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Extending MCQs

Once you have tackled the common form of MCQs you may wish to try more complicated forms such as multiple true/false and assertion-reason. Examples of these are given below.

A : Example of multiple true/false questions

In the following question, the examiner is assessing whether the student can apply his/her knowledge:
A 45 year old asthmatic woman who has lived all her life in Glasgow presents with a goitre of four years' duration and clinical features suggestive of hypothyroidism. Likely diagnoses include
  1. Iodine deficiency
  2. Dyshormonogenesis
  3. Drug-induced goitre
  4. Thyroid cancer
  5. Auto immune thyroiditis

(Correct answer: true C and E: false A, B and D)

The student has to appreciate that in Great Britain iodine deficiency is not likely to be associated with hypothyroidism, that a 45 year old patient with only a four year history is unlikely to have dyshormonogenisis, that asthmatic patients not uncommonly take iodine containing preparations which may result in a goitre, that hypothyroidism is not usually associated with thyroid cancer and that auto immune thyroiditis typically is found in a middle aged woman with hypothyroidism.
(From Brown, et al 1997)

B : Example of multiple true/false questions
In the following question, the student's clinical judgement is assessed:

A 28 year old woman with one child has taken anti-thyroid drugs for 6 months for thyrotoxicosis. She has a friend who has been successfully treated with radio-iodine. She finds she frequently forgets to take her drugs and wants to stop them to have radio-iodine treatment.

  1. She should be told that because of her age radio-iodine is best avoided.
  2. The problems associated with radio-iodine should be discussed with her.
  3. Surgery as a possible alternative should be discussed with her.
  4. She should be advised that some form of further treatment is required.
  5. You should find out more about her friend's treatment.
(Correct answer: true, B, C and D: false, A and E).

Examples from Harden, R.M. & Dunn, W.G. (1981) Assessment a Work Manual Dundee Centre of Medical Education in Brown et al 1997

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