Get Through Final FRCR Part A: SBAs for the Modular Examination

382 Pages·2009·1.781 MB·English

by  Megan Bydder, Alexander Clark, Nicholas Coupe, John Pattison

Get Through
Final FRCR Part A:
SBAs for the Modular Examination
© 2009 by Taylor & Francis Group, LLC
To our families, with love

© 2009 by Taylor & Francis Group, LLC
Get Through
Final FRCR Part A:
SBAs for the Modular
Examination
Megan Bydder MB ChB MRCP FRCR
SpecialistRegistrarinRadiology,UniversityHospitalofNorthStaffordshire,
Stoke-on-Trent,UK
Alexander Clark MA(Cantab) MB BChir FRCR
ConsultantRadiologist,UniversityHospitalofNorthStaffordshire,Stoke-on-Trent,UK
Nicholas Coupe BSc MB ChB MRCS
SpecialistRegistrarinRadiology,UniversityHospitalofNorthStaffordshire,
Stoke-on-Trent,UK
John Pattison MB BS MRCS FRCR
ConsultantRadiologist,RoyalShrewsburyHospital,Shrewsbury,UK

© 2009 by Taylor & Francis Group, LLC
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
© 2009 by Taylor & Francis Group, LLC
CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works
Version Date: 20121026
International Standard Book Number-13: 978-1-85315-854-4 (eBook - PDF)
This book contains information obtained from authentic and highly regarded sources. Reasonable
efforts have been made to publish reliable data and information, but the author and publisher cannot
assume responsibility for the validity of all materials or the consequences of their use. The authors and
publishers have attempted to trace the copyright holders of all material reproduced in this publication
and apologize to copyright holders if permission to publish in this form has not been obtained. If any
copyright material has not been acknowledged please write and let us know so we may rectify in any
future reprint.
Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced,
transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or
hereafter invented, including photocopying, microfilming, and recording, or in any information stor-
age or retrieval system, without written permission from the publishers.
For permission to photocopy or use material electronically from this work, please access www.copy-
right.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222
Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that pro-
vides licenses and registration for a variety of users. For organizations that have been granted a pho-
tocopy license by the CCC, a separate system of payment has been arranged.
Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are
used only for identification and explanation without intent to infringe.
Visit the Taylor & Francis Web site at
http://www.taylorandfrancis.com
and the CRC Press Web site at
http://www.crcpress.com
© 2009 by Taylor & Francis Group, LLC
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
© 2009 by Taylor & Francis Group, LLC
CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works
Printed in the United States of America on acid-free paper
Version Date: 20121026
International Standard Book Number: 978-1-85315-849-0 (Paperback)
This book contains information obtained from authentic and highly regarded sources. Reasonable
efforts have been made to publish reliable data and information, but the author and publisher cannot
assume responsibility for the validity of all materials or the consequences of their use. The authors and
publishers have attempted to trace the copyright holders of all material reproduced in this publication
and apologize to copyright holders if permission to publish in this form has not been obtained. If any
copyright material has not been acknowledged please write and let us know so we may rectify in any
future reprint.
Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced,
transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or
hereafter invented, including photocopying, microfilming, and recording, or in any information stor-
age or retrieval system, without written permission from the publishers.
For permission to photocopy or use material electronically from this work, please access www.copy-
right.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222
Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that pro-
vides licenses and registration for a variety of users. For organizations that have been granted a pho-
tocopy license by the CCC, a separate system of payment has been arranged.
Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are
used only for identification and explanation without intent to infringe.
Visit the Taylor & Francis Web site at
http://www.taylorandfrancis.com
and the CRC Press Web site at
http://www.crcpress.com
© 2009 by Taylor & Francis Group, LLC
#2009RoyalSocietyofMedicinePressLtd
PublishedbytheRoyalSocietyofMedicinePressLtd
1WimpoleStreet,LondonW1G0AE,UK
Tel: þ44(0)2072902921
Fax: þ44(0)2072902929
E-mail:[e-mail]
Website:www.rsmpress.co.uk
Apartfromanyfairdealingforthepurposesofresearchorprivatestudy,criticism
orreview,aspermittedundertheUKCopyright,DesignsandPatentsAct,
1988,nopartofthispublicationmaybereproduced,storedortransmitted,inany
formorbyanymeans,withoutthepriorpermissioninwritingofthepublishers
orinthecaseofreprographicreproductioninaccordancewiththetermsof
licencesissuedbytheCopyrightLicensingAgencyintheUK,orinaccordance
withthetermsoflicencesissuedbytheappropriateReproductionRights
OrganizationoutsidetheUK.Enquiriesconcerningreproductionoutsidethe
termsstatedhereshouldbesenttothepublishersattheUKaddressprintedon
thispage.
TherightsofMeganBydder,AlexanderClark,NicholasCoupeandJohnPattison
tobeidentifiedasauthorsofthisworkhavebeenassertedbytheminaccordance
withtheCopyright,DesignsandPatentsAct,1988.
BritishLibraryCataloguinginPublicationData
AcataloguerecordforthisbookisavailablefromtheBritishLibrary
ISBN:978-1-85315-849-0
DistributioninEuropeandRestofWorld:
MarstonBookServicesLtd
POBox269
Abingdon
OxonOX144YN,UK
Tel: þ44(0)1235465500
Fax: þ44(0)1235465555
Email:[e-mail]
DistributionintheUSAandCanada:
RoyalSocietyofMedicinePressLtd
c/oBookMastersInc
30AmberwoodParkway
Ashland,OH44805,USA
Tel: þ18002476553/þ18002665564
Fax: þ14192816883
Email:[e-mail]
DistributioninAustraliaandNewZealand:
ElsevierAustralia
30–52SmidmoreStreet
MarrickvilleNSW2204,Australia
Tel: þ61295178999
Fax: þ61295172249
Email:[e-mail]
TypesetbyTechsetCompositionLimited,Salisbury,UK
PrintedandboundinGreatBritainbyBell&Bain,Glasgow
© 2009 by Taylor & Francis Group, LLC
Contents
Preface vii
Abbreviations ix
Module 1: Cardiothoracic and Vascular 1
Module 2: Musculoskeletaland Trauma 55
Module 3: Gastrointestinal 117
Module 4: Genitourinary, Adrenal, Obstetrics
& Gynaecology, and Breast 179
Module 5: Paediatrics 233
Module 6: Central Nervous System and Head & Neck 293
References 357

