id
int64 173M
173M
| flagged
bool 1
class | index
int64 1
98
| questionChoiceId
null | marksheetId
int64 6.49M
6.5M
| timeTaken
null | isAnswered
bool 1
class | striked
sequencelengths 0
0
| mark
null | questionId
int64 264
22.8k
| question
dict | __typename
stringclasses 1
value |
|---|---|---|---|---|---|---|---|---|---|---|---|
173,460,001 | false | 1 | null | 6,495,014 | null | false | [] | null | 12,745 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The musculocutaneous nerve innervates the biceps brachii which is the prime supinator of the flexed elbow.",
"id": "10000991",
"label": "a",
"name": "Musculocutaneous nerve",
"picture": null,
"votes": 63
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The axillary nerve innervates the deltoid but does not innervate any supinating muscles.\n\n<br>",
"id": "10000995",
"label": "e",
"name": "Axillary nerve",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The radial nerve does innervate the supinator muscle but it is the prime mover of the extended elbow, not the flexed elbow.",
"id": "10000994",
"label": "d",
"name": "Radial nerve",
"picture": null,
"votes": 80
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The median nerve innervates most of the muscles in the anterior compartment of the forearm and hand, but no supinating muscles.",
"id": "10000992",
"label": "b",
"name": "Median nerve",
"picture": null,
"votes": 46
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The ulnar nerve innervates the flexor carpi ulnaris, medial interossei, lumbricals, hypothenar muscles and medial heads of the flexor digitorum profundus, but no supinating muscles.",
"id": "10000993",
"label": "c",
"name": "Ulnar nerve",
"picture": null,
"votes": 30
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3864",
"name": "Brachial plexus injuries",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3864,
"conditions": [],
"difficulty": 1,
"dislikes": 1,
"explanation": null,
"highlights": [],
"id": "12745",
"isLikedByMe": 0,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "The prime supinator of the forearm when the elbow is flexed is innervated by which branch of the brachial plexus?",
"sbaAnswer": [
"a"
],
"totalVotes": 234,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,002 | false | 2 | null | 6,495,014 | null | false | [] | null | 12,746 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The lunate is supplied by the branches of the deep palmar arch between the radial and ulnar arteries. Although it can undergo avascular necrosis (Kienbock's disease), proximal avascular necrosis of the lunate bone is not associated with a fall on the outstretched hand.",
"id": "10000998",
"label": "c",
"name": "Lunate",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The pisiform is supplied by the dorsal carpal, lateral pedicle and lower pedical branches of the ulnar artery. Pisiform fractures are typically associated with direct trauma, however, avascular necrosis is very rare.\n\n<br>",
"id": "10001000",
"label": "e",
"name": "Pisiform",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The hamate is supplied by the branches of the deep palmar arch between the radial and ulnar arteries. Although the hook of the hamate is at risk of avascular necrosis after fracture, the proximal aspect of the hamate is not.",
"id": "10000997",
"label": "b",
"name": "Hamate",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The trapezoid is supplied by numerous branches of the deep palmar arch between the radial and ulnar arteries. Avascular necrosis of the trapezoid is rare and is known to spontaneously resolve.",
"id": "10000999",
"label": "d",
"name": "Trapezoid",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The scaphoid bone has a retrograde arterial supply from the radial artery as it passes through the anatomical snuffbox, around the thumb, and back towards the wrist. This retrograde supply means a break can compromise the vascular supply to the proximal fragment, leading to avascular necrosis.",
"id": "10000996",
"label": "a",
"name": "Scaphoid",
"picture": null,
"votes": 175
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3865",
"name": "Scaphoid fractures",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3865,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12746",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "After a fall on an outstretched hand, which carpal bone is most at risk of proximal avascular necrosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 207,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,003 | false | 3 | null | 6,495,014 | null | false | [] | null | 12,747 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a description of the ulnar claw hand. Froment's sign will also be positive as a patient with ulnar nerve damage has to use flexor pollicis longus and brevis to grip a piece of paper between their thumb and index finger due to paralysis of the adductor pollicis.",
"id": "10001001",
"label": "a",
"name": "Extension of the metacarpophalangeal joint with flexion of the interphalangeal joints in the ring and little finger",
"picture": null,
"votes": 89
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a description of wrist drop, the result of radial nerve injury in which muscles of the extensor compartment of the forearm are paralysed, often as a result of compression or penetrating trauma.",
"id": "10001003",
"label": "c",
"name": "Inability to extend carpometacarpal, metacarpophalangeal or interphalangeal joints in each finger",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a description of Klumpke's palsy, the result of inferior brachial plexus root T1 and C8 avulsion when the arm is abducted and pulled superiorly, which sometimes occurs during childbirth.",
"id": "10001002",
"label": "b",
"name": "Extension of the metacarpophalangeal joint with flexion of the interphalangeal joints in each finger",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a description of Erb's palsy, the result of superior brachial plexus root C5 and C6 avulsion when the arm is adducted and pushed inferiorly. This typically occurs in babies who have difficult deliveries (usually due to shoulder dystocia or fetal macrosomia).\n\n<br>",
"id": "10001005",
"label": "e",
"name": "Adduction and internal rotation of the shoulder, extension of the elbow, pronation of the forearm and flexion of the wrist",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a description of the sign of Benediction which is a result of median nerve injury. It is usually accompanied by thenar muscle wasting.",
"id": "10001004",
"label": "d",
"name": "Inability to flex the thumb, index or middle finger",
"picture": null,
"votes": 17
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3866",
"name": "Ulnar nerve injuries",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3866,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12747",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following describes the motor signs seen upon lower ulnar nerve severance?",
"sbaAnswer": [
"a"
],
"totalVotes": 138,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,004 | false | 4 | null | 6,495,014 | null | false | [] | null | 12,748 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The foramen ovale allows the shunting of oxygenated blood from the inferior vena cava and right atrium to the left atrium. Once a baby takes its first breaths and the pulmonary circulation opens, the decrease in pulmonary resistance causes the left atrial pressure to exceed the right atrial pressure, forcing the foramen ovale to close. It then fuses shut, becoming the fossa ovalis.",
"id": "10001008",
"label": "c",
"name": "To shunt oxygenated blood from the right side of the heart to the left side of the heart",
"picture": null,
"votes": 43
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The ductus arteriosus shunts blood from the left pulmonary artery to the arch of the aorta, bypassing the foetal lungs. This blood comes from 2 places: the deoxygenated superior vena cava and the oxygenated inferior vena cava (this blood has picked up oxygen from the maternal circulation in the placenta). In actuality, only some blood passes through the ductus arteriosum, with most of it passing through the foramen ovale. Within hours of birth, the withdrawal of maternal prostaglandins causes closure and eventual fibrosis of the ductus arteriosus, resulting in the ligamentum arteriosum.",
"id": "10001006",
"label": "a",
"name": "To shunt partially oxygenated blood from the pulmonary circulation to the systemic circulation",
"picture": null,
"votes": 50
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although the formation of the recurrent laryngeal nerve does occur inferior to the ductus arteriosus, and the descent of the fetal heart does necessitate the long path of the recurrent laryngeal nerve so it can return to its innervation targets in the 6th pharyngeal arch, this is not the function of the ductus arteriosus.",
"id": "10001009",
"label": "d",
"name": "To guide the recurrent laryngeal nerve to its adult position",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The ductus venosus shunts blood from the umbilical vein to the inferior vena cava, and is inferior to the liver. This closes within 2-18 days of birth and fibroses to become ligamentum venosum.",
"id": "10001007",
"label": "b",
"name": "To shunt oxygenated blood from the placental circulation to the inferior vena cava",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although the ductus arteriosus does physically join the left pulmonary artery and arch of the aorta, its main role is to shunt blood from the pulmonary circulation to the systemic circulation.\n\n<br>",
"id": "10001010",
"label": "e",
"name": "To maintain the relative positions of the vessels within the mediastinum",
"picture": null,
"votes": 13
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3867",
"name": "Foetal Circulation",
"status": null,
"topic": {
"__typename": "Topic",
"id": "159",
"name": "Cardiovascular physiology",
"typeId": 7
},
"topicId": 159,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3867,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12748",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "What is the anti-natal function of the ligament found in adults at the same spinal level as the sternal angle?",
"sbaAnswer": [
"a"
],
"totalVotes": 127,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,005 | false | 5 | null | 6,495,014 | null | false | [] | null | 12,749 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "T8 is the level at which the inferior vena cava passes through the diaphragm.",
"id": "10001013",
"label": "c",
"name": "T8",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "T10 is the level at which the oesophagus passes behind the right crux of the diaphragm before joining the stomach at T11.",
"id": "10001014",
"label": "d",
"name": "T10",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "L1 is the transpyloric plane, containing the pylorus, duodenojejunal flexure, pancreatic neck, fundus of the gallbladder, splenic hilum, renal hila, portal vein origin, 2nd part of the duodenum, origin of the superior mesenteric artery, 9th costal cartilages and the termination of the spinal cord.\n\n<br>",
"id": "10001015",
"label": "e",
"name": "L1",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The thoracic duct arises from the upper extremity of the cisterna chyli in the abdomen at T12 and immediately passes through the aortic hiatus of the diaphragm (also at T12) into the posterior mediastinum.",
"id": "10001011",
"label": "a",
"name": "T12",
"picture": null,
"votes": 73
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The sternal angle (T4/5) contains the structures denoted by the acronym RATPLANT:\n\n* Rib 2,\n* Aortic arch,\n* Tracheal bifurcation\n* Pulmonary trunk bifurcation\n* Ligamentum arteriosum (and left recurrent laryngeal nerve)\n* Azygos vein\n* Nerves (cardiac plexus)\n* Thoracic duct switch from right to left.",
"id": "10001012",
"label": "b",
"name": "T4/5",
"picture": null,
"votes": 21
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3868",
"name": "Lymphatics",
"status": null,
"topic": {
"__typename": "Topic",
"id": "179",
"name": "Vascular Surgery",
"typeId": 7
},
"topicId": 179,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3868,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12749",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "The thoracic duct passes from the abdomen to the thorax at which spinal level?",
"sbaAnswer": [
"a"
],
"totalVotes": 155,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,006 | false | 6 | null | 6,495,014 | null | false | [] | null | 12,750 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The least splanchnic nerve with roots from T12 supplies the hindgut and can cause suprapubic pain in pathologies such as diverticulitis.",
"id": "10001019",
"label": "d",
"name": "T12",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The sympathetic nerves with roots from T2-4 supply the heart. Pain can be referred to these dermatomes during angina, causing chest pain.",
"id": "10001017",
"label": "b",
"name": "T2-4",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The greater splanchnic nerve with roots from T7-9 supplies the foregut and can cause epigastric pain in pathologies such as gastric ulcers.\n\n<br>",
"id": "10001020",
"label": "e",
"name": "T7-9",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The lesser splanchnic nerve with roots from T10-11 supplies the midgut and can cause periumbilical pain in pathologies such as early appendicitis.",
"id": "10001018",
"label": "c",
"name": "T10-11",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The phrenic nerve originates from C3-5, innervates the diaphragm, and may be irritated by stimuli such as blood from ruptured ectopic pregnancy. Irritation of the phrenic nerve can cause shoulder pain.",
"id": "10001016",
"label": "a",
"name": "C3-5",
"picture": null,
"votes": 113
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3780",
"name": "Dermatomes",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3780,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12750",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which dermatomes may pain refer to if the diaphragm is irritated?",
"sbaAnswer": [
"a"
],
"totalVotes": 157,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,007 | false | 7 | null | 6,495,014 | null | false | [] | null | 12,751 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The right and left main bronchi join at T4/5 to form the trachea.",
"id": "10001023",
"label": "c",
"name": "The right and left main bronchi",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The left and right common iliac veins join at T5 to form the inferior vena cava.",
"id": "10001022",
"label": "b",
"name": "The left and right common iliac veins",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The portal vein is formed at the transpyloric plane of L1 from the junction of the splenic vein and the superior mesenteric vein.",
"id": "10001021",
"label": "a",
"name": "The splenic vein and the superior mesenteric vein",
"picture": null,
"votes": 76
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The ileocaecal junction is typically found in the right iliac fossa at more inferior lumbar levels than L1.",
"id": "10001024",
"label": "d",
"name": "The ileum and the caecum",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The thoracic duct arises from the upper extremity of the cisterna chyli at T12, superior to the hila of the kidneys at L1.\n\n<br>",
"id": "10001025",
"label": "e",
"name": "Cisterna chyli and the thoracic duct",
"picture": null,
"votes": 20
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3869",
"name": "Vascular anatomy",
"status": null,
"topic": {
"__typename": "Topic",
"id": "179",
"name": "Vascular Surgery",
"typeId": 7
},
"topicId": 179,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3869,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12751",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which two structures join at the same spinal level as the hila of the kidneys?",
"sbaAnswer": [
"a"
],
"totalVotes": 127,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,008 | false | 8 | null | 6,495,014 | null | false | [] | null | 12,752 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The greater omentum, although lacking muscular tissue, moves to sites of infection within the peritoneum to reduce spread and prevent extensive peritonitis.",
"id": "10001028",
"label": "c",
"name": "The position of the greater omentum is fixed",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The posterior mesentery suspends the alimentary canal from the peritoneum. Both structures are derived from peritoneal folds, the mesentery from 2 layers and the greater omentum from 4.",
"id": "10001029",
"label": "d",
"name": "The greater omentum suspends the alimentary canal from the peritoneum",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The greater omentum is supplied by the left and right epiploic arteries, arising from the anastomotic right and left gastro-epiploic arteries, each derived from branches of the coeliac trunk.",
"id": "10001027",
"label": "b",
"name": "The greater omentum is avascular",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "One function of the greater omentum is the storage of visceral fat, which can be mobilised in catabolic states and deposited during caloric excess. This fat contributes more significantly to the development of metabolic syndrome and its complications than subcutaneous fat.\n\n<br>",
"id": "10001030",
"label": "e",
"name": "The greater omentum has no metabolic function",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The greater omentum is formed embryonically from 4 layers of peritoneum folded inferiorly from the bilayer between the greater curve of the stomach and the transverse colon.",
"id": "10001026",
"label": "a",
"name": "The greater omentum is a peritoneal structure",
"picture": null,
"votes": 70
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3870",
"name": "Abdominal anatomy",
"status": null,
"topic": {
"__typename": "Topic",
"id": "135",
"name": "General surgery",
"typeId": 7
},
"topicId": 135,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3870,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12752",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of these statements about the greater omentum is true?",
"sbaAnswer": [
"a"
],
"totalVotes": 121,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,009 | false | 9 | null | 6,495,014 | null | false | [] | null | 12,753 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The gubernaculum is the hyaluronic acid-rich column of extracellular matrix which spans between the inferior pole of the gonad and the scrotum. Its non-contractile shortening is what 'pulls' the testis to its adult position.",
"id": "10001033",
"label": "c",
"name": "Gubernaculum",
"picture": null,
"votes": 51
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "When passing through the abdominal wall, the testis descends laterally to the rectus abdominis. This occurs through the deep and superficial inguinal rings, the latter of which is found in the inguinal (Hesselbach's) triangle, the medial border of which is the rectus abdominis (the inferior border is the inguinal ligament, and the lateral border is the inferior epigastric vessels).",
"id": "10001032",
"label": "b",
"name": "Rectus abdominis",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The Foramen magnum is found at the base of the skull. It is the foramen through which structures including the conversion of the medulla oblongata to the spinal cord, the meninges, the spinal root of cranial nerve 11, the anterior and posterior spinal arteries and the vertebral arteries pass.\n\n<br>",
"id": "10001035",
"label": "e",
"name": "Foramen magnum",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The descending testis must pass through the parietal peritoneum. This results in a connection known as processus vaginalis. This connection closes, seals and disintegrates during development, leaving the tunica vaginalis covering the testis in the adult scrotum.",
"id": "10001031",
"label": "a",
"name": "Parietal peritoneum",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The epiploic foramen (the foramen of Winslow) is a connection between the greater and lesser sacs of the peritoneum found inferiorly to the caudate lobe of the liver and bounded by the free edge of the lesser omentum (containing the hepatic artery, portal vein and common bile duct) anteriorly, the inferior vena cava posteriorly and the 1st part of the duodenum inferiorly.",
"id": "10001034",
"label": "d",
"name": "Epiploic foramen",
"picture": null,
"votes": 11
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3871",
"name": "Development of the male reproductive system",
"status": null,
"topic": {
"__typename": "Topic",
"id": "171",
"name": "Embryology",
"typeId": 7
},
"topicId": 171,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3871,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12753",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Through which of these structures must the descending testicle pass last to reach its adult position?",
"sbaAnswer": [
"a"
],
"totalVotes": 113,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,010 | false | 10 | null | 6,495,014 | null | false | [] | null | 12,754 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The deltoid ligament is comprised of 4 components, each of which attaches to the medial malleolus of the tibia:\n\n1. The posterior tibiotalar ligament connects the medial malleolus to the posterosuperior aspect of the talus.\n2. The tibiocalcaneal ligament connects the medial malleolus to the sustenaculum tali of the calcaneus/\n3. The tibionavicular ligament connects the medial malleolus to the medial aspect of the navicular bone\n4. The anterior tibiotalar ligament connects the tip of the medial malleolus to the anterosuperior aspect of the talus.\n\nEversion stretches these ligaments, leading to sprain or tear.",
"id": "10001036",
"label": "a",
"name": "Medial malleolus",
"picture": null,
"votes": 74
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The lateral malleolus connects to 3 main lateral ligaments: the posterior talofibular ligament, the calcaneofibular ligament and the anterior talofibular ligament. These are stretched upon inversion of the ankle.",
"id": "10001037",
"label": "b",
"name": "Lateral malleolus",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The 2 most relevant structures which attach to the 5th metatarsal are the fibularis brevis and fibularis tertius tendons. These are responsible for some of the dorsiflexion and eversion of the ankle and are shortened, rather than stretched, upon ankle inversion and are therefore not vulnerable to injury by this mechanism.",
"id": "10001038",
"label": "c",
"name": "5th metatarsal",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The most significant ligaments joining to the cuboid are the plantar calcaneocuboid ligament (short plantar ligament) and the long plantar ligament. These are at risk of injury from mechanisms causing excessive stress on the arch of the foot rather than eversion.",
"id": "10001039",
"label": "d",
"name": "Cuboid",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The lateral cuneiform has short, strong, fibrous attachments to each of its surrounding bones such as the cuboid, middle cuneiform and navicular bone. None of these are particularly at risk in ankle eversion injuries.\n\n<br>",
"id": "10001040",
"label": "e",
"name": "Lateral cuneiform",
"picture": null,
"votes": 9
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3872",
"name": "Ankle sprain",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3872,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12754",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A student trips and everts their ankle.\n\nTo which bony structure do their sprained ligaments most likely attach?",
"sbaAnswer": [
"a"
],
"totalVotes": 128,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,011 | false | 11 | null | 6,495,014 | null | false | [] | null | 12,755 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Plantarflexion of the foot is performed by the gastrocnemius, soleus, flexor hallucis longus, flexor digitorum and tibialis posterior. The tibial nerve provides the motor component to each of these, not the fibular nerve.",
"id": "10001042",
"label": "b",
"name": "Inability to plantarflex their foot",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Active inversion and plantarflexion of the ankle are performed by the tibialis posterior which is innervated by the tibial nerve. This is opposed to the tibialis anterior which actively inverts and dorsiflexes the ankle and is innervated by the deep branch of the fibular nerve - this would be affected by severance of the common fibular nerve.",
"id": "10001043",
"label": "c",
"name": "Inability to actively invert and plantarflex their ankle",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Sensation of the skin in the popliteus is supplied by the posterior femoral nerve's cutaneous branch, which arises from the tibial portion of the sciatic nerve rather than the common fibular nerve. In a fibular nerve injury, sensation to the lower limb would be affected in the distribution of the sural (skin on the lower posterior leg and small toe), superficial fibular (skin on the lower lateral leg and the medial 4 toes) and deep fibular nerves (small triangle on the superior aspect of the skin between the hallux and second toe).",
"id": "10001044",
"label": "d",
"name": "Inability to feel touch sensation in their popliteus",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The common fibular nerve passes superficially around the neck of the fibula below the knee and is at risk of injury in this case. This results in foot drop whereby the muscles of the anterior and lateral compartments of the leg, which dorsiflex the ankle and are innervated by the deep and superficial branches of the fibular nerve respectively, are paralysed.",
"id": "10001041",
"label": "a",
"name": "Inability to dorsiflex their foot",
"picture": null,
"votes": 59
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The extension of the knee is mediated by the 4 components of the quadriceps: vastus medialis, vastus lateralis, vastus intermedius and rectus femoris. Each of these are innervated by the femoral nerve which has no branches that reach below the knee.\n\n<br>",
"id": "10001045",
"label": "e",
"name": "Inability to extend the knee",
"picture": null,
"votes": 4
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3856",
"name": "Foot drop",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3856,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12755",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "During a bike accident, a student lacerates the proximal lateral aspect of their leg below the knee.\n\nWhich of the following describes their most likely peripheral nerve injury?",
"sbaAnswer": [
"a"
],
"totalVotes": 107,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,012 | false | 12 | null | 6,495,014 | null | false | [] | null | 12,756 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A positive posterior drawer test indicates posterior cruciate ligament (PCL) rupture which is not part of the unhappy triad of O'Donoghue. The PCL spans from the posterior intercondylar area to the posterolateral aspect of the medial femoral condyle and stops the femur from slipping forwards on the tibia.",
"id": "10001049",
"label": "d",
"name": "Positive posterior drawer test",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Foot drop is the result of paralysis of the anterior compartment of the leg, and is most commonly due to common fibular nerve lesions. Although associated with trauma, it is not part of the unhappy triad of O'Donoghue.\n\n<br>",
"id": "10001050",
"label": "e",
"name": "Foot drop",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "A positive anterior drawer test indicates an anterior cruciate ligament (ACL) rupture which is part of the unhappy triad of O'Donoghue, alongside a medial meniscus tear and medial collateral ligament tear. The ACL spans from the anterior intercondylar area to the posteromedial aspect of the lateral femoral condyle and stops the femur from slipping backwards on the tibia.",
"id": "10001046",
"label": "a",
"name": "Positive anterior drawer test",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is McMurray's test for lateral meniscus tears. These tears are not part of the unhappy triad of O'Donoghue which consists of a medial meniscus tear, medial collateral ligament tear and anterior cruciate ligament (ACL) rupture.",
"id": "10001047",
"label": "b",
"name": "Click and discomfort upon varus stress, internal rotation and extension of the knee",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Tenderness over the lateral joint line is indicative of a lateral meniscus tear or lateral collateral ligament tear, neither of which are part of the unhappy triad of O'Donoghue. These tears would be produced upon varus stress to the leg such as when running and stopping suddenly by bracing against a planted foot with the foot internally rotated.",
"id": "10001048",
"label": "c",
"name": "Tenderness over the lateral joint line",
"picture": null,
"votes": 8
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3873",
"name": "Cruciate ligament injuries",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3873,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12756",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "The unhappy triad of O'Donoghue occurs upon valgus (inward) stress on the knees. It most commonly occurs when the foot is planted on the ground.\n\nWhich of the following describes one of the findings upon examination?",
"sbaAnswer": [
"a"
],
"totalVotes": 91,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,013 | false | 13 | null | 6,495,014 | null | false | [] | null | 12,757 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The adrenal medulla is formed from neural crest cells which are released from the neural plate's crest as it fuses into the neural tube during neurulation.",
"id": "10001051",
"label": "a",
"name": "Adrenal medulla",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Intercostal muscles are formed from paraxial mesoderm alongside the ribs and vertebra, each consisting of components from the 2 adjacent somites. They are encoded for by HOX genes which correspond to their appropriate spinal level.\n\n<br>",
"id": "10001055",
"label": "e",
"name": "Intercostal muscles",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The telencephalon is a paired structure formed from the neural tube's cranial aspect during the 5 vesicle stage. Together with the diencephalon, it forms the forebrain, making up the cerebral cortices, thalamus and hypothalamus.",
"id": "10001054",
"label": "d",
"name": "Telencephalon",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Intervertebral discs are formed from the remnants of the notochord after it has induced neurulation in the ectoderm through the release of factors such as BMP-4.",
"id": "10001052",
"label": "b",
"name": "Intervertebral discs",
"picture": null,
"votes": 46
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Glomeruli are formed from the intermediate layer mesoderm which forms the urogenital ridges from which the pronephros, mesonephros and metanephros arise. The glomeruli of the adult kidney are formed embryonically when the ureteric bud (endoderm-derived) and mesenchyme interact. The mesenchyme of the metanephric ridge expresses WT1, and undergoes mesenchymal to epithelial transition to form nephric vesicles which join to the tubular structures of the branching ureteric bud, making up the glomeruli of the nephrons.",
"id": "10001053",
"label": "c",
"name": "Glomeruli",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3874",
"name": "Neurulation",
"status": null,
"topic": {
"__typename": "Topic",
"id": "171",
"name": "Embryology",
"typeId": 7
},
"topicId": 171,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3874,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12757",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following is formed from cells which disperse from the neural plate during neurulation?",
"sbaAnswer": [
"a"
],
"totalVotes": 106,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,014 | false | 14 | null | 6,495,014 | null | false | [] | null | 12,758 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The coronary sinus is formed from the left horn of the sinus venosus. It drains the great, middle, small and oblique coronary veins directly into the right atrium.",
