mcqs techniques

Fayza RayesMBBCh. MSc. MRCGP

Consultant Family PhysicianJoint Program of Family & Community Medicine, Jeddah

www.fayzarayes.com

Objectives:

1. Improving your out come from studding

2. Improving your technique in answering MCQs

Introduction:

1. Do you follow any techniques while studying from

MCQ book

2. Do you follow any techniques while answering

MCQs questions

Contents:

10 tips in studying for MCQs exam

10 tips in answering MCQs

Answering 45 MCQs

10 Tips in studying MCQs:

1. Write your studying plan2. Study in a group3. Answering one MCQ is an opportunity to review lots of

knowledge . Make sure to get the maximum from every single MCQ . Read the explanation and review the related topic

4. Write a short abstract about each important topic5. Write table to compare between similar diseases6. Be specific in your information and extra specific

How can you benefit from this information ?


7. Concentrate on important topics in family medicine e.g.:Children growth and development VaccinationPresentation of common diseases special patients. e.g.

appendicitis in very young and in very elderly patientsPrescribing skills of antibiotics and psychotropic

medications


8. To improve your mental fitness, periodically take mock exam, start by 10 questions then increase it gradually till you take full mock exam (100-150 MCQs in 2-3 hours continuously)

9. Revise your mistake periodically (some mistakes are false believes… like delusion very difficult to correct )

10. Just before the exam, you need at least 2-3 weeks for revision (revise your mistakes , read your personal abstracts )

Correction of false believes:

Do you have any strategy??

1. Writing summaries

2. Teaching others the new information

3. Reminding cards

4. …….

How to write your valuable summery

1. Typical presentation of the disease2. Pathognomonic features 3. Areas of similarity and areas of difference from other

differential diagnosis (to make the question difficult)

4. Initial investigation (cost effectiveness and sensitivity)

5. Diagnostic test (more specific)

6. Initial management (non-pharmacological + or -)7. Most effective management (It could be costly , it

could have more side effect)8. New update ??!!

10 Tips in answering MCQs:

1. Pay attention to the key words2. When you chose an answer make sure the stem of the MCQ

and the answer you have chosen are grammatically correctIf you are not sure of the answer make intelligent guising:3. Find your correct answer by process of exclusion:First delete the apparently incorrect answer Any answer partially incorrect delete it from your choices If two choices are similar both are incorrectIf two choices are opposite to each other , one of them is the

correct answer If one choice is different from the rest, consider it the right

answer


4. Some MCQs ask about number . Learn how to deal with numbers

Arrange the answers in order – lowest->> highest Eliminate the lowest and highest number Go with the general theme of family medicine practice Chose the meaningful number 5. In general, respect your logical thinking & your clinical

experience


Examples logical thinking:Smoking is a risk factors of nearly any health problemOld medications have more side effects than new medicationsIn general drug with less side effect are with weaker effect,

and the vise versa To change to any new intervention (drug, procedure,

investigation or vaccine …) the effect of the new intervention must be the same or better effects and with less side effects


6. In controversial issues, respect what you can remember from your MCQs reference books

7. Don’t postponed writing in the answer sheet till near the end of the exam time

8. Don’t hand over your paper early . Use your time fully9. Near the end of exam time, you need 5-10 minutes for

revision to avoid stupid mistake10. Do not change any answer unless you are 100% sure that

your first choice was wrong

A 6-month-old infant is brought into your office by his mother. She presents with 2-day history of wheezing, a mild fever (38.5°C), and rhinorrhea. The child has no known allergies but there is a history of allergies in the family. On examination, the child’s respiratory rate is 60/minute. There is rhonchi and moist rales heard throughout the chest. The chest x-ray shows evidence of hyperaeration.

The most likely diagnosis in the child is:

A. Mycoplasma pneumoniae infection

B. Allergic bronchitis

C. Viral tracheitis

D. Bacterial tracheitis

E. Bronchiolitis

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Key words:A 6-month-old infant is brought into your office by

his mother. She presents with 2-day history of

wheezing, a mild fever (38.5°C), and rhinorrhea. The

child has no known allergies but there is a history of

allergies in the family. On examination, the child’s

respiratory rate is 60/minute. There is rhonchi and

moist rales heard throughout the chest. The chest x-

ray shows evidence of hyperaeration.

A 6-month-old infant is brought into your office by his mother. She presents with 2-day history of wheezing, a mild fever (38.5°C), and rhinorrhea. The child has no known allergies but there is a history of allergies in the family. On examination, the child’s respiratory rate is 60/minute. There is rhonchi and moist rales heard throughout the chest. The chest x-ray shows evidence of hyperaeration.

The most likely diagnosis in the child is:

A. Mycoplasma pneumoniae infection

B. Allergic bronchitis

C. Viral tracheitis

D. Bacterial tracheitis

E. Bronchiolitis

Bronchiolitis (RSV) In most “typical” kids, this virus is what most parents consider “just a cold,” but it has the potential to become serious, so here’s what you should know

Symptoms: Runny nose, fever, cough, wheezing with breathing, irritability, & loss of appetite.

Treatment Mild symptoms are treated with rest, fluids, and a cool air humidifier. Babies who are struggling to breath may hospitalized and given

supplemental humidified oxygen. Their breathing will be monitored and if necessary fluids will be given intravenously to prevent dehydration.

Occasionally infants need mechanical ventilation to fill and empty the lungs until the airways open.

