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C)

Oxygen

D)

Plavix

E)

Thrombolysis

The correct answer is “B”.

This is a poorly structured question. There are several abbreviations which may not be universally understood (A/E, O/E and STEMI). Observations have no units. The question is negatively worded. The correct answer is much longer than the others. It also contains 4 drugs whereas other answers contain 2 drugs or 1 drug only. Trade names have been used for some of the drugs which may not be universally understood. Answer “A” is contained within “B” and therefore is clearly not the correct answer to the question.

4. Which of the following is true in severe AS?

A)

It is always associated with a bicuspid aortic valve

B)

TAVI is never a treatment

C)

The incidence in Smith et al (1997) is 1.36%

D)

May present as angina

E)

All of the above

The correct answer is “D”.

This is a poorly structured question. There is no clinical stem and again abbreviations have been used. The question is not testing a single idea or learning objective about aortic stenosis. The way the question is presented it is more a “multiple true/false” type question, than a MCQ because different answers ask about pathology, epidemiology, symptoms and treatments. Answer “E” can be excluded by any candidate who can work out that any 2 of the other choices “A”, “B” and “C” are incorrect. One answer refers to a single paper and reference to individual studies should not be included in the distractors.

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