How to pass the essay question Part 1 What’s the point of the exam anyway?



Download 10,88 Kb.
Date conversion23.10.2016
Size10,88 Kb.

How to pass the essay question

  • Part 1

What’s the point of the exam anyway?

  • It is an opportunity for you to get across to the examiner(s) what you have learned during your training
  • As you plan and begin writing, think critically … imagine the examiner looking over your shoulder!
  • You need to pass to qualify and start paying off all those debts ………….

General points

General points

  • You have to make a choice between the two questions … this can be difficult!
  • Once you have selected the question to answer … read it three times to make sure you know what the examiner is after
  • Underline each significant word
  • Check the wording of the question to select the right way to answer

General points

  • Describe the problems of prescribing for elderly patients ….
  • Write an essay on the benefits and risks of using two or more drugs concurrently ….
  • Discuss the mechanisms and applications of pharmacological inhibition of the actions of the renin-angiotensin-aldosterone system.

General points

  • There is NO DIFFERENCE in your approach to answering these questions!
  • Essay does not mean one long paragraph in elegant English!

Wording which does make a difference!

  • Discuss, with examples, the mechanisms and applications of pharmacological inhibition of the actions of the renin-angiotensin-aldosterone system
  • Compare and contrast the benefits and disadvantages of paracetamol and aspirin
  • Discuss the management …….

Time management: Where to start

  • The clock is ticking away ….
  • Two minutes to select the question to answer
  • Don’t aim to write for longer than 30 - 35 minutes …. i.e. 4 to 5 sides of A4
  • Thus … you have about 10 minutes to PLAN your answer .. Get it right first time!

What does the plan look like?

  • Draw a diagram of the system which is being considered e.g. renin-angiotensin-aldosterone system, hypertension, heart failure and so on (helicopter view)
  • Headings of sections (like a table of contents)
    • sub headings
      • sub sections

What are the common or systemic mistakes?

  • Inadequate preparation: revision and practise in answering exam questions
  • Not being mentally prepared for the exam on the day (and all the other exams that week!)
  • Failure to read and understand the question
  • TIME MANAGEMENT IS CRITICAL!
  • Writing too much or ……… too little!
  • Bad planning and execution … poorly set out and/or illegible or poor spelling

An actual question!!

  • Discuss the management of chronic heart failure in a patient with known ischaemic heart disease (write out the question!)
  • Discuss the management of chronic heart failure in a patient with known ischaemic heart disease

Now it’s your turn!

  • Try and draw a diagram including most of the main points of this question
  • Then put down a set of headings and sub-headings, arising from the diagram, to cover your answer to the question
  • You have about 10 minutes!

The Question

  • Discuss the management of chronic heart failure in a patient with known ischaemic heart disease

How diagrams help

  • Chronic
  • Heart failure
  • Ischaemia
  • Cardiomyopathy
  • Valvular
  • disease
  • Smoking
  • Obesity
  • SNS activation
  • Tachycardia
  • PVR inc.
  • Inc. PRA
  • Aldosterone
  • Angiotensin
  • Dysrhythmias

How diagrams help

  • Low Q
  • Ischaemia
  • Cardiomyopathy
  • Valvular
  • disease
  • Smoking
  • Obesity
  • SNS activation
  • Tachycardia
  • PVR inc.
  • Decreased Renal BF
  • Inc. PRA
  • Aldosterone
  • Na retention
  • Angiotensin
  • Dysrhythmias
  • Role of surgery?

Plan (1)

  • Definition and classification (NYHA): emphasis on CHRONIC
  • Why is it important? Incidence and epidemiology
  • Precipitating causes: emphasis on ischaemia
  • Pathology : Effects of CCF on SNS and RAA axis on increasing problems

Plan (2)

  • Management … with particular emphasis on ischaemic heart disease and role of surgery
  • Aims and objectives of treatment
  • Diagnosis … can be difficult!
  • Conservative: life style and prevention : stop smoking, lose weight, exercise, diabetes etc ….
  • Drug therapies .. e.g. digoxin, diuretics, ACE inhibitors use diagram to point out their roles
  • Emphasise problems with Rx for ischaemic heart disease e.g. beta blockers to ‘depress the heart’

Mistakes in this question

  • Inadequate definition of heart failure ..
    • Inability to supply adequate oxygen and nutrients to tissues during normal activities despite an adequate filling pressure and systemic blood pressure
  • Management: Aims and objectives of Rx
    • conservative treatment and surgery (if necessary) as well as drugs
  • Impact of IHD on the treatment

Mistakes in this question

  • Discussion on the use of beta blockers and ACE inhibitors
  • Beta blockers now have a limited role in CCF if used judiciously
  • Both ACE inhibitors and beta blockers are useful post MI (a likely prospect in this patient)
  • Use of vasodilators (e.g. hydrallazine)

Another question!

Acute MI: the first 24 hours

  • Draw a diagram of the processes involved
  • Produce a plan for answering the question
  • You have 10 minutes!

The question!

  • Discuss the management of acute myocardial infarction in the first 24 hours following diagnosis
  • Atheromatous plaque
  • Rupture, erosion
  • Formation of thrombus
  • Platelet embolisation
  • Coronary artery blockade
  • Pain, sweating,
  • collapse
  • Nausea and vomiting
  • Dysrhythmias, VF
  • (ECG changes
  • CPK MB, Troponin)
  • Muscle
  • Necrosis
  • Infarction
  • Thrombolysis
  • Aspirin
  • Angioplasty
  • Beta blockers
  • ACE inhibitors
  • Diamorphine
  • Anti-emetic
  • DEATH

The plan

  • Pathophysiology
  • Presenting features and making the diagnosis
  • Before hospital treatment: reassurance/O2/iv
  • Thrombolysis
    • types: streptokinase, alteplase and reteplase
    • when to start, which to use, risks and contraindications
  • Anti platelet therapy/beta blockers etc
  • Admission to CCU (angioplasty etc.)


The database is protected by copyright ©sckool.org 2016
send message

    Main page