1. Example of Quick Revision

Bronchiolitis in infants

2. Example of Quicker Revision

1. Infants

2. Wheezing 3. Rhonchi and moist rales

4. Respiratory syncytial virus

5. Cold, humidified, oxygen

3. Example of Abstracts

Bronchiolitis in infants

A 5-year-old child is brought to the ER with his mother. The mother tells you that for the past 24 hours the child bas been “talking strangely” and drooling. He has had no appetite and has not been drinking. Based on this history, what is the diagnosis of major concern?

A. Viral pneumonia

B. Acute epiglottis

C. Bronchiolitis

D. Croup

E. Bacterial pneumonia

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A 5-year-old child is brought to the ER with his mother. The mother tells you that for the past 24 hours the child bas been “talking strangely” and drooling. He has had no appetite and has not been drinking. Based on this history, what is the diagnosis of major concern?

A. Viral pneumonia

B. Acute epiglottis

C. Bronchiolitis

D. Croup


2. Example of Quicker Revision

Epiglottitis:

1. ER

2. Delusion “talking strangely”

3. Drooling4. A lateral x-ray of the neck

5. IV/IM ceftriaxone

Epiglottitis:3. Example of Abstracts

An 18-month-old infant is brought to the ER by his mother. He developed an upper respirator tract infection 2 days ago and suddenly this evening developed a harsh, barky cough and difficulty breathing. On examination the child is coughing. His respiratory rate is 40/minute and he is in some respiratory distress. The breath sounds that are heard appear to be transmitted from the upper airway. There are nasal flaring and suprasternal, infrasternal, and intercostals retractions. The child’s temperature is 38.5°C.

What is the most likely diagnosis in this child?

A. Viral pneumonia

B. Acute epiglottis

C. Bronchiolitis

D. Croup


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What is the most likely diagnosis in this child?

A. Viral pneumonia - LRTI

B. Acute epiglottis - LRTI

C. Bronchiolitis - LRTI

D. Croup - URTI

E. Bacterial pneumonia - LRTI

Acute Larynotracheitis (Viral Croup)

Differential Diagnosis:The differential diagnosis of viral croup includes epiglottitis, foreign body, and angioneurotic edema.

Symptoms: Barking cough – especially at night; high pitched whistling noise with inhalation (stridor); runny nose; fever.

Management:Most children with croup do not require hospitalization. Treatment at home consists of air humidification, avoidance of agitation, and reduction of feverIf signs of severe obstruction develop, treatment withan aerosol of racemic epinephrine (2.25%), nebulized with 100% oxygen, frequently provides relief. Frequent aerosol treatments may be needed for the first few hours. A single parenteral dose of dexamethasone, 0.6 mg/kg, is effective in decreasing the length and severity of respiratory symptoms that are associated with viral croup. Inhaled corticosteroid therapy has also been used with some success, but parenteral dexamethasone is somewhat easier. Intubation or tracheostomy rarely is necessary.


A systematic review of clinical trials confirmed the observations

that nebulised adrenaline produces immediate and often

dramatic improvements in reducing the signs of airway obstruction in severe croup.


2. Update & EBM

1. Early childhood2. ER

3. Harsh, barky cough4. Respiratory distress

5. Parainfluenza virus

6. Aerosolized steroids

7. Nebulised adrenaline


3. Example of Abstracts

Tips in studying MCQs:

Answering one MCQ is an opportunity to review lots of knowledge . Make sure to get the maximum from every single MCQ . Read the explanation and review the related topic

Write a short abstract about each important topic

A. Write pathognomonic features

B. Write Update information

C. Write controversial issues AND stick to your NOTES

To master clear differentiation make comparisons between similar issues

A 25-year-old college student presents with a 3-week history of fatigue, malaise, fever, chills, and sore throat. On physical examination, the patient has a temperature of 39°C. There is pharyngeal hyperemia and edema and marked exudates are seen in both tonsillar areas. There is significant cervical lymphadenopathy present.

You suspect infectious mononucleosis.Of the following clinical features of acute infectious mononucleosis, the least common is:

A. SplenomegalyB. HepatomegalyC. FeverD. Exudative tonsillitisE. Generalized lymphadenopathy

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Key wordsA 25-year-old college student presents with a 3-week history of fatigue, malaise, fever, chills, and sore throat.On physical examination, the patient has a temperature of 39°C. There is pharyngeal hyperemia and edema and marked exudates are seen in both tonsillar areas. There is significant cervical lymphadenopathy present.You suspect infectious mononucleosis.Of the following clinical features of acute infectious

mononucleosis, the least common is:A. Splenomegaly – (30-45%)B. Hepatomegaly – (Impaired LFTs --30% of the patients) C. Fever - 85%D. Exudative tonsillitis – 60%E. Generalized lymphadenopathy – 85%

Breast CancerA 41-year-old woman comes to your office after finding a breast lump during a routine self-examination. She has been examining her breasts regularly for the past 5 years; this is the first lump she has found. On examination, there is a lump located in the right breast. The lump’s anatomic location is in the upper outer quadrant. It is approximately 3 cm in diameter and is not fixed to skin or muscle. It has a hard consistency. There are three axillary nodes present on the right side; each node is approximately 1 cm in diameter. No lymph nodes are present on the left. At this time, what would you do?

A. tell the patient that she has fibrocystic breast disease; ask her to return in 1 month, preferably 10 days after the next period, for a recheckB tell the patient to come back for a breast examination in 6 monthsC. order mammogramD. order an ultrasound examination of the areaE. arrange for urgent fine-needle biopsy

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Breast CancerA 41-year-old woman comes to your office after finding a breast lump during a routine self-examination. She has been examining her breasts regularly for the past 5 years; this is the first lump she has found. On examination, there is a lump located in the right breast. The lump’s anatomic location is in the upper outer quadrant. It is approximately 3 cm in diameter and is not fixed to skin or muscle. It has a hard consistency. There are three axillary nodes present on the right side; each node is approximately 1 cm in diameter. No lymph nodes are present on the left. At this time, what would you do?

