how to answer 2007 mcqs. why do we have this lecture? why do we have this lecture?
Post on 19-Dec-2015
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How To Answer
2007
MCQs
Why do we have this
lecture?
Importance of MCQ
- Many exams in medical collage are MCQ style
- A lot of other exam like -Saudi Counsel Exam-USMLE ( step 1 , step 2)-MCCEE
WHAT DO YOU EXPECT FROM
THIS LECTURE ?
Objectives
- How to prepare yourself for MCQs exam?
- Common MCQs types.- Common mistakes in MCQs- Strategies for answering MCQs. - How to make educated guess?
- there is no substitute for the knowledge.
- Main goal is
Knowledge
TO SHOW THE RIGHT WAY IN ANSWERING MCQs FOR
THOSE WHO HAVE THE KNOWLEDGE
What is more important for you ?
How to Prepare for MCQ Exam
1- Knowledge.
2- Pass the exam.Both of Them
• Decide what your goal is. • Plane how you will reach your goal• Choose what to study & what to ignore
Using– The course out line– Given lecture– Provided resource e.g. textbook ,web site..– Talk to students who took the exam
How to Prepare for MCQs Exam
• How to study3 stage– You must learn basic term & definition– You must learn central concept– You must be able to apply these concept
• Organize study scheduleNot to spend too much time on one area &
ignore others.• Decide your weak area
How to Prepare for MCQs Exam
1. Ask yourself questions
2. Use graphs and charts
3. Paraphrase
4. Summary note
5. Make use of past examination papers
6. Link up with a friend
Highly Effective Studying Methods
Advantages:• Framing the material• To focus on the key areas.• Preparing for questions you may see
on the examination• Get into the mind of the questions
writer
1) Ask Yourself Questions
• To enhance your comprehension of the material
• Drawing a graph from memory will give you the confidence that you have truly mastered the material
2) Use Graphs and Charts
Summarize the key content in your own word.
3) Paraphrase
If you can summaries the topic that means you are
ready !!!
4) Summary Note
If possible, get hold of some past papers and work through
them to get an idea of the kinds of questions asked and
what is expected from you.
5) Make Use of Past Examination Papers
Studying in a group and discussing key concepts and ideas with a friend may be helpful.
It can also help you to stay motivated and to keep you on track.
6) Link Up With a Friend
Advantages:•to learn how to deal with MCQ exam better (how to read it , how to avoid the misleading answer ,time management).• to acquired new knowledge . As you answering MCQs, examine whether you got them right and look at why you got the question right or wrong.• To evaluate your knowledge. and give you clues about what to study more. •To learn from your mistake e.g. if you misread the question then ask your self why I have misread it & how to avoid that in the future .
7) Practice MCQ
Be careful .Many students study what they know best and give less time to subjects that make them uncomfortable
How to Prepare?
Choose ONE main book as primary study book and the other as back-up to clarify
points as needed.
Resources
– STEMquestion or incomplete statement
– OPTIONSsuggested answers or completions
– DISTRACTERS incorrect responses
– KEY correct response
Anatomy of MCQ
• 1. Positively worded questions ("most likely")• 2. Negatively worded questions ("least likely")• 3. Clinical case questions (long clinical cases)• 4. "Two-Step" (double-jump) questions• 5. "Bait and Switch" questions• 6. Conjunction questions• 7. "True/False" (fast-recall) questions• 8. Visual questions
MCQ Question Subtypes
Positively worded questions ask you to
select the answer that is ("most likely") to be true
Positively Worded Questions
• An 85-year-old man has had urinary frequency, difficulty initiating stream, and dysuria for the last two months. A rectal exam reveals an enlarged prostate. Prostate-specific antigen (PSA) is not elevated. Which part of the prostate is most likely affected in this patients condition?
Positively Worded Questions
A. Peripheral zone
B. Prostatic capsule
C. Prostatic urethra
D. Posterior lobe of the prostate
E. Transitional/central zone
Correct answer (e)
Positively Worded Questions
• Clinical case questions are distinguished by a fairly lengthy presentation of a patients history, physical exam findings, and maybe even lab results. Your task is to read through this detailed information and arrive at the best answer to the question being asked.
