How To Answer 2007 MCQs. Why do we have this lecture? Why do we have this lecture?

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?


A. Peripheral zone

B. Prostatic capsule

C. Prostatic urethra

D. Posterior lobe of the prostate

E. Transitional/central zone

Correct answer (e)


• 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?


A. Cyst

B. Cysticerci

C. Encysted larvae

D. Ovum

E. Rhabditiform larvae

Correct answer (c)


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?


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)


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 ?


A. Glycogen phosphorylase

B. PEP carboxykinase

C. HydroxymethyIglutaryl-CoA reductase

D. Glycogen synthase

E. Carnitine acyltransferase


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


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


اللهم ال سهل إال ما جعلته سهال وأنت

تجعل الحزن إن شئت سهال

ومن األدعية:


دعاء الوالدين

والتنسى:


2nd Step

Reading The Questions


- 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.


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







diagnosis?

a) Cholecystitis

b) Pancreaitis


d) Appendicitis

Clinical Case







diagnosis?

a) Cholecystitis

b) Pancreaitis


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.







diagnosis?

a) Cholecystitis

b) Pancreaitis


d) Appendicitis

Clinical Case


3rd Step


Answering The Question


1st StepTry to answer the question

without looking at the choices

Why!!?? It’s the best way to avoid distracters


If You Couldn’t Answer

Next Step


2nd Step

Look at the choices & Try to pick the right

answer


If You Couldn't Answer

Next Step


3rd StepAnswering by exclusion

Consider each choice as a True/False question


If you can conclude that all choices are wrong except one that means you have reached the

right answer


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



Next Step


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


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


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( .


Example :

What are the complications of hypertension ? A. Intestinal obstruction

B. Bronchial asthma

C. Ischemic heart diseases

D. Pneumonia


- 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


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


- 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



Next Step


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

Documents

How To Answer 2007 MCQs. Why do we have this lecture? Why do we have this lecture?