v
© 2009 by Taylor & Francis Group, LLC
© 2009 by Taylor & Francis Group, LLC
Preface
P
r
e
fa
c
In 2008 the Royal College of Radiologists announced proposed changes e
to the format of the Examinations for the Fellowship in Clinical Radio-
logy, which included the introduction of single best answer questions
(SBAs) for the Final FRCR Part A examination from the Autumn 2009
sitting.
SBAs are being increasingly adopted by the Royal Colleges, because
they have a number of advantages over traditional true/false multiple-
choice questions. In particular they are better suited to the assessment
of higher levels of knowledge such as problem-solving and decision-
making, and are more relevant to everyday clinical practice.
The modular format of the Final FRCR Part A examination remains,
and the following six modules are examined:
Module 1: Cardiothoracic and Vascular
Module 2: Musculoskeletal and Trauma
Module 3: Gastrointestinal
Module4:Genitourinary,Adrenal,Obstetrics&Gynaecology,and
Breast
Module 5: Paediatrics
Module 6: Central Nervous System and Head & Neck
Each module consists of a single paper of two hours in duration con-
taining 75 questions. Radiological anatomy and techniques continue to
bepartoftheFinalFRCRPartAexamination,butphysicsisnowexam-
inedentirelyintheFirstFRCRexamination.Negativemarkinghasbeen
discontinued. Further detailed guidance is available from the College
website (www.rcr.ac.uk).
ThisbookcontainssixchaptersmirroringthesixmodulesoftheFinal
FRCRPartAexamination,eachofwhichcontains100singlebestanswer
format questions. The questions have been written using the commonly
used radiology textbooks, together with specialist textbooks and radio-
logy journals. All questions are accompanied by detailed explanations,
and are comprehensively referenced for further reading. Many of the
journal references are available in free full-text version on the internet.
To provide additional feedback, each question is assigned a difficulty
level, rangingfrom * (easiest) to ***** (most difficult).
This book aims to give radiology trainees a valuable insight into the
newFinalFRCRPartAexaminationformat,whileprovidingacompre-
hensive collection of practice questions to aid thorough preparation for
the examination.
Single best answer question (SBA) format
SBAsarecomposedofastem,oftenintheformofaclinicalscenario,fol-
lowedbyaquestiontowhichthecandidatemustselectasingleresponse
fromalistofpossibleoptions.Theoptionsconsistofonecorrectanswer
and a number of incorrect options or distractors, which are not necess-
arily completely wrong,merelyless correct in the given scenario. vii
© 2009 by Taylor & Francis Group, LLC
When attempting SBAs, it is advisable to read the question carefully
P
r and attempt to formulate the answer initially without looking at the
e
fa options.Ifyouareunsureoftheanswer,itisusuallypossibletoeliminate
c
e severalofthedistractors,improvingyourchancesofguessingtheanswer
correctly.Ifyouareunabletoanswer thequestionstraightaway,return
toitatalaterstage.Ensurethatyougiveyourselftimetoattemptallthe
questions, and do not leave any out, as incorrect answers are no longer
penalised.
Inourexperience,attemptingpracticequestionsisessentialforoptimal
exampreparation,asameansofidentifyinggapsinknowledgeand,when
performed under examination conditions, as a valuable self-assessment
technique. In addition, increasing familiarity with the examination
format is likely to enhance performance.
Furtherinformationaboutsinglebestanswerformatquestionsandgui-
dance on attemptingthem can beobtained from these sources:
Case SM, Swanson DB. Constructing Written Test Questions for the
Basic and Clinical Sciences, 3rd edn. Philadelphia: National Board
of Medical Examiners. Available at: www.nbme.org/publications/
item-writing-manual.html.
McCoubrieP,McKnightL.SinglebestanswerMCQs:anewformatfor
the FRCR part2a exam. ClinRadiol 2008; 63:506–10.

viii
© 2009 by Taylor & Francis Group, LLC