Clin Med
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Both the MRCP(UK) written examinations and the specialty certificate examinations (SCEs) use single-best-answer questions to assess the knowledge and problem-solving skills of physicians in training. Since 1999, specialists and senior trainees have created large banks of questions for these examinations that cover the relevant curricula. ⋯ Each question drafted is subjected to face-to-face peer review and subsequent stages of academic scrutiny before reaching the question bank, and later during the exacting processes of question selection and standard setting. Feedback to question writers at every level of scrutiny helps to support the development of question-writing competence, and the analysis of individual question performance provides some insight into optimal question design.
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ALF is a multisystem disorder necessitating both predictive and reactive management strategies to support and protect organs from the initial and subsequent insults encountered. Early referral to a specialist liver centre with the option of liver transplantation is recommended. Furthermore, a good understanding of the poor prognostic variables is necessary to determine those most at risk of developing ALF in order to facilitate timely, safe transfer and listing for liver transplantation.