A. tell the patient that she has fibrocystic breast disease; ask her to return in 1 month, preferably 10 days after the next period, for a recheckB tell the patient to come back for a breast examination in 6 monthsC. order mammogramD. order an ultrasound examination of the areaE. arrange for urgent fine-needle biopsy

What do we mean by being specific?!General information X Detailed information


This is general information


This is detailed information


Be specific in your information And be extra specific and meticulous

Immune-deficient ChildWhich one of the following vaccine must not be given to a household contact of an immune-deficient child?A. Mumps, measles and rubella.B. BCGC. Influenza vaccineD. Oral polio vaccineE. Hepatitis B vaccine

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Immune-deficient ChildWhich one of the following vaccine must not be given to a household contact of an immune-deficient child?A. Mumps, measles and rubella.B. BCGC. Influenza vaccineD. Oral polio vaccineE. Hepatitis B vaccine

Breast FeedingWhich of the following statements about breast-feeding is true?A) The infant should feed on each side for 8 to 15 minutes every 2 to 3 hours after birth.B) Colostrum is excreted 7 to 10 days after delivery and contains important antibodies, high calories, and other nutrients.C) The mother should weigh infants before and after feeding to quantify the amount consumed.D) Breast-feeding usually provides adequate nutrition for 2 to 4 months—supplementation should begin at that point.E) Breast-feeding should be based on timed intervals rather than on demand.

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Breast FeedingWhich of the following statements about breast-feeding is true?A) The infant should feed on each side for 8 to 15 minutes every 2 to 3 hours after birth.B) Colostrum is excreted 7 to 10 days after delivery and contains important antibodies, high calories, and other nutrients.C) The mother should weigh infants before and after feeding to quantify the amount consumed.D) Breast-feeding usually provides adequate nutrition for 2 to 4 months—supplementation should begin at that point.E) Breast-feeding should be based on timed intervals rather than on demand.The answer is A. Breast-feeding is encouraged for all mothers . Currently, as many as 50% of mothers.

Growth & DevelopmentAn 8-month-old infant is brought to the emergency department by his mother for an assessment of an upper respiratory tract infection. He has been coughing for the past 3 days and has had a runny nose. On examination, his temperature is 37.5°C. His weight is below the 3rd percentile for his age, his length is at the 25th percentile, and his head circumference is at the 50th percentile. He appears malnourished and has thin extremities, a narrow face, prominent ribs, and wasted buttocks. He has a prominent diaper rash, unwashed skin, a skin rash that resembles the skin infection impetigo contagious on his face, uncut fingernails, and dirty clothing. What is the most likely cause of this child’s condition? a. maternal deprivation b. cystic fibrosis c. constitutionally small for age d. infantile autism e. congenital bilateral sensorineural hearing loss

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Growth & DevelopmentAn 8-month-old infant is brought to the emergency department by his mother for an assessment of an upper respiratory tract infection. He has been coughing for the past 3 days and has had a runny nose. On examination, his temperature is 37.5°C. His weight is below the 3rd percentile for his age, his length is at the 25th percentile, and his head circumference is at the 50th percentile. He appears malnourished and has thin extremities, a narrow face, prominent ribs, and wasted buttocks. He has a prominent diaper rash, unwashed skin, a skin rash that resembles the skin infection impetigo contagiosum on his face, uncut fingernails, and dirty clothing. What is the most likely cause of this child’s condition? a. maternal deprivation b. cystic fibrosis c. constitutionally small for age d. infantile autism e. congenital bilateral sensorineural hearing loss

Growth & DevelopmentBone age can sometimes be used to differentiate certain causes of

short stature in children. With respect to bone age, which of the following statements is true?

A. bone age is normal in both familial short stature and constitutional delay of growth

B. bone age is normal in familial short stature and delayed in constitutional delay of growth

C. bone age is normal in constitutional delay of growth and delayed in growth hormone deficiency

D. bone age is delayed in both familial short stature and short stature caused by hypothyroidism

E. bone age is variable and cannot be used to differentiate familial short stature and constitutional delay

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Growth & DevelopmentBone age can sometimes be used to differentiate certain causes of

short stature in children. With respect to bone age, which of the following statements is true?

A. bone age is normal in both familial short stature and constitutional delay of growth

B. bone age is normal in familial short stature and delayed in constitutional delay of growth

C. bone age is normal in constitutional delay of growth and delayed in growth hormone deficiency

D. bone age is delayed in both familial short stature and short stature caused by hypothyroidism

E. bone age is variable and cannot be used to differentiate familial short stature and constitutional delay

Teeth EruptionA 9-month-old boy brought by his mother to see you in the clinic. Her main concern that her son did not have teeth eruption till now. He is developmentally normal. His height and weight are normal. What will be your advice to her?

A. Tell her don't worry except after 1 month.B. It is not unusual for the first deciduous teeth to erupt

before 12 months.C. Investigate for hypothyroidism.D. Do roentgenogram for mandible and maxillary X ray.E. Tell her that because her son have a nails, so he will also

have teeth eruption.

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Teeth EruptionA 9-month-old boy brought by his mother to see you in the clinic. Her main concern that her son did not have teeth eruption till now. He is developmentally normal. His height and weight are normal. What will be your advice to her?

