How To Answer

1. How To Answer MCQs 2007

2. Why do we have this lecture?

3. 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

4. WHAT DO YOU EXPECT FROM THIS LECTURE ?

5. Objectives • How to prepare yourself for MCQs exam? • Common MCQs types. • Common mistakes in MCQs • Strategies for answering MCQs. • How to make educated guess?

6. Knowledge - there is no substitute for the knowledge. - Main goal is TO SHOW THE RIGHT WAY IN ANSWERING MCQs FOR THOSE WHO HAVE THE KNOWLEDGE

7. How to Prepare for MCQ Exam What is more important for you ? Both of Them 1- Knowledge. 2- Pass the exam.

8. How to Prepare for MCQs Exam • 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

9. How to Prepare for MCQs Exam • How to study 3 stage • You must learn basic term & definition • You must learn central concept • You must be able to apply these concept • Organize study schedule Not to spend too much time on one area & ignore others. • Decide your weak area

10. Highly Effective Studying Methods • Ask yourself questions • Use graphs and charts • Paraphrase • Summary note • Make use of past examination papers • Link up with a friend

11. 1) Ask Yourself Questions 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

12. 2) Use Graphs and Charts • To enhance your comprehension of the material • Drawing a graph from memory will give you the confidence that you have truly mastered the material

13. 3) Paraphrase Summarize the key content in your own word.

14. 4) Summary Note If you can summaries the topic that means you are ready !!!

15. 5) Make Use of Past Examination Papers 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.

16. 6) Link Up With a Friend 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.

17. 7) Practice MCQ 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 .

18. How to Prepare? Be careful .Many students study what they know best and give less time to subjects that make them uncomfortable

19. Resources Choose ONE main book as primary study book and the other as back-up to clarify points as needed.

20. Anatomy of MCQ • STEM question or incomplete statement • OPTIONS suggested answers or completions • DISTRACTERS incorrect responses • KEY correct response

21. MCQ Question Subtypes • 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

22. Positively Worded Questions Positively worded questions ask you to select the answer that is ("most likely") to be true

23. 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?

24. Positively Worded Questions • Peripheral zone • Prostatic capsule • Prostatic urethra • Posterior lobe of the prostate • Transitional/central zone Correct answer (e)

25. Clinical Case 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

26. 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?

27. Clinical Case Questions • Cyst • Cysticerci • Encysted larvae • Ovum • Rhabditiform larvae Correct answer (c)

28. "Two-Step" Questions Given x ----- 1----- 2 ----- d stem Answer • Two-step (also called double-jump) questions require several cognitive steps to arrive at a correct answer.

29. "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?

30. "Two-Step" Questions • Alprazolam • Atenolol • Clonidine • Diazepam • Phenelzine Correct answer (b)

31. Conjunction 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

32. 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?

33. Conjunction Questions • Dominant parietal and frontal • Dominant parietal and dominant temporal • Dominant temporal and frontal • Nondominant parietal and dominant temporal • Nondominant parietal and nondominant temporal Correct answer (a)

34. "Bait and Switch" 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.

35. "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 ?

36. "Bait and Switch" Questions • Glycogen phosphorylase • PEP carboxykinase • HydroxymethyIglutaryl-CoA reductase • Glycogen synthase • Carnitine acyltransferase Correct answer (e)

37. Recall Questions - Stimulus – Response Questions Given x ----------------- d stem Answer These are easy questions and they depend on facts which you should know (knowledge)

38. Recall Questions The most important stimulus for respiratory centers in the brain is ? A- Oxygen B- Carbon dioxide C- Carbon monoxide D- pH E- Nitrogen Correct answer (b)

39. Visual Questions These questions including pictures, histology slides, and MRI and CT scan results, as a part of questions.

40. Common Problems on MCQs exams

41. Steps For Solving MCQs 1st Step

42. Steps For Solving MCQs الاستعانة بالله عز وجل ”ومن يتوكل على الله فهو حسبه إن الله بالغ أمره قد جعل الله لكل شيء قدرا“ ”وإذا سألك عبادي عني فإني قريب أجيب دعوة الداعي إذا دعان“

43. Steps For Solving MCQs ومن الأدعية: اللهم لا سهل إلا ما جعلته سهلا وأنت تجعل الحزن إن شئت سهلا

44. Steps For Solving MCQs ولاتنسى: دعاء الوالدين

45. Steps For Solving MCQs 2nd Step

46. Steps For Solving MCQs Reading The Questions

47. 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.

48. Important MCQs term

49. Golden Role In Reading The Questions Be Smart BUT don’t to be too smart Remember that the exam contains different levels of questions including easy & very easy questions

50. 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