MCQs for 6th year Students
Dr.Dhaher JS Al-habbo FRCP London UK Assistant Professor in Medicine DEPARTMENT OF MEDICINE UNIVERSITY OF MOSULHow to answer the MCQs
Always calculate the time available for each question before the exam and stick to that time strictly. Do not allow yourself to become delayed by any single question. Instead, answer the question using your first impression and mark the question with a star so you can return to it. After finishing your first run through the all questions, you should then start a second run returning to those questions which you have starred giving them further consideration.How to answer the MCQs
Always calculate the time available for each question before the exam and stick to that time strictly. Do not allow yourself to become delayed by any single question. Instead, answer the question using your first impression and mark the question with a star so you can return to it. After finishing your first run through the all questions, you should then start a second run returning to those questions which you have starred giving them further consideration.How to answer the MCQs
You should aim to answer at least 90% (ideally 100%) of MCQs in every paper. There are extremely few MCQs for which an educated guess will not increase your chance of a correct answer to greater than 50%.How to answer the MCQs
Only use the information given to you and don’t assume anything else. The root, stem and the options contain everything you need to answer each question. Perhaps an important fact is missing and you will need to identify what that is.Pay close attention to the facts. If you change your understanding of a topic based on the question, include that adjustment in your analysis and selection of an answer.Try to approach the questions simply and avoid introducing further complications. The exam is there to test your knowledge, not to trick you, so avoid unique interpretations of the facts.How to answer the MCQs
A process of elimination You should start by eliminating answers that you are sure are incorrect, and narrow the options down until you have the most likely answer. Always remember: Read the alternatives very closely. Look quickly at the modifier, then analyse the reasoning and then the result. The response will not be correct if the reasoning is not correct. Of the limited options possible, only one of them will identify and resolve the central issue.How to answer the MCQs
‘Best’ answer questionsRemember :Not every question will have several “wrong” answers. Often you will be asked to choose the “best” answer because there may be more than one answer to solve the problem. When approaching a question like this, remember:If you can prove an answer more easily, it is likely to be the correct one.More precise answers are usually better, because they will address the factual situation better than less precise answers.
Making educated guesses
When faced with an MCQ that you are unsure about, a number of points can help you make an educated guess. An understanding and familiarity with the key words and phrases that commonly feature in MCQs is vital to maximising your score . Questions which include absolute and sweeping statements such as never, always, or exclusively are generally false (because exceptions can be found to virtually any rule). Questions which include the keywords :could, possible, or may are more often true than not (after all, anything is possible).The correct answer is (A) Erythropoietin The patient most likely has a worsening of his blood pressure due to erythropoietin. This is seen in about 33% of dialysis patients.
A36 year old asthmatic man on salbutamol 100mcg inhaler once a day. Now he is concerned that his symptoms are worsening and his asthma is not as well controlled. Which single feature from the history would most support the man's concerns?
A-Chest tightness is brought on by cold weather. B-Having to use the salbutamol inhaler every day. C-Most breathless early in the morning. D-Walking at night with coughing. E-Wheezing is brought on by exercise.
The Answer is (D)
A17-year old man has lost 6kg over the past 2months.He has been excessively thirsty .A venous blood sample for glucose was 16mmol/Which is the single most appropriate next step in management?A-24h capillary glucose diary. B-Fasting venous blood glucose C-Oral glucose tolerance test(OGT). D-Repeat random venous blood glucose. E-Start treatment for diabetes.
The Answer is (E)
A twenty year old girl is taking anti tuberculosis treatment. She presents in eye clinic with out door visual complaints. The most likely cause of her symptoms is side effect of:A-Isoniazid. B- Rifampicin. C- Ethambutol. D- Pyrazinamide. E- Streptomycin
The Answer is (C) Adverse Reaction of First Line Anti Tuberculosis Drugs
A patient presents with mild fever and haemoptysis from Sinjar. Which of the following tests would be diagnostic of active tuberculosis disease?
A- Heaf test B-Mantoux test C-T-cell assay e.g. Quantiferon, ELIspot D- Sputum or biopsy cultures E- All of the above
The Answer is (D) skin sensitivity tests (Heaf, Mantoux) and the newer T-cell based assays are only useful to determine latent tuberculosis infection and tell you nothing about disease activity.
A28-year old woman has felt increasingly irritable over the last few months. She describes herself as "hot and bothered".She is always sweating and try to cool herself down, she lost 5kgm in this time. Which single examination finding is most likely to support the diagnosis?
A-Dry skin. B-Exophthalmos C-Hyperpigmented skin folds D-Lymphadenopathy. E-Malar rash.
The Answer is (B)
A forty year old lady gives history of weight gain and hoarseness of voice. On examination her pulse is 60 per minute and skin is pale, coarse and dry. The most important investigation to find diagnosis in this case is:A-Adrenocorticotrophin hormone (ACTH). B-Cortisol level. C-Gonadotrophin levels. D-Insulin like growth factor (IGF). E-T4 and TSH level.
The Answer is (E)
A44-year old man has had hoarseness of voice for the past year with increased of his shoe size over thepast3or4years.Which is the single most appropriate definitive test to support the likely diagnosis?A-Insulin growth factor1(IGF-1). B- Oral glucose tolerance test(OGT)with growth hormone. C-Random capillary blood glucose. D-Random growth hormone E-Somtostatin.