A. Tell her don't worry except after 1 month.B. It is not unusual for the first deciduous teeth to erupt

before 12 months.C. Investigate for hypothyroidism.D. Do roentgenogram for mandible and maxillary X ray.E. Tell her that because her son have a nails, so he will also

have teeth eruption.

Visual ScreeningWhich statement regarding visual screening in children is

correct?A. Visual screening is not indicated until age 5. B. Visual acuity can be assessed by the Random Dot E test. C. Stereopsis can be measured by the Tumbling E test. D. Strabismus can be assessed with the cover test during

the first year of life. E. Visual screening can be reliably assessed at age 2.

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Visual ScreeningWhich statement regarding visual screening in children is

correct?A. Visual screening is not indicated until age 5. B. Visual acuity can be assessed by the Random Dot E test. C. Stereopsis can be measured by the Tumbling E test. D. Strabismus can be assessed with the cover test during

the first year of life. E. Visual screening can be reliably assessed at age 2.

Influenza Vaccination

Which one of the following patients should not receive an influenza vaccination?

A. A 36-year-old pregnant woman at 12 weeks' gestation.

B. A 65-year-old man with diabetes mellitus.

C. A 28-year-old man with HIV infection.

D. A 54-year-old woman who is allergic to eggs.

E. A six-year-old girl who lives with a grandmother who has terminal cancer.

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Influenza VaccinationWhich one of the following patients should not receive an influenza vaccination?

A. A 36-year-old pregnant woman at 12 weeks' gestation.

B. A 65-year-old man with diabetes mellitus.

C. A 28-year-old man with HIV infection.

D. A 54-year-old woman who is allergic to eggs.

E. A six-year-old girl who lives with a grandmother who has terminal cancer.

Chose the different

Knowledge of Vaccination

A 68-year-old patient is seen for a general examination. Current recommendations for immunizations includeA. tetanus booster every 5 yearsB. influenza vaccination yearlyC. pneumococcal vaccination yearlyD. hepatitis booster every 5 yearsE. meningococcal vaccination

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Knowledge of Vaccination

A 68-year-old patient is seen for a general examination. Current recommendations for immunizations includeA. tetanus booster every 5 yearsB. influenza vaccination yearlyC. pneumococcal vaccination yearlyD. hepatitis booster every 5 yearsE. meningococcal vaccination

Tips in studying MCQs:Concentrate on important topics in family

medicine e.g.:Children growth and developmentBreast feeding VaccinationPresentation of common diseases special patients. e.g.

appendicitis in very young and in very elderly patients

You will be asked in this topics in any FM exam

ForgetfulnessA 57-year-old male has become forgetful, preoccupied, withdrawn and suspicious. His physical examination was normal. The patient has been with his company for 22 years and was considered an excellent employee. Which of the following is most likely diagnosis?A. Multi-infarct dementia. B. Depression. C. Vascular dementiaD. Alcoholism. E. Alzheimer

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ForgetfulnessA 57-year-old male has become forgetful, preoccupied, withdrawn and suspicious. His physical examination was normal. The patient has been with his company for 22 years and was considered an excellent employee. Which of the following is most likely diagnosis?A. Multi-infarct dementia. B. Depression. C. Vascular dementiaD. Alcoholism. E. Alzheimer

Tips in answering MCQs:

If you are not sure of the answer make inelegant guising:Find your correct answer by process of exclusion:First delete the apparently incorrect newer If two choices are similar both are incorrect

Post MI Medications

Which of the following improve survival after myocardial infarction in hypertensive patient?A. Nitrate.B. Morphine.C. ACE inhibitors.D. Calcium channel blockers.E. Aspirin.

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Post MI Medications

Which of the following improve survival after myocardial infarction in hypertensive patient?A. Nitrate.B. Morphine.C. ACE inhibitors.D. Calcium channel blockers.E. Aspirin.

H. Pylori Testing.16

Which of the following types of H. pylori testing is not useful to confirm eradication? A. stool antigen testB. urea breath test C. enzyme-linked immunosorbent assay (ELISA) D. Serology cultureE. Steiner stain of gastric biopsy specimen

H. Pylori TestingWhich of the following types of H. pylori testing is not useful to confirm eradication? A. stool antigen testB. urea breath test C. enzyme-linked immunosorbent assay (ELISA) D. Serology cultureE. Steiner stain of gastric biopsy specimen

Gout

Which one of these drug is not associated with gout?A. DiureticsB. Digoxin C. Niacin (vitamin B3)D. Aspirin E. Cyclosporine (Immunosuppressive)

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Gout

Which one of these drug is not associated with gout?A. DiureticsB. Digoxin C. Niacin (vitamin B3)D. Aspirin E. Cyclosporine (Immunosuppressive)

Vague Chest PainA 35-year-old male consults you about vague chest pain he

developed while sitting at his desk earlier in the day. The pain is right-sided and was sharp for a brief time when it began, but it rapidly subsided. There was no hemoptysis and the pain does not seem pleuritic. His physical examination, EKG, and oxygen saturation are unremarkable. A chest film shows a 10% right pneumothorax. Which one of the following should you do next?A. Admit the patient to the hospital for observation.B. Admit the patient to the hospital for chest tube placement.C. Obtain a repeat chest radiograph in 24–48 hours.D. Obtain an expiratory chest radiograph.E. Reassure the patient and do nothing

