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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
- Iodine deficiency
- Dyshormonogenesis
- Drug-induced goitre
- Thyroid cancer
- 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)
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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.
- She should be told that because of her age radio-iodine is best
avoided.
- The problems associated with radio-iodine should be discussed
with her.
- Surgery as a possible alternative should be discussed with her.
- She should be advised that some form of further treatment is
required.
- 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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