"id": "10001056",
"label": "a",
"name": "The coronary sinus",
"picture": null,
"votes": 42
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The aortic arch is formed from the bridging of the 4th left aortic arch between the ventral and left dorsal aorta. Up to 6 paired aortic arches initially form between the ventral aorta and paired dorsal aorta. Most of these atrophy but those remaining form the great vessels and their branches.",
"id": "10001059",
"label": "d",
"name": "The adult aortic arch",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The smooth right atrium is the adult structure formed from the right horn of the sinus venosus. It is separated from the right atrial appendage by the sulcus terminalis externally and crista terminalis internally and does not contain pectinate muscles.",
"id": "10001057",
"label": "b",
"name": "The smooth right atrium",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The right atrial appendage is the remnant of the primitive atrium on the cranial side of the sinus venosus. It is separated from the smooth right atrium by the sulcus terminalis externally and crista terminalis internally and contains pectinate muscles.\n\n<br>",
"id": "10001060",
"label": "e",
"name": "The right atrial appendage",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The aorticopulmonary (spiral) septum is formed from the septation of the truncus arteriosus by endocardial cushions and is aided by the infiltration of neural crest cells. Defects in this process can cause tetralogy of Fallot, a cyanotic congenital heart disease characterised by pulmonary stenosis, an over-riding aorta, a ventricular septal defect and right ventricular hypertrophy.",
"id": "10001058",
"label": "c",
"name": "The aorticopulmonary septum",
"picture": null,
"votes": 11
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3875",
"name": "Formation of heart chambers",
"status": null,
"topic": {
"__typename": "Topic",
"id": "171",
"name": "Embryology",
"typeId": 7
},
"topicId": 171,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3875,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12758",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which structure is formed from the left horn of the embryonic sinus venosus?",
"sbaAnswer": [
"a"
],
"totalVotes": 94,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,015 | false | 15 | null | 6,495,014 | null | false | [] | null | 12,759 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "SHH is produced in the zone of polarising activity in the caudal aspect of the distal limb bud. This results in the differential development of the digits into the digitus minimus to pollux morphologies.\n\nInjection of SHH or transplantation of the zone of polarising activity to another part of the limb bud in chicken embryos is sufficient to alter the development of the autopod into a different orientation.\n\nEnhanced SHH expression in vivo leads to polydactyly in which extra digits are produced.",
"id": "10001061",
"label": "a",
"name": "Polydactyly",
"picture": null,
"votes": 51
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Chondrodysplasia Grebe type is a micromelia (small, deformed limb) congenital malformation of the limbs. It results from autosomal recessive mutations in GDF5, a growth and differentiation factor which enhances the condensation of the mesenchyme to promote bone thickening.",
"id": "10001062",
"label": "b",
"name": "Grebe-type chondrodysplasia",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Phocomelia describes the lack of formation of the stylopod (forms the adult humerus) and sometimes zeugopod (forms the adult radius and ulna - lost in type 1 phocomelia, retained in type 2) whilst the development of the autopod (forms the most distal features including the carpals, metacarpals and phalanges) is retained.\n\nIn development, the more distal features of the embryonic limb bud are induced to become the autopod and zeugopod based on the concentration of FGF received from the apical ectodermal ridge.\n\nPhocomelia was a common thalidomide-induced birth defect as the drug impaired the proliferation of cells in the progress zone of the developing limb bud while not affecting FGF secretion.",
"id": "10001064",
"label": "d",
"name": "Phocomelia",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Split hand-foot malformation (SHFM) occurs due to multi-factorial genetic and environmental factors causing the failure of the apical ectodermal ridge, resulting in aplasia and hypoplasia of some phalanges and metacarpals/metatarsals. SHH can be implicated in SHFM but due to deficiency, not excess.\n\n<br>",
"id": "10001065",
"label": "e",
"name": "Split hand-foot malformation",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pituitary dwarfism occurs when the growth of an individual is restricted uniformly across the entire body due to a deficiency in growth hormone. This can occur due to factors at birth (genetic disease, congenital pituitary agenesis) or acquired factors in early life (severe brain injury, pituitary adenoma compressing the somatotropic anterior pituitary cells).",
"id": "10001063",
"label": "c",
"name": "Pituitary dwarfism",
"picture": null,
"votes": 9
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3876",
"name": "Development of the limb buds",
"status": null,
"topic": {
"__typename": "Topic",
"id": "171",
"name": "Embryology",
"typeId": 7
},
"topicId": 171,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3876,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12759",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "During limb development, excessive Sonic Hedgehog (SHH) release can lead to which condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 84,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,016 | false | 16 | null | 6,495,014 | null | false | [] | null | 12,760 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "To prevent scapular winging, the serratus anterior (under the control of the long thoracic nerve) contracts, pulling the scapula anteriorly. Disruption of this nerve, for example by misplaced chest drain insertion, can cause scapular winging which can be corrected using a scapular brace.",
"id": "10001068",
"label": "c",
"name": "When pushing the extended arm against a wall, a muscle contracts to keep the scapula in place",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the locking of the knee. Upon full extension of the knee, the femur rotates inwards on the tibial plateau, causing the tightening of the anterior and posterior cruciate ligaments. This allows the leg to remain extended with less muscular activity to conserve energy while standing. This locking can then be unlocked by the popliteus muscle externally rotating the femur on the tibia.",
"id": "10001067",
"label": "b",
"name": "Extension of the knee causes the leg to lock",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "When abducting the shoulder in the glenohumeral joint, the first 15 degrees of movement are mediated by the suprascapularis, and the next rotation up to 90 degrees is mediated by the deltoid. Further rotation from this point onwards is mediated by the rotation of the scapula at the acromioclavicular joint by the trapezius (as the glenohumeral joint is already at its full abduction).\n\n<br>",
"id": "10001070",
"label": "e",
"name": "The rotation of the scapula during arm abduction",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the windlass mechanism. Weight-bearing on the first metatarsophalangeal joint causes its extension, tightening the plantar aponeurosis into a tight band, raising the height of the medial longitudinal arch, externally rotating the leg, and inverting the calcaneus.",
"id": "10001066",
"label": "a",
"name": "Pressure on the hallux causes tightening of the arch of the foot through the plantar fascia",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The pelvis is formed of arches which produce strong structures for weight bearing. One arch is formed between the ischial tuberosities, pubis and pubic symphysis to support the body when sitting. Another is formed between the acetabulums, ilium and sacrum to support the body when standing.",
"id": "10001069",
"label": "d",
"name": "When sitting, a bony arch supports the weight of the body",
"picture": null,
"votes": 7
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3877",
"name": "Foot anatomy",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3877,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12760",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of these statements best describes the windlass mechanism?",
"sbaAnswer": [
"a"
],
"totalVotes": 67,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,017 | false | 17 | null | 6,495,014 | null | false | [] | null | 12,761 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the development of GnRH-releasing neurons. This process is disrupted in Kallmann syndrome resulting in an impaired sense of smell and delayed puberty.",
"id": "10001073",
"label": "c",
"name": "Migration of GnRH-releasing neurons from the nasal placode to the hypothalamus",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the process of Wallerian degeneration which occurs after axonotmesis or neurotmesis as the distal aspect of the axon is detached from its cell body.",
"id": "10001071",
"label": "a",
"name": "Schwann cells dissociate from the axon and macrophages remove axon debris",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This process is known as neural pruning which peaks between ages 2 and 16 to remove unused neurons, improving the strength of connections between more frequently utilised neurons.\n\n<br>",
"id": "10001075",
"label": "e",
"name": "The degeneration of central neurons due to insufficient signalling through them during development",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the process by which neuron axons link to their target structures in embryonic stages and during peripheral nerve regeneration after Wallerian degeneration (it is only likely to be successful after axonotmesis as the growth cone can be guided by the endoneurium, whilst after neurotmesis, the growth cone may not meet the epineurium).",
"id": "10001072",
"label": "b",
"name": "Axon growth cones follow the concentration gradient of neurotrophic factors to the target tissue",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This process is known as disuse atrophy, which occurs, for example, to the muscles of the thenar eminence in median nerve palsies.",
"id": "10001074",
"label": "d",
"name": "Degeneration of muscular tissue upon denervation",
"picture": null,
"votes": 8
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3878",
"name": "Wallerian degeneration",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3878,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12761",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of these statements best describes Wallerian degeneration?",
"sbaAnswer": [
"a"
],
"totalVotes": 74,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,018 | false | 18 | null | 6,495,014 | null | false | [] | null | 12,762 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "To enter the mitochondria, fatty acyl-CoA is conjugated to carnitine (which takes the place of coenzyme A) by carnitine acyltransferase 1. It can then be bound by translocase in the inner mitochondrial membrane. Once in the mitochondrial matrix, it can be de-conjugated by carnitine acyltransferase 2, becoming fatty acyl-CoA again.",
"id": "10001078",
"label": "c",
"name": "To enter the mitochondria, fatty acyl-CoA must be bound to translocase in the cytoplasm. Once bound, it can then freely diffuse across the lipid bilayer of the inner mitochondrial membrane",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ACP is a co-factor which is added to 3-carbon malonyl-groups by switching places with the co-enzyme A on malonyl-CoA. This generates malonyl-ACP.",
"id": "10001077",
"label": "b",
"name": "Acyl carrier proteins (ACP) cofactors must first be added to fatty acids to facilitate beta-oxidation",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Beta-oxidation releases an acetyl-CoA molecule, an FADH2 molecule and an NADH molecule for each 2-carbon unit of fatty acid. Oxidative glycolysis produces a net gain of 2 acetyl-CoA molecules, 2 NADH molecules and 2 ATP molecules per 6-carbon glucose molecule. Through the citric acid cycle and oxidative phosphorylation, these products are converted to a total of 17.7 ATP per 2 carbon unit of fatty acid (Mr=28) and 34.2 ATP per 6 carbon unit of glucose (Mr=180). Therefore per gram of molecular weight, beta-oxidation with oxidative phosphorylation generates 0.63 moles of ATP whilst oxidative glycolysis with oxidative phosphorylation generates 0.19 moles of ATP.",
"id": "10001079",
"label": "d",
"name": "The process of beta-oxidation and subsequent oxidative phosphorylation releases less energy per gram than oxidative glycolysis and subsequent oxidative phosphorylation",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the final stage of beta-oxidation. Prior to this stage, fatty acyl-CoA is oxidised by acyl-CoA dehydrogenase, and the resulting trans-delta-squared enoyl-CoA is hydrated by enoyl-CoA hydratase. Hydroxyacyl-CoA is then oxidised by hydroxy acyl-CoA dehydrogenase to ketoacyl-CoA.",
"id": "10001076",
"label": "a",
"name": "Beta-oxidation involves the thiolysis of ketoacyl-CoA into the shorter fatty acids acyl-CoA and acetyl CoA",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Acyl-CoA dehydrogenases use FAD cofactors and are divided into 4 types: very long-chain acyl-CoA dehydrogenase, long-chain acyl-CoA dehydrogenase, medium-chain acyl-CoA dehydrogenase and short-chain acyl-CoA dehydrogenase. Each dehydrogenase processes fatty acyl-CoA molecules of different lengths during beta-oxidation. Reduction in the activity of the acyl-CoA dehydrogenases by a compound in unripe ackee fruit inhibits beta-oxidation causing the depletion of glycogen reserves, resulting in Jamaican vomiting sickness.\n\n<br>",
"id": "10001080",
"label": "e",
"name": "Acyl-CoA dehydrogenases are NAD+ dependent",
"picture": null,
"votes": 13
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3879",
"name": "Beta oxidation of fatty acids",
"status": null,
"topic": {
"__typename": "Topic",
"id": "180",
"name": "Biochemistry",
"typeId": 7
},
"topicId": 180,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3879,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12762",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of these statements about beta-oxidation is true?",
"sbaAnswer": [
"a"
],
"totalVotes": 79,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,019 | false | 19 | null | 6,495,014 | null | false | [] | null | 12,763 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The electron transport chain drives protons out of the mitochondrial matrix across the inner mitochondrial membrane to create an electrochemical gradient into the matrix through the F0 component of ATP synthase.",
"id": "10001082",
"label": "b",
"name": "The electron transport chain drives protons into the mitochondrial matrix",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "FADH2 is converted to FAD by complex 2 (succinate dehydrogenase, also involved in the citric acid cycle). Complex 2 does not pump protons itself but transfers electrons to ubiquinone, which are subsequently accepted by complex 3 (which pumps 4 protons). These electrons are then transferred to cytochrome C which transfers the electrons to complex 4 which pumps 2 protons (total protons pumped = 6). The electrons are finally transferred to oxygen, the terminal acceptor, which generates water.",
"id": "10001084",
"label": "d",
"name": "FADH2 is converted to FAD by complex 1, resulting in the pumping of 10 protons across the inner mitochondrial membrane",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ATP synthase is formed of the F0 proton pore and the F1 rotating component which binds and combines ADP and phosphate molecules. This occurs in 3 stages: binding, combination and release. A full turn of F1 requires 3 individual 120-degree rotations of F1 (each of which produces 1 ATP molecule). All 3 stages (binding, combination and release) occur simultaneously, meaning they occur 3 times during each 360-degree rotation, generating 3 ATP molecules.\n\n8 protons have to pass through the F0 pore to facilitate a full rotation of F1. Since the ATP synthesis reaction occurs in one out of the three stages of ATP synthase rotation (combination stage), we can deduce that only 1/3 of the energy from the movement of the 8 protons is used to drive the ATP synthesis reaction, whilst the rest is used to bind the ADP and phosphate (binding stage) and release the newly formed ATP (release stage).\n\n<br>",
"id": "10001085",
"label": "e",
"name": "The ATP synthesis reaction demands most of the energy that the proton gradient confers onto ATP synthase",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The greatest changes in redox potential in the electron transport chain are from NADH to iron-sulfur complexes, from cytochrome b562 to cytochrome b566, and from cytochrome a to cytochrome a3, all of which occur in complexes 1, 3 and 4. This corresponds with the complexes in which protons are pumped across the inner mitochondrial membrane as there is sufficient energy to drive this movement.",
"id": "10001081",
"label": "a",
"name": "The reactions with the largest changes in redox potential in the electron transport chain occur within complexes 1, 3 and 4",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "2,4-dinitrophenol is a molecule which uncouples the electron transport chain from ATP synthase by inserting itself into the inner mitochondrial membrane and facilitating proton transport back into the matrix. This dissipates the electrochemical gradient and leads to an increased rate of oxidative phosphorylation without ATP generation.",
"id": "10001083",
"label": "c",
"name": "2,4-dinitrophenol increases the rate of oxidative phosphorylation, boosting ATP production",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3880",
"name": "Electron transport chain",
"status": null,
"topic": {
"__typename": "Topic",
"id": "180",
"name": "Biochemistry",
"typeId": 7
},
"topicId": 180,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3880,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12763",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Regarding oxidative phosphorylation, which of the following statements is true?",
"sbaAnswer": [
"a"
],
"totalVotes": 74,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,020 | false | 20 | null | 6,495,014 | null | false | [] | null | 12,764 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hexokinase hydrolyses ATP to release a phosphate molecule which is used to generate glucose-6-phosphate from glucose. Hexokinase will not, however, catalyse the opposite reaction, instead requiring glucose-6-phosphatase to hydrolyse phosphate from glucose-6-phosphate during gluconeogenesis.",
"id": "10001087",
"label": "b",
"name": "Hexokinase",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Fructose-2,6-bisphosphatase catalyses the removal of phosphate from the '2' group of fructose-2,6-bisphosphate. Fructose-2,6-bisphosphate is the most potent known activator of phosphofructokinase-1, stimulating increased glycolysis. Fructose-2,6-bisphosphatase, therefore, down-regulates glycolysis and could be used to indirectly up-regulate gluconeogenesis. However, fructose-2,6-bisphosphatase is not involved in the core processes in the way enzymes like fructose-1,6-bisphosphatase are.\n\n<br>",
"id": "10001090",
"label": "e",
"name": "Fructose-2,6-bisphosphatase",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Phosphofructokinase-1 catalyses the addition of an extra phosphate group to the '1' position of fructose-6-phosphate to generate fructose-1,6-bisphosphate. Phosphofructokinase-1 will not, however, catalyse the opposite reaction, instead requiring fructose-1,6-bisphosphatase to hydrolyse phosphate from fructose-1,6-bisphosphate during gluconeogenesis.",
"id": "10001088",
"label": "c",
"name": "Phosphofructokinase-1",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Pyruvate carboxylase hydrolyses ATP to release energy so that it can add a bicarbonate group to pyruvate, generating oxaloacetate. Phosphoenolpyruvate carboxykinase can then use the energy from GTP hydrolysis to remove CO2 from oxaloacetate and generate phosphoenolpyruvate. This overcomes the non-reversible reaction by pyruvate kinase during glycolysis and facilitates gluconeogenesis.",
"id": "10001086",
"label": "a",
"name": "Pyruvate carboxylase",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pyruvate kinase catalyses the transfer of a phosphate group from phosphoenolpyruvate to ADP during glycolysis, generating ATP and pyruvate. This reaction, however, has a large Gibbs free energy change and the hydrolysis of a single ATP molecule is insufficient to reverse it. This makes the reaction effectively irreversible. To overcome this during gluconeogenesis, an intermediate step is performed in which an ATP molecule is hydrolysed to produce oxaloacetate. A GTP molecule is then hydrolysed to convert the oxaloacetate into phosphoenolpyruvate oxaloacetate.",
"id": "10001089",
"label": "d",
"name": "Pyruvate kinase",
"picture": null,
"votes": 25
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3881",
"name": "Carbohydrate chemistry",
"status": null,
"topic": {
"__typename": "Topic",
"id": "180",
"name": "Biochemistry",
"typeId": 7
},
"topicId": 180,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3881,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12764",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following enzymes is directly utilised in the conversion of pyruvate to glucose during gluconeogenesis?",
"sbaAnswer": [
"a"
],
"totalVotes": 87,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,021 | false | 21 | null | 6,495,014 | null | false | [] | null | 12,765 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although it may be found in small proportions in collagen molecules, methionine does not contribute to the tight twists of collagen molecules. Methionine's R-group consists of a 2-carbon alkyl chain linked to a sulphur molecule which is itself linked to a methyl group.",
"id": "10001094",
"label": "d",
"name": "Methionine",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although it may be found in small proportions in collagen molecules, isoleucine does not contribute to the tight twists of collagen molecules. Isoleucine's R-group consists of a 3-carbon alkyl chain with a methyl group branching off the 1st carbon of the chain.",
"id": "10001092",
"label": "b",
"name": "Isoleucine",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Collagen is formed mainly of repeats of glycine, proline and hydroxyproline. Proline's variable R-group consists of a 3-carbon acyl chain, the terminal carbon of which is linked to the nitrogen atom in the amine group. This causes a tight bend in amino acid chains in which proline is present.",
"id": "10001091",
"label": "a",
"name": "Proline",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although it may be found in small proportions in collagen molecules, phenylalanine does not contribute to the tight twists of collagen molecules. Phenylalanine's R-group consists of a single carbon alkyl group linked to a benzene ring.\n\n<br>",
"id": "10001095",
"label": "e",
"name": "Phenylalanine",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although it may be found in small proportions in collagen molecules, lysine does not contribute to the tight twists of collagen molecules. Lysine's R-group consists of a 4-carbon alkyl chain with an amine group linked to the 4th carbon of the chain.",
"id": "10001093",
"label": "c",
"name": "Lysine",
"picture": null,
"votes": 24
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3882",
"name": "Collagen",
"status": null,
"topic": {
"__typename": "Topic",
"id": "181",
"name": "Structure and Function of Cells",
"typeId": 7
},
"topicId": 181,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3882,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12765",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "The unique structure of which amino acid allows tight twists in the structure of collagen molecules?",
"sbaAnswer": [
"a"
],
"totalVotes": 77,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,022 | false | 22 | null | 6,495,014 | null | false | [] | null | 12,766 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This describes SDS-PAGE, a method of determining the mass of a protein accurately. The SDS addition to a denatured protein ensures a standardised polypeptide chains mass-to-charge ratio so the movement induced by the current accurately reflects the mass of each protein subunit when compared to the standard ladder.",
"id": "10001096",
"label": "a",
"name": "Denature the protein by boiling with SDS, add Coomassie blue stain, load into a well of polyacrylamide gel, apply a current, and compare the test well to a well with a standard ladder",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although the structures resolved by X-ray cryo-crystallography could technically be used retrospectively to work out the mass of a protein subunit, to resolve the structure of a protein, the primary structure must already be known which means the mass of the protein must already be known. Structural techniques are used after the determination of a protein subunit's mass. They are also highly laborious, long and expensive compared to methods for determining mass such as SDS-PAGE.\n\n<br>",
"id": "10001100",
"label": "e",
"name": "A solution of a protein is concentrated and a precipitant is added to cause crystallisation, then the crystals are rapidly frozen in a loop by liquid nitrogen and X-rays from a synchrotron are passed through the repeating 'cells' of protein causing a scatter pattern. From this pattern, the structure and therefore mass of a protein can be determined using Fourier transformations once the phase problem is accounted for by repeating with alterations of the protein structure through synthesis with heavy atoms added such as selenium in selenomethionine, or by molecular replacement models using similar previously resolved protein structures",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Flow cytometry is used to identify subsets of cells that express different amounts of a protein of interest, but has no function in the determination of protein subunit mass.",
"id": "10001097",
"label": "b",
"name": "Add a fluorescent antibody complementary to the protein to cells expressing it then pass the cells through a flow cytometer",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This answer choice describes enzyme-linked immunosorbent assay (ELISA), which is a sensitive method used to measure the presence and concentration of a specific protein in a solution rather than its molecular mass.",
"id": "10001098",
"label": "c",
"name": "Addition of different dilutions of a solution of the protein to a 96-well plate to which antibodies complementary to the protein have been attached. This is followed by washing and the addition of a second complementary antibody to which a reporter enzyme is conjugated. Further washing is performed and a reporter solution is added after which the intensity of the signal received is analysed through comparison to a standard curve",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a Bradford assay which is a method used to measure the presence and concentration of all proteins in a solution rather than the molecular mass of a specific protein.",
"id": "10001099",
"label": "d",
"name": "Addition of different dilutions of a solution of the protein to a 96-well plate, followed by the addition of Coomassie blue stain to each well and then analysis of the intensity of the signal received through comparison to a standard curve",
"picture": null,
"votes": 9
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3883",
"name": "Types of blotting",
"status": null,
"topic": {
"__typename": "Topic",
"id": "156",
"name": "Medical Genetics",
"typeId": 7
},
"topicId": 156,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3883,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12766",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following describes a commonly used method of determining protein subunit mass?",
"sbaAnswer": [
"a"
],
"totalVotes": 60,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,023 | false | 23 | null | 6,495,014 | null | false | [] | null | 12,767 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is one of the functions of the Ga-13 subunits which bind to the guanine nucleotide exchange factors for Rho GTPases. This activates their modulatory action on the actin cytoskeleton to alter cell conformation.",
"id": "10001104",
"label": "d",
"name": "Modulates the cytoskeleton",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is one of the functions of the beta-gamma subunit: they promote the opening of inward-rectifying potassium channels, thus hyper-polarising cells. These subunits can also modulate the activity of calcium channels and the Ras-Raf mitogenic signalling pathway.\n\n<br>",
"id": "10001105",
"label": "e",
"name": "Opens potassium channels",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the function of Ga-s which increases the generation of cAMP. This activates PKA which phosphorylates intracellular targets to modulate cell activity.",
"id": "10001102",
"label": "b",
"name": "Activates adenylyl cyclase",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the function of Ga-q which increases the generation of diacylglycerol. This activates PKC which phosphorylates intracellular targets to modulate cell activity and inositol trisphosphate, which binds to IP3 receptors. This allows for calcium efflux from the endoplasmic reticulum into the cytoplasm to modulate cell activity.",
"id": "10001101",
"label": "a",
"name": "Activates phospholipase C",
"picture": null,
"votes": 38
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the function of Ga-i/o subunits. This reduces the generation of cAMP which reduces the activity of PKA and subsequently reduces the phosphorylation of intracellular targets to modulate cell activity.",
"id": "10001103",
"label": "c",
"name": "Inactivates adenylyl cyclase",
"picture": null,
"votes": 0
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3884",
"name": "Cell signalling",
"status": null,
"topic": {
"__typename": "Topic",
"id": "181",
"name": "Structure and Function of Cells",
"typeId": 7
},
"topicId": 181,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3884,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12767",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Upon activation, the Ga-q subunit of a G-protein does what?",
"sbaAnswer": [
"a"
],
"totalVotes": 83,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,024 | false | 24 | null | 6,495,014 | null | false | [] | null | 12,768 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Serine phosphorylation of Akt is performed by PDK-1 and mTORC2, activating its anabolic functions only when insulin is bound to the receptor and the cell is in an ATP-rich state.\n\n<br>",
"id": "10001110",
"label": "e",
"name": "Serine phosphorylation of Akt",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Phospholipase C catalyses the hydrolysis of PIP3 to diacylglycerol (DAG). This activates PKC which phosphorylates intracellular targets to modulate cell activity, as well as inositol trisphosphate (IP3) which binds to IP3 receptors and allows for calcium efflux from the endoplasmic reticulum into the cytoplasm to modulate cell activity.",
"id": "10001107",
"label": "b",
"name": "Hydrolysis of PIP3 to IP3 and DAG",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the description of a guanine nucleotide exchange factor such as a G-protein coupled receptor. An example of a G-protein coupled receptor is the a1 adrenoceptor which accelerates GDP release from Ga-q type G-proteins to allow GTP entry and the activation of G-protein function.",
"id": "10001109",
"label": "d",
"name": "Exchange of GDP for GTP in G-proteins",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Phosphoinositide-3-kinase (PI3K) phosphorylates PIP2 to PIP3 on the inner side of the plasma membrane. This acts as a scaffold for the pleckstrin homology domain of Akt which phosphorylates targets including FOXO1, mTOR, glycogen synthase kinase and components of the GLUT4 exocytosis pathway. Together, this promotes protein synthesis, inhibits gluconeogenesis, promotes glycogenesis and promotes glucose uptake into cells.",
"id": "10001106",
"label": "a",