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Vague Chest PainA 35-year-old male consults you about vague chest pain he

developed while sitting at his desk earlier in the day. The pain is right-sided and was sharp for a brief time when it began, but it rapidly subsided. There was no hemoptysis and the pain does not seem pleuritic. His physical examination, EKG, and oxygen saturation are unremarkable. A chest film shows a 10% right pneumothorax. Which one of the following should you do next?A. Admit the patient to the hospital for observation.B. Admit the patient to the hospital for chest tube placement.C. Obtain a repeat chest radiograph in 24–48 hours.D. Obtain an expiratory chest radiograph.E. Reassure the patient and do nothing

Fatigue and WeaknessA 60-year-old man is being evaluated for fatigue, weakness, and exercise intolerance. Laboratory assessment reveals: Hemoglobin: 9.1 mg/dL (L) Serum iron: 46 μg/dL (L) Ferritin: 9 ng/mL (L) Total iron binding capacity (TIBC): 626 μg/dL (H) Mean corpuscular volume (MCV): 76 fL (L) What is the most common cause of this condition? A. Blood loss B. Poor nutrition C. Inadequate absorption of iron D. Chronic disease E. Folic acid deficiency

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Fatigue and WeaknessA 60-year-old man is being evaluated for fatigue, weakness, and exercise intolerance. Laboratory assessment reveals: Hemoglobin: 9.1 mg/dL (L) Serum iron: 46 μg/dL (L) Ferritin: 9 ng/mL (L) Total iron binding capacity (TIBC): 626 μg/dL (H) Mean corpuscular volume (MCV): 76 fL (L) What is the most common cause of this condition? A. Blood loss B. b. Poor nutrition C. c. Inadequate absorption of iron D. d. Chronic disease E. e. Folic acid deficiency

Liver Disease with CirrhosisYou are seeing a patient who has end-stage liver

disease with cirrhosis due to hepatitis C. What will be her most likely cause of death?A. Liver failure.B. Myocardial infarction.C. Bleeding varices.D. Hepatocellular carcinoma.E. Renal failure.

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The main causes of 436 deaths among 532 patients with cirrhosis followed up for up to 16 years constituted liver failure (24%), liver failure with gastrointestinal bleeding (13%), gastrointestinal bleeding (14%) i.e. bleeding ±hepatic failure (27%), primary liver cell carcinoma (4%), other liver-related causes (2%), infections (7%), cardiovascular diseases (22%), extra hepatic malignancies (9%), and other non-liver-related causes (5%). Totally, 57% died of liver-related causes

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The main causes of 436 deaths among 532 patients with cirrhosis followed up for up to 16 years constituted liver failure (24%), liver failure with gastrointestinal bleeding (13%), gastrointestinal bleeding (14%) i.e. bleeding ±hepatic failure (27%), primary liver cell carcinoma (4%), other liver-related causes (2%), infections (7%), cardiovascular diseases (22%), extra hepatic malignancies (9%), and other non-liver-related causes (5%). Totally, 57% died of liver-related causes

Prostate CancerThe best management of localized, well-differentiated prostate cancer in men older than 65 is:

A. Radiation implants.B. External beam radiation therapy.C. Watchful waiting.D. Primary androgen deprivation therapy.E. Robot-assisted prostatectomy.

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Prostate CancerThe best management of localized, well-differentiated prostate cancer in men older than 65 is:

A. Radiation implants.B. External beam radiation therapy.C. Watchful waiting.D. Primary androgen deprivation therapy.E. Robot-assisted prostatectomy.


Be specific in your information And be extra specific and meticulous

AAAWhich one of the following is the greatest risk factor for abdominal aortic aneurysm (AAA)?A. Cigarette smoking.B. Diabetes mellitus.C. Hypertension.D. African-American race.E. Female gender.

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AAAWhich one of the following is the greatest risk factor for abdominal aortic aneurysm (AAA)?A. Cigarette smoking.B. Diabetes mellitus.C. Hypertension.D. African-American race.E. Female gender.

Abdominal Aortic Aneurysm (AAA)In the UK the rate of Abdominal Aortic Aneurism (AAA) in

Caucasian men older than 65 years is about 4.7%

The peak incidence is among males around 70 years of age, the prevalence among males over 60 years totals 2-6%.

In the U.S. the incidence of AAA is 2-4% in the adult population.

AAA is 4-6 times more common in male siblings of known patients, with a risk of 20-30%.

Rupture of the AAA occurs in 1-3% of men aged 65 or more, the mortality is 70-95%.

http://en.wikipedia.org/wiki/Incidence_(epidemiology)

http://en.wikipedia.org/wiki/Prevalence

Smoking & AAA

Cervical CancerWhich of the following statements regarding cervical cancer screening is true?

A. The death rate from cervical cancer continues to increase despite Pap smear screening.

B. Immunosuppression has not been identified as a risk factor for cervical cancer.

C. Human papillomavirus (HPV) types 1 and 3 are most closely linked to cervical cancer.

D. Smoking has been linked to the development of cervical cancer.

E. Most cases of cervical cancer occur between the ages of 20 and 30 years.

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Cervical CancerWhich of the following statements regarding cervical cancer screening is true?

A. The death rate from cervical cancer continues to increase despite Pap smear screening.

B. Immunosuppression has not been identified as a risk factor for cervical cancer.

C. Human papillomavirus (HPV) types 1 and 3 are most closely linked to cervical cancer.

D. Smoking has been linked to the development of cervical cancer.E. Most cases of cervical cancer occur between the ages of 20 and 30

years.

