Part 1 of the test currently consists of an Extended Matching Question (EMQ) Examination, referred to throughout this annex as the Examination. The Examination paper will contain 200 questions divided into a number of themes. It will last three hours. From September 2004 the Examination will consist of extended matching questions and single best answer (SBA) questions. The number of questions will remain the same. The proportion of SBA questions may vary from examination to examination but no more than 30% of the paper will be composed of SBA questions.
Information on how to approach the Examination and some sample EMQ and SBA questions are at the end of this annex.
Please discuss the
implications of this change here.
Single Best Answer Questions
Consider each of the questions and decide what you think the answer is to the lead-in question given at the end of each scenario, which typically reads What is the SINGLE most likely diagnosis?. You should then look for that answer in the list of options below (each of which is identified by a letter of the alphabet). If you cannot find the answer you have thought of, you should look for the option which, in your opinion, is the best answer to the problem posed.
For each question, you must choose ONE, and only one, of the options. You may feel that there are several possible answers, but you must choose the one most likely from the option list. If you enter more than one answer on the answer sheet you will gain no mark for the question even though you may have given the right answer along with one or more wrong ones.
Sample Single Best Answer Questions
A 17 year boy attends the Accident and Emergency Department having been taken ill whilst playing football. He gives a history of sudden onset of left-sided chest pain followed by severe and persistent breathlessness.
What is the SINGLE investigation most likely to provide a definitive diagnosis?
A Blood gases
B Chest x-ray
D Electrocardiogram (ECG)
E Pulmonary function tests
An 85 year old man who weighs 80 kg is admitted as an emergency with fever and delirium. He gives a history of dysuria and frequency. His blood pressure (BP) is 70/50 mmHg and temperature 38.6o C. His serum creatinine is 620 μmol/l and his serum urea is 46 mmol/l. The microbiologist recommends the prescription of gentamicin.
What is the SINGLE most appropriate dose of gentamicin?
A 40 mg single dose
B 40 mg once daily
C 80 mg 8 hourly
D 80 mg 12 hourly
E 160 mg single dose
A 55 year old man presents having recently noticed a lump in his right groin. He smokes heavily, has a persistent cough and has previously had an appendicectomy.
What is the SINGLE most likely diagnosis?
A Epigastric hernia
B Femoral hernia
C Incisional hernia
D Inguinal hernia
E Spigelian hernia
A 58 year old postmenopausal woman presents with a one week history of vaginal bleeding. Digital vaginal examination is normal.
What is the SINGLE most appropriate diagnostic test?
A Cervical smear
B Endometrial aspiration
C Plasma oestrogen
D Serum FSH/LH levels
E Transvaginal ultrasound scan
A two year old boy is brought to the Accident and Emergency Department by his mother. He has been unable to bear weight since a fall from a chair last night. He is tender over the mid-tibia but there is no obvious limb deformity.
What is the SINGLE most likely radiographic appearance of the fracture?
A Angulated fracture
B Compound fracture
C Epiphyseal fracture
D No fracture likely
E Spiral fracture
An 83 year old woman admitted with a chest infection becomes confused with poor concentration. She is restless and frightened. She is verbally abusive and has perceptual abnormalities. There is no significant previous psychiatric history.
What is the SINGLE most likely diagnosis?
A Acute confusional state
B Drug induced psychosis
C Lewy body dementia
D Multi-infarct dementia
E Psychotic depression
A 32 year old woman was painting her bathroom when she experienced a sudden, severe headache, vomited and collapsed hitting her head. She has been brought to the Accident and Emergency department. She now has a Glasgow Coma Scale (GCS) score of 15, a temperature of 37.7o C, a blood pressure of 145/85 mmHg and a pulse rate of 70 beats/minute. Her physical examination is normal apart from an abrasion over her right temple.
What is the SINGLE most appropriate initial management?
A Admit for head injury observation
B Carboxyhaemoglobin level
C Computed tomography (CT) brain scan
D Lumbar puncture
E Skull x-ray
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