"name": "Phosphorylation of PIP2 to PIP3",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Upon binding of insulin to the external domains of the constitutively hetero-tetrameric insulin receptor, the tyrosine-rich cytoplasmic domains change conformation, allowing for the trans-phosphorylation of the tyrosine residues on each domain. This creates a scaffold for the SH3 domains of substrates to bind to and initiate downstream signalling.",
"id": "10001108",
"label": "c",
"name": "Tyrosine phosphorylation of the insulin receptor",
"picture": null,
"votes": 16
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3884",
"name": "Cell signalling",
"status": null,
"topic": {
"__typename": "Topic",
"id": "181",
"name": "Structure and Function of Cells",
"typeId": 7
},
"topicId": 181,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3884,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12768",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which reaction does PI3K catalyse (upon activation) downstream of the insulin receptor?",
"sbaAnswer": [
"a"
],
"totalVotes": 67,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,025 | false | 25 | null | 6,495,014 | null | false | [] | null | 12,769 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Primer addition is a vital process in DNA replication in both bacteria and eukaryotes and is mediated by DnaG in bacteria and primase in eukaryotes. In eukaryotes, there is an extra step in which a DNA primer is added by DNA Pol-alpha. Further differences exist such as the removal of primers in bacteria by DNA Pol-1 via nick translation, compared to the removal of RNase H1 and flap endonuclease-1 then replacement by DNA pol-delta in eukaryotes.",
"id": "10001114",
"label": "d",
"name": "Primase adds RNA primers to DNA strands, providing a basis for DNA polymerase activity on the leading strand and Okazaki fragments",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The 5' m7G cap of mRNA is required by most mRNAs for binding to the small ribosomal subunit. This can however be overcome by internal ribosome entry sites on some eukaryotic and viral mRNAs resulting in cap-independent translation.\n\n<br>",
"id": "10001115",
"label": "e",
"name": "The 5' m7G cap of mRNA mediates binding to the 40S subunit of the eukaryotic ribosome",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the spindle assembly checkpoint (SAC). When the SAC is satisfied, CDC20 is released and bound to APC/C, allowing it to ubiquitinate securin (and cyclin B) for degradation. Securin inhibits separase, so the ubiquitination of securin dis-inhibits separase which then cleaves the Scc1 component of cohesin. This allows chromatid separation by the contractile forces of kinetochore-microtubule depolymerisation, initiating anaphase.",
"id": "10001113",
"label": "c",
"name": "Once each kinetochore is attached to two microtubules from opposite poles, anaphase can begin",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is replication licensing, the process by which a finite number of the available origins are selected to be utilised before DNA replication begins to avoid under-replication or re-replication of the DNA.",
"id": "10001111",
"label": "a",
"name": "Loading of MCM2-7 helicases onto origins of DNA replication",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This occurs during the signalling that initiates replication, but is not replication licensing. Once Myc is activated, it promotes the transcription of Cyclin D which binds to CDK4 which in turn phosphorylates the retinoblastoma protein so that it can dissociate itself from E2F1. E2F1 then promotes Cyclin E transcription, moving the cell cycle from the G0 to G1 stage.",
"id": "10001112",
"label": "b",
"name": "Mitogens act through tyrosine kinase receptors, activating Ras-Raf-Mek-MAPK signalling which activates pro-mitogenic transcription factors such as Myc",
"picture": null,
"votes": 16
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3885",
"name": "Processes in mitosis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "156",
"name": "Medical Genetics",
"typeId": 7
},
"topicId": 156,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3885,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12769",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Initiated by CyclinE/CDK2, which of the following describes replication licensing?",
"sbaAnswer": [
"a"
],
"totalVotes": 57,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,026 | false | 26 | null | 6,495,014 | null | false | [] | null | 12,770 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This occurs during the initiation of the cell cycle and is stimulated by mitogen pathways. It results in E2F1 promoting the transcription of Cyclin E. Excess CDK4-Cyclin D activity due to gain of function or over-expression is a common mechanism utilised by breast cancer cells and glioblastomas.",
"id": "10001119",
"label": "d",
"name": "CDK4-Cyclin D phosphorylates retinoblastoma protein, dissociating it from E2F1",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This process occurs normally during the cell cycle, acting as a molecular switch. APC-CDH1 ubiquitinates Cyclin A to cause its degradation. CDK2-Cyclin A binds and phosphorylates CDH1, inactivating APC-CDH1. In G1, Cyclin A synthesis is low so APC-CDH1 predominates however, once the synthesis of Cyclin A is sufficient, the balance is shifted and CDK2-Cyclin A inhibition of APC-CDH1 predominates. The resultant rise in CDK2-Cyclin A promotes the shift from G1 to the S-phase.",
"id": "10001118",
"label": "c",
"name": "CDK2-Cyclin A is activated, activating a negative feedback loop on APC-CDH1",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Once these kinases are activated, one of their actions is to phosphorylate Chk1/2 kinases which phosphorylate Wee1 kinase and Cdc25 phosphatase, activating and inhibiting them respectively. This results in increased phosphorylation of CDK1, inhibiting CDK1-Cyclin B complexes and inhibiting cell cycle progression at the G2/M checkpoint. This is known as the DNA damage checkpoint.",
"id": "10001116",
"label": "a",
"name": "ATM/ATR kinases detect the free ends of damaged DNA",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "APC-CDC20 does ubiquitinate Cyclin B to promote its proteasomal degradation, but this is a normal process in mitosis, occurring at the start of anaphase alongside the degradation of securin and allowing the chromatids to separate.\n\n<br>",
"id": "10001120",
"label": "e",
"name": "APC-CDC20 promotes the degradation of Cyclin B, inhibiting G2/M progression",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These SMADs activate p107 binding to E2F4 which represses transcription of Cyclin E. SMADs also activate p15-INK4b which in turn represses CDK4-Cyclin D to further decrease Cyclin E transcription. This describes the inhibition of replication by external signals which prevents the G1/S transition, rather than the DNA damage checkpoint.",
"id": "10001117",
"label": "b",
"name": "Anti-mitogens such as TGF-B bind receptors, activating SMADs",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3885",
"name": "Processes in mitosis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "156",
"name": "Medical Genetics",
"typeId": 7
},
"topicId": 156,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3885,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12770",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Upon DNA damage, which of these processes occur as part of a mechanism to prevent cell cycling until the damage is repaired?",
"sbaAnswer": [
"a"
],
"totalVotes": 56,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,027 | false | 27 | null | 6,495,014 | null | false | [] | null | 12,771 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Cytochrome C molecules released by the MOMP activate APAF1 which associates with pro-caspase 9 to form the apoptosome. Pro-caspase 9 is then cleaved, activating its own protease activity. Caspase 9 cleaves effector caspases 3 and 7 which activate apoptotic enzymes such as caspase-dependent DNase.",
"id": "10001121",
"label": "a",
"name": "Pro-caspase 9 is cleaved",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cytochrome C molecules released by the MOMP activate APAF1 which associates with pro-caspase 9 to form the apoptosome. Pro-caspase 9 is then cleaved, activating its protease activity. Caspase 9 cleaves effector caspases 3 and 7 which activate apoptotic enzymes such as caspase-dependent DNase.",
"id": "10001124",
"label": "d",
"name": "Released cytochrome C inhibits APAF1",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "BH3-only is a protein activated by p53 after DNA damage or endoplasmic reticulum stress. It activates BAX/BAK which oligomerises in the mitochondrial outer membrane to form a pore through which factors including cytochrome C can be released to cause apoptosis. This action is therefore upstream of the MOMP.\n\n<br>",
"id": "10001125",
"label": "e",
"name": "BH3-only activates BAX/BAK",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "XIAP is an inhibitor of apoptosis that is constitutively active in cells and inhibits the activity of caspase 9 in the apoptosome and effector caspases 3 and 7 to prevent the inappropriate activation of apoptosis. XIAP levels decrease upon apoptotic signalling. In type 1 cells (mostly immune cells), this is initiated by the activation of death receptors without the need for a MOMP. In type 2 cells (most other cells), this is mediated by MOMP release of SMAC which inhibits XIAP.",
"id": "10001123",
"label": "c",
"name": "XIAP levels rise",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Caspase 8 is an initiator caspase which is activated by proximity to other caspase 8 molecules. This occurs upon trimeric death receptor activation by extracellular ligands, resulting in the recruitment of FADD to the cytoplasmic components which in turn recruits caspase 8. Caspase 8 can then cleave effector caspases 3/7 or cleave BID to tBID to activate BAX/BAK formation of the MOMP. This action is therefore upstream of the MOMP.",
"id": "10001122",
"label": "b",
"name": "Caspase 8 activation",
"picture": null,
"votes": 15
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3886",
"name": "Apoptosis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "181",
"name": "Structure and Function of Cells",
"typeId": 7
},
"topicId": 181,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3886,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12771",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "The formation of the mitochondrial outer membrane pore (MOMP) leads to which of the following events?",
"sbaAnswer": [
"a"
],
"totalVotes": 59,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,028 | false | 28 | null | 6,495,014 | null | false | [] | null | 12,772 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Due to the twisting nature of DNA, the progression of the replication fork rapidly causes super-coiling of the DNA which halts further progression unless topoisomerases cut the DNA and unwind it. Topoisomerase 1 cuts a single strand to unwind single DNA double helices, whilst topoisomerase 2 cuts both strands of the double helix to allow another to pass through to unwind the super-coiling. Topoisomerase inhibitors, therefore, inhibit replication fork progression and are used as antibiotics and chemotherapeutics.",
"id": "10001126",
"label": "a",
"name": "Replication fork progression",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "DNA polymerase 3 is the leading strand DNA polymerase in bacterial DNA replication. Its continuous activity without dissociation during the replication of the leading strand is facilitated by its association with the sliding B-clamp processivity factor. Topoisomerases are not directly involved in this process.",
"id": "10001129",
"label": "d",
"name": "DNA polymerisation",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "DnaG is the bacterial primase which adds a single RNA primer to the leading strand and numerous RNA primers to the lagging strand to prime each Okazaki fragment. Topoisomerases are not directly involved in this process.",
"id": "10001128",
"label": "c",
"name": "Priming by an RNA primer",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In bacteria, primers are replaced by DNA polymerase 1 which mediates nick translation. This involves the removal of RNA nucleotides and replacement with DNA nucleotides in the 5' to 3' direction. Once DNA polymerase 1 dissociates, the strands are re-joined by DNA ligases. Topoisomerases are not directly involved in this process.\n\n<br>",
"id": "10001130",
"label": "e",
"name": "Primer replacement",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "DnaA is the origin recognition complex used to bind DnaA boxes, unwind AT-rich regions and load DnaC. This loads the DnaB helicase and then the DnaG primase, the DNA polymerase 3 holoenzyme and the B-clamp processivity factors to form the bacterial DNA replication complex. Topoisomerases are not directly involved in this process.",
"id": "10001127",
"label": "b",
"name": "Binding of DnaA to bacterial origins",
"picture": null,
"votes": 1
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3887",
"name": "Antibiotics",
"status": null,
"topic": {
"__typename": "Topic",
"id": "148",
"name": "Microbiology",
"typeId": 7
},
"topicId": 148,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3887,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12772",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Topoisomerase inhibitors prevent which part of DNA replication?",
"sbaAnswer": [
"a"
],
"totalVotes": 69,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,029 | false | 29 | null | 6,495,014 | null | false | [] | null | 12,773 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes homologous recombination (HR), a high-fidelity method of repairing double-stranded breaks. HR requires a sister chromatid to pair with, meaning it can only occur during S and G2 phases. This method is more common in prokaryotes with smaller genomes due to less complex DNA folding which makes it easier to align homologous sequences.",
"id": "10001132",
"label": "b",
"name": "Free ends of DNA are degraded by exonucleases to make 3' overhangs, stabilised by nucleoprotein filaments which mediate invasion into the homologous sequence on the sister chromatid. The 3' overhangs are then extended by DNA polymerisation using the sister chromatid template to form a holiday junction which is cleaved, separating the chromatids",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the base excision repair (BER) method of repairing single-stranded DNA damage. Mutations in proteins involved in BER have been associated with cancers. For example, OGG1 (a glycosidase) variants have been associated with breast cancers, lung cancers, renal cell carcinoma and leukaemias.",
"id": "10001133",
"label": "c",
"name": "Damaged bases are flipped out: the bases are removed by a DNA glycosidase while the deoxyribose-phosphate backbone is left to be cleaved by an apyramidic or apurinic endonuclease. The break is recognised by DNA polymerase B which removes nucleotides in its way, replacing them until dissociating, after which a ligase re-joins the strands",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This describes non-homologous end-joining (NHEJ), a low-fidelity method of repairing double-stranded breaks. NHEJ does not require pairing with a sister chromatid, allowing it to occur at any phase. This method is more common in eukaryotes with large genomes due to the complex folding of chromatin making it more difficult to align homologous sequences.",
"id": "10001131",
"label": "a",
"name": "Free ends of DNA are recognised by proteins such as Ku70/80 and phosphorylated by DNA-PKcs. This recruits nuclease complexes which cleave down the ends before ligation by DNA ligase 4",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the mismatch repair (MMR) method of repairing single-stranded DNA damage. Mutations in proteins involved in MMR such as MSH2, MLH1 and MSH6 can cause Lynch syndrome (also known as hereditary non-polyposis colorectal cancer - HNPCC), an autosomal dominant condition characterised by DNA microsatellite instability and increased risk of cancers, particularly colorectal cancer.\n\n<br>",
"id": "10001135",
"label": "e",
"name": "Mismatched bases are flipped out, and then recognised and extruded into a loop. The daughter strand is cleaved by an endonuclease and exonuclease and is then replaced by polymerase delta/eta. A ligase re-joins the strands",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the nucleotide excision repair (NER) method of repairing single-stranded DNA damage. Mutations in proteins involved in NER such as XPB, XPD and XPF can cause xeroderma pigmentosum, an autosomal recessive condition characterised by a thousand times increased incidence of tumours associated with UV light sensitivity. This is because cyclo-pyrimidine dimers generated by UV light are not repaired, causing the rapid mutation of exposed skin cells.",
"id": "10001134",
"label": "d",
"name": "Damaged bases are flipped out: the DNA is unwound by the assembly of a TF2H holoenzyme, and then a wide margin of nucleotides are excised and replaced by polymerase delta/eta. A ligase then re-joins the strands",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3888",
"name": "DNA",
"status": null,
"topic": {
"__typename": "Topic",
"id": "181",
"name": "Structure and Function of Cells",
"typeId": 7
},
"topicId": 181,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3888,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12773",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following describes the main mechanism of double-strand break repair in the resting phase and G1?",
"sbaAnswer": [
"a"
],
"totalVotes": 55,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,030 | false | 30 | null | 6,495,014 | null | false | [] | null | 12,774 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The spliceosome mediates RNA splicing at GT-AG consensus sequences. A 2' -OH group from the 3' end of an intron undergoes hydrophilic attack of a phosphate group at the 5' end of the intron, and is followed by the newly free 3' -OH group of the 5' exon attacking the phosphate of the 3' exon. This results in the removal of the intron in a circular lariat. Rho is not involved.\n\n<br>",
"id": "10001140",
"label": "e",
"name": "pre-mRNA splicing",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The stop codons UAA, UAG and UGA are complementary to release factor, a protein which binds to the A-site of the ribosome and causes the dissociation of the small and large ribosomal subunits. Rho is not involved.",
"id": "10001138",
"label": "c",
"name": "Termination of translation",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Transcription is initiated when a promoter site is bound by the components of the pre-initiation complex. In eukaryotes, there is a TATA consensus motif 25 bases upstream of the translation start site to which TF2D (with the TATA-binding protein), other general transcription factors and RNA polymerase 2 bind to form the pre-initiation complex. Rho is not involved.",
"id": "10001137",
"label": "b",
"name": "Initiation of transcription",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Rho-dependent termination occurs when the rho RNA helicase binds newly-translated C-rich RNA followed by a GC-rich hairpin and unwinds the RNA-DNA complex to mediate dissociation. In contrast, rho-independent termination of transcription occurs when the RNA polymerase reaches a palindromic GC-rich DNA sequence followed by an AT-rich DNA sequence and pauses then dissociates, with the RNA adopting a GC-rich hairpin and a string of uracils.",
"id": "10001136",
"label": "a",
"name": "Termination of transcription",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Translation is initiated when the small ribosomal subunit binds the 5' m7G cap (or IRES sequence) of an mRNA molecule. It then scans along the mRNA until the AUG start codon, at which point the large ribosomal subunit associates and the methionine tRNA is recruited to the A-site and translation begins. Rho is not involved.",
"id": "10001139",
"label": "d",
"name": "Initiation of translation",
"picture": null,
"votes": 7
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3885",
"name": "Processes in mitosis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "156",
"name": "Medical Genetics",
"typeId": 7
},
"topicId": 156,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3885,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12774",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Rho-dependent could be used to describe which of the following processes?",
"sbaAnswer": [
"a"
],
"totalVotes": 54,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,031 | false | 31 | null | 6,495,014 | null | false | [] | null | 12,775 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Picornavirus RNAs have IRES sequences in their RNAs which form 3-dimensional structures and bypass the need for 5' 7mG caps.",
"id": "10001141",
"label": "a",
"name": "Internal ribosome entry sites (IRES)",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Stealing 5' 7mG caps from host mRNAs is a viral DNA changing method employed by influenza's RNA-dependent RNA polymerases, but not by picornaviruses.",
"id": "10001142",
"label": "b",
"name": "5' cap stealing",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Intron removal by pre-mRNA splicing is not done in viruses as they contain no introns in their genomic material.\n\n<br>",
"id": "10001145",
"label": "e",
"name": "Intron removal by pre-mRNA splicing",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cleaving 5' 7mG caps from host mRNAs is a change mediated by picornaviruses, but is not a change to picornavirus mRNAs.",
"id": "10001143",
"label": "c",
"name": "5' cap cleavage",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Highly active promoters are used by most viruses, including the 5' promoter element of picornavirus RNA genomes, but this is a constitutional state of viral genomic RNA rather than a change to mRNAs.",
"id": "10001144",
"label": "d",
"name": "Use of highly active promoters",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3889",
"name": "Translation",
"status": null,
"topic": {
"__typename": "Topic",
"id": "181",
"name": "Structure and Function of Cells",
"typeId": 7
},
"topicId": 181,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3889,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12775",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Picornaviruses use which method in their mRNAs to get hosts to express their proteins?",
"sbaAnswer": [
"a"
],
"totalVotes": 50,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,032 | false | 32 | null | 6,495,014 | null | false | [] | null | 12,776 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A missense mutation is a single nucleotide substitution which produces a non-redundant codon change, but does not introduce a stop codon. An example is the BRAF V600E mutation in cancers such as melanoma.",
"id": "10001147",
"label": "b",
"name": "Missense",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would not be a single nucleotide change as to remain in-frame, deletions must occur in multiples of 3 nucleotides. In-frame additions and deletions are common at 3-nucleotide repeat microsatellites, such as the CAG repeats in the Huntingtin gene.",
"id": "10001148",
"label": "c",
"name": "In-frame deletion",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A frameshift mutation occurs upon the addition or deletion of nucleotides (not in multiples of 3) which alter the reading frame of the mRNA, meaning each subsequent amino acid is different. This makes the protein misfold and become non-functional.",
"id": "10001149",
"label": "d",
"name": "Frameshift deletion",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "A nonsense mutation is a single nucleotide substitution which produces a stop codon (UAA, UAG or UGA), truncating the protein without changing any other amino acids.",
"id": "10001146",
"label": "a",
"name": "Nonsense",
"picture": null,
"votes": 57
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Splice-site mutations occur when a GT-AG splice consensus site is added or removed by a missense mutation. These can cause the inclusion of an intronic sequence or the removal of an exon. An example of a splice-site mutation is the MYBPC3 gene in hypertrophic cardiomyopathy.\n\n<br>",
"id": "10001150",
"label": "e",
"name": "Splice-site mutation",
"picture": null,
"votes": 4
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3890",
"name": "Mechanisms of genetic disorders",
"status": null,
"topic": {
"__typename": "Topic",
"id": "156",
"name": "Medical Genetics",
"typeId": 7
},
"topicId": 156,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3890,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12776",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A single nucleotide change causing a stop codon and truncating a protein without changing any subsequent amino acids is called what?",
"sbaAnswer": [
"a"
],
"totalVotes": 79,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,033 | false | 33 | null | 6,495,014 | null | false | [] | null | 12,777 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Transcription is up-regulated by enhancer elements which recruit enzymes such as p300, a histone acetylase which de-represses the target gene promoters that the sequences are folded to be adjacent to. Up-regulation of transcription does not involve Xist.",
"id": "10001154",
"label": "d",
"name": "Up-regulation of transcription",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "In cells with multiple X-chromosomes, one chromosome expresses Xist, a long non-coding RNA which coats the X-chromosome from which it is expressed and recruits a polycomb repressive complex which uses EZH2 to catalyse H3K27me3 formation. This results in the recruitment of SETDB1 which catalyses the formation of H3K9me3. DNA methyltransferases then methylate the DNA, and laminin B receptors are recruited to anchor the newly condensed Barr body to the nuclear membrane.",
"id": "10001151",
"label": "a",
"name": "X-inactivation",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Genomic imprinting is the process by which a subset of genes is expressed in a parent-of-origin-specific manner. This is mediated by the differential methylation of imprinting control regions during epigenetic reprogramming in utero. Genomic imprinting does not involve Xist.",
"id": "10001152",
"label": "b",
"name": "Genomic imprinting",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Up-regulation of translation can be mediated by epi-transcriptomic changes. m6Adenine marks are the most common, added by METTL3/METTL14 at RRACH motifs. m6A binding proteins contain domains such as YTHDF2 which enhances mRNA translation. Up-regulation of translation does not involve Xist.\n\n<br>",
"id": "10001155",
"label": "e",
"name": "Up-regulation of translation",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Endogenous retroviruses are suppressed by specific KRAB zinc finger proteins binding to endogenous retroviral sequences and recruiting KAP1 to induce repressive chromatin remodelling using NuRD, HDAC and SETDB1. This promotes the methylation of endogenous retroviral promoters to repress transcription. piwi RNAs are also used during epigenetic reprogramming in germ cells and the blastocyst to prevent transcription when epigenetic markers are removed. Endogenous retrovirus suppression does not involve Xist.",
"id": "10001153",
"label": "c",
"name": "Endogenous retrovirus suppression",
"picture": null,
"votes": 10
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3888",
"name": "DNA",
"status": null,
"topic": {
"__typename": "Topic",
"id": "181",
"name": "Structure and Function of Cells",
"typeId": 7
},
"topicId": 181,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3888,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12777",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Xist, H3K27me3 and H3K9me3 are all associated with which process?",
"sbaAnswer": [
"a"
],
"totalVotes": 55,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,034 | false | 34 | null | 6,495,014 | null | false | [] | null | 12,778 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "A small island population founded by a single boat is unlikely to have a large enough population for the Hardy-Weinberg equilibrium to be applicable. Small populations increase the effect of random chance during mating on the proportion of a population with a specific genotype, increasing the chance of a genetic variant becoming fixed in a population, such as pp = 1.",
"id": "10001156",
"label": "a",
"name": "Population size",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A neutral variant is by definition not selected for or against. If a variant were to be selected for or against, the proportion surviving and reproducing would become non-random and disrupt the Hardy-Weinberg equilibrium by altering the proportions of each genotype. For example, if the q variant was selected against, the population proportions would shift towards pp = 1.",
"id": "10001158",
"label": "c",
"name": "Selection",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A neutral, non-visible genetic variant is unlikely to affect mating choices. If it were to affect mating choices, then mating would become non-random and disrupt the Hardy-Weinberg equilibrium by altering the proportions of each genotype. For example, if individuals with pp genotypes attracted pp genotypes and qq genotypes attracted qq genotypes, the proportions would shift towards pp + qq = 1.",
"id": "10001159",
"label": "d",
"name": "The variant affects mating choices",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An isolated population is unlikely to have significant migration. If there was migration, individuals with different genotypes may not immigrate or emigrate in equal proportions to their respective population size, altering the proportions of each genotype on the island.",
"id": "10001157",
"label": "b",
"name": "Migration",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although this is possible, it is very unlikely. Indeed, the population size is much more likely to affect the suitability for Hardy-Weinberg equilibrium. New mutations would disrupt the formula pp + 2pq + q = 1 by introducing another genetic variant, 'r'.\n\n<br>",
"id": "10001160",
"label": "e",
"name": "New mutations arise in the gene locus",
"picture": null,
"votes": 8
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3891",
"name": "Genetic Inheritance",
"status": null,
"topic": {
"__typename": "Topic",
"id": "156",
"name": "Medical Genetics",
"typeId": 7
},
"topicId": 156,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3891,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12778",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A neutral, non-visible genetic variant in a small, isolated island population founded by a single boat is unlikely to be in Hardy-Weinberg equilibrium because of what failed criterium?",
"sbaAnswer": [
"a"
],
"totalVotes": 55,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,035 | false | 35 | null | 6,495,014 | null | false | [] | null | 12,779 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The equilibrium potential (V) of an ion across a membrane is equal to the natural logarithm of the concentration of the ion on the outside of the membrane divided by the concentration of the ion within the membrane (ln([X]o/[X]i)), multiplied by the gas constant (R) and the temperature in kelvin (T), and divided by the ion's valence (z) and Faraday's constant (F). This is described by Nernst's equation: V = (RT/zF)ln([X]o/[X]i). By multiplying z by -2, the V is multiplied by -1/2. If the original equilibrium potential is +100mV, the new equilibrium potential is -50mV. To get +200mV, the relative concentrations would need to be changed.",
"id": "10001164",
"label": "d",
"name": "+200mV",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The equilibrium potential (V) of an ion across a membrane is equal to the natural logarithm of the concentration of the ion on the outside of the membrane divided by the concentration of the ion within the membrane (ln([X]o/[X]i)), multiplied by the gas constant (R) and the temperature in kelvin (T), and divided by the ion's valence (z) and Faraday's constant (F). This is described by Nernst's equation: V = (RT/zF)ln([X]o/[X]i). By multiplying z by -2, the V is multiplied by -1/2. If the original equilibrium potential is +100mV, the new equilibrium potential is -50mV. To get +50mV, the ion would have to be substituted for a divalent cation.",
