Multiple Choice Patients

In taking an endocrinology exam the other day, I realized how much more I like multiple choice exams over any other format. Recognition trumps recall any day. On a side note, good exam formats trump horrible exam formats also. But I digress. Never fear, I'm pretty sure that the vast majority of med school exams are multiple choice. Actually, as a premed one of your bigger tests in the MCAT is multiple choice. And as a med student, the various steps of USMLE are multiple choice. With all this learning and testing happening mostly through MC, it'd be nice if patients presented clinically in a multiple choice format. Here are two patients I made up.

Patient A
"Hi doctor. From what I can tell, I've got normal TRH regulation, with elevated TSH production and increased T3/T4. If your really want my symptoms I'll tell you. Otherwise, I think I've got a.) primary hypothyroidism b.) primary hyperthyroidism c.) secondary hypothyroidism d.) secondary hyperthyroidism."

Patient B
"Hey doc. I'm pretty sure I've got some decreased calcium levels, increased phosphate, increased PTH, along with some muscle fatigue. Do I have a.) primary hypothyroidism b.) primary hyperparathyroidism c.) secondary hypothyroidism d.) secondary hyperparathyroidism?"

The answers, which I'm sure I'll slowly forget, are d and b. At least, I think those are the answers.

Sure these "patients" are exceedingly simple and there are probably numerous differentials that I'm unaware of. At this point, it'd take me a bit to figure out which of the choices is right, and that's including knowing the proper context to look in. It'd take even longer if I had to pull stuff like this out of my ass. Ah well, I guess that's what med schools are there for: sciences and clinical applications of science.

Either way, as long as multiple choice patients don't bring in the answer choices "none of the above" or "all of the above," MC patients would be sweet.