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title: Qbase Anaesthesia. Vol. 4, MCQs for the Anaesthesia
Primary
author: Blunt, Mark.; Hammond, Edward.; McIndoe, Andrew.
publisher: Greenwich Medical Media Limited
isbn10 | asin: 1900151987
print isbn13: 9781900151986
ebook isbn13: 9780511043567
language: English
subject Anesthesia--Examinations, questions, etc.
publication date: 1998
lcc: RD82.3.Q23 1998eb
ddc: 617.9/6/076
subject: Anesthesia--Examinations, questions, etc.
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Page iii
QBase Anaesthesia:
4
MCQs for the Anaesthesia Primary
by
Henry G W Paw
BPharm MRPharmS MBBS FRCA
Consultant in Anaesthesia and Intensive Care
York District Hospital
QBase series editors
Edward Hammond MA BM BCh MRCP FRCA
Shackleton Department of Anaesthetics
Southampton University Hospital NHS Trust
Andrew McIndoe MB ChB FRCA
Sir Humphrey Davy Department of Anaesthetics
Bristol Royal Infirmary
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Page iv
Disclaimer:
This netLibrary eBook does not include the ancillary media that was packaged with the original printed version
of the book.
© 1998
Greenwich Medical Media Ltd
219 The Linen Hall
162168 Regent Street
London
W1R 5TB
ISBN: 1 900151 987
First Published 1998
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 Henry Paw to be identified as author of this Work has been asserted by him 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
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Page v
Contents
Foreword vii
Editor's Note ix
Tables x
Introduction xi
MCQ techniques xiii
Acknowledgement xiv
Exam 1 1
Answers 15
Exam 2 35
Answers 49
Exam 3 69
Answers 83
Exam 4 101
Answers 115
Exam 5 135
Answers 149
QBase Anaesthesia on CD-ROM
174
CD-ROM System Requirements and Installation Instructions
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Page vii
Foreword
Multiple Choice Examinations (MCQs) 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 ones exam technique can provide valuable
feedback leading to improved performance.
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
candidates acquisition of knowledge and insight skews this towards a positive score. This can significantly
improve performance leading to success in the examination. QBase has been designed to facilitate the process
of assessing exam technique.
This book by Dr Henry Paw provides 300 questions in 5 Primary FRCA papers of 60 questions that
complement those in QBase 1 and cover the material required for the examination. The questions are provided
with comprehensive explanations and references for further reading. 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.
Candidates for the Primary FRCA Examination should find this book and CD-ROM a valuable learning
experience. It should be used repeatedly to improve exam technique. Candidates should remember that
knowledge and technique act synergistically to improve scores. Proper preparation will prevent poor
performance in the MCQ exam.
Good luck!
EDWARD HAMMOND
ANDREW McINDOE
QBASE SERIES DEVELOPERS/EDITORS
MAY 1998
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Page ix
Editors Note
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 you 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 the QBase CD in your CD drive. If you
reinstall QBase from this CD (see back of book for instructions) it will update previous versions of the
program. Owners of previous QBase titles will then have 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 6. The author has included 10 statistics questions on this CD. They do not
form part of the current Primary Examination, but candidates may find them useful for revision for the viva and
OSCE. They can be accessed via the Exam 6 button or by using the create your own exam option.
Many of you have requested shorter predefined examinations. The exams directory on this CD contains a large
number of predefined examinations. To access these exams, go to the main menu screen in the QBase program
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 following table gives details of the exams available and their
structure. You can save the exam to your hard disk as normal. We have included predefined options to allow
you to do all the questions from a subject or a series of 5 mini-exams in each subject that will cover all the
questions in each subject in the book without repeating any. We have also included 1 hour mock exams of 30
questions each containing 10 pharmacology, physiology and physics questions. You should allow 40 minutes
for exams with 20 questions, 1 hour for exams with 30 questions and 2 hours for exams with 60 questions. To
add some spice to 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 shuffled at random, removing your ability to
remember the pattern of true/false answers rather than the facts.
We hope that you will find these notes, suggestions and improvements in the program useful in your
preparation for the exam. As always, we look forward to your feedback so that we can continue to improve
QBase for the future.