"id": "10001162",
"label": "b",
"name": "+50mV",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The equilibrium potential (V) of an ion across a membrane is equal to the natural logarithm of the concentration of the ion on the outside of the membrane divided by the concentration of the ion within the membrane (ln([X]o/[X]i)), multiplied by the gas constant (R) and the temperature in kelvin (T), and divided by the ion's valence (z) and Faraday's constant (F). This is described by Nernst's equation: V = (RT/zF)ln([X]o/[X]i). By multiplying z by -2, the V is multiplied by -1/2. If the original equilibrium potential is +100mV, the new equilibrium potential is -50mV.",
"id": "10001161",
"label": "a",
"name": "-50mV",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The equilibrium potential (V) of an ion across a membrane is equal to the natural logarithm of the concentration of the ion on the outside of the membrane divided by the concentration of the ion within the membrane (ln([X]o/[X]i)), multiplied by the gas constant (R) and the temperature in kelvin (T), and divided by the ion's valence (z) and Faraday's constant (F). This is described by Nernst's equation: V = (RT/zF)ln([X]o/[X]i). By multiplying z by -2, the V is multiplied by -1/2. If the original equilibrium potential is +100mV, the new equilibrium potential is -50mV. To get -100mV, the ion would have to be substituted for a monovalent anion.\n\n<br>",
"id": "10001165",
"label": "e",
"name": "-100mV",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The equilibrium potential (V) of an ion across a membrane is equal to the natural logarithm of the concentration of the ion on the outside of the membrane divided by the concentration of the ion within the membrane (ln([X]o/[X]i)), multiplied by the gas constant (R) and the temperature in kelvin (T), and divided by the ion's valence (z) and Faraday's constant (F). This is described by Nernst's equation: V = (RT/zF)ln([X]o/[X]i). By multiplying z by -2, the V is multiplied by -1/2. If the original equilibrium potential is +100mV, the new equilibrium potential is -50mV. To get -200mV, the relative concentrations would need to be changed.",
"id": "10001163",
"label": "c",
"name": "-200mV",
"picture": null,
"votes": 11
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3822",
"name": "Membrane Potential",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3822,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12779",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "If the equilibrium potential of a monovalent cation across a membrane is +100mV, what would its equilibrium potential be at the same relative concentrations if it were a divalent anion?",
"sbaAnswer": [
"a"
],
"totalVotes": 61,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,036 | false | 36 | null | 6,495,014 | null | false | [] | null | 12,780 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes spatial inhibition. This is a method by which an inhibitory synapse can make action potential firing less likely without negating signals from separate dendrites.",
"id": "10001169",
"label": "d",
"name": "Inhibitory synapses on different dendrites to excitatory synapses subtract from their excitatory potential",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This describes shunting inhibition. This is a powerful way for excitatory potentials to be diminished, effectively turning the dendrite into a NOT logic gate in which sufficient excitatory synapses must be active, but not the inhibitory synapse, for an action potential to be stimulated.",
"id": "10001166",
"label": "a",
"name": "Inhibitory synapses which are closer to the soma than excitatory synapses on the same dendrite divide the excitatory potential",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes pre-synaptic inhibition. This is a powerful method by which an inhibitory synapse can entirely stop the chance of an action potential firing (but requires accurate timing).\n\n<br>",
"id": "10001170",
"label": "e",
"name": "Inhibitory synapses towards the end of an axon hyperpolarise the synaptic terminal as the action potential reaches it, preventing neurotransmitter release",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes temporal summation. This is the method by which strong signals through a smaller number of weak excitatory synapses can sum together to stimulate action potentials.",
"id": "10001168",
"label": "c",
"name": "Multiple excitatory potentials transmitted rapidly after one another sum at the soma",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes spatial summation. This is the method by which multiple weak excitatory synapses from different sources can sum together to stimulate action potentials.",
"id": "10001167",
"label": "b",
"name": "Multiple excitatory synapses on different dendrites sum their excitatory potentials at the soma",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3826",
"name": "Central and peripheral nervous system",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3826,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12780",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following describes shunting inhibition?",
"sbaAnswer": [
"a"
],
"totalVotes": 50,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,037 | false | 37 | null | 6,495,014 | null | false | [] | null | 12,781 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Action potentials propagate down transverse tubules to a triad structure consisting of a transverse tubule and two cisternal ends of sarcoplasmic reticulum. At these triads, modified dihydropyridine receptors which themselves cannot cause calcium flux alter their conformation when the membrane is depolarised, causing allosteric interaction with attached ryanodine receptors on the sarcoplasmic reticulum. This allows calcium to move down its electrochemical gradient from the sarcoplasmic reticulum into the sarcoplasm.",
"id": "10001171",
"label": "a",
"name": "Action potentials activate dihydropyridine receptors coupled with sarcoplasmic reticulum ryanodine receptors, causing calcium release into the sarcoplasm",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Muscle cells use ACh which binds nAChRs to achieve this initial depolarisation which stimulates neighbouring sodium channels to open, generating an action potential which spreads across the muscle cell.",
"id": "10001172",
"label": "b",
"name": "Glutamate binds NMDA and AMPA receptors on skeletal muscle membranes, opening channels which allow sodium entry and depolarising the muscle cell",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Calcium flux through dihydropyridine receptors occurs in cardiac muscle but not skeletal muscle. This is necessary due to the poorly developed transverse tubules, particularly in the atria which only have caveolae.\n\n<br>",
"id": "10001175",
"label": "e",
"name": "Action potentials activate dihydropyridine receptors which subsequently allow calcium flux into the cytoplasm. This induces calcium-induced calcium release via ryanodine receptors on the sarcoplasmic reticulum",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Caldesmon is used in smooth muscle for this role whilst skeletal and cardiac muscle use troponin. In smooth muscle, there is also modulation of caldesmon activity by phosphorylation by protein kinase C (downstream of PLC which generates DAG and IP3 from PIP3) and modulation by calcium-calmodulin complexes.",
"id": "10001173",
"label": "c",
"name": "Upon calcium flux into the cytoplasm, caldesmon undergoes a conformational change, removing tropomyosin from actin-binding sites, and allowing myosin cross-bridging",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Latch bridges are only formed in smooth muscle. These are used to fix the muscle at a set length without continuous ATP consumption. This occurs when myosin is dephosphorylated when it is bound to actin, whereas dephosphorylation when myosin is not bound to actin causes relaxation. Myosin is constantly activated in skeletal muscle, and the limiting factor is troponin moving tropomyosin to reveal actin binding sites, rather than myosin phosphorylation.",
"id": "10001174",
"label": "d",
"name": "After contraction initiation, if myosin phosphatase removes the phosphate group from myosin, latch bridges are formed",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3822",
"name": "Membrane Potential",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3822,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12781",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following statements about skeletal muscle excitation-contraction coupling is true?",
"sbaAnswer": [
"a"
],
"totalVotes": 61,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,038 | false | 38 | null | 6,495,014 | null | false | [] | null | 12,782 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Smooth muscle cells are fusiform cells, typically 200-300um long. In contrast, skeletal muscle cells can be much longer, spanning the entire distance of muscles. For example, skeletal muscle cells in the sartorius (the longest muscle in the body, spanning from the ASIS to Pes anserinus) can reach up to 600mm in length.",
"id": "10001179",
"label": "d",
"name": "The cells can reach up to 600mm in length",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although smooth muscle cells do allow calcium entry from the extracellular space, cardiac muscle also allows this through dihydropyridine receptors. The difference is that the sources of calcium entry into the cytoplasm are much more varied in smooth muscle, and are under both neurotransmitter and hormonal control for the tight regulation of contraction in different situations.",
"id": "10001178",
"label": "c",
"name": "Allow calcium entry from the extracellular space",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Smooth muscle is the only type of muscle that does not contain sarcomeres. In cardiac and skeletal muscle, there are: linear Z-discs at either end of each sarcolemma to which actin connects; I bands in which there is actin and titin to anchor myosin but no myosin itself; A bands where actin and myosin overlap; and central M bands in which there is myosin but no actin. These structures can be seen on transmission electron microscopy.",
"id": "10001177",
"label": "b",
"name": "Contain sarcomeres",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Smooth muscle cells are typically stimulated to relax by nitric oxide. This occurs because nitric oxide activates soluble guanylate cyclases, generating cGMP which activates PKG. Amongst other functions, PKG lays down inhibitory phosphorylation marks on MLCK, reducing the phosphorylation of myosin, and subsequently reducing contraction.\n\n<br>",
"id": "10001180",
"label": "e",
"name": "Contraction stimulated by nitric oxide",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Smooth muscles are called smooth due to the lack of striations visible on microscopy. This is because actin and myosin are arranged around dense bodies in the cytoplasm and are attached to attachment plaques in the plasma membrane rather than in sarcomeres.",
"id": "10001176",
"label": "a",
"name": "Contain dense bodies and attachment plaques",
"picture": null,
"votes": 19
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3783",
"name": "Types of muscle",
"status": null,
"topic": {
"__typename": "Topic",
"id": "154",
"name": "Musculoskeletal physiology and disease",
"typeId": 7
},
"topicId": 154,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3783,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12782",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following statements only applies to smooth muscle cells?",
"sbaAnswer": [
"a"
],
"totalVotes": 72,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,039 | false | 39 | null | 6,495,014 | null | false | [] | null | 12,783 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Viscosity has more effect on the flow in vessels than density as most flow is laminar (except some turbulent at branch points). The role of viscosity in laminar flow resistance is described by Poiseuille's law: resistance is proportional to the length of the tube multiplied by the viscosity of the fluid divided by the 4th power of the radius of the tube. Density has more effect on resistance during turbulent blood flow.",
"id": "10001182",
"label": "b",
"name": "In the majority of the lumens of blood vessels, the density of the blood has more effect than the viscosity",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In small vessels such as capillaries, erythrocytes tend to flow centrally and the plasma peripherally. This causes a cell-free plasma layer which effectively decreases the viscosity of the blood, decreasing resistance to flow. This is known as the Fahraeus-Lindqvist effect in which the effective viscosity of a fluid changes depending on the diameter of the tube it is flowing through.",
"id": "10001184",
"label": "d",
"name": "In small vessels, erythrocytes tend towards the peripheries",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The majority of the total peripheral resistance of vessels is due to the arterioles, otherwise known as the resistance vessels. Indeed, the decrease in mean pressure from the large arteries to the capillaries is the largest change in any part of the vascular system. This is one of the reasons why altering tunica media contraction in arterioles is one of the main methods used to regulate the blood flow to a tissue.\n\n<br>",
"id": "10001185",
"label": "e",
"name": "The majority of total peripheral resistance comes from the capillaries",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is true as the resistance of a liquid in a tube is inversely proportional to the 4th power of the radius of the tube. This is described by Poiseuille's law: resistance is proportional to the length of the tube multiplied by the viscosity of the fluid divided by the 4th power of the radius of the tube.",
"id": "10001181",
"label": "a",
"name": "Dilating a vessel to double the diameter will reduce its resistance to 12.5% of the previous value",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Longer tubes have higher resistances to fluid flow than shorter tubes. This is described by Poiseuille's law: resistance is proportional to the length of the tube multiplied by the viscosity of the fluid divided by the 4th power of the radius of the tube.",
"id": "10001183",
"label": "c",
"name": "The longer the vessel, the lower the internal resistance",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3809",
"name": "Structure and physiology of blood vessels",
"status": null,
"topic": {
"__typename": "Topic",
"id": "159",
"name": "Cardiovascular physiology",
"typeId": 7
},
"topicId": 159,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3809,
"conditions": [],
"difficulty": 1,
"dislikes": 1,
"explanation": null,
"highlights": [],
"id": "12783",
"isLikedByMe": 0,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following statements about vascular resistance is true?",
"sbaAnswer": [
"a"
],
"totalVotes": 67,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,040 | false | 40 | null | 6,495,014 | null | false | [] | null | 12,784 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In a non-failing heart, the increased contraction of the ventricle clears the increased end-diastolic volume. This prevents a significant increase in right atrial pressure. However, in a failing heart, contraction cannot increase sufficiently, thus increasing right atrial pressure as insufficient blood is cleared. This causes the release of atrial natriuretic peptide from the atrium and B-type natriuretic peptide (BNP) from the ventricles. BNP and NT-pro-BNP are therefore used as markers of heart failure.",
"id": "10001188",
"label": "c",
"name": "A significant rise in right atrial pressure",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "When pre-load is increased, the increased venous return causes the right atrium and ventricle to be more distended by the end of diastole. The contraction of the right ventricle is increased by this distension. Pulmonary venous return is increased by the same proportion, increasing the distension of the left ventricle. The same increase in contraction occurs, therefore increasing cardiac output to the same amount as the venous return.",
"id": "10001187",
"label": "b",
"name": "Decreased cardiac output",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The Anrep effect describes how increased stretch on a cardiomyocyte causes increased calcium entry into the cytoplasm, increasing the contraction of the ventricles. This explains why increased end-diastolic volume during increased pre-load causes increased contraction and increases cardiac output in accordance with Starling's law.",
"id": "10001189",
"label": "d",
"name": "Decreased calcium entry into cardiomyocytes",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "When pre-load is increased, the increased venous return causes the right atrium and ventricle to be more distended by the end of diastole. The contraction of the right ventricle is increased by this distension. Pulmonary venous return is increased by the same proportion, increasing the distension of the left ventricle. The same increase in contraction occurs, therefore increasing cardiac output to the same amount as the venous return.",
"id": "10001186",
"label": "a",
"name": "Increase in end-diastolic volume of the ventricles",
"picture": null,
"votes": 53
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Peripheral oedema would occur in a failing heart due to the inability of the heart to maintain a low right atrial pressure upon increased pre-load. This increases venous pressure and decreases re-absorption of fluid at the venous end of capillaries, resulting in peripheral oedema. Furthermore, the decreased ability to increase cardiac output in heart failure results in the renal retention of fluid, increasing pre-load further and worsening peripheral oedema.\n\n<br>",
"id": "10001190",
"label": "e",
"name": "Peripheral oedema",
"picture": null,
"votes": 1
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3892",
"name": "The Frank-Starling curve",
"status": null,
"topic": {
"__typename": "Topic",
"id": "159",
"name": "Cardiovascular physiology",
"typeId": 7
},
"topicId": 159,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3892,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12784",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "According to Starling's law, an increase in pre-load in a non-failing heart will cause what?",
"sbaAnswer": [
"a"
],
"totalVotes": 77,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,041 | false | 41 | null | 6,495,014 | null | false | [] | null | 12,785 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Increased capillary permeability to proteins will increase protein extravasation, increasing the extracellular fluid colloid pressure and by extension, fluid extravasation. In Starling's equation, this decreases the value of 𝝈(𝝅c - 𝝅if), increasing the value of JV (JV represents the net extravasation of fluid by the end of the capillary bed).",
"id": "10001194",
"label": "d",
"name": "Decreased fluid extravasation",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Increased capillary permeability to proteins will increase protein extravasation, increasing the extracellular fluid colloid pressure and by extension, fluid extravasation. In Starling's equation, this decreases the value of 𝝈(𝝅c - 𝝅if), increasing the value of JV (JV represents the net extravasation of fluid by the end of the capillary bed).",
"id": "10001191",
"label": "a",
"name": "Increased fluid extravasation",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Capillaries are incapable of active vasodilation or vasoconstriction as they consist of an endothelial layer without contractile tunica media.\n\n<br>",
"id": "10001195",
"label": "e",
"name": "Vasodilation",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Increased capillary permeability to proteins will increase protein extravasation, increasing the extracellular fluid colloid pressure and by extension, fluid extravasation. In Starling's equation, this decreases the value of 𝝈(𝝅c - 𝝅if), increasing the value of JV (JV represents the net extravasation of fluid by the end of the capillary bed).",
"id": "10001192",
"label": "b",
"name": "Decreased protein in the extracellular fluid",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Capillary hydrostatic pressure can be increased by increasing cardiac output, decreasing arteriolar resistance proximal to the capillary, or increasing venous pressure distal to the capillary. Changes in the permeability of the capillary will not significantly affect any of these factors, therefore will not increase capillary hydrostatic pressure.",
"id": "10001193",
"label": "c",
"name": "Increased capillary hydrostatic pressure",
"picture": null,
"votes": 15
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3809",
"name": "Structure and physiology of blood vessels",
"status": null,
"topic": {
"__typename": "Topic",
"id": "159",
"name": "Cardiovascular physiology",
"typeId": 7
},
"topicId": 159,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3809,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12785",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "An increase in capillary permeability will cause what changes according to Starling's equation?\n\nJV = K((Pc - Pif) - 𝝈(𝝅c - 𝝅if))",
"sbaAnswer": [
"a"
],
"totalVotes": 62,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,042 | false | 42 | null | 6,495,014 | null | false | [] | null | 12,786 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An obstructive pattern is seen in asthma: FEV1/FVC is less than 0.75. This occurs because the inflammatory bronchoconstriction increases the resistance to airflow, especially during acute attacks in which a wheeze can be auscultated.",
"id": "10001198",
"label": "c",
"name": "Asthma",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "In pulmonary fibrosis, a restrictive pattern is seen in which FEV1/FVC is greater than 0.75. This occurs as the fibrotic lung cannot expand to the same degree as the normal lung but its airways remain open, allowing rapid flow on exhalation. Patients have a decreased capacity to inhale (decreasing forced vital capacity).",
"id": "10001196",
"label": "a",
"name": "Pulmonary fibrosis",
"picture": null,
"votes": 43
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In healthy lungs, FEV1/FVC is usually 0.75-0.85. Any higher represents a restrictive pattern, whilst lower represents an obstructive pattern. In these conditions, both FEV1 and FVC are often reduced however, one is more decreased than the other, resulting in the characteristic ratios.\n\n<br>",
"id": "10001200",
"label": "e",
"name": "Healthy lungs",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In cystic fibrosis, an obstructive pattern is seen in which FEV1/FVC is less than 0.75. This occurs as defective CFTR decreases chloride secretion into the alveoli, decreasing osmosis into the bronchioles, and resulting in thick mucus which narrows and blocks the airways.",
"id": "10001199",
"label": "d",
"name": "Cystic fibrosis",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An obstructive pattern is seen in COPD with emphysema: FEV1/FVC is less than 0.75. This occurs because the bronchioles narrow increasing resistance to flow while the parenchyma loses its elasticity which decreases the ability of the lung to expel air without increased effort. This results in the dichotomy of the 'red puffers' who can expend this increased effort, and the 'blue bloaters' who cannot.",
"id": "10001197",
"label": "b",
"name": "COPD with emphysema",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3893",
"name": "Volume, pressure and compliance",
"status": null,
"topic": {
"__typename": "Topic",
"id": "150",
"name": "Respiratory physiology",
"typeId": 7
},
"topicId": 150,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3893,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12786",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A patient's FEV1/FVC is found to be 0.9.\n\nWhich of the following conditions do they most likely have?",
"sbaAnswer": [
"a"
],
"totalVotes": 77,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,043 | false | 43 | null | 6,495,014 | null | false | [] | null | 12,787 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "PV=nRT\nTherefore, n=(PV)/(RT)\nThe total pressure in the alveoli at the end of inspiration is 100,000Pa. Pressure in the lungs exerted by inhaled air is equal to the total pressure minus the pressure of water added upon hydration: 100,000Pa - 6000Pa = 94,000Pa.\nThe pressure exerted by perfect gas A in the alveoli is therefore 30% of 94,000Pa = 28,200Pa = 28,200N/m(squared).\nVolume of perfect gas A is 30% of 500ml = 150ml = 150cm(cubed) = 150/(100 x 100 x 100)m(cubed) = 0.00015m(cubed).\nThe temperature in the alveoli in Kelvin is 273 + 37 = 310K.\nn=(28,200N/m(squared) x 0.00015m(cubed))/(8.314J/mol.K x 310K)\nn=(4.23Nm)/(2521.54J/mol)=(4.23J)/(2521.54J/mol)\nn=0.00167754626mol\nn=1.6mmol\n1.7mmol could have been reached if the temperature was not corrected from 293K to 310K.",
"id": "10001203",
"label": "c",
"name": "1.7mmol",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "PV=nRT\nTherefore, n=(PV)/(RT)\nThe total pressure in the alveoli at the end of inspiration is 100,000Pa. Pressure in the lungs exerted by inhaled air is equal to the total pressure minus the pressure of water added upon hydration: 100,000Pa - 6000Pa = 94,000Pa.\nThe pressure exerted by perfect gas A in the alveoli is therefore 30% of 94,000Pa = 28,200Pa = 28,200N/m(squared).\nVolume of perfect gas A is 30% of 500ml = 150ml = 150cm(cubed) = 150/(100 x 100 x 100)m(cubed) = 0.00015m(cubed).\nThe temperature in the alveoli in Kelvin is 273 + 37 = 310K.\nn=(28,200N/m(squared) x 0.00015m(cubed))/(8.314J/mol.K x 310K)\nn=(4.23Nm)/(2521.54J/mol)=(4.23J)/(2521.54J/mol)\nn=0.00167754626mol\nn=1.6mmol\n1.8mmol could have been reached if the water vapour saturated pressure was not corrected for.",
"id": "10001202",
"label": "b",
"name": "1.8mmol",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "PV=nRT\nTherefore, n=(PV)/(RT)\nThe total pressure in the alveoli at the end of inspiration is 100,000Pa. Pressure in the lungs exerted by inhaled air is equal to the total pressure minus the pressure of water added upon hydration: 100,000Pa - 6000Pa = 94,000Pa.\nThe pressure exerted by perfect gas A in the alveoli is therefore 30% of 94,000Pa = 28,200Pa = 28,200N/m(squared).\nVolume of perfect gas A is 30% of 500ml = 150ml = 150cm(cubed) = 150/(100 x 100 x 100)m(cubed) = 0.00015m(cubed).\nThe temperature in the alveoli in Kelvin is 273 + 37 = 310K.\nn=(28,200N/m(squared) x 0.00015m(cubed))/(8.314J/mol.K x 310K)\nn=(4.23Nm)/(2521.54J/mol)=(4.23J)/(2521.54J/mol)\nn=0.00167754626mol\nn=1.6mmol",
"id": "10001201",
"label": "a",
"name": "1.6mmol",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "PV=nRT\nTherefore, n=(PV)/(RT)\nThe total pressure in the alveoli at the end of inspiration is 100,000Pa. Pressure in the lungs exerted by inhaled air is equal to the total pressure minus the pressure of water added upon hydration: 100,000Pa - 6000Pa = 94,000Pa.\nThe pressure exerted by perfect gas A in the alveoli is therefore 30% of 94,000Pa = 28,200Pa = 28,200N/m(squared).\nVolume of perfect gas A is 30% of 500ml = 150ml = 150cm(cubed) = 150/(100 x 100 x 100)m(cubed) = 0.00015m(cubed).\nThe temperature in the alveoli in Kelvin is 273 + 37 = 310K.\nn=(28,200N/m(squared) x 0.00015m(cubed))/(8.314J/mol.K x 310K)\nn=(4.23Nm)/(2521.54J/mol)=(4.23J)/(2521.54J/mol)\nn=0.00167754626mol\nn=1.6mmol\n42mol.mmHg.ml/J could have been reached if the standard unit conversions for pressure and volume were not used, instead using mmHg and ml.\n\n<br>",
"id": "10001205",
"label": "e",
"name": "42mmol",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "PV=nRT\nTherefore, n=(PV)/(RT)\nThe total pressure in the alveoli at the end of inspiration is 100,000Pa. Pressure in the lungs exerted by inhaled air is equal to the total pressure minus the pressure of water added upon hydration: 100,000Pa - 6000Pa = 94,000Pa.\nThe pressure exerted by perfect gas A in the alveoli is therefore 30% of 94,000Pa = 28,200Pa = 28,200N/m(squared).\nVolume of perfect gas A is 30% of 500ml = 150ml = 150cm(cubed) = 150/(100 x 100 x 100)m(cubed) = 0.00015m(cubed).\nThe temperature in the alveoli in Kelvin is 273 + 37 = 310K.\nn=(28,200N/m(squared) x 0.00015m(cubed))/(8.314J/mol.K x 310K)\nn=(4.23Nm)/(2521.54J/mol)=(4.23J)/(2521.54J/mol)\nn=0.00167754626mol\nn=1.6mmol\n18.6mmol could have been reached if the pressure and volume were not corrected to reflect perfect gas A accounting for 30% rather than 100% of the room air pressure and volume.",
"id": "10001204",
"label": "d",
"name": "18.6mmol",
"picture": null,
"votes": 10
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3893",
"name": "Volume, pressure and compliance",
"status": null,
"topic": {
"__typename": "Topic",
"id": "150",
"name": "Respiratory physiology",
"typeId": 7
},
"topicId": 150,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3893,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12787",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Assume room temperature is 20 degrees Celsius, room pressure is 760mmHg (100,000Pa), room air is dry, saturated air at 37 Celsius contains 47mmHg (6000Pa) of water vapour, the gas constant (R) is 8.314J/mol.K, tidal volume subtract dead space is 500ml, alveoli are water vapour saturated at body temperature and perfect gas A makes up 30% of room air pressure and volume.\n\nHow many moles of perfect gas A will be added to the alveoli after a single inhalation?",
"sbaAnswer": [
"a"
],
"totalVotes": 48,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,044 | false | 44 | null | 6,495,014 | null | false | [] | null | 12,788 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "At a steady arterial concentration, the rate infused is equal to the rate urinated out, and if a substance is freely filtered and not reabsorbed or actively excreted, its clearance is equal to the GFR.\nClearance x arterial concentration = urinary rate x urinary concentration = infusion rate x infusion concentration\nGFR = (infusion rate x infusion concentration)/arterial concentration\nGFR = (50ml/min x 250umol/L)/100umol/L\nGFR = 50ml/min x ((250umol/L)/(100umol/L)) = 50ml/min x 2.5 = 125ml/min",
"id": "10001206",
"label": "a",
"name": "125ml/min",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "At a steady arterial concentration, the rate infused is equal to the rate urinated out, and if a substance is freely filtered and not reabsorbed or actively excreted, its clearance is equal to the GFR.\nClearance x arterial concentration = urinary rate x urinary concentration = infusion rate x infusion concentration\nGFR = (infusion rate x infusion concentration)/arterial concentration\nGFR = (50ml/min x 250umol/L)/100umol/L\nGFR = 50ml/min x ((250umol/L)/(100umol/L)) = 50ml/min x 2.5 = 125ml/min",
"id": "10001207",
"label": "b",
"name": "120ml/min",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "At a steady arterial concentration, the rate infused is equal to the rate urinated out, and if a substance is freely filtered and not reabsorbed or actively excreted, its clearance is equal to the GFR.\nClearance x arterial concentration = urinary rate x urinary concentration = infusion rate x infusion concentration\nGFR = (infusion rate x infusion concentration)/arterial concentration\nGFR = (50ml/min x 250umol/L)/100umol/L\nGFR = 50ml/min x ((250umol/L)/(100umol/L)) = 50ml/min x 2.5 = 125ml/min\n\n<br>",
"id": "10001210",
"label": "e",
"name": "25ml/min",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "At a steady arterial concentration, the rate infused is equal to the rate urinated out, and if a substance is freely filtered and not reabsorbed or actively excreted, its clearance is equal to the GFR.\nClearance x arterial concentration = urinary rate x urinary concentration = infusion rate x infusion concentration\nGFR = (infusion rate x infusion concentration)/arterial concentration\nGFR = (50ml/min x 250umol/L)/100umol/L\nGFR = 50ml/min x ((250umol/L)/(100umol/L)) = 50ml/min x 2.5 = 125ml/min",
"id": "10001209",
"label": "d",
"name": "20ml/min",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "At a steady arterial concentration, the rate infused is equal to the rate urinated out, and if a substance is freely filtered and not reabsorbed or actively excreted, its clearance is equal to the GFR.\nClearance x arterial concentration = urinary rate x urinary concentration = infusion rate x infusion concentration\nGFR = (infusion rate x infusion concentration)/arterial concentration\nGFR = (50ml/min x 250umol/L)/100umol/L\nGFR = 50ml/min x ((250umol/L)/(100umol/L)) = 50ml/min x 2.5 = 125ml/min",