The answer is D. Tip: Smoking always the first to blame


Examples logical thinking:

Smoking is the first to blame …

Smoking is “ criminal ”

Smoking Risks

In the British Journal of Psychiatry, the researchers wrote, “The best-fitting causal model was one in which nicotine dependence led to increased risk of depression.” They suggest two possible routes, one involving common risk factors, and the second a direct causal link.

According to the researchers, “this evidence is consistent with the conclusion that there is a cause and effect relationship between smoking and depression in which cigarette smoking increases the risk of symptoms of depression.”

http://psychcentral.com/lib/can-smoking-cause-depression/0007153

Smoking and Depression



SmokingWhich of the following conditions is NOT associated with smoking?

A. Peptic ulcer diseaseB. DepressionC. Children of smokers are at increased risk for otitis mediaD. OsteoporosisE. Cervical cancer

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SmokingWhich of the following conditions is NOT associated with smoking?

A. Peptic ulcer diseaseB. DepressionC. Children of smokers are at increased risk for otitis mediaD. OsteoporosisE. Cervical cancer


In general, respect your clinical experience

In controversial issues, respect what you can remember from your MCQs reference books

Hepatitis C & Brest MilkWhich of the following statements is correct concerning hepatitis C virus (HCV)?A. There is no risk to infants if the mother is affected.B. There is no risk associated with sexual intercourse with an

individual with hepatitis C.C. Cesarean section should be performed on mothers who

test positive for hepatitis C to prevent transmission to the newborn.

D. Hepatitis C can be spread by contaminated water supplies.E. Hepatitis C does not appear to be transmitted in breast

milk.

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Hepatitis C & Brest MilkWhich of the following statements is correct concerning hepatitis C virus (HCV)?A. There is no risk to infants if the mother is affected.B. There is no risk associated with sexual intercourse with an

individual with hepatitis C.C. Cesarean section should be performed on mothers who

test positive for hepatitis C to prevent transmission to the newborn.

D. Hepatitis C can be spread by contaminated water supplies.E. Hepatitis C does not appear to be transmitted in breast

milk.

1. Learn to write very clear message to correct any false believes in your MCQs Knowledge

2. It is more helpful if you add new relevant information to maximize your benefit from MCQs studying


Answering one MCQ is an opportunity to review lots of knowledge . Make sure to get the maximum from every single MCQ . Read the explanation and review the related topic

Write a short abstract about each important topic

Headache Red FlagsEach of the following is a solid indication for neuroimaging in a patient with headache except: A. Onset of headaches over the age of 50 years B. Seizures associated C. Prolonged aura D. Nausea and vomiting E. Headache worsening with movement

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Headache Red FlagsEach of the following is a solid indication for neuroimaging in a patient with headache except: A. Onset of headaches over the age of 50 years B. Seizures associated C. Prolonged aura D. Nausea and vomiting E. Headache worsening with movement

Head LiceWhich of the following is true regarding management of head lice?

A. Children should be kept out of school until no visible evidence of nits is noted.

B. Household members should only be treated if live lice or eggs are noted within 1 cm of the scalp.

C. Head lice programs have had a significant impact on lowering the incidence of head lice.

D. Cleaning of bedding has little impact on lice eradication.E. The health of those exposed is more important than the

confidentiality of the child affected.

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Head LiceWhich of the following is true regarding management of head lice?

A. Children should be kept out of school until no visible evidence of nits is noted.

B. Household members should only be treated if live lice or eggs are noted within 1 cm of the scalp.

C. Head lice programs have had a significant impact on lowering the incidence of head lice.

D. Cleaning of bedding has little impact on lice eradication.E. The health of those exposed is more important than the confidentiality of

the child affected.The answer is B. Practice guidelines published by the American Academy of

Pediatrics (AAP) state that if a case of head lice is identified, all household members should be checked, and only those with live lice or eggs within 1 cm of the scalp should be treated. It is recommended to treat family members who share a bed with the person who is infected


In general, respect your clinical experience

If your clinical practice is different than MCQ correct answer according to the reference book . Go with the book

Number Technique

Before the diagnosis of post-traumatic stress disorder (PTSD) is made, symptoms should be present for at leastA. 1 yearB. 6 monthsC. 3 monthsD. 1 monthE. 1 week

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Number Technique

Before the diagnosis of post-traumatic stress disorder (PTSD) is made, symptoms should be present for at leastA. 1 yearB. 6 monthsC. 3 monthsD. 1 monthE. 1 week

Number /Anorexia Nervosa

In young women with an eating disorder, at what point would you expect her menstrual periods to resume?A. 75% of ideal body weightB. 80% of ideal body weight C. 90% of ideal body weightD. 100% of body weightE. It is unusual for menstrual cycles to resume with any weight gain.

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Number /Anorexia Nervosa

In young women with an eating disorder, at what point would you expect her menstrual periods to resume?A. 75% of ideal body weightB. 80% of ideal body weight C. 90% of ideal body weightD. 100% of body weightE. It is unusual for menstrual cycles to resume with any weight gain.

In a healthy patient, what is the appropriate age to administer Pneumococcal vaccine?

A. 50 years B. 5 yearsC. 75 yearsD. 16 yearsE. 65 years

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In a healthy patient, what is the appropriate age to administer Pneumococcal vaccine?

A. 5 yearsB. 16 yearsC. 50 yearsD. 65 yearsE. 75 years


Some MCQs ask about number . Learn how to deal with numbers Arrange the answers in order – lowest->> highest Eliminate the lowest and highest number Go with the general theme of family medicine practice Chose the meaningful number

Use of AntibioticsWhich one of the following is appropriate and effective treatment for genitourinary gonorrhea in a 20-year-old male with a purulent urethral discharge?

