Test Taking Tips

• Note key words: “but”, “except”, “most likely”
• Note red flags (e.g. abnormal vital signs)
• Eliminate all wrong answers
• If part of the answer is wrong, the whole answer is wrong
• Assume the worst-case scenario
• Don’t be lured by new information/newest EBM
• Avoid Slang answers

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Tips Continued

• Unfamiliar or wordy information is usually wrong
• Answers with “all”, “none”, “always” and “never” are usually wrong
• Choose “gold standard” answers rather than the latest theory
• Outdated treatments and harmful therapies are wrong
• Negative physician behavior is wrong

Common Mistakes

• Not reading the question stem carefully
• Second-guessing yourself
• Not answering the question asked
• Not pacing yourself

Misc Concerns

• What if more than 1 answer seems correct?
• Do the answers COMPLETELY address the question?
• If the answer is only partly true or true only under certain conditions then its wrong
• If you have to make a significant assumption in order for the answer to be true then also probably not correct
• Trick question? Probably not, ABEM believe it or not WANTS you to pass. Most “Trick Questions” are only tricky because they are not taken at face value
• Go with your gut and move on
• Clue words/phrases
• If 2 answers are opposite - One of them is right
• Answers with the following are usually correct: seldom, generally, tend to, probably, usually
• Grammer clues -- Stem and Foil usually have verbs of the same tense and nouns and verbs that agree
• Try to dissect difficult words or words you don’t know….don’t just pick the words you know.
• DON’T WASTE TIME
• Anticipate the correct answer before looking at the options vs look at the options first then read the question?

Calculations

• Involve simple math with round numbers
• Check units carefully
• Don’t waste a lot of time on these
• Memorize need to know equations and memory dump onto cheat sheet given at beginning of test

Calculations

• Anion gap: (Na⁺) - (Cl^- + HCO₃^-) ≤ 12
• OSM gap: 2 Na + BUN + Glu + EtOH = 285-295

2.8 18 4.6

• Parkland
• 4 mL x kg x % BSA per day of LR
• 1/2 of volume over 1^st 8 hours
• MAP = DBP + (SBP - DBP)/3
• Pediatric ET size (mm) = (age + 16)/4, depth= 3x size
• A-a = 140 - (PaO₂ + PaCO₂) Nml= (age + 10)/4

Guessing

• Guessing is not penalized
• % questions: midrange is usually right
• Don’t waste time; take your best guess and

move on

• If you have no idea, choose B or C
• Your first guess is usually right

General Advice

• Don’t study the last day
• Brief/Limited review if anxious
• Arrive the day before
• Know where the testing station is
• Dress comfortably
• Be well-rested and ready to focus

During the Exam

• 225 Q, One BIG block
• Memory Dump
• Scrap paper provided: use it
• Don’t know the answer?
• Pick your best guess
• Mark the question and come back to
• Can highlight/strike through - this function is honestly clunky so try to get used to test taking without it
• Look for cues
• If 2 answers are similar - probably neither of them is right
• Look for the one answer that is different from the rest - usually right
• Look for clues from other questions/linked questions
• Ignore “patterns” - they aren’t a thing
• Try to get through whole test once before taking a break

Questions Introduction (1)

• Every question contains a stem and several foils. Examinees tend to focus on the stem, but exam writers will tell you that the foils make the exam. Believable, biteable foils are tougher to come up with than questions

Question . . . . . . . . .?

A. ______________

B. ______________

C. ______________

D. ______________

E. ______________

Questions Introduction (2)

• There are several question types
• Facts
• Information vs. data
• Concepts
• Research
• Two-parters
• Make the diagnosis
• Some T/F questions

Facts

• Fact questions directly query medical knowledge. Some are very good and some are trivial. Don't spend a lot of time on these questions - you either know it or you don’t. Take your best guess.

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1. Which of the following does not transmit rabies to man?

A. Raccoon

B. Skunk

C. Mongoose

D. Rabbit

E. Bats

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2. Which of the following ACE inhibitors commonly causes a skin rash?

A. Captopril

B. Lisinopril

C. Benazepril

D. Isuprel

Make the Diagnosis

• Provide a clinical scenario which requires you to make an emergent diagnosis, often differentiating between two similar entities

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Q. A 28-year-old woman on oral contraceptives presents with gradual onset chest pain, myalgias and SOB. The pain is much worse when she lies flat. Which diagnosis is most likely?

A. Dressler’s syndrome

B. Chagas’ disease

C. Acute pericarditis

D. Pulmonary embolism

E. Tietze’s syndrome

Two-Parter

• A conclusion must be drawn first. The second part of the question applies to the conclusion

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Q. A hiker from Connecticut presents with Bell’s � Palsy and a rash. Which treatment is best?

A. Amoxicillin 500 TID x 10 days

B. Head CT and NSAIDs

C. Bactrim DS BID x 3 days

D. Valacyclovir alone for 7 days

E. Valacyclovir + prednisone

Information vs. Data

• These questions contain a tremendous amount of information in the stem, much of which is irrelevant. Camouflaged within the stem are critical pieces of data which, if presented out in the open, would suggest an obvious diagnosis
• These are good questions to use the strikethrough feature to cut out the nonsense

Information vs. Data (2)

Q. A 75 year old man has weakness, dizziness, and nausea associated with ataxia over the last two weeks. He is confused and is unable to provide a PMH or family information. He denies seizures and has no evidence of tongue-biting but his pants are soaked with urine. His EKG is normal. Which diagnostic approach will have the highest yield?

A. A sed rate to rule out temporal arteritis

B. A head CT to assess for normal pressure

hydrocephalus

C. LFTs to rule out hepatic encephalopathy

D. CPK BB to rule out CVA

E. Carotid angiogram for berry aneurysm

Information vs. Data

• If the question had been

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Q. What does a geriatric patient with ataxia, dementia, and incontinence have?

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A. NPH . . . it would be too easy. Therefore, you must weed through the static and find the real data

Concept

• The best tests of knowledge, but also the most difficult to write. These questions are rare. Thought is required to answer correctly, not facts, trivia or even memory.

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Q. Which of the following organs is susceptible to barotrauma?

A. Liver

B. Spleen

C. Sinuses

D. Spinal Cord

E. Heart

Research Questions

• These questions don’t count toward the grade. The examiners are assessing concordance, foils and wording. Research questions provide a buffer between the examinee and new test materials.

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Which treatment can decrease the rate of rebleeding in hyphemas?

A. Voltaren eye drops

B. Aspirin

C. EACA (Epsilon-aminocaproic acid)

D. Phenobarbital

E. Enoxaparin

Foils (Answer Choices)

• As indicated earlier, good answer choices are critical to question writing. Some disease entities as foils are challenging because you may not remember much about the disease. The choice may or may not be the right answer but they destabilize your selection process. These are the “Killer Foils”
• Killer Foils cannot be resisted by test writers. There are only 50-100 true killer foils and some basic knowledge of these entities goes a long way towards successful test taking

Killer Foils

• Learn some basic killer foil facts so you can fend them off when they are fakes, and recognize them when they are indeed the correct answer
• Instead of destabilizing your thoughts, they will help you choose. By default, you will also begin to focus on the foils more and more. This shift away from the stem to the foil is critical to good exam-taking skills

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