"id": "10001208",
"label": "c",
"name": "100ml/min",
"picture": null,
"votes": 12
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3894",
"name": "Glomerular Filtration Rate",
"status": null,
"topic": {
"__typename": "Topic",
"id": "170",
"name": "Clinical Chemistry",
"typeId": 7
},
"topicId": 170,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3894,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12788",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A patient is infused with inulin at a constant rate until arterial concentration stabilises at 100uM. The infusion concentration of inulin is 250uM, and the patient is infused with 50ml of this solution per hour.\n\nAssuming inulin is freely filtered and not reabsorbed, what is the patient's GFR?",
"sbaAnswer": [
"a"
],
"totalVotes": 50,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,045 | false | 45 | null | 6,495,014 | null | false | [] | null | 12,789 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Glutamine is metabolised to glutamate then a-ketoglutarate, releasing ammonium at each step. A-ketoglutarate is then metabolised to malate, releasing bicarbonate. Malate is then metabolised through the Krebs cycle and gluconeogenesis into glucose, releasing more bicarbonate in the process. The bicarbonate released can be reabsorbed to alkalinise the blood while the ammonia and protons produced are excreted and trapped as ammonium in the lumen.",
"id": "10001211",
"label": "a",
"name": "Used in bicarbonate synthesis",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Potassium is reabsorbed in an unregulated manner in the proximal convoluted tubule by potassium-chloride co-transporters, in the thick ascending loop of Henle using NKCC2, and in the collecting ducts using potassium-proton exchanging ATPases. It is mainly in the distal convoluted tubule where potassium is excreted under the control of aldosterone through the action of the basal sodium-potassium exchanger ATPase and apical potassium channels. Glutamine does not have a significant role.",
"id": "10001214",
"label": "d",
"name": "Used to secrete potassium",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although glutamine is used in protein translation, this is a function common to all metabolically active cells and not notably more important in the proximal convoluted tubule.",
"id": "10001212",
"label": "b",
"name": "Used to build proteins",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Sodium is reabsorbed in an unregulated manner under the power of the basolateral sodium-potassium exchanger ATPase in the thick ascending limb (using apical NKCC2). Sodium is also reabsorbed in an unregulated manner in the proximal convoluted tubule using apical SGLT-1/2, and in a regulated manner due to angiotensin 2 which increases the expression of apical sodium-proton exchangers. Sodium is also reabsorbed under the control of aldosterone through the induction of expression of ENaC on the apical membranes of distal convoluted tubule cells. Glutamine does not have a significant role.\n\n<br>",
"id": "10001215",
"label": "e",
"name": "Used to reabsorb sodium",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Fatty acids are the main source of energy in the proximal convoluted tubule. It is in the gastrointestinal epithelium where glutamine is metabolised extensively as an energy source as well as to provide ammonium for the synthesis of other amino acids.",
"id": "10001213",
"label": "c",
"name": "Used as the main source of energy",
"picture": null,
"votes": 4
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3895",
"name": "Bicarbonate re-absorption",
"status": null,
"topic": {
"__typename": "Topic",
"id": "168",
"name": "Renal Physiology",
"typeId": 7
},
"topicId": 168,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3895,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12789",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Glutamine is particularly important in the proximal convoluted tubule for which of the following reasons?",
"sbaAnswer": [
"a"
],
"totalVotes": 62,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,046 | false | 46 | null | 6,495,014 | null | false | [] | null | 12,790 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Sodium is reabsorbed under the control of aldosterone which induces the expression of ENaC on the apical membranes of distal convoluted tubule cells. Furthermore, in the distal convoluted tubule, potassium is excreted under the control of aldosterone via basal sodium-potassium exchanger ATPase and apical potassium channels. Therefore, spironolactone (which opposes the action of aldosterone) will decrease the reabsorption of sodium (and therefore water) and increase the reabsorption of potassium. It is for this reason that it is referred to as a potassium-sparing diuretic. Spironolactone is used to reduce peripheral oedema caused by fluid retention during heart failure, rather than causing peripheral oedema.",
"id": "10001218",
"label": "c",
"name": "Peripheral oedema",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Sodium is reabsorbed under the control of aldosterone which induces the expression of ENaC on the apical membranes of distal convoluted tubule cells. Furthermore, in the distal convoluted tubule, potassium is excreted under the control of aldosterone via basal sodium-potassium exchanger ATPase and apical potassium channels. Therefore, spironolactone (which opposes the action of aldosterone) will decrease the reabsorption of sodium (and therefore water) and increase the reabsorption of potassium. It is for this reason that it is referred to as a potassium-sparing diuretic. It is therefore more likely to cause hyperkalaemia than hypokalaemia.",
"id": "10001219",
"label": "d",
"name": "Hypokalaemia",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Sodium is reabsorbed under the control of aldosterone which induces the expression of ENaC on the apical membranes of distal convoluted tubule cells. Furthermore, in the distal convoluted tubule, potassium is excreted under the control of aldosterone via basal sodium-potassium exchanger ATPase and apical potassium channels. Therefore, spironolactone (which opposes the action of aldosterone) will decrease the reabsorption of sodium (and therefore water) and increase the reabsorption of potassium. It is for this reason that it is referred to as a potassium-sparing diuretic and can be associated with hyperkalaemia.",
"id": "10001216",
"label": "a",
"name": "Hyperkalaemia",
"picture": null,
"votes": 61
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Malignant hyperthermia is caused by the inappropriate activation of ryanodine receptor calcium channels, causing muscular contraction and increased metabolism. This can be triggered by drugs such as volatile anaesthetics and reversed by dantrolene.\n\n<br>",
"id": "10001220",
"label": "e",
"name": "Malignant hyperthermia",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Sodium is reabsorbed under the control of aldosterone which induces the expression of ENaC on the apical membranes of distal convoluted tubule cells. Furthermore, in the distal convoluted tubule, potassium is excreted under the control of aldosterone via basal sodium-potassium exchanger ATPase and apical potassium channels. Therefore, spironolactone (which opposes the action of aldosterone) will decrease the reabsorption of sodium (and therefore water) and increase the reabsorption of potassium. It is for this reason that it is referred to as a potassium-sparing diuretic. It is therefore more likely to cause hyponatraemia than hypernatremia.",
"id": "10001217",
"label": "b",
"name": "Hypernatraemia",
"picture": null,
"votes": 2
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3896",
"name": "Actions of aldosterone",
"status": null,
"topic": {
"__typename": "Topic",
"id": "168",
"name": "Renal Physiology",
"typeId": 7
},
"topicId": 168,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3896,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12790",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Spironolactone opposes the action of aldosterone.\n\nThis could lead to which of the following?",
"sbaAnswer": [
"a"
],
"totalVotes": 79,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,047 | false | 47 | null | 6,495,014 | null | false | [] | null | 12,791 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This occurs in salivary duct cells, driven by the Na/K-ATPase. This process occurs to reduce sodium content in the saliva, allowing the glial-like cells of the taste buds to more sensitively detect dietary sodium.",
"id": "10001222",
"label": "b",
"name": "Sodium is absorbed from the lumen by apical channels and sodium-proton exchangers and returned to the extracellular fluid",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Driven by sodium gradients (into the cell, maintained by the Na/K-ATPase), basolateral NKCC1 brings chloride (alongside sodium and potassium) into salivary acinar cells. This creates a chloride concentration gradient from the cell into the lumen which chloride diffuses down via apical channels. This generates an electrochemical and osmolality gradient which results in the para-cellular flux of sodium and water into the lumen, generating saliva.",
"id": "10001221",
"label": "a",
"name": "Chloride is actively secreted using basolateral NKCC1 and apical channels, resulting in passive sodium flux into the lumen",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This occurs in pancreatic ducts, alkalinising secretions. The bicarbonate is generated by carbonic anhydrase from CO2 and water, and the proton is reabsorbed into the extracellular fluid by a sodium-proton exchanger while the chloride diffuses back into the lumen via apical channels.",
"id": "10001224",
"label": "d",
"name": "Bicarbonate is generated in acinar cells and secreted in exchange for chloride by chloride-bicarbonate exchangers",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is part of the mechanism of gastric acid secretion by parietal cells. The bicarbonate is generated by carbonic anhydrase from CO2 and water, and the proton generated is secreted in exchange for potassium by a proton-potassium exchanger ATPase.",
"id": "10001223",
"label": "c",
"name": "Chloride moves down its gradient from the extracellular fluid into cells using basolateral chloride-bicarbonate exchangers and diffuses into the lumen using apical channels",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes some of the ion flux in the large intestine in which sodium and chloride are absorbed to draw water out of the faeces. Potassium may be re-secreted under the control of aldosterone depending on the plasma concentration.\n\n<br>",
"id": "10001225",
"label": "e",
"name": "Sodium diffuses into cells from the lumen using ENaC and potassium exits (apical potassium channels) while chloride diffuses down a para-cellular concentration gradient",
"picture": null,
"votes": 13
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3805",
"name": "Saliva",
"status": null,
"topic": {
"__typename": "Topic",
"id": "149",
"name": "Gastro-intestinal physiology",
"typeId": 7
},
"topicId": 149,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3805,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12791",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following describes the generation of ion gradients in the production of saliva by acinar cells?",
"sbaAnswer": [
"a"
],
"totalVotes": 56,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,048 | false | 48 | null | 6,495,014 | null | false | [] | null | 12,792 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Histamine is secreted by enterochromaffin-like cells and binds H2 receptors. These receptors are Ga-s coupled GPCRs and stimulate adenylate cyclase, raising cAMP levels in parietal cells which, through activating the PKA phosphorylation of targets, leads to increased gastric acid secretion.",
"id": "10001226",
"label": "a",
"name": "Histamine",
"picture": null,
"votes": 43
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Somatostatin is secreted by D-cells, binding Ga-i coupled somatostatin receptor GPCRs which inhibit adenylyl cyclase activity, reducing cAMP generation in parietal cells. This reduces PKA activation and by extension, its target phosphorylation which reduces gastric acid secretion.",
"id": "10001229",
"label": "d",
"name": "Somatostatin",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gastrin is secreted by G-cells and binds CCK-B receptors and Ga-q coupled GPCRs which activate PLC. PLC generates IP3 which binds to IP3 receptors, causing calcium efflux from endoplasmic reticular stores in parietal cells which activates other effectors and leads to increased gastric acid secretion.",
"id": "10001227",
"label": "b",
"name": "Gastrin",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ACh is secreted by vagal efferents to the stomach and binds Ga-q coupled GPCR M3 muscarinic receptors which activate PLC. PLC generates IP3 which binds IP3 receptors, causing calcium efflux from endoplasmic reticular stores in parietal cells which activates other effectors and leads to increased gastric acid secretion.",
"id": "10001228",
"label": "c",
"name": "Acetylcholine (ACh)",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ghrelin is secreted by cells of the gastric fundus when the stomach has been empty for several hours. It acts in the arcuate nucleus of the hypothalamus to stimulate neuropeptide-Y-secreting neurons which act on Y1/Y5 receptors of the lateral hypothalamus which signal hunger to other relevant parts of the brain involved in motivation, emotion and decision making such as the basal ganglia, amygdala and pre-frontal cortex. Ghrelin also stimulates AgRP-releasing neurons which antagonise a-melanocyte stimulating hormone at melanocortin 3/4 receptors in the ventromedial hypothalamus to reduce the generation of satiety signals.\n\n<br>",
"id": "10001230",
"label": "e",
"name": "Ghrelin",
"picture": null,
"votes": 2
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3776",
"name": "Gastric Secretion",
"status": null,
"topic": {
"__typename": "Topic",
"id": "149",
"name": "Gastro-intestinal physiology",
"typeId": 7
},
"topicId": 149,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3776,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12792",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which factor secreted by enterochromaffin-like cells stimulates gastric acid secretion by parietal cells?",
"sbaAnswer": [
"a"
],
"totalVotes": 76,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,049 | false | 49 | null | 6,495,014 | null | false | [] | null | 12,793 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Excess PRL in hyperprolactinaemia causes weight gain, amenorrhoea, infertility, galactorrhoea (inappropriate lactation), decreased libido, vaginal dryness, erectile dysfunction and loss of facial hair.\n\n<br>",
"id": "10001235",
"label": "e",
"name": "Prolactin (PRL)",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Excess ACTH causes secondary hyperadrenocorticism: a form of Cushing's syndrome characterised by weight gain with muscle wasting, weakness (giving a 'lemon on a stick' appearance), shoulder fat 'hump', round 'moon face', hirsutism, bruising, abdominal striae, slow healing, hypertension, insulin resistance and depressed immune responses.",
"id": "10001231",
"label": "a",
"name": "Adrenocorticotropic hormone (ACTH)",
"picture": null,
"votes": 43
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Excess thyroid-stimulating hormone causes secondary hyperthyroidism. This can be associated with goitre, weight loss, amenorrhoea, muscle wasting, heat intolerance, tremor, palpitations, exophthalmos and increased immune responses.",
"id": "10001233",
"label": "c",
"name": "Thyroid-stimulating hormone (TSH)",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ADH is secreted from the posterior pituitary. Excess ADH is produced in the syndrome of inappropriate ADH secretion (SIADH) which is often secondary to malignancy or head injury. Symptoms of excess ADH include fluid retention and severe hyponatraemia.",
"id": "10001234",
"label": "d",
"name": "Anti-diuretic hormone (ADH)",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Excess growth hormone can cause gigantism in childhood and acromegaly in adults (once the epiphyseal plates are fused). The generalised effects of excess growth hormone include weight gain, muscle growth, some insulin resistance and complex interactions with immune responses (broadly stimulatory but GH deficiency is not associated with an immune deficiency in humans).",
"id": "10001232",
"label": "b",
"name": "Growth hormone (GH)",
"picture": null,
"votes": 11
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3897",
"name": "Hormones of the anterior pituitary gland",
"status": null,
"topic": {
"__typename": "Topic",
"id": "167",
"name": "Endocrine physiology",
"typeId": 7
},
"topicId": 167,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3897,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12793",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which factor released by the anterior pituitary stimulates the secretion of a hormone which, when in excess, can cause weight gain, muscle wasting, insulin resistance and depressed immune responses?",
"sbaAnswer": [
"a"
],
"totalVotes": 80,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,050 | false | 50 | null | 6,495,014 | null | false | [] | null | 12,794 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This function is achieved by the thyroid hormones T3 and T4 (T3 is the more active form) under the control of the thyroid (TSH).",
"id": "10001240",
"label": "e",
"name": "Increase basal metabolic rate",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Thirst is rapidly decreased by neural afferents upon drinking and by hypothalamic osmoreceptor signals once the fluid drunk has been absorbed into the blood and restored the normal osmolality.",
"id": "10001239",
"label": "d",
"name": "Decrease thirst",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "AgRP-releasing neurons are stimulated by ghrelin which is released by the gastric fundus when it has not been stretched for several hours. These cells antagonise a-melanocyte stimulating hormone at melanocortin 3/4 receptors in the ventromedial hypothalamus to reduce the generation of satiety signals, thereby increasing appetite in response to an empty stomach.",
"id": "10001236",
"label": "a",
"name": "Increase appetite",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Thirst is increased by dipsogens such as angiotensin 2, generated upon dehydration by the renin-angiotensin system. Renin is secreted from juxtaglomerular cells upon hypotension, increased sympathetic activity or decreased GFR (decreases NaCl reaching the macula densa, altering paracrine ATP secretion to juxtaglomerular cells). Renin cleaves angiotensinogen to angiotensin 1 which is cleaved in the lungs by angiotensin-converting enzyme (ACE) into angiotensin 2 (which is a dipsogen).",
"id": "10001238",
"label": "c",
"name": "Increase thirst",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Appetite is decreased by several hormones in contrast to the single hormone ghrelin which stimulates hunger. Early hormones include cholecystokinin (which also stimulates gallbladder contraction for bile secretion) and the incretin GLP-1, whilst later hormones include leptin from adipose tissue and insulin from pancreatic B-cells. These activate POMC/CART neurons in the arcuate nucleus of the hypothalamus which release a-melanocyte stimulating hormone to stimulate melanocortin 3/4 receptors in the ventromedial hypothalamus. This increases the generation of satiety signals, thereby decreasing appetite in response to feeding, and increasing glucose and adiposity.",
"id": "10001237",
"label": "b",
"name": "Decrease appetite",
"picture": null,
"votes": 9
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3898",
"name": "Appetite",
"status": null,
"topic": {
"__typename": "Topic",
"id": "167",
"name": "Endocrine physiology",
"typeId": 7
},
"topicId": 167,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3898,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12794",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "The release of AgRP by cells of the arcuate nucleus inhibits signals through MC3/4R.\n\nWhich of the following effects does this have?",
"sbaAnswer": [
"a"
],
"totalVotes": 63,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,303 | false | 1 | null | 6,495,020 | null | false | [] | null | 12,795 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This man scores 3 points on the CURB-65 scoring system for community-acquired pneumonia (CAP): 1 point for urea > 7mmol/L, respiratory rate ≥ 30 breaths per minute and age ≥ 65 respectively. Although his AMTS score would most likely be less than 8, this would not count towards his CURB-65 score because his confusion is chronic due to dementia; confusion must be new-onset to score a point. He does not score a point for his blood pressure because his systolic blood pressure is not < 90mmHg and/or diastolic < 60mmHg.",
"id": "10001244",
"label": "d",
"name": "5",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This man scores 3 points on the CURB-65 scoring system for community-acquired pneumonia (CAP): 1 point for urea > 7mmol/L, respiratory rate ≥ 30 breaths per minute and age ≥ 65 respectively.\n\nThe full CURB-65 criteria are:\n\n* **C** - Confusion\n* **U** - Urea > 7 mmol/L\n* **R** - Respiratory rate >30\n* **B** - Blood pressure SBP <90 or DBP <60\n* **65** - Age > 65",
"id": "10001241",
"label": "a",
"name": "3",
"picture": null,
"votes": 100
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This man scores 3 points on the CURB-65 scoring system for community-acquired pneumonia (CAP): 1 point for urea > 7mmol/L, respiratory rate ≥ 30 breaths per minute and age ≥ 65 respectively.",
"id": "10001243",
"label": "c",
"name": "1",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This man scores 3 points on the CURB-65 scoring system for community-acquired pneumonia (CAP): 1 point for urea > 7mmol/L, respiratory rate ≥ 30 breaths per minute and age ≥ 65 respectively. Although his AMTS score would most likely be less than 8, this would not count towards his CURB-65 score because his confusion is chronic due to dementia; confusion must be new-onset to score a point. He does not score a point for his blood pressure because his systolic blood pressure is not < 90mmHg and/or diastolic < 60mmHg.",
"id": "10001245",
"label": "e",
"name": "2",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This man scores 3 points on the CURB-65 scoring system: 1 point for urea > 7mmol/L, respiratory rate ≥ 30 breaths per minute and age ≥ 65 respectively. Although his AMTS score would most likely be less than 8, this would not count towards his CURB-65 score because his confusion is chronic due to dementia; confusion must be new-onset to score a point. He does not score a point for his blood pressure because his systolic blood pressure is not < 90mmHg and/or diastolic < 60mmHg.",
"id": "10001242",
"label": "b",
"name": "4",
"picture": null,
"votes": 60
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3709",
"name": "Pneumonia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3709,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12795",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 70-year-old male with dementia is admitted to the hospital following a fall at home. He has a productive cough and appears short of breath on observation.\n\n\nOn examination, he has a temperature of 38 degrees, a respiratory rate of 33 breaths per minute, and a blood pressure is 110/ 62.\n\n\nBloods show a urea of 9mmol/L.\n\n\nWhat is this gentleman's CURB–65 score?",
"sbaAnswer": [
"a"
],
"totalVotes": 189,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,304 | false | 2 | null | 6,495,020 | null | false | [] | null | 12,796 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In a life-threatening asthma attack, CO2 levels are normal because patients are still able to blow off CO2 as they breathe. Only in near-fatal asthma attacks does PaCO2 rise as patients become exhausted and are no longer able to blow off CO2. This results in them becoming hypercapnic.",
"id": "10001248",
"label": "c",
"name": "High PaCO2",
"picture": null,
"votes": 64
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although wheeze is heard on auscultation during most asthma exacerbations, it can sometimes not be heard in life-threatening asthma attacks. A patient's chest in life-threatening exacerbations can actually be silent due to there not being enough airflow inside the lungs for a wheezing sound to be formed. This tends to occur when a patient's chest becomes really tight and their respiratory muscles become tired.",
"id": "10001247",
"label": "b",
"name": "Wheeze",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a sign of a severe asthma exacerbation. As a patient's symptoms worsen, they become more short of breath and are unable to complete sentences in a single breath.",
"id": "10001249",
"label": "d",
"name": "Unable to complete sentences in one breath",
"picture": null,
"votes": 45
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "CO2 levels are normal in a life-threatening asthma attack because patients still have enough energy to blow off CO2 through rapid breathing. Only in near-fatal asthma attacks does PaCO2 rise as patients become exhausted and are no longer able to blow off CO2. This results in them becoming hypercapnic.",
"id": "10001246",
"label": "a",
"name": "Normal PaCO2",
"picture": null,
"votes": 62
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although coughing is a symptom of asthma, it is not indicative of the severity of an asthma exacerbation and therefore cannot be used to identify a life-threatening asthma attack.",
"id": "10001250",
"label": "e",
"name": "Cough",
"picture": null,
"votes": 2
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3725",
"name": "Asthma",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3725,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12796",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 17-year-old female with a history of asthma presents to Accident and Emergency with acute onset shortness of breath and chest pain.\n\nOn examination her PEFR is 39%, her oxygen saturation is 90%, her lips are blue-tinged, and her heart rate is 120 beats per minute. She is diagnosed with a life-threatening asthma attack.\n\nWhich of the following features is most strongly associated with a life-threatening asthma attack?",
"sbaAnswer": [
"a"
],
"totalVotes": 180,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,305 | false | 3 | null | 6,495,020 | null | false | [] | null | 12,797 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A chest drain is indicated in a pneumothorax if it is a tension pneumothorax which has already been treated with needle decompression, if it is a primary pneumothorax which has not resolved with aspiration, or if it is a secondary pneumothorax >2cm/the patient is breathless.",
"id": "10001255",
"label": "e",
"name": "Chest drain",
"picture": null,
"votes": 42
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be appropriate in a secondary pneumothorax 1-2cm in size, however, this patient has no underlying lung disease so does not meet the criteria for a secondary pneumothorax.",
"id": "10001254",
"label": "d",
"name": "High flow oxygen",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a primary pneumothorax which is >2cm, therefore the patient requires aspiration in the second intercostal space mid-clavicular line.",
"id": "10001251",
"label": "a",
"name": "Aspiration",
"picture": null,
"votes": 47
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be appropriate if the primary pneumothorax was <2cm and the patient was not breathless.",
"id": "10001253",
"label": "c",
"name": "Discharge and follow up in 2 weeks",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the treatment for a tension pneumothorax which would be indicated by tracheal deviation, hypotension and tachycardia.",
"id": "10001252",
"label": "b",
"name": "Needle decompression",
"picture": null,
"votes": 76
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3899",
"name": "Pneumothorax",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3899,
"conditions": [],
"difficulty": 1,
"dislikes": 1,
"explanation": null,
"highlights": [],
"id": "12797",
"isLikedByMe": 0,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 23-year-old male presents in the Emergency Department with sudden onset chest pain and shortness of breath. His vital signs are normal and he has no significant past medical history.\n\nOn auscultation, there are absent breath sounds and increased vocal resonance over the right lung, and the trachea is central. A chest X-ray shows a 3cm right-sided pneumothorax.\n\nWhich of the following is the best management option for this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 175,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,306 | false | 4 | null | 6,495,020 | null | false | [] | null | 12,798 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would occur if the patient was blowing off carbon dioxide due to a high respiratory rate. However, in obstructive sleep apnoea airway obstruction leads to carbon dioxide retention. Furthermore, it is very difficult for patients to maintain a raised respiratory rate for long enough for renal compensation to occur.",
"id": "10001258",
"label": "c",
"name": "Compensated respiratory alkalosis",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would occur if there was a build-up of acid due to a metabolic cause which was then compensated for through hyperventilation and blowing off carbon dioxide. However, the most likely diagnosis in this gentleman is obstructive sleep apnoea which results in hypercapnia, not hypocapnia.",
"id": "10001259",
"label": "d",
"name": "Compensated metabolic acidosis",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The most likely diagnosis is obstructive sleep apnoea (OSA). The airway obstruction in OSA leads to type 2 respiratory failure as patients retain carbon dioxide, however as OSA is a chronic disease, the kidneys have time to produce bicarbonate and compensate for the hypercapnia.",
"id": "10001256",
"label": "a",
"name": "Compensated respiratory acidosis",
"picture": null,
"votes": 106
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would occur if there was a reduction of acid due to a metabolic cause which was then compensated for by the patient hyperventilating and retaining carbon dioxide.",
"id": "10001260",
"label": "e",
"name": "compensated metabolic alkalosis",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In obstructive sleep apnoea, airway obstruction leads to hypercapnia as well as hypoxemia due to air retention in the lungs.",
"id": "10001257",
"label": "b",
"name": "Type 1 respiratory failure",
"picture": null,
"votes": 15
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3718",
"name": "Obstructive Sleep Apnoea",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3718,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12798",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 40-year-old lorry driver presents to the GP with a 6-month history of headaches when he wakes up. He explains that he is tired during the day and finds himself occasionally falling asleep whilst driving. His wife, who is with him, also mentions that he seems to stop breathing when sleeping at night.\n\nOn observation, the patient is of large body habitus and appears to have large hands and apparent prognathism. On examination, his blood pressure is 130/80 and his heart rate is 115.\n\nGiven the most likely diagnosis, which is the following is the most likely ABG finding?",
"sbaAnswer": [
"a"
],
"totalVotes": 159,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,307 | false | 5 | null | 6,495,020 | null | false | [] | null | 12,799 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Lung cancer is a cause of exudative pleural effusions (>35g/L). Furthermore, a patient with lung cancer would more likely present with a several-month history of dry cough and chest pain as opposed to a one week history.",
"id": "10001263",
"label": "c",
"name": "Lung Cancer",
"picture": null,
"votes": 61
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a cause of transudative pleural effusion, however, only occurs alongside an ovarian tumour which would not be possible for this male patient.",
"id": "10001262",
"label": "b",