• The most important part of the clinical case question is the last sentence
Clinical Case Questions
A 24-year-old woman presents with a fever and myalgias. She experienced brief, self-limited diarrhea 24 hours after attending a barbecue two weeks earlier. She remained asymptomatic until the day prior to presentation when she developed a fever of 39.4 C (105 F), conjunctivitis, and severe muscle pain. On physical examination, she appears acutely ill and has a fever of 39.4 C . There is a diffuse maculopapular rash and generalized muscular tenderness. Several hemorrhages are noted beneath the fingernails. Admission hemogram reveals a white blood cell count of 15,000/mm3 with 25% eosinophils. What is the infectious form of the most likely causative agent?
Clinical Case Questions
A. Cyst
B. Cysticerci
C. Encysted larvae
D. Ovum
E. Rhabditiform larvae
Correct answer (c)
Clinical Case Questions
Given x ----- 1----- 2 ----- d
stem Answer
"Two-Step" Questions• Two-step (also called double-jump)
questions require several cognitive steps to arrive at a correct answer.
"Two-Step" Questions• A 46-year-old, bright, energetic, overweight man
loves to talk and give his opinion on the world around him. He is always quick with a joke and seems to love a good laugh. Yet, whenever he has to talk in front of more than three or four people, he reports sweating, heart palpitations, and trembling hands. "My mind just goes blank," he says, "and I feel that I'm going to say something so stupid that I would rather die" What would be the most appropriate treatment for this man?
A. Alprazolam
B. Atenolol
C. Clonidine
D. Diazepam
E. PhenelzineCorrect answer
(b)
"Two-Step" Questions
• In the same manner as two-step questions, conjunction questions require two correct choices to arrive at the best answer.
• Options are presented as sets of terms or facts linked by a conjunction (usually the word "and"). The best answer is the one in which both parts of the option are correct
Conjunction Questions
A 66-year-old man has been brought to his physician's office by his wife who expresses concern that "something is just not right." During neurological examination, both recent and long-term memory appear unimpaired. However, the patient seems to have difficulty concentrating. He asks repeatedly where he is am what he is doing there. He has difficulty with simple arithmetic and writing simple sentences. He has no difficulty outlining or reproducing presented figures, but on discrimination task, he confuses his right and left hands. This patient is most like suffering from lesions affecting which lobes?
Conjunction Questions
A. Dominant parietal and frontal
B. Dominant parietal and dominant temporal
C. Dominant temporal and frontal
D. Nondominant parietal and dominant temporal
E. Nondominant parietal and nondominant temporal
Correct answer (a)
Conjunction Questions
Bait and switch questions begin by presenting material that may lead you to think about content in one direction, but they then shift you to another line of thought at the end;
The key question is always given in the last line of the question stem.
"Bait and Switch" Questions
•A 59-year-old man with a history of hypertension and cigarette smoking survived myocardial infarction two years ago. He has been reluctant to follow the die prescribed by his physician, but as part of his recovery program. Following an early morning run, he consumes a breakfast consisting of cereal, eggs, sausage, pancakes with maple syrup, and coffee with cream and sugar. Which of the following proteins will most likely be activate in the liver of the patient ?
"Bait and Switch" Questions
A. Glycogen phosphorylase
B. PEP carboxykinase
C. HydroxymethyIglutaryl-CoA reductase
D. Glycogen synthase
E. Carnitine acyltransferase
"Bait and Switch" Questions
Correct answer (e)
- Stimulus – Response Questions
Given x ----------------- d
stem Answer
Recall Questions
These are easy questions and they depend on facts which you
should know (knowledge)
The most important stimulus for respiratory centers in the brain is ?
A- Oxygen
B- Carbon dioxide
C- Carbon monoxide
D- pH
E- Nitrogen
Recall Questions
Correct answer (b)
These questions including pictures, histology slides,
and MRI and CT scan results, as a part of
questions.