A. Amoxicillin, 3.5 g orally once.B. Ciprofloxacin, 500 mg orally once.C. Ceftriaxone, 125 mg intramuscularly once.D. Doxycycline, 100 mg 2 times daily for 3 days.E. Erythromycin, 500 mg 4 times daily for 7 days.

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Use of AntibioticsWhich one of the following is appropriate and effective treatment for genitourinary gonorrhea in a 20-year-old male with a purulent urethral discharge?

A. Amoxicillin, 3.5 g orally once.B. Ciprofloxacin, 500 mg orally once.C. Ceftriaxone, 125 mg intramuscularly once.D. Doxycycline, 100 mg 2 times daily for 3 days.E. Erythromycin, 500 mg 4 times daily for 7 days.

Use of AntibioticsOf the following antibiotics, which one would be acceptable to use when treating penicillin-resistant S. pneumoniae otitis media?

A. AzithromycinB. ClarithromycinC. CefuroximeD. CefaclorE. Cephalexin

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Use of AntibioticsOf the following antibiotics, which one would be acceptable to use when treating penicillin-resistant S. pneumoniae otitis media?

A. AzithromycinB. ClarithromycinC. CefuroximeD. CefaclorE. CephalexinOnly five antibiotics—high-dose amoxicillin (80 mg/kg/day),

amoxicillin–clavulanate (Augmentin), cefuroxime (Ceftin), cefprozil (Cefzil), and ceftriaxone (Rocephin)—have demonstrated a modest degree (60% to 80%) of clinical efficacy in the treatment of acute

otitis media caused by penicillin-resistant S. pneumoniae.

AntibioticsAn 18-year-old woman presents with swelling, warmth, and spreading redness at the upper part of her ear, where she recently underwent an ear piercing. Appropriate antibiotic coverage includesA. cephalexinB. ciprofloxacinC. azithromycinD. penicillinE. tetracycline

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AntibioticsAn 18-year-old woman presents with swelling, warmth, and spreading redness at the upper part of her ear, where she recently underwent an ear piercing. Appropriate antibiotic coverage includesA. cephalexinB. ciprofloxacinC. azithromycinD. penicillinE. tetracycline

DepressionA 14-year-old girl is diagnosed with major depressive disorder. It is her first episode and the clinical assessment is that it is mild depression. Which one of the following treatment choices is appropriate?A. Tricyclic antidepressant..B. SSRI.C. St. John's wart.D. Cognitive-behavioral therapy.E. Lithium.

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DepressionA 14-year-old girl is diagnosed with major depressive disorder. It is her first episode and the clinical assessment is that it is mild depression. Which one of the following treatment choices is appropriate?A. Tricyclic antidepressant..B. SSRI.C. St. John's wart.D. Cognitive-behavioral therapy.E. Lithium.

Alcoholism management A 56-year-old business executive with a history of

alcoholism and associated liver disease presents to your office and would like to stop drinking. In order to prevent alcohol withdrawal, you select which of the following medications?A. LorazepamB. ClonazepamC. DiazepamD. FlurazepamE. Buspirone

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Alcoholism management A 56-year-old business executive with a history of

alcoholism and associated liver disease presents to your office and would like to stop drinking. In order to prevent alcohol withdrawal, you select which of the following medications?A. LorazepamB. ClonazepamC. DiazepamD. FlurazepamE. Buspirone

Anti depressant MedicationsWhich of the following medications is least likely to cause sexual side effects?A. Fluoxetine (Prozac)B. Sertraline (Zoloft)C. Venlafaxine (Effexor)D. Citalopram (Celexa)E. Bupropion (Wellbutrin)

.36

Anti depressant MedicationsWhich of the following medications is least likely to cause sexual side effects?A. Fluoxetine (Prozac)B. Sertraline (Zoloft)C.Venlafaxine (Effexor)D. Citalopram (Celexa)E. Bupropion (Wellbutrin)

AntidepressantAbout how many patients in the total treated population respond only partially or don't respond at all to antidepressant monotherapy?

A. 5 to 20 percent.

B. 10 to 30 percent.

C. 20 to 40 percent.

D. 30 to 50 percent.

E. 40 to 60 percent.

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AntidepressantAbout how many patients in the total treated population respond only partially or don't respond at all to antidepressant monotherapy?

A. 5 to 20 percent.





Placebo effect is up to 60%

About how many patients in the total treated population respond only partially or don't respond at all to antidepressant monotherapy?

A. 5 to 20 percent.





Placebo effect is up to 60%

Antidepressant

Tips in studying MCQs:Concentrate on important topics in family medicine e.g.: Important Medications• Antibiotics• Antidepressant• Other psychotropic medications• Anti epilepsy medications• Anti TB• Anti ulcer medications• Antihypertensive medications• Hypoglycemic medications• Asthma medications

Hepatitis C InfectionWhich one of the following is the approximate risk that a health care worker will contract hepatitis C infection following a needle stick injury contaminated by blood from a patient testing positive for hepatitis C by polymerase chain reaction?

A. 0.6 percent.B. 50 percent.C. 6.1 percent.D. 16 percent.E. 26 percent.

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Hepatitis C InfectionWhich one of the following is the approximate risk that a health care worker will contract hepatitis C infection following a needle stick injury contaminated by blood from a patient testing positive for hepatitis C by polymerase chain reaction?


Which one of the following is the approximate risk that a health care worker will contract hepatitis C infection following a needle stick injury contaminated by blood from a patient testing positive for hepatitis C by polymerase chain reaction?