"name": "Meig's syndrome",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a cause of exudative pleural effusions and on aspiration presents with frank pus and pH <7.2.",
"id": "10001265",
"label": "e",
"name": "Empyema",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pneumothorax would present with pleuritic chest pain as well as increased vocal resonance and hype resonance on percussion. It is not a cause of pleural effusions.",
"id": "10001264",
"label": "d",
"name": "Pneumothorax",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Heart failure is a cause of transudative pleural effusions with low protein levels (<35g/L) as per light's criteria. Light's criteria states that an effusion is an exudate if: the pleural fluid to serum protein ratio is >0.5, the pleural fluid to serum LDH ratio is >0.6, or the pleural fluid LDH is >2/3 the upper reference limit for serum LDH. If these criteria are not satisfied, then the effusion is transudative.",
"id": "10001261",
"label": "a",
"name": "Heart Failure",
"picture": null,
"votes": 50
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3900",
"name": "Pleural effusion",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3900,
"conditions": [],
"difficulty": 1,
"dislikes": 1,
"explanation": null,
"highlights": [],
"id": "12799",
"isLikedByMe": 0,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 70-year-old male presents to the Emergency Department with a 1-week history of pleuritic chest pain and a new cough. His past medical history includes a 20-year history of hypertension and he has smoked for 40 years.\n\n\nOn examination, there is stony dullness to percussion in the left lung base, reduced breath sounds, and reduced vocal resonance.\n\n\nA chest x-ray shows a left-sided pleural effusion. The fluid aspirated has a protein level of 30g/L.\n\n\nWhat is the most likely cause of this patient's pleural effusion?",
"sbaAnswer": [
"a"
],
"totalVotes": 156,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,308 | false | 6 | null | 6,495,020 | null | false | [] | null | 12,800 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This causes a metabolic acidosis with a raised anion gap. It is unlikely in this case as there is no history which indicates tricyclic antidepressant use.",
"id": "10001269",
"label": "d",
"name": "Tricyclic antidepressant overdose",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Patients with chronic kidney disease develop a metabolic acidosis with raised anion gap. This occurs because the kidneys are unable to clear acids from the bloodstream.",
"id": "10001270",
"label": "e",
"name": "Chronic kidney disease",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Vomiting would result in a metabolic alkalosis due to the gastrointestinal loss of H+ ions.",
"id": "10001267",
"label": "b",
"name": "vomiting",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Diarrhoea would result in a metabolic acidosis with a normal anion gap. This is due to the loss of bicarbonate ions in the stool.",
"id": "10001268",
"label": "c",
"name": "Diarrhoea",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This ABG shows a respiratory alkalosis which is likely to be secondary to a panic attack. The patient is breathing faster due to her panicked state and is blowing off carbon dioxide, resulting in her low PaCO2 and paraesthesia.",
"id": "10001266",
"label": "a",
"name": "Panic attack",
"picture": null,
"votes": 124
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3901",
"name": "Acid-base concept",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3901,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12800",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 16-year-old female presents to hospital with complaints of perioral paraesthesia and tingling in her fingers and toes. She admits to episodes of shortness of breath and chest tightness over the last 2 months at school.\n\n\nAn arterial blood gas is done which demonstrates the following:\n\n||||\n|--------------|:-------:|------------------|\n|pH|7.47|7.35 - 7.45|\n|PaO₂|14 kPa|11 - 15|\n|PaCO₂|3.9 kPa|4.6 - 6.4|\n|Bicarbonate|24 mmol/L|22 - 30|\n\n\n\nWhat is the most likely cause of this patient's presentation?",
"sbaAnswer": [
"a"
],
"totalVotes": 150,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,309 | false | 7 | null | 6,495,020 | null | false | [] | null | 12,801 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Idiopathic lung fibrosis is a restrictive lung disease so we would expect the FEV1/FVC ratio should be > 70%. The FEV1/FVC ratio for this answer choice is 72% which is suggestive of restrictive lung disease. However, in restrictive lung diseases, the total lung capacity of carbon monoxide (TLCO) is reduced due to the reduction in lung volume.",
"id": "10001273",
"label": "c",
"name": "FEV1 2.1, FVC 3.2, TLCO increased",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Idiopathic lung fibrosis is a restrictive lung disease so we would expect the FEV1/FVC ratio should be > 70%. This answer choice shows an FEV1/FVC ratio of 66% making it incorrect.",
"id": "10001272",
"label": "b",
"name": "FEV1 2.1, FVC 3.2, TLCO increased",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Idiopathic lung fibrosis is a restrictive lung disease so we would expect the FEV1/FVC ratio should be > 70%. The FEV1/FVC ratio for this answer choice is 86% which is suggestive of restrictive lung disease. However, in restrictive lung diseases, the total lung capacity of carbon monoxide (TLCO) is reduced due to the reduction in lung volume.",
"id": "10001274",
"label": "d",
"name": "FEV1 2.4, FVC 2.8, TLCO normal",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The most likely diagnosis is idiopathic pulmonary fibrosis which is a restrictive lung disease. As a result, we would expect this patient's FEV1/FVC ratio to be above 70%. Indeed, her FEV1/FVC ratio is 83%. Her total lung capacity of carbon monoxide (TLCO) is reduced because there is a reduction in overall lung volume.",
"id": "10001271",
"label": "a",
"name": "FEV1 2.5, FVC 3.0, TLCO reduced",
"picture": null,
"votes": 71
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Idiopathic lung fibrosis is a restrictive lung disease so we would expect the FEV1/FVC ratio should be > 70%. This answer choice shows an FEV1/ FVC ratio of 66% making it incorrect. Also, in restrictive lung diseases, the total lung capacity of carbon monoxide (TLCO) is reduced due to the reduction in lung volume.",
"id": "10001275",
"label": "e",
"name": "FEV1 2.5, FVC 3.7, TLCO normal",
"picture": null,
"votes": 16
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3693",
"name": "Pulmonary Fibrosis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3693,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12801",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "An 80-year-old female presents to her GP with a 2-month history of shortness of breath and dry cough.\n\nOn examination, her fingernails are clubbed and on auscultation of the lungs there are fine end-inspiratory crackles.\n\nBased on the most likely diagnosis, which of the following spirometry findings is the patient most likely to have?",
"sbaAnswer": [
"a"
],
"totalVotes": 134,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,310 | false | 8 | null | 6,495,020 | null | false | [] | null | 12,802 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A patient with idiopathic pulmonary fibrosis would suffer from a dry cough as opposed to a productive cough. IPF is typically seen as honeycombing of the lungs on High-Resolution CT (HRCT), or interstitial shadowing on an x-ray.",
"id": "10001279",
"label": "d",
"name": "Idiopathic pulmonary fibrosis (IPF)",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Sarcoidosis on an x-ray would show bilateral hilar lymphadenopathy.",
"id": "10001278",
"label": "c",
"name": "Sarcoidosis",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "X-rays are not typically used in the diagnosis of asthma but might show some pulmonary hyperinflation as seen in the image. However, a flattened diaphragm is not consistent with asthma.",
"id": "10001280",
"label": "e",
"name": "Asthma",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although this patient is pyrexic, has shortness of breath and has a productive cough, the x-ray findings are not consistent with a diagnosis of pneumonia. In pneumonia, we would expect to see consolidation of the affected zone.",
"id": "10001277",
"label": "b",
"name": "Pneumonia",
"picture": null,
"votes": 57
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The x-ray shows hyperinflation of the lungs with 10 posterior ribs visible and flattened hemidiaphragms which are characteristic of COPD.",
"id": "10001276",
"label": "a",
"name": "COPD",
"picture": null,
"votes": 42
}
],
"comments": [
{
"__typename": "QuestionComment",
"comment": "image isn't there ",
"createdAt": 1685789362,
"dislikes": 0,
"id": "27653",
"isLikedByMe": 0,
"likes": 2,
"parentId": null,
"questionId": 12802,
"replies": [],
"user": {
"__typename": "User",
"accessLevel": "subscriber",
"displayName": "Lumbar Womb",
"id": 33598
}
}
],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3902",
"name": "COPD",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3902,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12802",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [
{
"__typename": "Picture",
"caption": "A chest x-ray showing hyperinflated lungs and a flattened diaphragm in an individual with COPD.",
"createdAt": 1665036254,
"id": "1089",
"index": 0,
"name": "COPD.jpeg",
"overlayPath": null,
"overlayPath256": null,
"overlayPath512": null,
"path": "images/7sn9efza1665036171695.jpg",
"path256": "images/7sn9efza1665036171695_256.jpg",
"path512": "images/7sn9efza1665036171695_512.jpg",
"thumbhash": "G/gNDQAH2XeJeHiHd4lnd7K3D22q",
"topic": null,
"topicId": null,
"updatedAt": 1708373886
}
],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 50-year-old woman presents to Accident and Emergency with a one week history of worsening shortness of breath and productive cough.\n\nOn auscultation of the lungs, there is a widespread audible wheeze.\n\nHer oxygen saturation is 90%, heart rate is 110 beats per minute, blood pressure is 125/80 and temperature is 37.7 degrees.\n\nA chest x-ray is done which shows:\n\n[lightgallery]\n\nWhat is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 134,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,311 | false | 9 | null | 6,495,020 | null | false | [] | null | 12,803 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Due to the acute presentation of sarcoidosis, it is most appropriate for the patient to be treated with bed rest and NSAIDs (to control pain and act as an antipyretic).",
"id": "10001281",
"label": "a",
"name": "Bed rest and NSAIDs",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Methotrexate is used to treat sarcoidosis if it does not respond to oral corticosteroids. This presentation does not meet the criteria to be treated with steroids as there is no eye involvement, hypercalcaemia, neurological involvement or cardiac involvement.",
"id": "10001285",
"label": "e",
"name": "Methotrexate",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In order for sarcoidosis to be treated with steroids there must be eye involvement, hypercalcaemia, neurological involvement or cardiac involvement. Steroids are also indicated in severe and persistent erythema nodosum; the 5-day history from this patient does not fulfil this criterion.",
"id": "10001282",
"label": "b",
"name": "Oral prednisolone",
"picture": null,
"votes": 72
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Supportive treatment is required for this acute presentation with NSAIDs to target pain and prevent pyrexia.",
"id": "10001283",
"label": "c",
"name": "No treatment required",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the treatment for Tuberculosis. Although bilateral hilar lymphadenopathy may be visible on an x-ray for tuberculosis, the clinical features in this patient including lupus pernio and erythema nodosum make sarcoidosis a much more likely diagnosis.",
"id": "10001284",
"label": "d",
"name": "Rifampicin, isoniazid, pyrazinamide, ethambutol quadruple therapy",
"picture": null,
"votes": 29
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3694",
"name": "Sarcoidosis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3694,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12803",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 30-year-old Afro–Caribbean female presents to Accident and Emergency with a 5-day history of shortness of breath and complaints of pain in both legs.\n\nOn examination, there are red lesions on her shins as well as a violaceous rash across her nose and cheeks. There are widespread crackles on auscultation of the lungs.\n\nChest x-ray shows bilateral hilar lymphadenopathy.\n\nGiven the most likely diagnosis, which of the following is the most appropriate management plan?",
"sbaAnswer": [
"a"
],
"totalVotes": 134,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,312 | false | 10 | null | 6,495,020 | null | false | [] | null | 12,804 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a good differential when considering the cause of haemoptysis, frail appearance (which could be due to weight loss) and shortness of breath. However, TB would not explain this patient's confusion and ECG results.",
"id": "10001289",
"label": "d",
"name": "Tuberculosis",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would present with systemic subacute symptoms. You would also expect a fever alongside her chest pain, shortness of breath and clubbing.",
"id": "10001288",
"label": "c",
"name": "Lung abscess",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient has symptoms suggesting lung cancer and hypercalcemia. Hypercalcemia is associated with squamous cell lung cancers due to the release of parathyroid hormone-related protein (PTHrp).\n\nA helpful way to remember the signs of hypercalcaemia is by learning 'bones (bone pain), stones (renal stones), abdominal groans (abdominal pain and GI upset) and psychiatric moans (confusion)'. This woman has psychiatric moans by way of her confusion and disorientation. In addition, hypercalcemia is associated with shortened QT intervals on ECG.",
"id": "10001286",
"label": "a",
"name": "Squamous cell lung cancer",
"picture": null,
"votes": 63
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although it is likely that this patient has lung cancer due to her haemoptysis and clubbing, small-cell lung cancers are not associated with hypercalcemia. In fact, small-cell lung cancers are associated with Cushing's syndrome due to the ectopic release of ACTH.",
"id": "10001287",
"label": "b",
"name": "Small cell lung cancer",
"picture": null,
"votes": 50
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Asthma would not present with clubbing or haemoptysis and would be associated with shortness of breath on exertion and a diurnal variation in symptoms.",
"id": "10001290",
"label": "e",
"name": "Asthma",
"picture": null,
"votes": 1
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3702",
"name": "Lung Cancer",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3702,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12804",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 70-year-old female presents to the clinic with a 3-month history of shortness of breath and chest pain. She mentions that she has noticed blood in his sputum.\n\nOn examination, she has finger clubbing and appears frail, confused and disorientated.\n\nAn ECG is carried out which shows a shortened QT interval.\n\nWhat is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 134,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,313 | false | 11 | null | 6,495,020 | null | false | [] | null | 12,805 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An osteotomy is not indicated for the treatment of compartment syndrome or fractures as it involves cutting bone to shorten or lengthen it.",
"id": "10001295",
"label": "e",
"name": "Osteotomy",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be indicated to aid the healing of the broken bone but it is not the definitive management for compartment syndrome (which needs to be addressed imminently to prevent further complications). A plaster cast would be counterproductive in this acute situation as it would apply further compression to the leg.",
"id": "10001294",
"label": "d",
"name": "Plaster cast",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be indicated if she had developed further neurovascular complications and if a fasciotomy would not be able to save the leg. In addition to the pain, pallor and paraesthesia, she could develop pulselessness and paralysis of the muscle group.",
"id": "10001292",
"label": "b",
"name": "Amputation",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the definitive management for compartment syndrome, and a delay in performing it could result in amputation. Fasciotomy is performed by incisions being made to the appropriate leg compartment to relieve the pressure.",
"id": "10001291",
"label": "a",
"name": "Urgent fasciotomy",
"picture": null,
"votes": 111
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Morphine is indicated for the pain but is not the definitive management for compartment syndrome.",
"id": "10001293",
"label": "c",
"name": "Oral morphine",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3903",
"name": "Compartment syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3903,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12805",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 6-year-old female presents to Accident & Emergency after falling off her bike.\n\nOn examination, she cries out in pain on passive movement of her right foot which appears pale. She also complains of tingling in her toes.\n\nX-ray shows a closed fracture to the right distal tibia.\n\nA diagnosis of compartment syndrome is confirmed.\n\nWhich of the following is the definitive treatment for this condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 123,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,314 | false | 12 | null | 6,495,020 | null | false | [] | null | 12,806 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The scaphoid fracture is not confirmed so it would be unnecessary to apply a plaster for 6 – 8 weeks - this is unnecessary immobilisation which could result in muscle atrophy.",
"id": "10001299",
"label": "d",
"name": "Plaster for 6–8 weeks",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be indicated if the patient had a displaced scaphoid fracture, however, this is not evident in the x-rays.",
"id": "10001298",
"label": "c",
"name": "Immediate screw fixation",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Scaphoid fractures may not be radiologically visible until 10 days after the injury so repeating the x-ray so quickly is unlikely to impact management.",
"id": "10001300",
"label": "e",
"name": "Repeat x-ray within one hour",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The combination of falling on an outstretched hand and pain over the anatomical snuffbox is highly indicative of a scaphoid fracture. However, a scaphoid fracture may only become visible radiologically after 10 days. A scaphoid fracture must be treated, even if it is not confirmed radiologically, to prevent the development of avascular necrosis of the scaphoid bone.",
"id": "10001296",
"label": "a",
"name": "Plaster for 10 days then repeat x-rays",
"picture": null,
"votes": 85
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Discharging the patient would put him at risk of avascular necrosis of the scaphoid bone secondary to a lack of treatment.",
"id": "10001297",
"label": "b",
"name": "Discharge",
"picture": null,
"votes": 0
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3904",
"name": "scaphoid fracture",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3904,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12806",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 13-year-old male presents to hospital after falling onto an outstretched hand while playing football.\n\nOn examination, there is pain in the anatomical snuffbox. A scaphoid fracture is suspected but x-rays are unremarkable.\n\nWhich of the following is the most appropriate next step in management?",
"sbaAnswer": [
"a"
],
"totalVotes": 124,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,315 | false | 13 | null | 6,495,020 | null | false | [] | null | 12,807 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypomagnesemia is a risk factor for the deposition of calcium pyrophosphate dihydrate crystals as opposed to hypermagnesemia.",
"id": "10001303",
"label": "c",
"name": "Hypermagnesemia",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Primary (and tertiary) hyperparathyroidism leads to hypercalcaemia which leads to the deposition of calcium pyrophosphate dihydrate crystals in articular cartilage. This results in flares of pseudogout. Secondary hyperparathyroidism, on the other hand, leads to hypocalcaemia.",
"id": "10001301",
"label": "a",
"name": "Primary hyperparathyroidism",
"picture": null,
"votes": 67
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a risk factor for gout as high purine foods raise uric acid levels which leads to the formation of uric acid crystals. These can build up in articular structures causing gout.",
"id": "10001304",
"label": "d",
"name": "Diet high in purines",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a risk factor for gout as hyperuricemia leads to the formation of urate crystals which can be found in synovial fluid on aspiration.",
"id": "10001305",
"label": "e",
"name": "Hyperuricemia",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypoparathyroidism results in hypocalcaemia which means there is less calcium available for synovial deposits to form.",
"id": "10001302",
"label": "b",
"name": "Hypoparathyroidism",
"picture": null,
"votes": 12
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3905",
"name": "pseudogout",
"status": null,
"topic": {
"__typename": "Topic",
"id": "146",
"name": "Rheumatology",
"typeId": 7
},
"topicId": 146,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3905,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12807",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 45-year-old male presents to clinic with a 5-day history of knee pain.\n\nOn examination, the joint is erythematous, hot and swollen. Aspiration of the knee shows calcium pyrophosphate dihydrate crystals.\n\nGiven the most likely diagnosis, which of the following is a risk factor?",
"sbaAnswer": [
"a"
],
"totalVotes": 124,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,316 | false | 14 | null | 6,495,020 | null | false | [] | null | 12,808 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are most associated with SLE.",
"id": "10001307",
"label": "b",
"name": "Anti–dsDNA antibodies",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are most associated with systemic sclerosis.",
"id": "10001310",
"label": "e",
"name": "Anticentromere antibodies",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are most associated with Sjogren's syndrome.",
"id": "10001308",
"label": "c",
"name": "Anti-Ro/La antibodies",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Anti Jo–1 antibodies are associated with both polymyositis and dermatomyositis but are more commonly found in polymyositis.",
"id": "10001306",
"label": "a",
"name": "Anti Jo–1 Antibodies",
"picture": null,
"votes": 66
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are most associated with antiphospholipid syndrome.",
"id": "10001309",
"label": "d",
"name": "Anticardiolipin antibodies",
"picture": null,
"votes": 9
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3906",
"name": "polymyositis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "146",
"name": "Rheumatology",
"typeId": 7
},
"topicId": 146,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3906,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12808",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 45-year-old female presents to her GP with a 6-month history of proximal muscle weakness. She explains that she struggles to get up from her chair.\n\n\nOn examination, there are no abnormalities and vital signs are within normal range.\n\n\nBloods are unremarkable apart from a creatine kinase of 300U/L (normal range 25-175 U/L).\n\n\nA diagnosis of polymyositis is suspected.\n\n\nWhich of the following is most associated with polymyositis?",
"sbaAnswer": [
"a"
],
"totalVotes": 116,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,317 | false | 15 | null | 6,495,020 | null | false | [] | null | 12,809 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is indicated in femoral shaft fractures.",
"id": "10001314",
"label": "d",
"name": "Intramedullary nail",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is normally indicated in younger patients (who are medically fit enough for the procedure) with displaced intracapsular fractures to preserve mobility.",
"id": "10001313",
"label": "c",
"name": "Total hip replacement",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is indicated in older patients with displaced intracapsular fractures.",
"id": "10001312",
"label": "b",
"name": "Hemi–arthroplasty",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Surgery is the treatment option for a hip fracture, simply reducing the fracture is not enough to fix it.",
"id": "10001315",
"label": "e",
"name": "Reduce the fracture",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Extracapsular neck of femur fractures are treated with ORIF and a dynamic hip screw.",
"id": "10001311",
"label": "a",
"name": "Open repair with internal fixation (ORIF) and a dynamic hip screw",
"picture": null,
"votes": 62
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3907",
"name": "fractured neck of femur",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3907,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12809",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 73-year-old woman presents to Accident & Emergency following a fall at home. Paramedics found her with a shortened and externally rotated right leg.\n\nA right pelvis x-ray shows an intertrochanteric fracture with partial displacement.\n\nWhat is the most appropriate management of this fracture?",
"sbaAnswer": [
"a"
],
"totalVotes": 117,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,318 | false | 16 | null | 6,495,020 | null | false | [] | null | 12,810 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This set of bloods might be seen in the early stages of Paget’s disease, but since this patient has hearing loss, he likely has advanced disease. Hence, we would expect his ALP to be raised.",
"id": "10001320",
"label": "e",
"name": "Normal ALP, normal calcium, normal phosphate",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the typical blood test result in a patient with osteomalacia.",
"id": "10001318",
"label": "c",
"name": "Raised ALP, low calcium, low phosphate",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the typical blood test result in a patient with multiple myeloma.",
"id": "10001317",
"label": "b",
"name": "Normal ALP, raised calcium, normal phosphate",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These bloods are indicative of primary hyperparathyroidism.",
"id": "10001319",
"label": "d",
"name": "Normal ALP, raised calcium, low phosphate",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a typical presentation of Paget’s disease of the bone. The elevated ALP is caused by increased levels of osteoblast activity due to the accelerated rate of bone remodelling and formation of new bone.",
"id": "10001316",
"label": "a",
"name": "Raised ALP, normal calcium and normal phosphate levels",
"picture": null,
"votes": 37
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3908",
"name": "paget's disease of the bone",
"status": null,
"topic": {
"__typename": "Topic",
"id": "170",
"name": "Clinical Chemistry",
"typeId": 7
},
"topicId": 170,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3908,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12810",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 70-year-old male with no past medical history presents to his GP with a slowly worsening dull aching pain in his hips. During the consultation, it is noted that the patient struggles to hear, and on observation of his gait, it is clear that he has a varus leg deformity.\n\nHe is referred to secondary care where bloodwork is done.\n\nBased on the most likely diagnosis, which of the following results are you most likely to find on his blood tests?",
"sbaAnswer": [
"a"
],
"totalVotes": 116,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,319 | false | 17 | null | 6,495,020 | null | false | [] | null | 12,811 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The median nerve is compressed in carpal tunnel syndrome and results in loss of sensation over the lateral three-and-a-half fingers on the palmar surface of the hand.",
"id": "10001325",
"label": "e",
"name": "Median nerve",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The axillary nerve gives off the superior lateral cutaneous nerve which innervates the regimental badge area (inferior region of deltoid), therefore damage to this nerve causes a loss of sensation over the regimental badge area.",
"id": "10001324",
"label": "d",
"name": "Axillary nerve",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The suprascapular nerve innervates the supraspinatus muscle. Damage to the suprascapular nerve leads to the loss of active shoulder abduction.",
"id": "10001323",
"label": "c",
"name": "Suprascapular nerve",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The long thoracic nerve innervates the serratus anterior which protracts the scapula. Damage to the long thoracic nerve causes winging of the scapula.",
"id": "10001322",
"label": "b",
"name": "Long thoracic nerve",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is suffering from ‘Saturday night palsy’, which is a compressive neuropathy of the radial nerve that occurs due to prolonged, direct pressure on the upper medial axilla; the chair has compressed his axilla in this case.",
"id": "10001321",
"label": "a",
"name": "Radial nerve",
"picture": null,
"votes": 103
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3909",
"name": "brachial plexus injuries",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3909,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12811",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 21-year-old male wakes up with his arm draped over his chair after a night out.\n\nHe has a right-sided wrist drop and loss of sensation over the posterior aspect of the right arm, forearm, and posterolateral aspect of the right hand.\n\nWhich nerve is most likely to be affected?",
"sbaAnswer": [
"a"
],
"totalVotes": 122,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,320 | false | 18 | null | 6,495,020 | null | false | [] | null | 12,812 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The raised ALP alongside low phosphate and low calcium is evidence of failed bone mineralisation; this is seen in osteomalacia, resulting in softer and more brittle bones,",
"id": "10001326",
"label": "a",
"name": "Osteomalacia",
"picture": null,
"votes": 57
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The muscle weakness described in this patient is consistent with polymyositis, however, the calcium, phosphate and ALP levels would be normal in polymyositis. Creatine kinase would also be elevated.",
"id": "10001329",
"label": "d",
"name": "Polymyositis",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The muscle aches align with fibromyalgia as a differential diagnosis, however, the abnormal blood test results do not. The calcium, phosphate and ALP levels would be normal in fibromyalgia.",
"id": "10001330",
"label": "e",
"name": "Fibromyalgia",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In Paget’s disease, the ALP is very raised (more than in osteomalacia), but the calcium and phosphate are usually normal.",
"id": "10001328",
"label": "c",
"name": "Paget’s disease",
"picture": null,
"votes": 31
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Osteopenia would present with normal bloods and reduced bone density.",
"id": "10001327",
"label": "b",
"name": "Osteopenia",
"picture": null,
"votes": 12
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3910",
"name": "osteomalacia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "170",
"name": "Clinical Chemistry",
"typeId": 7
},
