Up to 200 words with only the amount of information required to answer the question.

Approximate age to protect patient privacy, for example, ‘A man in his 60s’.

Patient characteristics such as race, disability or socioeconomic status unless critical for the correct diagnosis.

Extraneous details in the history or physical examination.

Red herrings, or intentionally misleading information.

High-quality, still single image or multipanel figure, ideally coloured.

Accompanying video for online version.

Very brief legend (eg, ‘Transthoracic echocardiogram in the parasternal-long axis orientation’ or ’12-lead ECG’).

Identifying patient information (names, medical record numbers).

Interpretation of the image in the legend.

A single clear question which allows the test-taker to answer even before looking at the options.

Negatively phrased lead-ins.

Questions which ask the reader to choose more than one correct answer.

True/false questions (which sometimes masquerade as ‘which of the following statements are true’).

Four or five short homogenous options.

Plausible distractors which need to be less correct than the right answer.

Explanations of ‘why’ in the answer options.

Long or complicated answer choices.

Ambiguous terms such as usually, often or useful.

Brand-name drugs or devices.

Up to 200 words.

Reasons why one option is the most correct and the others are less correct.

Interpretation of the image.

Supplementary figures or videos.

Brief clinical pearls which expound on the teaching point.

Up to five references, ideally contemporary.

Clinical information which was needed to answer the question correctly.

Personal or institutional opinion which deviates from standards of practice.