Visual Questions
Common Problems on MCQs exams
Problem Type Source of ErrorsFormat problems Particular question subtypes
Anxiety problems Questions containing numbers, or done early in the review session
Fatigue problems Questions done late in reviewsession
Reading errors More common in long questions
Directionality errors Questions that ask prediction consequences
Steps For Solving MCQs
1st Step
Steps For Solving MCQs
االستعانة بالله عز ومن يتوكل على الله ”وجل
فهو حسبه إن الله بالغ أمره قد جعل الله لكل
وإذا سألك عبادي عني ”“شيء قدرافإني قريب أجيب دعوة
“الداعي إذا دعان
Steps For Solving MCQs
اللهم ال سهل إال ما جعلته سهال وأنت
تجعل الحزن إن شئت سهال
ومن األدعية:
Steps For Solving MCQs
دعاء الوالدين
والتنسى:
Steps For Solving MCQs
2nd Step
Reading The Questions
Steps For Solving MCQs
- Read instructions and questions most carefully.
- Ask yourself, is the question asking for
- The only correct answer ? - The best answer ? - The incorrect answer (except) ?
- Convert any double negatives to positives.
Steps For Solving MCQs
Important MCQs term
Golden Role In Reading The Questions
Be SmartBUT don’t to be too smart
Remember that the exam contains different levels of questions including
easy & very easy questions
A 19 year-old patient presents in the emergency department
Complaining of abdominal pain in right iliac fossa of 3 hours duration
associated with nausea, vomiting, and loss of appetite. On examination
he shows tenderness on the right iliac fossa, and low grade fever. Lab
test shows normal red blood cell count with elevation of leucocytes
count. Nothing appear clearly in AXR or US. What is most likely the
diagnosis?
a) Cholecystitis
b) Pancreaitis
c) Intestinal obstruction
d) Appendicitis
Clinical Case
- Time spent reading question is well spent
- Studies have shown most students look at the answers first. ????!!!
- Pick out key words (high light them)
- Paraphrase the question
Read the Question
A 19 year-old patient presents in the emergency department
Complaining of abdominal pain in right iliac fossa of 3 hours duration
associated with nausea, vomiting, and loss of appetite. On examination
he shows tenderness on the right iliac fossa, and low grade fever. Lab
test shows normal red blood cell count with elevation of leucocytes
count. Nothing appear clearly in AXR or US. What is most likely the
diagnosis?
a) Cholecystitis
b) Pancreaitis
c) Intestinal obstruction
d) Appendicitis
Clinical Case
A 19 year-old patient presents in the emergency department
Complaining of abdominal pain in right iliac fossa of 3 hours duration
associated with nausea, vomiting, and loss of appetite. On examination
he shows tenderness on the right iliac fossa, and low grade fever. Lab
test shows normal red blood cell count with elevation of leucocytes
count. Nothing appear clearly in AXR or US. What is most likely the
diagnosis?
a) Cholecystitis
b) Pancreaitis
c) Intestinal obstruction
d) Appendicitis
Clinical Case
Cholecytitis: Abdominal pain & tenderness in the right upper quadrant fever & +ve Murphy’s sign.
Pancreatitis: Epigastric pain & tendrenss radiate to the back with High amylase level
Intestinal obstruction : abdominal pain, vomiting, constipation and distention
Appendcitis: Abdominal pain in the right iliac fossa associated with nausea, vomiting and loss of appetite.
A 19 year-old patient presents in the emergency department
Complaining of abdominal pain in right iliac fossa of 3 hours duration
associated with nausea, vomiting, and loss of appetite. On examination
he shows tenderness on the right iliac fossa, and low grade fever. Lab
test shows normal red blood cell count with elevation of leucocytes
count. Nothing appear clearly in AXR or US. What is most likely the
diagnosis?