EDWARD HAMMOND
ANDREW McINDOE
QBASE SERIES DEVELOPERS/EDITORS
MAY 1998
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Page x
Predefined exams included in the exams directory of QBase 4
Exam name No of Questions Subjects Type Time Allowed
20
Pharm 1 Pharmacology Revision 40 mins
20
Pharm 2 Pharmacology Revision 40 mins
20
Pharm 3 Pharmacology Revision 40 mins
20
Pharm 4 Pharmacology Reviison 40 mins
20
Pharm 5 Pharmacology Revision 40 mins
20
Physiol 1 Physiology Revision 40 mins
20
Physiol 2 Physiology Revision 40 mins
20
Physiol 3 Physiology Revision 40 mins
20
Physiol 4 Physiology Revision 40 mins
20
Physiol 5 Physiology Revision 40 mins
20
Physics 1 Physics Revision 40 mins
20
Physics 2 Physics Revision 40 mins
20
Physics 3 Physics Revision 40 mins
20
Physics 4 Physics Revision 40 mins
20
Physics 5 Physics Revision 40 mins
30
Exam 11 All Mock 60 mins
30
Exam 12 All Mock 60 mins
30
Eaxm 13 All Mock 60 mins
30
Exam 14 All Mock 60 mins
30
Exam 15 All Mock 60 mins
30
Exam 16 All Mock 60 mins
30
Exam 17 All Mock 60 mins
30
Exam 18 All Mock 60 mins
30
Exam 19 All Mock 60 mins
30
Exam 20 All Mock 60 mins
100 (all questions)
Pharm 0 Pharmacology Revision 200 mins
100 (all questions)
Physiol 0 Physiology Revision 200 mins
100 (all questions)
Physics 0 Physics Revision 200 mins
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Page xi
Introduction
There is no getting away from MCQ's despite some candidates dislike for them. Unlike essays and vivas which
tend to be subjective, MCQs enable an objective test of factual knowledge to be made over a wide area of the
syllabus. They are often criticised for being a superficial test, for they do not assess the candidates' ability to
weigh up the relative importance of information as may be required in clinical practice.
For certain topics such as physiology, pharmacology, physics and statistics, it is not difficult to set
unambiguous MCQs. On the other hand, in clinical anaesthesia and medicine, where things are often less black
and white, the setting of questions is more difficult.
A good MCQ can test more than simple factual re-call: reasoning ability and understanding of basic principles
can also be assessed. If you strongly disagree with any of the answers given in this book, please do not hesitate
to let me know, preferably with the appropriate references.
For the Primary FRCA, the MCQ paper consists of 90 questions to be completed in 3 hours. The paper
comprising approximately 30 questions in pharmacology, 30 in physiology and 30 in physics.
MCQs provide a good way of learning: they stimulate interest in a topic which will then encourage further
reading. I also believe that the more MCQs you do, the better you become at answering them.
The surest way to pass the MCQs is to have as wider a knowledge as possible of the subjects being tested. Try
to identify your weak subjects and concentrate on these.
There is such a thing as 'MCQ technique' and I have, on the following page, listed some pointers which I hope
will be useful.
Candidates for the Final FRCA will also benefit from attempting these questions and refreshing their
knowledge. It is surprising how much information may have been forgotten in the short interval between the
Primary and Final FRCA.
HENRY G. W. PAW
CAMBRIDGE
MAY 1998
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Page xiii
MCQ Techniques
Read the Question Carefully
Each question consist of a stem and five leaves identified by A B C D E. Take care not to let the questions or
your answers to one leaf influence your response to the other leaves. Re-read the stem each time in conjunction
with the individual leaf as a complete statement.
Trust the Examiner
Trust the examiner and do not look for ambiguities and difficulties that do not exist. The questions have all
been very carefully selected and vetted. Some candidates read the questions as if they are legal experts and
quote obscure references to justify their answer. Take the questions at face value and do not look for difficulties
that are not there.
Marking the Answer Sheet
The answer sheet will be read by an automatic document reader, which transfers the information to a computer
marking system. Using the pencil provided mark your answers carefully according to the instructions given. If
you then change your mind about the answer, erase your original selection completely with the erasure
provided.
There are essentially two ways to mark the sheet. As you go through the questions, you can either mark your
answers immediately onto the sheet, or you can mark them in the question book and then transfer to the answer
sheet at the end. If you adopt the second approach, you must remember to allow at least 30 mins to transfer the
answers from the question book.
Watch the Time
Answer only the questions you know in the first round and allow at least 60 mins to go over your answers again
and make a reasoned guess at the difficult questions you were unsure about in the first round. At the same time
check that you have marked the answer sheet correctly. Do not spend too much time rethinking those answers
about which you were originally confident you might become confused.
To Guess or Not to Guess
True random guesses (i.e. heads or tails) are unlikely to improve your score. As already mentioned in the
foreword to this book, the negative marking system employed by the College tends to result in guessing
producing a null score. The key is to improve your level of knowledge and skew your guesses towards a
positive score. It is probable that the pass mark is around 60% and allowing for a variable proportion of the
answers to be wrong, it is unlikely that a candidate will pass if less than 75% of the questions are answered.
QBase allows you to assess the benefit of your guesses. You should use the CD repeatedly to determine the
strategy that will best reward your knowledge and technique.
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