"topicId": 170,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3910,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12812",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 40-year-old female presents to the GP following 6 months of muscle aches and fatigue. She has also experienced difficulty climbing up the stairs in her home.\n\n\nHer blood test results are as follows:\n\n||||\n|---------------------------|:-------:|--------------------|\n|Calcium|2.0 mmol/L|2.2 - 2.6|\n|Phosphate|0.52 mmol/L|0.8 - 1.5|\n|Alkaline Phosphatase (ALP)|240 IU/L|25 - 115|\n\n\nWhat is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 115,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,321 | false | 19 | null | 6,495,020 | null | false | [] | null | 12,813 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "It has been stated that NSAIDs have not been successful in managing this patient's symptoms. Paracetamol is at the bottom of the pain ladder, so it alone would not be appropriate in this case.",
"id": "10001334",
"label": "d",
"name": "Paracetamol",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Disease-modifying anti-rheumatic drugs (DMARDs) are most useful in the treatment of ankylosing spondylitis with enthesitis and do not improve spinal inflammation. This patient is suffering from spinal inflammation and extra-articular involvement, therefore this is not the most appropriate next step.",
"id": "10001335",
"label": "e",
"name": "Methotrexate",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "NICE guidance suggests that TNF–alpha inhibitors should be used in cases of ankylosing spondylitis where NSAID treatment has failed. They should also be used in severe cases as demonstrated in this patient who has anterior uveitis (a complication of ankylosing spondylitis).",
"id": "10001331",
"label": "a",
"name": "Etanercept",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oral steroids are not indicated in the treatment of ankylosing spondylitis; steroids must be given intra-articularly in ankylosing spondylitis.",
"id": "10001333",
"label": "c",
"name": "Oral prednisolone",
"picture": null,
"votes": 53
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Physiotherapy is indicated in ankylosing spondylitis for improving and maintaining posture, flexibility and mobility. However, physiotherapy alone would not be enough for this patient with extra-articular involvement who has experienced no relief from NSAID therapy.",
"id": "10001336",
"label": "f",
"name": "Physiotherapy",
"picture": null,
"votes": 12
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3911",
"name": "ankylosing spondylitis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "146",
"name": "Rheumatology",
"typeId": 7
},
"topicId": 146,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3911,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12813",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 21-year-old male presents to clinic following a 5-month history of early morning back pain and stiffness that improves with activity. The patient also complains of an acutely red eye and sensitivity to light that has developed over 2 weeks.\n\nOn examination, there is a limited range of lumbar motion.\n\nThe patient was recently diagnosed with ankylosing spondylitis and has received NSAID treatment which has been unsuccessful in managing his symptoms.\n\nWhat is the next most appropriate step in treatment?",
"sbaAnswer": [
"a"
],
"totalVotes": 113,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,322 | false | 20 | null | 6,495,020 | null | false | [] | null | 12,814 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Type IV is a T-cell mediated delayed hypersensitivity reaction.",
"id": "10001337",
"label": "a",
"name": "Type IV",
"picture": null,
"votes": 69
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Type II is known as a cell-bound hypersensitivity reaction in which IgG or IgM binds to antigens on the cell surface. Pemphigus Vulgaris and immune thrombocytopenic purpura are examples of type II hypersensitivity reactions.",
"id": "10001339",
"label": "c",
"name": "Type II",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In Type V hypersensitivity reactions, antibodies are produced that recognise and bind to cell surface receptors, and either stimulate them or block ligand binding. Graves' disease and myasthenia gravis are examples of Type V hypersensitivity reactions.",
"id": "10001341",
"label": "e",
"name": "Type V",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In Type I hypersensitivity reactions, an antigen reacts with IgE bound to mast cells. Anaphylaxis and asthma are examples of type I hypersensitivity reactions.",
"id": "10001338",
"label": "b",
"name": "Type I",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Type III is known as an immune complex hypersensitivity reaction in which free antigen and antibody (IgG, IgA) combine. Systemic lupus erythematosus is an example of a type III hypersensitivity reactions",
"id": "10001340",
"label": "d",
"name": "Type III",
"picture": null,
"votes": 10
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3912",
"name": "contact dermatitis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3912,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12814",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 22-year-old female presents to her GP with weeping eczema along the margins of her hairline. She discloses that she dyed her hair 2 days ago and the skin irritation has only occurred since then. She is diagnosed with allergic contact dermatitis.\n\nWhich of the following best describes the type of hypersensitivity reaction that occurs in allergic contact dermatitis?",
"sbaAnswer": [
"a"
],
"totalVotes": 120,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,323 | false | 21 | null | 6,495,020 | null | false | [] | null | 12,815 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This disease presents with pearly white papules with central umbilication. Molluscum contagiosum is caused by the molluscum contagiosum virus and is not linked to GI upset.",
"id": "10001343",
"label": "b",
"name": "Molluscum contagiosum",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Eczema herpeticum usually presents with a widespread vesicular rash and systemic symptoms such as fever and lethargy. In addition, eczema herpeticum is usually secondary to a pre-existing skin condition, which this patient does not have.",
"id": "10001344",
"label": "c",
"name": "Eczema herpeticum",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pemphigus vulgaris presents with superficial blisters and vesicles. Patients with pemphigus vulgaris tend to also experience blistering in their mouths as well as their skin. Pemphigus vulgaris is normally triggered by drug treatment as opposed to gastrointestinal upset.",
"id": "10001345",
"label": "d",
"name": "Pemphigus Vulgaris",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Erythema multiforme presents with target lesions and is usually triggered by an infection, most commonly a herpes simplex infection.",
"id": "10001346",
"label": "e",
"name": "Erythema multiforme",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is most likely suffering from coeliac disease and is experiencing dermatitis herpetiformis as a complication of this. This can be relieved by complying with a gluten-free diet.",
"id": "10001342",
"label": "a",
"name": "Dermatitis herpetiformis",
"picture": null,
"votes": 83
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3913",
"name": "coeliac disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3913,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12815",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 27-year-old female presents to her GP with itchy, vesicular lesions on her elbows and knees in a symmetrical distribution. She discloses that she has also suffered from intermittent diarrhoea for the past 7 months along with abdominal pain and weight loss. Her vital signs are normal.\n\nGiven the most likely diagnosis, which rash is she most likely experiencing?",
"sbaAnswer": [
"a"
],
"totalVotes": 112,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,324 | false | 22 | null | 6,495,020 | null | false | [] | null | 12,816 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This may be a treatment option further down the line but must be started in secondary care.",
"id": "10001350",
"label": "d",
"name": "Methotrexate",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is indicated when both topical vitamin D analogue monotherapy and topical steroid have been trialled and failed.",
"id": "10001349",
"label": "c",
"name": "Coal tar",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The second-line treatment for chronic plaque psoriasis is vitamin D analogue monotherapy.",
"id": "10001347",
"label": "a",
"name": "Topical calcipotriol twice daily",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the third-line treatment for chronic plaque psoriasis; very potent steroids must be prescribed in a secondary care setting.",
"id": "10001348",
"label": "b",
"name": "Topical Dermovate twice daily",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Smoking cessation is good advice to prevent psoriasis from worsening, but it is not enough in this case to treat the severity of the patient's psoriasis.",
"id": "10001351",
"label": "e",
"name": "Smoking cessation",
"picture": null,
"votes": 8
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3914",
"name": "psoriasis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3914,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12816",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 32-year-old male presents to his GP for a review of his chronic plaque psoriasis treatment. On examination, there are well-demarcated, red, scaly patches on his elbows and knees. He describes the rash as being extremely itchy but not painful.\n\nHis psoriasis has already been treated with topical betamethasone and topical calcipotriol, however, there has been no improvement.\n\nWhat is the most appropriate next step in treatment for his psoriasis?",
"sbaAnswer": [
"a"
],
"totalVotes": 104,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,325 | false | 23 | null | 6,495,020 | null | false | [] | null | 12,817 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Steroids are not indicated in the curative treatment of scabies. Permethrin 5% is the first-line treatment and malathion 0.5% is the second-line treatment.",
"id": "10001356",
"label": "e",
"name": "Apply topical hydrocortisone 0.5% on cool dry skin all over the body",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Malathion 0.5% is the second-line treatment for scabies, so it is more appropriate to treat with permethrin first and assess its effectiveness.",
"id": "10001355",
"label": "d",
"name": "Apply topical malathion 0.5% on cool dry skin all over the body",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Members of a household are required to start treatment at the same time as the patient",
"id": "10001354",
"label": "c",
"name": "Members of the household can start treatment 24 hours later",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Topical permethrin 5% is the first-line treatment for scabies and it is important that it is not only applied to the itchy areas with a rash, but to the entire body.",
"id": "10001352",
"label": "a",
"name": "Apply topical permethrin on cool dry skin all over the body",
"picture": null,
"votes": 62
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Individuals can return to work/school 24 hours after the treatment is initiated.",
"id": "10001353",
"label": "b",
"name": "She cannot return to work until the rash has completely disappeared",
"picture": null,
"votes": 15
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3915",
"name": "scabies",
"status": null,
"topic": {
"__typename": "Topic",
"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3915,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12817",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 54-year-old female presents to her GP with a one-week history of a rash. On examination, there is a papular rash in the finger webs which she describes as being extremely itchy. The rash is diagnosed as scabies.\n\nWhich of the following is the most appropriate advice to give?",
"sbaAnswer": [
"a"
],
"totalVotes": 107,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,326 | false | 24 | null | 6,495,020 | null | false | [] | null | 12,818 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient scores 2 points each for change in size and irregular borders, and 1 point for a diameter of 8mm, giving a total of 5.",
"id": "10001360",
"label": "d",
"name": "4",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "In the Glasgow 7-point checklist, 2 points are awarded for major features: change in shape, irregular shape, irregular colour; and 1 point is awarded for minor features: diameter > 7mm, inflammation, oozing or crusting, change in sensation. Therefore, this patient scores 2 points each for change in size and irregular borders and 1 point for a diameter of 8mm.",
"id": "10001357",
"label": "a",
"name": "5",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient scores 2 points each for change in size and irregular borders, and 1 point for a diameter of 8mm, giving a total of 5.",
"id": "10001359",
"label": "c",
"name": "3",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient scores 2 points each for change in size and irregular borders, and 1 point for a diameter of 8mm, giving a total of 5.",
"id": "10001358",
"label": "b",
"name": "2",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient scores 2 points each for change in size and irregular borders, and 1 point for a diameter of 8mm, giving a total of 5.",
"id": "10001361",
"label": "e",
"name": "6",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3758",
"name": "Malignant Melanoma",
"status": null,
"topic": {
"__typename": "Topic",
"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3758,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12818",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 57-year-old male presents to his GP concerned about a strange mole on his back which she noticed 6 months ago. On examination, you notice the lesion is brown with irregular borders. The patient explains that over the past 6 months, the lesion has noticeably increased in size. You measure the lesion to be 8mm. He denies any itchiness, inflammation, oozing or change in colour. Further investigation leads to a diagnosis of malignant melanoma.\n\nBased on the findings, what is the Glasgow score for his lesion?",
"sbaAnswer": [
"a"
],
"totalVotes": 100,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,327 | false | 25 | null | 6,495,020 | null | false | [] | null | 12,819 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Doxycycline is a tetracycline antibiotic which is indicated for the management of Acne vulgaris but has no role in the treatment of pemphigus vulgaris.",
"id": "10001363",
"label": "b",
"name": "Oral doxycycline",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Topical steroids are more likely to be used in the treatment of bullous pemphigoid.",
"id": "10001364",
"label": "c",
"name": "Topical corticosteroids",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Aciclovir is an antiviral medication used in the treatment of eczema herpeticum which is caused by the herpes simplex virus.",
"id": "10001366",
"label": "e",
"name": "Oral aciclovir",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The most likely diagnosis is pemphigus vulgaris. Oral corticosteroids are indicated in pemphigus vulgaris to control the symptoms, however, they are not curative.",
"id": "10001362",
"label": "a",
"name": "Oral corticosteroids",
"picture": null,
"votes": 40
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Dressing wounds is useful as part of the supportive management of pemphigus vulgaris, but oral corticosteroids are most useful for controlling symptoms and are therefore the most appropriate treatment.",
"id": "10001365",
"label": "d",
"name": "Wound dressing",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3916",
"name": "pemphigus and pemphigoid",
"status": null,
"topic": {
"__typename": "Topic",
"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3916,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12819",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 55-year-old male presents to clinic following the onset of oral blisters. On examination, the patient has a widespread erythematous rash with blisters. The patient explains that the rash is extremely itchy and painful and that his skin peels off when he applies pressure.\n\nBased on the most likely diagnosis, what is the most appropriate treatment?",
"sbaAnswer": [
"a"
],
"totalVotes": 105,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,328 | false | 26 | null | 6,495,020 | null | false | [] | null | 12,820 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although pemphigus vulgaris also presents with blisters, desquamation and a positive Nikolsky sign, it is not the most likely diagnosis as the fact that the oral mucosa is not affected in this patient. Furthermore, pemphigus vulgaris tends to present in adults and would not present with a fever as it is not an infectious disease.",
"id": "10001368",
"label": "b",
"name": "Pemphigus Vulgaris",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Bullous pemphigoid is not Nikolsky sign positive and presents with tense, rather than superficial, blisters",
"id": "10001369",
"label": "c",
"name": "Bullous pemphigoid",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the most likely diagnosis based on the sparing of the oral mucosa, the positive Nikolsky sign and the patient's age. Staphylococcal scalded skin syndrome normally occurs in young children.",
"id": "10001367",
"label": "a",
"name": "Staphylococcal scalded skin syndrome",
"picture": null,
"votes": 49
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Eczema herpeticum presents with a widespread painful vesicular rash, rather than blisters. Also, eczema herpeticum is caused by the herpes simplex virus whereas pemphigus vulgaris is an autoimmune disease.",
"id": "10001370",
"label": "d",
"name": "Eczema herpeticum",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "TEN presents similarly to pemphigus vulgaris with widespread erythema, desquamation and a positive Nikolsky sign. However, TEN is more likely to present with involvement of the oral mucosa and usually occurs as a reaction to a newly initiated drug.",
"id": "10001371",
"label": "e",
"name": "Toxic epidermal necrolysis (TEN)",
"picture": null,
"votes": 11
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3917",
"name": "staphylococcal scalded skin syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3917,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12820",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 4-year-old girl presents to A&E with a 24-hour history of widespread large superficial blisters. On examination, there is widespread erythema and patches of desquamation. The oral mucosa is unaffected and Nikolsky sign is positive. Vital signs are normal apart from a temperature of 38 degrees. The patient has no significant past medical history.\n\nWhat is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 99,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,329 | false | 27 | null | 6,495,020 | null | false | [] | null | 12,821 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "It is most likely that oral isotretinoin has been prescribed. Isotretinoin is a systemic retinoid and is known to be teratogenic. As a woman of childbearing age, the patient is required to be on contraception (ideally 3 methods) before, during and after treatment. Retinoids are also contraindicated in breastfeeding and pregnancy.",
"id": "10001372",
"label": "a",
"name": "Teratogenicity",
"picture": null,
"votes": 55
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Skin thinning is commonly associated with the prolonged use of topical corticosteroids. Corticosteroids are not indicated in the treatment of acne.",
"id": "10001373",
"label": "b",
"name": "Skin thinning",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "It is most likely that oral isotretinoin has been prescribed. Hence, this patient may experience dry skin as a side effect of the systemic retinoid. However, this is not harmful and it is more important that the patient is counselled on the teratogenicity associated with isotretinoin.",
"id": "10001376",
"label": "e",
"name": "Dry skin",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cushing's syndrome often occurs as a side effect of systemic steroid use. However, steroids are not indicated in the treatment of acne vulgaris.",
"id": "10001375",
"label": "d",
"name": "Cushing's syndrome",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Photosensitivity is commonly associated with tetracycline use, and excessive sun exposure can result in blistering. However, this patient has already trialled oral antibiotics and seen no improvement, so it is unlikely that tetracyclines would be prescribed again by the dermatologist.",
"id": "10001374",
"label": "c",
"name": "Photosensitivity",
"picture": null,
"votes": 14
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3918",
"name": "acne vulgaris",
"status": null,
"topic": {
"__typename": "Topic",
"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3918,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12821",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "An 18-year-old female presents to the Dermatologist for a follow-up appointment regarding her treatment for acne vulgaris. She has already tried topical retinoid treatment, benzoyl peroxide and oral erythromycin but has not seen any improvement in her acne. The dermatologist prescribes a new medication.\n\nBased on the most likely medication prescribed, which of the following side effects should the patient be counselled about?",
"sbaAnswer": [
"a"
],
"totalVotes": 99,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,330 | false | 28 | null | 6,495,020 | null | false | [] | null | 12,822 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Brimonidine is specifically indicated for facial erythema in rosacea. It can be applied once daily and its effects last up to 12 hours.",
"id": "10001377",
"label": "a",
"name": "Topical brimonidine",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Topical metronidazole is indicated for the treatment of acne rosacea, however, it does not specifically target facial erythema.",
"id": "10001379",
"label": "c",
"name": "Topical metronidazole",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Topical emollients can be used as a soap substitute to target dry, scaly skin in acne rosacea. However, it is not used to resolve symptoms or target facial erythema.",
"id": "10001381",
"label": "e",
"name": "Topical emollient",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Topical benzoyl peroxide is the first-line treatment for acne vulgaris. It is not indicated in the treatment of acne rosacea.",
"id": "10001378",
"label": "b",
"name": "Topical benzoyl peroxide",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "PUVA is indicated for severe cases of psoriasis; there is no benefit in using PUVA to treat acne rosacea.",
"id": "10001380",
"label": "d",
"name": "PUVA",
"picture": null,
"votes": 2
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3919",
"name": "acne rosacea",
"status": null,
"topic": {
"__typename": "Topic",
"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3919,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12822",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 42-year-old female presents to the GP with complaints of redness across her nose and her cheeks. She has spent a lot of time in the sun over the previous 7 days. On examination, you notice papules and pustules on these areas as well as rhinophyma. The patient is diagnosed with acne rosacea and wonders what can be done to treat the facial erythema.\n\nWhich of the following is the most appropriate treatment for facial erythema?",
"sbaAnswer": [
"a"
],
"totalVotes": 97,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,331 | false | 29 | null | 6,495,020 | null | false | [] | null | 12,823 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the most likely diagnosis based on the short history of a fast-growing lesion on an area that is frequently sun exposed. The ulcerated core is also characteristic of squamous cell carcinoma.",
"id": "10001382",
"label": "a",
"name": "Squamous cell carcinoma",
"picture": null,
"votes": 48
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Seborrheic keratosis presents as brown lesions with a 'stuck on' appearance; they are benign skin growths and are very common.",
"id": "10001385",
"label": "d",
"name": "Seborrheic keratosis",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Keratoacanthomas present as rapidly growing skin tumours with a dome shape and a central keratin-filled crater.",
"id": "10001386",
"label": "e",
"name": "Keratoacanthoma",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although basal cell carcinomas are found on sun-exposed areas, they are slower growing than squamous cell carcinomas. Also, basal cell carcinomas usually have a pearly rolled edge and surrounding telangiectasia.",
"id": "10001383",
"label": "b",
"name": "Basal cell carcinoma",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Actinic keratoses are found on areas of sun-exposed skin, but are not malignant and do not present with an ulcerated core.",
"id": "10001384",
"label": "c",
"name": "Actinic keratosis",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3920",
"name": "squamous cell carcinoma",
"status": null,
"topic": {
"__typename": "Topic",
"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3920,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12823",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 55-year-old man presents to his GP with a lesion on the pinna of his ear which appeared last month and has since increased in size. On examination, there is a 6mm lesion with irregular borders and an ulcerated core. Vital signs are normal and there is no significant past medical history.\n\nWhat is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 98,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,332 | false | 30 | null | 6,495,020 | null | false | [] | null | 12,824 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a complication of sickle cell anaemia which normally occurs in children (the spleen in sickle cell patients is normally atrophied by adulthood) and is caused by the pooling of blood in the spleen. Patients typically present with shock, abdominal pain and severe anaemia.",
"id": "10001390",
"label": "d",
"name": "Splenic sequestration crisis",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Asthma would also present with a wheeze, however, it would not cause pulmonary infiltrates on chest x-ray and is not a complication of sickle cell disease.",
"id": "10001389",
"label": "c",
"name": "Asthma",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Aplastic crisis is a complication of sickle cell disease in which there is a sudden reduction in bone marrow production due to parvovirus B19 infection, resulting in the temporary cessation of new red blood cell production. A patient experiencing an aplastic crisis would have a sudden drop in haemoglobin and no respiratory changes.",
"id": "10001388",
"label": "b",
"name": "Aplastic crisis",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Acute chest syndrome presents with chest pain, fever, tachypnoea and wheeze. It is characterised by pulmonary infiltrates on chest x-ray and is treated with antibiotics, oxygen and analgesia.",
"id": "10001387",
"label": "a",
"name": "Acute chest syndrome",
"picture": null,
"votes": 47
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Vaso-occlusive crisis is caused by the occlusion of small vessels causing distal limb ischaemia. Patients present with severe sudden onset pain but do not experience pyrexia or respiratory symptoms such as wheeze or low oxygen saturations.",
"id": "10001391",
"label": "e",
"name": "Vaso-occlusive crisis",
"picture": null,
"votes": 21
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3921",
"name": "sickle cell disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "157",
"name": "Haematology",
"typeId": 7
},
"topicId": 157,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3921,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12824",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 16-year-old male presents to A&E with chest pain and shortness of breath. He has a past medical history of sickle cell anaemia. On examination, he has an audible wheeze throughout both lungs.\n\n\nHis basic observations show the following:\nRespiratory rate: 27 breaths per minute\nOxygen saturation: 85%\nHeart rate: 112 beats per minute\nTemperature: 37.8\nBlood pressure: 110/80mmHg\n\n\nHis haemoglobin is 83g/L and was 84g/L 6 months prior (normal range 103-170 g/L). A chest x-ray is done which shows pulmonary infiltrates.\n\n\nWhat complication of sickle cell anaemia is most likely occurring in this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 97,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,333 | false | 31 | null | 6,495,020 | null | false | [] | null | 12,825 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ALL is caused by the proliferation of lymphoid precursor cells. ALL presents similarly to AML, but Auer rods are specifically associated with AML which makes it the most likely diagnosis.",
"id": "10001395",
"label": "d",
"name": "Hodgkin's lymphoma",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "AML causes anaemia and thrombocytopenia as a result of myeloid blast cells infiltrating the bone marrow. It normally presents in patients over 65 with lymphadenopathy, splenomegaly, features of anaemia (e.g. palpitations and breathlessness), neutropenia and thrombocytopenia. Auer rods are a classic finding on blood film in AML.",
"id": "10001392",
"label": "a",
"name": "Acute myeloblastic leukaemia (AML)",
"picture": null,
"votes": 67
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Myeloma is a blood disorder which occurs as a result of the proliferation of plasma cells. It presents with anaemia, acute kidney injury, hypercalcaemia and bone pain. Therefore, it does not fit the clinical picture of this patient. Furthermore, the blood film in multiple myeloma would show rouleaux formation.",
"id": "10001396",
"label": "e",
"name": "Multiple myeloma",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ALL is caused by the proliferation of lymphoid precursor cells. ALL presents similarly to AML, but Auer rods are specifically associated with AML which makes it the most likely diagnosis.",
"id": "10001393",
"label": "b",
"name": "Acute lymphoblastic leukaemia (ALL)",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Aplastic anaemia is characterised by pancytopenia and hypoplastic bone marrow. Although aplastic anaemia is a valid differential for the signs of anaemia (e.g. fatigue, palpitations), it would not explain the high white cell count in this case.",
"id": "10001394",
"label": "c",
"name": "Aplastic anaemia",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3922",
"name": "haematological malignancies",
"status": null,
"topic": {
"__typename": "Topic",
"id": "157",
"name": "Haematology",
"typeId": 7
},
"topicId": 157,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3922,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": "Acute myeloblastic leukaemia (AML)",
"highlights": [],
"id": "12825",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "An 84-year-old male presents to his GP with a sore throat. He explains that he has felt fatigued over the past 4 months, and intermittently feels his heart beating hard and fast. He also mentions that he has lost a large amount of weight. On examination, he appears cachexic and has hepatomegaly.\n\n\n\nBlood results show the following:\n\n\n||||\n|--------------|:-------:|---------------|\n|Haemoglobin|68 g/L|(M) 130 - 170, (F) 115 - 155|\n|Mean Cell Volume (MCV)|89 fL|80 - 96|\n|White Cell Count|24x10<sup>9</sup>/L|3.0 - 10.0|\n|Neutrophils|1.2x10<sup>9</sup>/L|2.0 - 7.5|\n|Lymphocytes|2x10<sup>9</sup>/L|1.5 - 4.0|\n|Monocytes|0.4x10<sup>9</sup>/L|0.2 - 1.0|\n|Eosinophils|0.1x10<sup>9</sup>/L|0 - 0.4|\n|Basophils|0.1x10<sup>9</sup>/L|0 - 0.1|\n|Platelets|80x10<sup>9</sup>/L|150 - 400|\n|Urea|6 mmol/L|2.5 - 7.8|\n|Creatinine|110 µmol/L|60 - 120|\n|Calcium|2.3 mmol/L|2.2 - 2.6|\n\n\nA blood film shows Auer rods.\n\n\n\nBased on the clinical history and the above findings, what is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 93,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,334 | false | 32 | null | 6,495,020 | null | false | [] | null | 12,826 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Patients can experience renal failure in multiple myeloma. Renal failure can result in increased thirst as the kidneys fail to concentrate urine and thus excrete more water.",
