g., major depressive disorder)
• Eating disorders
• Neurodevelopmental disorders (e.g., autism spectrum disorder, attention-deficit hyperactivity disorder)
• Obsessive-compulsive disorder
• Personality disorders
• Schizophrenia spectrum and other psychotic disorders (e.g., schizophrenia)
• Somatic symptom and related disorders
• Suicidality
• Trauma- and stressor-related disorders (e.g. adjustment disorder, prolonged grief disorder, posttraumatic stress disorder)
• Type 1 and type 2 bipolar disorder

Musculoskeletal and Rheumatologic

• Bone health (e.g., osteoporosis)
• Connective tissue disease (e.g., systemic lupus erythematosus)
• Fracture
• Generalized pain (e.g., fibromyalgia)
• Joint pain (e.g., inflammatory arthritis, osteoarthritis, gout)
• Neck and back pain (e.g., mechanical, sciatica, ankylosing spondylitis)
• Repetitive strain injuries (e.g., carpal tunnel syndrome, lateral epicondylitis)
• Soft tissue pain (e.g., plantar fasciitis)
• Vasculitis (e.g., temporal arteritis)

Neurologic

• Altered sensation (e.g., peripheral neuropathy)
• Headache (e.g., migraine, tension headache)
• Head injury (e.g., concussion)
• Localized weakness (e.g., Bell palsy)
• Loss of consciousness (e.g., syncope, coma)
• Movement disorder (e.g., tic, Parkinson disease)
• Seizure (e.g., epilepsy)
• Stroke
• Tremor (e.g., essential tremor)

Ophthalmologic

• Dry eye
• Red eye (e.g., uveitis)
• Visual loss (e.g., glaucoma, retinopathy)

Palliative

• End-of-life care
• Psychosocial support
• Symptom management (e.g., pain, nausea)

Pediatric

• Enuresis, encopresis
• Failure to thrive
• Febrile seizure
• Learning concerns (e.g., learning disability)
• Neonatal care (e.g., neonatal jaundice)
• Well-child care

Pregnancy and Reproductive Health

• Contraception (e.g., oral contraceptives, condoms, intrauterine devices)
• Infertility (e.g., polyendocrine metabolic ovarian syndrome)
• Pregnancy complications (e.g., hyperemesis gravidarum, preeclampsia, postpartum hemorrhage)
• Pregnancy termination
• Prenatal care (e.g., folic acid use)

Renal and Genitourinary

• Acute kidney injury
• Chronic renal disease
• Electrolyte disturbance (e.g., hyperkalemia, hyponatremia)
• Renal colic

Respiratory

• Asthma
• Chronic obstructive pulmonary disease
• Cough
• Dyspnea (e.g., pneumothorax)
• Wheezing (e.g., bronchitis)

Substance Use and Toxicology

• Drug overdose (e.g., accidental, intentional)
• Poisoning (e.g., ingestion of household products, carbon monoxide)
• Substance use and substance use disorders (e.g., alcohol use disorder, opioid use disorder, intoxication)
• Withdrawal syndromes (e.g., alcohol withdrawal, benzodiazepine withdrawal)

Undifferentiated Presentations

• Dizziness
• Fatigue
• Fever
• Generalized weakness
• Mass (e.g., cervical, abdominal)
• Shock
• Sleep disturbance (e.g., obstructive sleep apnea, restless legs syndrome)
• Weight loss (e.g., malignancy)

Urologic

• Dysuria (e.g., interstitial cystitis)
• Erectile dysfunction
• Hematuria
• Incontinence (e.g., stress incontinence, urge incontinence)
• Phimosis
• Prostate disorders
• Testicular pain
• Urinary retention