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MCQ Preparation Guidelines

  1. Type of MCQ:

As proposed by the UEMS Council (10/04/2015) we have chosen for Type A MCQ, meaning that there should be 5 possible answers with only one correct answer

  1. Format of the Questions:
  • Use 5 possible answers (synonym: options, distractors or challengers) of roughly the same textual length.

  • The possible answers (or statements) should be set out in alphabetical order.

  • Please use TRUE or FALSE instead of correct or incorrect, right or wrong…

  • Indicate the correct answer in BOLD

  • Please use as font Times New Roman 12

  • Please use interline spacing 1.15

  • Start every answer with a capital letter

  • Indicate the answers by a, b, c, d, e, (small, lower case letter) followed by a point (a.)

  • No indentation


QUESTION : In the central nervous system myelin derives from:

  1. Cajal-Retzius cells
  2. External granular cells
  3. Microglia
  4. Oligodendrocytes
  5. Schwann cells

  1. If indicated please use a stem or an introduction.


Stem: A 32-year-old unemployed alcoholic who underwent a mastoidectomy as a youth presents with headaches, nausea, vomiting, drowsiness, and confusion. He does not have a fever, but his right eardrum is not visualized and there appears to be some discharge. There is slight neck stiffness as well.

Question or Lead-in: What is the most appropriate investigation at this time?


a. CT scan the head

b. ECG

c. Lumbar puncture

d. PET-scan

e. X-ray the skull

4. Define 2 or 3 clear questions strictly related to your topic. Please verify that the answer is included in your presentation and that the question reflects the objectives of your topic.

5. In principle questions should not include messages from the workshops but only from the plenary lectures, except if stated otherwise.

6. The formulation of stem, question and answers should be clear, concise and simple (most students are not native English speakers).

7. The questions should ask both for facts and comprehension.

8. There should be an evidence base for determining both which of the answers are correct and which are incorrect. This source of evidence base should be available to the question writer and the question-writing group as well as to the candidates (when preparing for the assessment).

9. Avoid:

- misleading terms

- shortenings and abbreviations (eg NMO instead of Neuro-myelitis optica).

- tricky or unnecessarily complicated stems or questions.

- clues to the answer in the stem or question

- absolute terms – terms such as ‘always/never’ and vague terms, e.g. frequency and absolute terms (as described above), usually, may, can.

- overlapping options, e.g. one option being ‘analgesics’ while another being ‘paracetamol’

- avoid concepts such as “all of the above”, “none of the above”, “answers 2 and 3 only”,

10. The list of options should have only one clearly correct answer. When ‘the best’ or ‘the most likely’ answer is sought this should be clearly stated in the lead-in. All the options should be homogeneous, i.e. belonging to the same category such as, diagnosis, treatment methods, list of nerves, list of muscles.

11. The position of the correct answer in the option list should vary among MCQs.

12. Use coherent, consistent terminology and inform the candidates of the meaning of the commonly used terms.

- “Recognised” means “an accepted feature of the disease”.

- “Pathognomonic” means “a feature specific to the disease, but to no other”.

- “Characteristic” means “a feature without which the diagnosis is in question”. This term must therefore be used with care.

- “Typical” is synonymous with “characteristic”.

- “The majority” or “most” means over 50%. However, these are vague terms that should be avoided, if possible.

- Percentages as a specific figure are unacceptable, and should be given as a range e.g. 30-40%.

- Eponyms s should be defined unless in common use, e.g. von Recklinghausen’s Disease.