Hepatitis C Infection

Urinary Tract InfectionsWhich one of the following is the most sensitive laboratory indicator for urinary tract infections?

A. Pyuria.B. Bacteriuria.C. Leukocyte esterase.D. Increased vaginal pH.E. Urine nitrite.

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Urinary Tract Infections

Which one of the following is the most sensitive laboratory indicator for urinary tract infections?

A. Pyuria.B. Bacteriuria.C. Leukocyte esterase.D. Increased vaginal pH.E. Urine nitrite.

Respect your practical experience

HIVIn which one of the following situations should a health care worker be offered antiretroviral prophylaxis after an occupational exposure to a patient known to be infected with human immunodeficiency virus?

A. Urine with no visible blood in it splashed into the worker's eyes.

B. Needle-stick injury when recapping a clean needle.

C. Intact skin contact with patient's tears.

D. Accidental cut from a used sharp instrument.

E. Urine with no visible blood in it splashed onto exposed skin.

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HIVIn which one of the following situations should a health care worker be offered antiretroviral prophylaxis after an occupational exposure to a patient known to be infected with human immunodeficiency virus?

A. Urine with no visible blood in it splashed into the worker's eyes.

B. Needle-stick injury when recapping a clean needle.

C. Intact skin contact with patient's tears.

D. Accidental cut from a used sharp instrument.

E. Urine with no visible blood in it splashed onto exposed skin.

Common sense

HIV Infection

What is the approximate risk of (HIV) seroconversion after a needle-stick injury when the source patient has documented HIV infection?

A. 0.01 to 0.05 percent.B. 0.3 to 0.5 percent.C. 1.0 to 5.0 percent.D. 25 to 30 percent.E. Nearly 100 percent.

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HIV Infection

What is the approximate risk of (HIV) seroconversion after a needle-stick injury when the source patient has documented HIV infection?

A. 0.01 to 0.05 percent.B. 0.3 to 0.5 percent.C. 1.0 to 5.0 percent.D. 25 to 30 percent.E. Nearly 100 percent.

Needle Stick injury &Risk to the Health Care Worker

HIV

Hepatitis C

Hepatitis B

0.3 to 0.5 percent

6.1 percent

….

بالعباد رحيم ربك

Tips in studying MCQs:Concentrate on important topics in family medicine e.g.: Important infections TB Hepatitis B & C HIV Any current epidemic disease TB

Falls In The Elderly

Which of the following is responsible for the largest proportion of falls in the elderly?

A. Extrinsic (environmental) factors.B. Postural changes.C. Dizziness.D. Gait problems.E. Impaired vision.

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Falls In The Elderly

Which of the following is responsible for the largest proportion of falls in the elderly?

A. Extrinsic (environmental) factors.B. Postural changes.C. Dizziness.D. Gait problems.E. Impaired vision.

Different

Asymptomatic BacteriuriaOf the following outcomes, which one is associated

with antibiotic treatment of asymptomatic

bacteriuria in elderly women?

A. Prevention of pyelonephritis.

B. Prevention of hypertension.

C. Sterilization of the urinary tract.

D. Emergence of drug-resistant bacterial strains.

E. Overall reduction in mortality.

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Asymptomatic BacteriuriaOf the following outcomes, which one is associated with antibiotic treatment of asymptomatic bacteriuria in elderly women?

A. Prevention of pyelonephritis.

B. Prevention of hypertension.

C. Sterilization of the urinary tract.

D. Emergence of drug-resistant bacterial strains.

E. Overall reduction in mortality.Different


and the answer you have chosen are grammatically correctIf you are not sure of the answer make intelligent guising:

If one choice is different from the rest, consider it the right answer

Acellular Pertussis Vaccine

Which one of the following statements about the acellular pertussis vaccine is true?

A. It is about as effective as the whole-cell vaccine with fewer side effects.

B. It is a little less effective than the whole-cell vaccine with fewer side effects.

C. It is as effective as the whole-cell vaccine but does not show an appreciable difference in side effects.

D. It is less effective than the whole-cell vaccine with no significant difference in side effects.

E. It is less effective than the whole-cell vaccine with more side effects.

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Which one of the following statements about the acellular pertussis vaccine is true?

A. It is about as effective as the whole-cell vaccine with fewer side effects.

B. It is a little less effective than the whole-cell vaccine with fewer side effects.

C. It is as effective as the whole-cell vaccine but does not show an appreciable difference in side effects.

D. It is less effective than the whole-cell vaccine with no significant difference in side effects.

E. It is less effective than the whole-cell vaccine with more side effects.

New vaccine has same or better effects and less side effects


Examples logical thinking:To change to any new intervention (drug, procedure,

investigation or vaccine …) the effect of the new intervention must be the same or better effects and with less side effects

Thrombocytopenic Purpura

The following statement about thrombocytopenic purpura is correct?

A. They present most often with nosebleeds or bleeding gums.

B. They tend to be girls.C. They remit spontaneously in up to 90 percent of

cases.D. They have a slightly higher risk of intracerebral

hemorrhage than adults.E. They show poikilocytosis and nucleated red cells on

the peripheral smear.

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Thrombocytopenic Purpura

The following statement about thrombocytopenic purpura is correct?

A. They present most often with nosebleeds or bleeding gums.

B. They tend to be girls.C. They remit spontaneously in up to 90 percent of

cases.D. They have a slightly higher risk of intracerebral

hemorrhage than adults.E. They show poikilocytosis and nucleated red cells on

the peripheral smear.


Respect your logical thinking & your clinical experience

Thank you

mcqs techniques

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