Page iii Qbase Anaesthesia: 3 MCQs in Medicine for the FRCA Edited by Edward J Hammond MA BM BCh MRCP FRCA Specialist Registrar Shackleton Department of Anaesthetics Southampton University Hospital NHS Trust Andrew K McIndoe MB ChB FRCA Consultant Anaesthetist Sir Humphry Davy Department of Anaesthesia Bristol Royal Infirmary Contributors Punit Ramrakha Emert White Tom Peck Justine Nanson Andrew Padkin Richard Protheroe David Jones Page iv Disclaimer: This netLibrary eBook does not include the ancillary media that was packaged with the original printed version of the book. © 1999 Greenwich Medical Media Ltd 219 The Linen Hall 162–168 Regent Street London W1R 5TB ISBN: 1 900 151 588 First Published 1999 Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the UK Copyright Designs and Patents Act, 1988, this publication may not be reproduced, stored, or transmitted, in any form or by any means, without the prior permission in writing of the publishers, or in the case of reprographic reproduction only in accordance with the terms of the licences issued by the Copyright Licensing Agency in the UK, or in accordance with the terms of the licences issued by the appropriate Reproduction Rights Organization outside the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publishers at the London address printed above. The right of Edward Hammond and Andrew McIndoe to be identified as authors of this Work has been asserted by them in accordance with the Copyright Design and Patents Act 1988. The publishers make no representation, express or implied, with regard to the accuracy of the information contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made. A catalogue record for this book is available from the British library. Distributed worldwide by Oxford University Press Designed and Produced by Diane Parker, Saldatore Limited Printed in Great Britain by Ashford Colour Press Page v CONTENTS Foreword vii Editors Note and Tips for QBase Users ix Questions Cardiology 3 Respiratory 24 Gastro 34 Hepatobiliary 40 Renal 45 Neurology 52 Endocrine 65 Metabolism/Nutrition 72 Haematology 75 Infectious Diseases 83 Psychiatry 89 Substance Abuse 95 Immunology/Genetics 97 Paediatrics 101 Medical Biochemistry 105 Pharmacology 113 Rheumatology 118 Answers Cardiology 125 Respiratory 163 Gastro 179 Hepatobiliary 186 Renal 189 Neurology 200 Endocrine 218 Metabolism/Nutrition 229 Haematology 232 Infectious Diseases 248 Psychiatry 257 Substance Abuse 265 Immunology/Genetics 267 Paediatrics 274 Medical Biochemistry 280 Pharmacology 292 Rheumatology 299 QBase Anaesthesia on CD-ROM CD-ROM System Requirements Installation Instructions 306 Page vii FOREWORD Multiple Choice Examinations (MCQ's) form part of the assessment process in many postgraduate examinations. The MCQ paper is perceived as a threatening test of breadth of knowledge. It is said that the use of negative marking discourages guessing and that candidates fail by answering too many questions. Whilst not a substitute for knowledge and adequate preparation, the assessment of an individuals exam technique can provide valuable feedback that may lead to improved performance. Candidates should remember that knowledge and technique act synergistically to improve scores. Our experience in teaching MCQ technique to candidates suggests that the advice "do not guess" is not correct. Candidates are consistently surprised at the positive benefits of their educated and wild guesses. From a statistical viewpoint, for true random guesses, the negative marking system employed by the Royal College of Anaesthetists tends to produce a null score rather than a negative score. However, with proper preparation, a candidate's acquisition of knowledge and insight can skew the distribution towards a positive score. This may significantly improve an individual's performance in the MCQ section of the examination. The QBase CD-ROM has been designed to allow candidates to analyse how their guessing strategy affects their performance at MCQ's examinations. QBase 3: MCQ's in Medicine for the FRCA has been developed in response to comments from candidates sitting the Final FRCA Examination. Many have found revising for the General Medicine component of the examination difficult. This book contains 555 MCQ's in Medicine that complement those in QBase 2. The Questions are provided with comprehensive explanations and references for further reading. They broadly cover the subject of General Medicine with a bias towards areas particularly relevant to anaesthesia. Some questions are more difficult than others. Do not be disheartened. They are aimed at the level of knowledge an SHO might be expected to achieve after completing six months of general medicine. The Questions have designed to assist your revision of this vast topic rather than just test your knowledge. Candidates specialising in intensive care medicine may find these questions a useful refresher for their general medical knowledge. The accompanying CD-ROM contains the latest version of the QBase Interactive MCQ Examination software. It allows the