Important Tips for attempting MCQs

[sashank]

IMPORTANT TIPS FOR ATTEMPTING MCQS

There's no shortage of help on how to answer MCQs. You can find them in the prefaces of membership books, on all respectable MCQ websites, and—perhaps most commonly—you hear them outside examination halls in May coming straight from the horse's mouth. But some tips sound like ones you hear at Cheltenham and are about as reliable. Perhaps the oldest tip about true/false MCQs is "never believe an answer that contains the word never or always"; for example, "patients with gout always get pain in their big toe." Only rarely in medicine is an answer always true or always false, so you should not believe these statements. But true/false type MCQs have fallen out of favour in recent years and in any case most MCQ writers long ago stopped falling into the "always or never" trap.
True/false MCQs have been replaced by "best of many" questions and extended matching questions.
In "best of many" questions, there is:
· A stem (usually a short clinical story)
· A question that tests application of knowledge (for example, what is the most likely diagnosis?)
· Four or five options (only one of the options should be correct).
Extended matching questions are a variation on this theme. In this type of question you list a number of possible answers and write a few case scenarios below them. The reader is then asked to match the case scenarios with the likely answer. Examiners think that these are more educationally sound but almost inevitably a new generation of questions has led to a new generation of tips. Should you believe them? Let's have a look.
Always read the question carefully before answering


One of the most common mistakes made in exams occurs when panic stricken students fail to read questions correctly. This leads to spectacular disaster when answering MCQs. Instead of reading "which of the following suggests a disease other than multiple sclerosis", students read "which of the following suggests multiple sclerosis" and give the wrong answer. So always read questions carefully. Look out especially for the phrase—"all of the following statements are correct except..."
Cover the list of possible answers and see if you can answer a question without any hints or distractors


Look at the following question but cover the answers below:
A 60 year old man complains of central chest pain. His ECG shows ST elevation in leads II, III, and AVF. What is the most likely diagnosis?
Now look at the answers:
A. Anterior myocardial infarction
B. Inferior myocardial infarction
C. Pericarditis
D. Posterior myocardial infarction.
In this way you can diagnose an inferior myocardial infarction before the examiner has a chance to throw distractors at you.
Long and specific answers are correct

A 39 year old man goes to see his doctor as he is feeling slowed down. He has previously been super fit. What did his doctor do?
A. Diagnose hypothyroidism
B. Diagnose hypothyroidism and start thyroxine
C. Diagnose hypothyroidism, start thyroxine, and send him out to fight Leon Spinks.
You don't need to be a fight fan to realise that option C is the longest and most specific and therefore correct (Ali's doctor had perhaps not heard of parkinsonism due to multiple head trauma). But long and specific answers can sometimes be wrong. In any case canny examiners usually close off this loophole by making all the answers homogenous and of about equal length.


Choose the option in the middle
What is the optimal dose of bisoprolol in patients with heart failure?
A. 5 mg
B. 10 mg
C. 20 mg.
The correct answer is 10 mg in this case, but this is not a reliable method. Good examiners will not put all the correct answers in the middle. And this tip will definitely let you down when you are faced with a "best of four" question where there is no middle answer.


If you don't know the right answer then exclude the wrong ones and pick the one that's left


Which of the following prime ministers lived the longest?
A. William Pitt the younger
B. Harold Macmillan
C. Harold Wilson.
By the process of exclusion you can quickly exclude the distractors and conclude that the correct answer has to be Macmillan. But cunning examiners are unlikely to ask you such simple questions and are much more likely to come up with something like this
Which of the following four prime ministers lived the longest?
A. William Gladstone
B. Harold Macmillan
C. Winston Churchill
D. David Lloyd George.
Look for the hint in the question


A 45 year old man is rushed to Casualty as he is in status epilepticus. Which of the following treatments would you start him on?
A. CT brain
B. Protect the airway
C. Diazepam
C has to be correct, but examiners rarely make these mistakes.
Always choose all of the above


Which of the following are signs of heart failure?
A. Ankle oedema
B. Raised jugular venous pulse
C. Displaced apex beat
D. Third heart sound
E. All of the above.
You may not know all the signs of heart failure but if you know that two of the answers are correct then all of them have to be correct. But because of this flaw you rarely see an "all of the above" option any more.
The most important tip


No—it's not to bring a pencil with an eraser or to remember that there are other things in life besides exams. The best tip of all is not to rely on tips—they are no substitute for knowledge of your subject. Concentrate on the textbook rather than the form book. But ask yourself questions as you read—this will improve your memory. And supplement your reading with regular dips into MCQ books—practice will eventually make perfect.





But avoid reading MCQs in the final few days before the exam. There is a chance that you will remember the wrong answers and perhaps reinforce your mistakes. Instead, concentrate on the explanations at the back—they are often the most interesting and you are more likely to remember them

[GUNNER]

thanx sashank...it will surely help.
the most important thing is to concentrate on the explanation which is mentioned at the end.

[de.malady]

valuable, i reckon. thankyouvrymuch..

what i'v heard is thather's always old questns repeatin so it's wise to work on -oldies- nicely. hopin seniors 'll provide us with past -mcqs- here in xenomed..

[rajeeb]

thanks sashank ...
It will be really helpful ....