1. Short Answer Questions: Writing Better Answers Julian Ingle Thinking Writing

2. Activity 1: Raising awareness of good writing 1.What are your thoughts about writing SAQs? 2.Thinking about your answers to previous SAQs, to what extent do you think the following are important in good-quality written answers: e.g. style, content, level of detail – anything else?

3. Features of SAQ Writing SAQs ask you to do one or a combination of the following: To write accurate definitions, descriptions and explanations. To show clear reasoning and argumentation. To show cause-and-effect relationships. To write concisely.

4. Types of Questions a) Descriptive: e.g. Defining terms or listing (primarily the facts) b) Explanatory: e.g. ‘explain the significance with regard to’ questions (why/how is x important for y?) or ‘cause and effect’ relationships c) Applied – may involve analysis: e.g. scenario + explanation questions (Given x scenario, why does y happen/why is y important, etc?) Think! What’s the question asking for: is it facts, or facts and something more (explanation of importance of those facts, indication of a relationship between those facts, etc.)?

5. Activity 2: Awareness of Question Types Here are some typical SAQs: Which type of questions do they relate to primarily? a)Define the terms: spider naevi, lymphadenopathy, ascites and myxoedema b)State 5 clinical features of this patient that are important to make a diagnosis c)Giving 2 examples, explain how splenomegaly can arise d)Explain the significance of lactic acid with respect to energy metabolism during exercise e)Give 2 reasons why an adolescent with a chronic disease might not comply with treatment

6. Activity 3: Awareness of Strong and Weak Answers Look at the four answers to the question below and mark them as if you were the tutor – what mark would each of them receive? What strengths/weaknesses does each one have? Question: Explain the significance of lactic acid with respect to energy metabolism during exercise. (2 marks)

7. Answer A) Lactic acid could be converted back into pyruvate in sufficient oxygen. Lactate builds up in insufficient oxygen when pyruvate could not be converted into acetyl CoA with the emission of CO 2. Mark 1/2 Statement of fact not related to question. Significance?

8. Answer B) Lactic acid causes fatigue. Produced when no glycogen is available and lipid is used to create ATP to form glucose. This inhibits PDH & lactate is formed from pyruvate. Mark 0/2 X X

9. Answer C) During exercise there may be an insufficient oxygen supply to the skeletal muscles (due to vigorous contractions). Therefore, glucose can be converted to pyruvate via glycolysis but it cannot be oxidised to acetyl-CoA. Due to the lack of oxygen, the pyruvate dehydrogenase complex is blocked and so lactate dehydrogenase converts pyruvate to lactic acid. This oxidises NADH to NAD + which can be used in glycolysis. Mark 2/2

10. Answer D) Lactic acid is a product of anaerobic respiration. This occurs when oxygen is starved. Glycolysis of glucose to pyruvate produces a net gain of 2 ATP. Also, in glycolysis, NAD is reduced to form NADH. The conversion of pyruvate produces NAD+ from NADH so NAD+ can be recycled. ATP is an energy intermediary. Mark: 1.5/2 Why? inadequate

11. Activity 4: Awareness of Strong and Weak Answers The next example is worth more (5 marks) and so requires a longer answer, re-reading the situation and allowing 5 minutes to write. Mark the 3 answers as if you were the tutor – what mark would each of them receive? What strengths/weaknesses does each one have? Question: Briefly describe the histological findings in the epidermis and dermis of psoriasis plaques. (5 marks)

12. Answer A Increased keratinocyte proliferation. – multiple layers. Infiltration by T-cells. There is increased keratinocyte proliferation leading to multiple layers found at the stratum corneum and the keratinocytes maintain their nuclei. There is also dilation of capillaries in the dermis. T-lymphocytes are also seen and they aid the inflammatory process. Mark: 2/5 Where?

13. Answer B →inflamation of the epidermal & dermal layers of the skin →swollen finger joints →salmon pink rash →scaly dry patch →onycholysis → whitening of the nail plate & separation from the nail bed →nail pitting →leukonychia →hyperkeratosis Mark: 2/5

14. Answer C) There is thickening of the epidermis – with proliferation of the keratinocytes and increased keratinisation. Strateum corneus becomes thickened and ↑number of parakeratotic cells. In the dermis there is an accumulation of inflammatory cells, such as lymphocytes and release of inflammatory mediators. Vasodilation of vessels within the dermis. Also proliferation of the basal cells and as cells migrate through the layers an increasing amount retain their nuclei. Mark: 5/5

15. Activity 5: Writing Concisely (Part 1) Look at the following two examples: –The central nervous system does not function correctly –CNS dysfunction What do you notice about them? How do they function at the level of grammar? Nominalisation!

16. Nominalisation Exercise Look at the phrases below and transform them into noun phrases or nominalisations: 1) The production of leucocytes gradually increased. 2) The tissue responded with inflammation which decreased over time. 3) This is followed by an excessive amount of mucus being produced. Possible answers: 1)Increased leucocyte production. 2) Decreased inflammatory response. 3) Excessive mucus production follows.

17. Activity 6: Writing Concisely (Part 2) Look at a student’s answer to the question below and summarise it in NO MORE THAN 20 words. Question: The enzyme pyruvate dehydrogenase (PDH) catalyses the conversion of pyruvate to acetyl CoA in the mitochondria. Some children have a deficiency of this enzyme activity. Explain why: these children have impaired neurological function. Student’s answer: The conversion of pyruvate to lactate does not yield enough ATP. Krebs cycle cannot take place as there is little acetyl CoA (from glucose there is none!) No reduced coenzymes to enter oxidative phosphorylation stage and so not enough ATP is made. Without ATP, cells (neurones, etc.) cannot carry out work and the brain and body cannot function properly. [ 60 words ] Possible answer: Caused by inadequate supply of ATP to neurones - dependent on complete oxidation of glucose via PDH (16 words)