Students' certainty during course test-taking and performance on clerkships and board exams.

Psychometric aspects of multiple-choice tests were investigated using a confidence-weighted scoring technique. The contributions of two indices, overconfidence and underconfidence, in the prediction of subsequent academic performance of examinees were studied. A total of 444 sophomore students (entering classes of 1982 and 1983) in one medical school were asked to indicate their confidence, on a 5-point scale (100, 75, 50, 25, and 0), in the correctness of their responses to each multiple-choice item on an Introduction to Clinical Medicine examination.

An unusual cause of GI bleeding in a quadriplegic: report of a case and review of the literature.

The authors report a case of upper gastrointestinal hemorrhage in a quadriplegic. The cause was a Mallory-Weiss tear, a previously unrecognized problem in these patients. The incidence of bleeding in patients with spinal cord injury is as high as 25 percent in the few reported series.

Evaluation of the 3 alpha-hydroxysteroid dehydrogenase assay for ursodeoxycholic acid, and 7 oxo- and 12 oxo- bile acids.

3 alpha-Hydroxysteroid dehydrogenase (SDH) quantifies ursodeoxycholic acid, 3 alpha,12 alpha-diol-7-one-5 beta-cholanoic acid, 3 alpha-ol-7-one-5 beta-cholanoic acid, and 3 alpha,7 alpha-diol-12-one-5 beta-cholanoic acid in a manner similar to the more commonly measured bile acids, exemplified by taurocholic acid. The type of oxygen function at the 7 or 12 position and its orientation at the 7 position has no effect on the rate of reaction of the enzyme. Discrepancies in the glycine/taurine ratios of patient intestinal aspirates containing ursodeoxycholic acid and oxo bile acids, obtained by SDH and gas-liquid chromatographic methods are not a result of the enzyme assay procedure.