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UNION EUROPÉENNE DES MÉDEC INS SPÉC IAL I STES
EUROPEAN UNION OF MEDI CAL SPEC IAL I STS
Association internationale sans but lucratif – International non-profit organisation
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VENUE DE LA
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OURONNE
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F +32 2 640 37 30
www.uems.net info@uems.netExample MCQ’s:
As a simple exercise, examine the examples below and think about the tips you have reviewed in the
preceding text. As you look at each of the 5 questions, think about whether or not the item was
written correctly, whether it needs improvement and if so what improvements would you make.
1)
A 32 year old woman presents to the emergency department with a 3 day history of cough and
increasing shortness of breath. On examination she has a respiratory rate of 30 breaths per
minute and there is an audible expiratory wheeze.
Which of the following is the most likely diagnosis?
A)
Acute exacerbation of asthma
B)
Diabetic ketoacidosis
C)
Hypothyroidism
D)
Myocardial infarction
E)
Uncontrolled hypertension
The correct answer is “A”.
This would appear to be a good question because it fulfils many of the criteria that have been
reviewed in the text, such as: a) there is a clear, concise history followed by salient examination
findings, b) there is a positively worded question and c) there are 5 distinct answers, listed in
alphabetical order and all of similar length. The question is of course extremely easy with the stem
including only information related to the respiratory system. Therefore based on guessing the most
likely diagnosis is A as this is the response that most closely relates to the respiratory system. This
means the Angoff score is likely to be very high (greater than +0.95) so the question will not
adequately discriminate. The Angoff score will be improved with the use of more difficult distractors
such as other respiratory diagnoses.