a) Cholecystitis
b) Pancreaitis
c) Intestinal obstruction
d) Appendicitis
Clinical Case
Steps For Solving MCQs
3rd Step
Steps For Solving MCQs
Answering The Question
Steps For Solving MCQs
1st StepTry to answer the question
without looking at the choices
Why!!?? It’s the best way to avoid distracters
Steps For Solving MCQs
If You Couldn’t Answer
Next Step
Steps For Solving MCQs
2nd Step
Look at the choices & Try to pick the right
answer
Steps For Solving MCQs
If You Couldn't Answer
Next Step
Steps For Solving MCQs
3rd StepAnswering by exclusion
Consider each choice as a True/False question
Steps For Solving MCQs
If you can conclude that all choices are wrong except one that means you have reached the
right answer
Steps For Solving MCQs
Till this step, you have answered the question
with your pure knowledge & you don’t need to revise it at the end of the time
Steps For Solving MCQs
If You Couldn't Answer
Next Step
Steps For Solving MCQs
If after exclusion you have:
2 choices = 50 % to be the right answer
3 choices = 33% to be the right answer
4 choices = 25 % to be the right answer
Steps For Solving MCQs
4th StepEducated Guess
The main goal is to maximize the chance of getting the right answer & minimize the chance
of getting the wrong answer
Consider Guessing Only
If There is
NO Negative Marking
Steps For Solving MCQs
Educated Guess
If an option is much longer or much
shorter its more likely to be correct
1) Length of the Question
Example :Progressive weakness, first of the lower extremities then of the upper extremities is most likely to occur in patients with:
A. Tularemia B. Crohn's disease C. Goodpasture's syndrome D. Guillain-Barre syndrome (acute idiopathic
polyneuritis)
1) Length of the Question
• Options that are not grammatically aligned with the stem are probably false
• There is grammatical alignment between the stem and the correct answer
2) Grammatical Consistency
Grammatical mistakes…if the last word of the lead line of the question is “an”, you would infer the first letter of the correct choice would be an vowel )a, e, i, o, u( .
2) Grammatical Consistency
Example :
What are the complications of hypertension ? A. Intestinal obstruction
B. Bronchial asthma
C. Ischemic heart diseases
D. Pneumonia
2) Grammatical Consistency
- Two choices say the opposite thing: Then one of them may be the correct answer
- If you think two answer are so close that you cannot reasonably choose between them, then the odds are that neither one is correct; you need to look carefully at a different option
3) Opposites
Example :Carpal spasm following inflation of blood pressure cuff for 2 minutes above the systolic blood pressure (positive Trousseau sign) occurs in:
A. Hypocalcemia
B. Hypercalcemia
C. Hypoglycemia
D. Hypokalemia
3) Opposites
False Response
• All • Always• Never• Only
True Responses
• May be• Can be • Is possible• Can appear
4) Specific Determiners
- All the above (>1)
- Non of the above
- A and B
4) Specific Determiners
Example :The following statements regarding epistaxis
are false EXCEPT:A. Epistaxis never occurs in children
B. It results from rupture of posterior nasal vessels only
C. It always treated by ligation of the ipsilateral internal carotid artery
D. Epistaxis may be treated by cautery of Little's area
4) Specific Determiners
- Some test makers have tendency to repeat word or phrases in the options
- If you are unsure of an answer select from options with the repeated words or phrases
- Select an option in which a key word from the stem is repeated
5) Overuse of the Same Word or Expression
ExampleWhat is the complication of
premature rupture of membrane ?
A.Premature labor B.Post partum hemorrhage C.Anemia D.Hypertension
5) Overuse of the Same Word or Expression
When all option can listed in numeric order (e.g percentages ) the correct choice will most often be one of the two middle values.
6) Numeric mid-range
ExampleWhat percentage of patients with acute myocardial infarction die before reaching a hospital?
A. 1%
B. 20%
C. 50 %
6) Numeric mid-range
- Try to think why he put that
question in the exam - LECTURES
- HIS WAY
- IMPROTANT POINTS
- REPEATED QUESTION
7) Think Backwards
Steps For Solving MCQs
If You Couldn't Answer
Next Step
Steps For Solving MCQs
5th StepPick Any Choice
That means 25% you may get the right answer if you have 4 choices
Don’t waste your time trying to answer difficult question because the easy & difficult
question has the same mark
Golden Role In Answering MCQs
Try To Be Relaxed
Remember that unconscious mind doesn’t work under stress
In general your odds of changing a correct answer to a wrong is much higher than the reverse that is simply not worth the risk
Changing Answers
Check time /10 questions
Time Management
If I finished earlier what I have to do?!!
- Make sure you have answered all questions
- Review what you have marked already
BOOKS• KAPLAN MEDICAL• NMS REVIEW FOR USMLE
WEB SITES• www.residencyandfellowship.com• www.studentbmj.com• www.bmjlearning.com• www.mededuc.com
REFERENCES
THANK YOUAmer Khojah
Seraj Makkawi