candidate to generate customised exams for revision or assessment purposes. Furthermore the system provides detailed structured analysis of performance and exam technique using the unique "Confidence Option" facility. This CD will update previous versions of QBase. It should be used repeatedly to improve exam technique. We hope that candidates will find this book and CD-ROM a useful adjunct to their revision for the Final FRCA Examination. EDWARD HAMMOND ANDREW MCINDOE QBASE SERIES DEVELOPERS/EDITORS SEPTEMBER 1998 Page ix NOTES FOR USERS OF QBASE ON CD-ROM Since we released the first version of QBase, we have tried to respond to the requests and suggestions of trainees on how we can improve it. This latest version of the program contains improvements in the exam analysis functions. These allow you to review your performance based on all the questions in the exam or by subject allowing you to identify areas that need further revision. This also allows you to see whether your technique varies with the subject of the question. The QBase program resides on your hard disk and reads the data from whatever QBase CD is in your CD drive. If you reinstall QBase from this CD (see back of book for instructions) it will update previous version of the program. Owners of previous QBase titles will then have all the new functions available to them. All QBase CDs will work with the new program. To check for successful installation of the new program, look at the Quick Start Menu screen. It should have 6 exam buttons. Exam 6 will be used by QBase titles containing the appropriate predefined examination. Many of you have requested shorter examinations. The exams directory on this CD contains a large number of predefined examinations. To access these exams, go to the Main Menu screen and select the 'Resit exam' option. From the dialogue box that appears, select the exam directory on your CD drive and then the exam you wish to attempt. The table that follows gives details of the exams available. You can save the exam to your hard disk as normal. To further enhance your revision, instead of selecting the 'Resit exam' button, we suggest you select the 'Resit shuffled exam' button. The leaves within each question will be randomly shuffled removing your ability to remember the pattern of the answers rather than the facts. The questions in these exams follow the order in the book. The Autoset an exam option on this CD selects questions from only some of the subjects. You will be presented with exams containing 25 questions made up as follows; Cardiology 6, Respiratory 3, Gastro/Hepatobiliary 2, Renal 2, Neurology 2, Endocrine 2, Haematology 2, Inf Disease 1, Psychiatry 1, Paeds 1, Med Biochem 2, and Pharmacology 1. These shorter exams focus more closely on questions that may appear in the actual Final FRCA paper. The 6 predefined exams on this CD are constructed in this way. You can generate your own customised exams using the "Create your own exam" option. We have provided the revision exams details below to allow you to do all the questions in the book without repetition. We hope that you will find these notes, suggestions and improvements in the program useful in your preparation for the exam. Don't be discouraged if you only achieve a low overall score at first. The standard of the questions probably exceeds that required of the average anaesthetic trainee sitting the Final FRCA. However the material covered is highly relevant and should also assist your clinical practice. EDWARD HAMMOND ANDREW MCINDOE QBASE SERIES DEVELOPERS/EDITORS SEPTEMBER 1998 Page x Exams included in the exams directory of QBase 3 Exam name No. of Questions Subjects Type Time Allowed Cardio1 20 Cardiology Revision 40 mins Cardio2 20 Cardiology Revision 40 mins Cardio3 20 Cardiology Revision 40 mins Cardio4 20 Cardiology Revision 40 mins Cardio5 20 Cardiology Revision 40 mins Resp1 20 Respiratory Revision 40 mins Resp2 20 Respiratory Revision 40 mins Resp3 10 Respiratory Revision 20 mins Gastro 25 Gastroenterology Revision 50 mins Hepato 25 Hepatobiliary Revision 50 mins Renal1 20 Renal Revision 40 mins Renal2 10 Renal Revision 20 mins Neuro1 20 Neurology Revision 40 mins Neuro2 20 Neurology Revision 40 mins Neuro3 25 Neurology Revision 50 mins Endo1 20 Endocrine Revision 40 mins Endo2 15 Endocrine Revision 30 mins Metab 10 Metabolism Revision 20 mins Haem1 20 Haematology Revision 40 mins Haem2 15 Haematology Revision 30 mins InfDis1 20 Infectious Dis Revision 40 mins InfDis2 10 Infectious Dis Revision 20 mins Psych 25 Psychiatry Revision 50 mins Subst 10 Substance abuse Revision 20 mins Immun 10 Immunology Revision 20 mins Paeds 20 Paediatrics Revision 40 mins MedBio1 20 Medical Biochem Revision 40 mins MedBio2 15 Medical Biochem Revision 30 mins Pharm 25 Pharmacology Revision 50 mins Rheum 15 Rheumatology Revision 30 mins Exam1 25 Mixed Mock 50 mins Exam2 25 Mixed Mock 50 mins Exam3 25 Mixed Mock 50 mins Exam4 25 Mixed Mock 50 mins Exam5 25 Mixed Mock 50 mins Exam6 25 Mixed Mock 50 mins Page xi QUESTIONS
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