A set of design patterns for digital item types has been developed in response to challenges identified in various projects by teachers in higher education. The goal of the projects in question was to design and develop formative and summative tests, and to develop interactive learning material in the form of quizzes. The subject domains involved were mainly in the life sciences, medical sciences and engineering sciences. The use of digital item types and facilitating the process of designing items were typical examples of the challenges involved. From the viewpoint of subject matter experts, the main challenge in digital item type design was to design items that test for understanding. Furthermore, lecturers want to reduce student behaviour that is based on guesswork. With these conditions in mind, this paper presents a set of design patterns for digital items, together with a standard format for describing these patterns. (Contains 1 table.)