The Answer is (B)
An 70 year woman has a history of dry cough for 2 months. She has lost 5 kg of weight over the 2 months. Her chest X ray shows a left apical shadowing. Blood tests reveal a raised white cell count of 16. She has not managed to cough up any sputum. Which of following tests should be performed?
The Answer is (E)
A66-year old man has had worsening acid reflux over the last 4months.He uses salbutamol inhaler for asthma when required but otherwise has no medical problems.which single additional factor in his history warrant urgent referral for endoscopy?A-Family history of oesophageal cancer. B-Progressively worsening shortness of breath. C-Smoker of 20cigarettes per day. D-The recent onset of reflux-like symptoms. E-Weight gain of half a stone.
The Answer is (D) (ALARMS) Symptoms(Anaemia,Loss of weight,Anorexia,Recent onset of progressive symptoms,Melaenna or haematemesis and Swallowing difficulty)
A 26-year-old woman with a history of a tingling sensation in her fingers and toes for 2 days and rapidly progressive weakness of her legs. Deep tendon reflexes are absent. She had an upper respiratory tract infection 2 weeks ago. The most likely diagnosis is?
The Answer is (C)
A 66-year-old woman presented with sudden retrosternal chest pain with nausea and diaphoresis. She has hypotension, jugular venous distention, and a murmur of tricuspid regurgitation. An ECG shows ST-segment elevation in the right precordial leads. Which of the following is the most likely diagnosis?The Answer is (E)
A-Acute glomerulonephritis. B-Bacterial cystitis C-Benign prostatic hyperplasia D- Urolithiasis E-Bladder carcinoma
The Answer is (D)
A 40 year old lady was admitted to hospital with fevers and cough productive of sputum. Chest X-ray shows diffuse patchy consolidation around the left lung. She has had a flu like illnes 4 weeks ago, and has a past medical history of asthma. She also smokes. Which organism is likely to be responsible?The Answer is (D) staphylococcus. Following a viral infection, patients are predisposed to staphylococcal infection. The chest XR changes suggest staphlococcus rather than streptococcus (which would cause lobar consolidation)
A66-year old man has fallen three times in a day. He is confused and is responding to things that are not there. (Bp:85/60mmhg,Hb:8.5gm/dl,MCV105fl,INR:1.7 and Albumin:26gm/dl).His abdomen is tense and distended. Which single most appropriate course of action?
A-Abdominal paracentesis. B-Packed red cells 2U. C-Propranolol 80mg. D-Spironolactone 100mg E-Lactulose 45ml.
The Answer is (E)
A forty year old woman gives history of fever for last three weeks accompanied by dry cough, night sweats and weight loss. Chest examination is normal. Abdominal examination reveals hepatosplenomegaly. Chest X-ray shows symmetrically distributed fine nodules. The most likely diagnosis is:A-Typhoid. B-Chronic liver disease. C-Malaria. D-Pneumonia. E- Military tuberculosis
The Answer is (E)
The Answer is (D)
An old patient presented in emergency ward with history of weakness of right side of body of rapid onset. The most helpful first line investigation for management of this patient is:
A-Cerebral angiography. B-Cerebro spinal fluid examination. C-Computerized tomography scan brain. D-Fasting lipid profile. E-Nerve conduction study
The Answer is (C)
A 45-year old non-smoker woman with no medical problems apart from difficulty in swallowing for both solids and fluids for the last 18-months.She often regurgitates her oral intake and has lost over5kgm.Which single investigation is most likely to support the diagnosis?A-Abdominal X-ray. B-Chest X-ray C-Endoscopic ultrasound scan D-Oesophagogastroduodenoscopy(OGD) E-Barium swallow.
The Answer is (E)
A78-year old man has painfully distended lower abdomen that has developed over the past 2 days and with anuria .BPH was made, a urinary cathetar is placed .Which is the single most appropriate course of action?A-Abdominal X-ray B-Digital rectal examination C-IV antibiotics D-IV fluids E-Ultrasound scan o the kidneys.
The Answer is (D)
A70-year old man has had series of heavy epistaxis started yesterday, three days ago he started antibiotic for urinary tract infection. He has aterial fibrillation for which he takes warfarin. His INR(6.4).Which single antibiotics has he been taking?A-Amoxicillin B-Cephalxin. C-Nitrofurantion D-Co-amoxiclave. E-Trimethoprim
The Answer is (E)
A 17-year-old boy has had two episodes of severe anaphylactic shock following bee stings. Which of the following is the most appropriate intervention?
A. Administration of corticosteroids during the summer B. Long-term prophylactic antihistamine therapy C. Protective clothing D. Desensitization with bee venom extract E. Restrict him to the house during the summer months
The Answer is (D)
The nursing staff calls you about 70 year old woman on regular treatment for chest infection feeling her heart beating fast and she is anxious ,uncomfortable. Which single question would be most useful in the immediate assessment of this patient?A-Is the heart beat regular or irregular? B-Is she confused? C-Is she short of breath? D-What is her blood pressure? E-What is her temperature?