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Question Analysis in Step 1 Preparation

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Tricuspid atresia Coarctation of the aorta Aortic valve stenosis Patent ductus arteriosus Transposition of the great arteries What was/were most important trigger word – PowerPoint PPT presentation

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Title: Question Analysis in Step 1 Preparation


1
Question Analysis in Step 1 Preparation
  • John Pelley, PhD
  • Texas Tech HSC SOM

2
Types of Exam Questions
  • One-step thinking
  • Answers right or wrong
  • Basic information but not understanding
  • Can still milk the question for learning
  • Multi-step thinking
  • Some answers possibly correct
  • Conditional probabilities
  • One specific most correct choice

3
Sample One-Step Question
  • Gyrase is important in the replication of DNA
    because it
  • A. covalently joins Okazaki fragments
  • B. relaxes positive supercoiled DNA created by
    helicase action
  • C. degrades nucleosomal histones
  • D. proofreads newly synthesized DNA
  • E. synthesizes the RNA primer

4
True Multi-step Question
  • An 18 month male is brought to the clinic because
    the infant has exhibited excessive biting of his
    fingers and lips. His mother has also been
    alarmed at an accumulation of an orange-colored
    sandy deposit in the infants diapers. On physical
    examination the child showed poor motor control
    and difficulty maintaining balance. His blood
    urate measures 11.8 mg/dL (normal range, 3.5 to 7
    mg/dL). What other findings or outcomes would be
    most likely in this patient?

5
Why does the patient have the sandy deposit in
his diapers?
  • A. Urea crystals have formed due to the acidity
    of the urine.
  • B. Hypoxanthine and guanine are excreted in
    excessive amounts.
  • C. The pentose phosphate pathway has been
    stimulated.
  • D. Xanthine oxidase activity has been
    stimulated.
  • E. The patient has become dehydrated.

6
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9
  • A 15-year-old male complains of pain in his legs
    when he runs more than 300m. Physical
    examination reveals a blood pressure of 165/90
    mmHg along with a temperature of 36.5 C, pulse of
    76, and respiration rate of 22 per minute. His
    radial pulses are 4, and dorsalis pedis pulses
    are 1. Arterial blood gas measurement reveals
    normal oxygen saturation. Which of the following
    lesions is probably present?
  • What are the trigger words?
  • History
  • PE
  • Labs
  • What is the significance of...?

10
  • A 15-year-old male complains of pain in his legs
    when he runs more than 300m. Physical
    examination reveals a blood pressure of 165/90
    mmHg along with a temperature of 36.5 C, pulse of
    76, and respiration rate of 22 per minute. His
    radial pulses are 4, and dorsalis pedis pulses
    are 1. Arterial blood gas measurement reveals
    normal oxygen saturation. Which of the following
    lesions is probably present?
  • Tricuspid atresia
  • Coarctation of the aorta
  • Aortic valve stenosis
  • Patent ductus arteriosus
  • Transposition of the great arteries
  • What was/were most important trigger word(s)?

11
Other Lead-ins Requiring Integrative Learning
(NBME templates)
  • Which additional finding would suggest/suggests
    a diagnosis of (disease 1) rather than (disease
    2)?
  • These observations suggest that the disease is a
    result of the (absence or presence) of which of
    the following (enzymes, mechanisms)?
  • Which of the following (positive laboratory
    results) would be expected?
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