Highest % wrong answer picked, tells you what?

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purplelife

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Looking at the questions I'm getting wrong after narrowing it down to 2 options, I see that most of the time I'm in group of students with highest wrong answer picked. For example, UW QID: 431: 31% chose the correct answer cyclooxygenase-2 and 37% chose the wrong answer ribonucleotide reductase and I'm in the 2nd group. Another one: UW QID: 1889, 37% chose the correct answer glycerol kinase and 27% chose the wrong answer aceytl CoA carboxylase, again I'm in the 2nd group of students.

Since these percentage are provided for all the questions, what do they say about my prep?
 
From a test construction perspective, that data doesn't tell you very much unless you also know how those percentages break down among students at different levels. Ideally, the best students overall would be the ones getting it right, but it may also be a poorly written question where both high and low scoring students have equal chances of getting it right.

From UWorld's perspective, they will often write "bad" questions with flawed answers because their aim is to teach rather than examine. In this case, tricky and somewhat misleading answer choices combined with vague/incomplete stems may be playing a role, but these are designed to help you learn subtle distinctions that will benefit you later.

In the questions you listed above, without looking at the stems it's still pretty obvious what the stems had to say, so these are not bad questions at all. Biochemistry is generally a weaker area for students overall and thus you often see these sporadic distributions. After describing a pathway or a disease resulting from a pathway defect, I can ask which part of that pathway is defective and simply list A through E with plausible enzymes. Students with strong understanding will select the correct options, but less informed students will be more likely to go for any option that sounds familiar.

In your case, I think it means your biochemistry is weak but you're not alone. Depending on your overall performance thus far, it may or may not be worth investing the time to strengthen this area. For example, if you're averaging 220s right now with weakness across all areas, then biochem is pretty low yield and may not be worth the time. If you're averaging 240s and looking to hit 250s and 260s, then biochem may be worth some additional time.
 
QID 431 is a stupid one-liner. Might as well ask what was MJ's longest slam dunk during the '90 series against the LA Lakers, then write 3 paragraphs on how this relates to the intensity of the opening snap in aortic stenosis.

There's no reasoning behind it (at least at the level medical students need to be at), just a stupid fact some researcher found out and got his paper cited >100 times.

Q1889 is more about what enzymes are involved in fatty acid metabolism. Then you have know that Glycerol-3-Kinase is the rate limiting enzyme for glycerol metabolism and the only organ that participates in glycerol biosynthesis is the liver.

Basically, the only time you should pay attention to the #2 most answered choice is when #2 is actually the real answer. That tells you that something you learned during medical school is missing or was miscommunicated. Or that the question is crap. Or both.
 
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