"id": "10001400",
"label": "d",
"name": "Decreased thirst",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Multiple myeloma results in thrombocytopenia due to the proliferation of plasma cells in the bone marrow which overcrowds it. Thrombocytopenia leads to an increased risk of bruising and bleeding.",
"id": "10001401",
"label": "e",
"name": "Decreased risk of bleeding",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypercalcaemia is seen in multiple myeloma, the symptoms of which can be remembered using 'bones, stones, abdominal groans and psychiatric moans'. Abdominal pain can be experienced with hypercalcaemia as a result of constipation.",
"id": "10001399",
"label": "c",
"name": "Hypocalcaemia",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Weight loss is observed in multiple myeloma, not weight gain.",
"id": "10001398",
"label": "b",
"name": "Weight gain",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Patients with multiple myeloma are anaemic. Fatigue is a manifestation of anaemia.",
"id": "10001397",
"label": "a",
"name": "Fatigue",
"picture": null,
"votes": 58
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3923",
"name": "myeloma",
"status": null,
"topic": {
"__typename": "Topic",
"id": "157",
"name": "Haematology",
"typeId": 7
},
"topicId": 157,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3923,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12826",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 55-year-old female presents to her GP with back pain. The patient undergoes serum electrophoresis and an IgG paraprotein spike is found.\n\nWhich of the following is consistent with the most likely diagnosis??",
"sbaAnswer": [
"a"
],
"totalVotes": 90,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,335 | false | 33 | null | 6,495,020 | null | false | [] | null | 12,827 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These findings are indicative of haemophilia A, an X-linked inherited bleeding disorder caused by a deficiency in factor VIII. The bleeding time is normal because it measures the response of platelets to vascular injury which is not affected in Haemophilia A.",
"id": "10001405",
"label": "d",
"name": "PT normal, APTT increased, factor VIII activity decreased, bleeding time normal",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Normally, Von Willebrand factor (VWF) protects factor VIII from proteolysis and enables contact between platelets and an injured vessel wall. In Von Willebrand disease (VWD), there are abnormalities in VWF which prevent this process from taking place. This results in reduced factor VIII activity.",
"id": "10001403",
"label": "b",
"name": "PT normal, APTT increased, factor VIII activity normal, bleeding time prolonged",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is indicative of DIC in which there is dysregulated blood clotting, resulting in increased PT, APTT and bleeding time.",
"id": "10001404",
"label": "c",
"name": "PT increased, APTT increased, factor VIII activity normal, bleeding time prolonged",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In Von Willebrand disease (VWD), the prothrombin time is normal because the extrinsic pathway of the clotting cascade is unaffected.",
"id": "10001406",
"label": "e",
"name": "PT increased, APTT increased, factor VIII activity decreased, bleeding time prolonged",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with Von Willebrand disease (VWD). Patients with VWD have abnormalities in Von Willebrand factor (VWF) which normally aids the clotting process. In VWD, there is decreased factor VIII activity which results in a normal prothrombin time (PT) and prolonged activated partial thromboplastin time (APTT). Bleeding time is also prolonged because VWF normally enables platelets to bind to exposed epithelium, and the abnormal/absent VWF in VWD prevents this.",
"id": "10001402",
"label": "a",
"name": "PT normal, APTT increased, factor VIII activity decreased, bleeding time prolonged",
"picture": null,
"votes": 37
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3924",
"name": "von Willebrand disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "157",
"name": "Haematology",
"typeId": 7
},
"topicId": 157,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3924,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12827",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 22-year-old female presents to her GP with complaints of heavy periods since the onset of menarche. She also reports lightheadedness and fatigue. She explains that her father has previously had episodes of prolonged bleeding and her twin sister also suffers from heavy periods.\n\nWhich of the following investigation findings is consistent with the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 95,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,336 | false | 34 | null | 6,495,020 | null | false | [] | null | 12,828 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In Von Willebrand disease, the prothrombin time (PT) is normal and activated partial thromboplastin time (APTT) and bleeding time are prolonged. The PT is normal because the extrinsic pathway of the clotting cascade is unaffected.",
"id": "10001411",
"label": "e",
"name": "Von Willebrand disease",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Haemophilia A is an X-linked recessive bleeding disorder, hence is primarily seen in males. It results in a deficiency in factor VIII which is involved in the intrinsic pathway of the clotting cascade, measured using activated partial thromboplastin time (APTT). It often presents in young males with haemarthrosis, as demonstrated by this patient.",
"id": "10001407",
"label": "a",
"name": "Haemophilia A",
"picture": null,
"votes": 41
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Trauma is a good differential for bleeding in joints. However, the coagulation screen suggests an underlying bleeding disorder.",
"id": "10001409",
"label": "c",
"name": "Trauma",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The hot, swollen, painful joint in this case could suggest septic arthritis. However, a patient with septic arthritis would also present with systemic symptoms such as fever and lethargy.",
"id": "10001410",
"label": "d",
"name": "Septic arthritis",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Haemophilia B is an X-linked recessive bleeding disorder that results in a deficiency in clotting factor IX. Factor IX is involved in the extrinsic pathway of the clotting cascade, which is measured using prothrombin time (PT). Haemophilia B is less common than Haemophilia A, so it is not the most likely diagnosis.",
"id": "10001408",
"label": "b",
"name": "Haemophilia B",
"picture": null,
"votes": 15
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3925",
"name": "haemophilia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "157",
"name": "Haematology",
"typeId": 7
},
"topicId": 157,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3925,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12828",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 4-year-old boy presents to A&E with a painful, hot, swollen left knee. His parents explain that he gets recurrent nosebleeds and often bruises easily. Blood results show an increased PT, increased APTT and normal bleeding time.\n\nWhat is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 97,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,337 | false | 35 | null | 6,495,020 | null | false | [] | null | 12,829 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a gene mutation associated with acute myeloid leukaemia.",
"id": "10001415",
"label": "d",
"name": "DNA (cytosine-5)-methyltransferase 3A (DNMT3A) mutation",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient has polycythaemia rubra vera. Nearly 100% of patients with polycythaemia rubra vera have a JAK2 mutation.",
"id": "10001412",
"label": "a",
"name": "JAK2",
"picture": null,
"votes": 61
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The c-myc gene is associated with Burkitt's lymphoma.",
"id": "10001414",
"label": "c",
"name": "C-myc gene translocation",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This gene mutation is associated with chronic myeloid leukaemia as there is a translocation between the BCR and ABL genes.",
"id": "10001413",
"label": "b",
"name": "BCR-ABL",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is associated with sickle cell disease, as a mutation in the haemoglobin subunit beta (HBB) gene leads to the formation of haemoglobin S instead of beta-globin.",
"id": "10001416",
"label": "e",
"name": "HBB gene mutation",
"picture": null,
"votes": 6
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3926",
"name": "polycythaemia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "157",
"name": "Haematology",
"typeId": 7
},
"topicId": 157,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3926,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12829",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 50-year-old male presents to his GP with headaches and dizziness. On further questioning, he reports feeling itchy after taking hot showers. On examination, you notice he has a plethoric face.\n\nBased on the most likely diagnosis, which of the following gene mutations would confirm the diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 88,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,338 | false | 36 | null | 6,495,020 | null | false | [] | null | 12,830 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Blood transfusions are indicated when haemoglobin is < 75g/L (< 80g/l in patients with a history of acute coronary syndrome)",
"id": "10001420",
"label": "d",
"name": "Red blood cell transfusion",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The blood results suggest iron deficiency anaemia. In a patient 60 or over, a new iron deficiency anaemia may suggest colorectal cancer, so the 2-week wait pathway should be initiated. Thrombocytosis also suggests underlying inflammation which could be caused by malignancy.",
"id": "10001417",
"label": "a",
"name": "2 week wait colonoscopy",
"picture": null,
"votes": 58
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be useful for staging malignancies such as colorectal cancer, however, it is more appropriate to carry out a colonoscopy first to confirm the diagnosis.",
"id": "10001419",
"label": "c",
"name": "CT abdomen + pelvis",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Colonoscopy is the first-line investigation in patients aged 60 or over with new onset iron deficiency anaemia. Investigations must be initiated under the 2-week wait pathway so that malignancies can be excluded or treated quickly.",
"id": "10001421",
"label": "e",
"name": "Non-urgent colonoscopy",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Iron deficiency anaemia can be treated with ferrous fumarate, however, it is more prudent to exclude malignancy in a patient aged 60 or over with new iron deficiency anaemia.",
"id": "10001418",
"label": "b",
"name": "Oral ferrous fumarate 210mg OD",
"picture": null,
"votes": 24
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3794",
"name": "Iron deficiency anaemia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "157",
"name": "Haematology",
"typeId": 7
},
"topicId": 157,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3794,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12830",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 60-year-old female presents to her GP with fatigue. She reports having palpitations and has conjunctival pallor on examination.\n\n\nHer blood results are the following:\n\n\n||||\n|--------------|:-------:|---------------|\n|Haemoglobin|80 g/L|(M) 130 - 170, (F) 115 - 155|\n|Mean Cell Volume (MCV)|70 fL|80 - 96|\n|White Cell Count|6x10<sup>9</sup>/L|3.0 - 10.0|\n|Platelets|420x10<sup>9</sup>/L|150 - 400|\n\n\nHer last blood results 1 year ago were normal.\n\n\nWhat is the most appropriate next step in the management of this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 95,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,339 | false | 37 | null | 6,495,020 | null | false | [] | null | 12,831 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is suffering from a deep vein thrombosis (DVT). Her Wells' score is 3: 1 point each for major surgery within the past 12 weeks, the symptomatic calf measuring >3cm more than the asymptomatic calf, and pitting oedema in the symptomatic calf. It is therefore likely that this patient has a DVT, and they should undergo a doppler ultrasound scan within 4 hours.",
"id": "10001422",
"label": "a",
"name": "Venous doppler ultrasound",
"picture": null,
"votes": 69
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the gold-standard investigation to diagnose a pulmonary embolism (PE). This patient does not appear to be suffering from a PE as they do not have pleuritic chest pain, dyspnoea or haemoptysis.",
"id": "10001425",
"label": "d",
"name": "CTPA",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An x-ray would not be able to visualise a thrombus, and this is not a useful investigation for DVT.",
"id": "10001426",
"label": "e",
"name": "X-ray of the leg",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This could be an appropriate treatment but is not the most appropriate investigation.",
"id": "10001424",
"label": "c",
"name": "Warfarin for 3 months",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "D-dimer is the best initial investigation for patients with a low risk of DVT (Wells' score <2). This patient has a high DVT risk, so a d-dimer would not be sufficient.",
"id": "10001423",
"label": "b",
"name": "D-dimer",
"picture": null,
"votes": 19
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3927",
"name": "deep vein thrombosis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "157",
"name": "Haematology",
"typeId": 7
},
"topicId": 157,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3927,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12831",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 60-year-old female presents to A&E with pain and swelling in her right leg. She had a hip replacement 5 weeks ago. On examination, her left calf measures 45cm whilst her right calf measures 41cm, and there is pitting oedema in her right shin. She has a history of stable angina. Her vital signs are normal.\n\nWhich of the following is the most appropriate next investigation?",
"sbaAnswer": [
"a"
],
"totalVotes": 101,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,340 | false | 38 | null | 6,495,020 | null | false | [] | null | 12,832 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Warfarin only affects the extrinsic pathway by inhibiting factors II, VII, IX and X.",
"id": "10001428",
"label": "b",
"name": "Inhibits the intrinsic pathway",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Examples of antiplatelet drugs include clopidogrel and aspirin.",
"id": "10001431",
"label": "e",
"name": "Inhibits platelet aggregation",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Anticoagulants such as apixaban inhibit Factor Xa in the common pathway.",
"id": "10001429",
"label": "c",
"name": "Factor Xa inhibitor",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Examples of direct thrombin inhibitors include dabigatran.",
"id": "10001430",
"label": "d",
"name": "Inhibits thrombin",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Warfarin acts on the extrinsic pathway by inhibiting factors II, VII, IX and X. This is because warfarin inhibits vitamin K epoxide reductase, reducing the levels of vitamin K available to activate factors II, VII, IX and X. A useful mnemonic is 1972 WEPT where 1972 refers to factors 10, 9, 7 and 2 being inhibited, and W = Warfarin, E = extrinsic pathway affected, PT = PT prolonged.",
"id": "10001427",
"label": "a",
"name": "Factor II, VII, IX, X inhibitor",
"picture": null,
"votes": 77
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3928",
"name": "coagulation cascade",
"status": null,
"topic": {
"__typename": "Topic",
"id": "157",
"name": "Haematology",
"typeId": 7
},
"topicId": 157,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3928,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12832",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 70-year-old female with a deep vein thrombosis (DVT) is prescribed warfarin as treatment.\n\nWhat is the mechanism of action of warfarin?",
"sbaAnswer": [
"a"
],
"totalVotes": 99,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,341 | false | 39 | null | 6,495,020 | null | false | [] | null | 12,833 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The transfusion must be stopped or slowed to prevent the progression of fluid overload into pulmonary oedema. A chest x-ray might help show pulmonary oedema but is not an appropriate first-line management as the fluid overload needs to be reversed with furosemide.",
"id": "10001436",
"label": "e",
"name": "Stop the transfusion and order a chest x-ray",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Continuing the transfusion might worsen the fluid overload, increasing the risk of pulmonary oedema and worsening symptoms. The transfusion should be stopped and fluid overload treated with IV furosemide.",
"id": "10001433",
"label": "b",
"name": "Continue the transfusion and review in 30 minutes",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is suffering from transfusion-associated circulatory overload(TACO) as a complication of the blood transfusion. This is more likely to occur in patients with a history of cardiovascular disease. The aim of TACO treatment is to reverse the fluid overload through the use of diuretics.",
"id": "10001432",
"label": "a",
"name": "Stop the transfusion and administer 30mg IV furosemide",
"picture": null,
"votes": 57
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the treatment for anaphylaxis which can also be a complication of blood transfusions. A patient with anaphylaxis would present with dyspnoea, wheeze, angioedema and hypotension.",
"id": "10001434",
"label": "c",
"name": "Stop the transfusion and administer IM adrenaline",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Furosemide is indicated to treat the fluid overload, but the IV route is favoured over oral as it has a higher bioavailability and faster onset.",
"id": "10001435",
"label": "d",
"name": "Stop the transfusion and administer 30g oral furosemide",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3929",
"name": "Blood Transfusion",
"status": null,
"topic": {
"__typename": "Topic",
"id": "157",
"name": "Haematology",
"typeId": 7
},
"topicId": 157,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3929,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12833",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 52-year-old female is in hospital following surgery for renal cell carcinoma. Bloods showed Hb levels of 69g/L (normal range 115 - 155 g/L), so 1 unit of blood is transfused. Following the blood transfusion, she develops progressively worsening shortness of breath. On auscultation, bilateral crackles are heard at the lung bases. She has a past medical history of stable angina. Vital signs are normal apart from a blood pressure of 147/81.\n\n\nWhat is the most appropriate management for this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 93,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,342 | false | 40 | null | 6,495,020 | null | false | [] | null | 12,834 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "D-dimer is high in DIC because it is a fibrin degradation product and fibrinolysis occurs in DIC.",
"id": "10001439",
"label": "c",
"name": "Low platelets, low fibrinogen, raised APTT, low d-dimer",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "APTT is raised in DIC because fibrinolysis is taking place. Fibrinogen and fibrin are key components of the intrinsic clotting pathway, therefore the consumption of these clotting products in DIC results in a prolonged APTT.",
"id": "10001440",
"label": "d",
"name": "Low platelets, low fibrinogen, normal APTT, low d-dimer",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Fibrinogen is low in DIC because fibrinolysis is activated which results in the consumption of fibrin and fibrinogen.",
"id": "10001441",
"label": "e",
"name": "Low platelets, high fibrinogen, raised APTT, raised d-dimer",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Platelets are low in DIC because the activation of the clotting pathway leads to excess thrombus formation which consumes platelets.",
"id": "10001438",
"label": "b",
"name": "High platelets, low fibrinogen, raised APTT, raised d-dimer",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient has DIC. In DIC, the coagulation pathway is activated throughout the body which consumes platelets and clotting factors and leads to a low platelet count. Fibrinogen is low because fibrinolysis is activated, and d-dimer is high as it is a fibrin degradation product.",
"id": "10001437",
"label": "a",
"name": "Low platelets, low fibrinogen, raised APTT, raised d-dimer",
"picture": null,
"votes": 46
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3930",
"name": "disseminated intravascular coagulation",
"status": null,
"topic": {
"__typename": "Topic",
"id": "157",
"name": "Haematology",
"typeId": 7
},
"topicId": 157,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3930,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12834",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 42-year-old male is admitted to the hospital with sepsis following surgery for colorectal cancer.\n\nHis respiratory rate is 25, oxygen saturations are 92%, heart rate is 120bpm, and temperature is 38.2.\n\nOn examination, he is not oriented to time and place, and a purpuric rash is noted over his arms. There is also blood oozing from his cannula sites. His past medical history is unremarkable.\n\nWhich of the following is most likely to be his blood results?",
"sbaAnswer": [
"a"
],
"totalVotes": 89,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,343 | false | 41 | null | 6,495,020 | null | false | [] | null | 12,835 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "If the right coronary artery was involved, the ST elevation would be seen in the inferior leads: II, III and AVf.",
"id": "10001444",
"label": "c",
"name": "Right coronary artery STEMI",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Unstable angina is a good differential due to the chest pain relieved by GTN spray, however unstable angina is often brought on without triggers such as exercise. Furthermore, the ECG changes, in this case, are more suggestive of a STEMI.",
"id": "10001446",
"label": "e",
"name": "Unstable angina",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although this patient experienced chest pain on exertion which was relieved by GTN spray, the ECG changes and pain radiation are more suggestive of a STEMI.",
"id": "10001443",
"label": "b",
"name": "Stable angina",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The chest pain and ST elevation here suggest that the patient is having a STEMI. The V1-V4 ECG leads view the heart from the anteroseptal plane, so it is most likely that the left anterior descending artery is blocked.",
"id": "10001442",
"label": "a",
"name": "Left anterior descending artery STEMI",
"picture": null,
"votes": 84
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "If the left circumflex artery was involved, ST elevation would be seen in the lateral leads; I, AVL, V5 and V6.",
"id": "10001445",
"label": "d",
"name": "Left circumflex artery infarct causing STEMI",
"picture": null,
"votes": 1
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3802",
"name": "Myocardial Infarction",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3802,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12835",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 60-year-old male presents to A&E with central crushing chest pain that has been ongoing for 1 hour. He says the pain came on while he was playing tennis. The pain radiates to his left arm and his jaw.\n\nThe paramedics gave him GTN spray in the ambulance which reduces the severity of his symptoms. An ECG is done which shows ST elevation in V1 - V4.\n\nWhat is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 98,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,344 | false | 42 | null | 6,495,020 | null | false | [] | null | 12,836 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Only patients with abdominal aortic aneurysm diameters <3cm can be discharged with no further action.",
"id": "10001451",
"label": "e",
"name": "No further action",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is good advice for patients who smoke, but may only impact the growth in a low rupture-risk patient. It is more important that the patient undergoes surgery within 2 weeks to prevent rupture.",
"id": "10001450",
"label": "d",
"name": "Smoking cessation advice",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Medium aneurysms (4.5-5.4cm) are normally rescanned every 3 months as a part of the screening programme. However, the diameter of this man's abdominal aorta has increased by >1cm within a year, so the patient has a high rupture risk and must be treated.",
"id": "10001448",
"label": "b",
"name": "Repeat ultrasound in 3 months",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient has a high rupture risk because his abdominal aorta is rapidly enlarging and has increased by >1cm within a year. Therefore, this patient must be treated with EVAR or open repair despite being asymptomatic.",
"id": "10001447",
"label": "a",
"name": "Urgent 2-week referral to vascular surgery for intervention",
"picture": null,
"votes": 72
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The diameter of the abdominal aorta has increased by >1cm within a year, so the patient has a high rupture risk and must be treated.",
"id": "10001449",
"label": "c",
"name": "Repeat ultrasound in 12 months",
"picture": null,
"votes": 2
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3931",
"name": "abdominal aortic aneurysms",
"status": null,
"topic": {
"__typename": "Topic",
"id": "179",
"name": "Vascular Surgery",
"typeId": 7
},
"topicId": 179,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3931,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12836",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 65-year-old patient attends his abdominal aortic aneurysm monitoring appointment. 12 months ago, his abdominal aortic aneurysm diameter measured 4.2cm, today it measures 5.3cm. He has a 25-pack-year smoking history. His vital signs are normal and he is well in himself.\n\nWhich of the following is the most appropriate management?",
"sbaAnswer": [
"a"
],
"totalVotes": 97,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,345 | false | 43 | null | 6,495,020 | null | false | [] | null | 12,837 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A high-pitched early diastolic murmur would be heard on auscultation aortic regurgitation.",
"id": "10001456",
"label": "e",
"name": "Aortic regurgitation",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A pan-systolic murmur loudest on inspiration would be heard on auscultation in tricuspid regurgitation.",
"id": "10001455",
"label": "d",
"name": "Tricuspid regurgitation",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A pan-systolic murmur radiating to the axilla would be heard on auscultation in mitral regurgitation.",
"id": "10001454",
"label": "c",
"name": "mitral regurgitation",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An ejection systolic murmur would be heard on auscultation in aortic stenosis and may radiate to the carotid arteries.",
"id": "10001453",
"label": "b",
"name": "Aortic stenosis",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is experiencing shortness of breath and dizziness alongside a mid-diastolic murmur which indicates mitral stenosis. Other symptoms of mitral stenosis include haemoptysis and chest pain.",
"id": "10001452",
"label": "a",
"name": "Mitral stenosis",
"picture": null,
"votes": 72
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3720",
"name": "Mitral stenosis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3720,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12837",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 70-year-old female presents to her GP with a 3-month history of worsening shortness of breath. She also describes intermittent palpitations before episodes of dizziness.\n\nAuscultation of the heart reveals a mid-diastolic murmur which is loudest in the apex and louder on expiration with the patient laying on her left side. The patient appears comfortable at rest and her vital signs are normal.\n\nWhat is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 99,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,346 | false | 44 | null | 6,495,020 | null | false | [] | null | 12,838 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Amiodarone may cause hyper or hypothyroidism, but it is more likely to cause hypothyroidism than hyperthyroidism.",
"id": "10001457",
"label": "a",
"name": "Hyperthyroidism",
"picture": null,
"votes": 60
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Amiodarone use may cause a slate-grey appearance to the skin.",
"id": "10001460",
"label": "d",
"name": "Green discolouration of the skin",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Amiodarone can cause pneumonitis which can develop into pulmonary fibrosis, a restrictive lung pathology.",
"id": "10001461",
"label": "e",
"name": "Pneumonia",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Amiodarone may cause hypotension in acute settings due to vasodilation.",
"id": "10001459",
"label": "c",
"name": "Hypertension",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Amiodarone does not contribute to the development of obstructive lung diseases such as asthma.",
"id": "10001458",
"label": "b",
"name": "Asthma",
"picture": null,
"votes": 4
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3695",
"name": "Side effects of amiodarone",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3695,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12838",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 44-year-old male has been started on amiodarone for ventricular tachycardia.\n\nWhich of the following is a side effect of amiodarone therapy?",
"sbaAnswer": [
"a"
],
"totalVotes": 98,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,347 | false | 45 | null | 6,495,020 | null | false | [] | null | 12,839 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In chronic limb ischaemia, patients gradually develop a reduced blood supply to the limbs as a result of atherosclerosis. This patient presents with factors suggesting chronic limb ischaemia such as a smoking history and pain. However, the sudden onset nature of the pain is suggestive of acute limb ischaemia, as opposed to chronic. Furthermore, chronic limb ischaemia typically presents with intermittent claudication which is triggered by exercise and relieved by rest.",
"id": "10001463",
"label": "b",
"name": "Chronic limb ischaemia",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Compartment syndrome usually occurs secondary to trauma which this patient does not have a history of.",
"id": "10001466",
"label": "e",
"name": "Compartment syndrome",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is suffering from acute limb ischaemia characterised by sudden onset pain caused by the blockage of the arterial supply to the foot. The features of acute limb ischaemia can be remembered using the 6 Ps: pain, pallor, paresthesia, pulselessness, perishingly cold and paralysis.",
"id": "10001462",
"label": "a",
"name": "Acute limb ischaemia",
"picture": null,
"votes": 61
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Patients with critical limb ischaemia typically present with worsening pain and ischaemic lesions such as ulcers. A patient with critical limb ischaemia would be expected to experience pain at rest for more than 2 weeks.",
"id": "10001464",
"label": "c",
"name": "Critical limb ischaemia",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient does not present with risk factors for deep vein thrombosis (DVT). In a patient with DVT, you would not expect the foot to be pulseless, cold and pale; it is more likely to be swollen, red and warm.",
"id": "10001465",
"label": "d",
"name": "Deep vein thrombosis",
"picture": null,
"votes": 4
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3932",
"name": "acute limb ischaemia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "179",
"name": "Vascular Surgery",
"typeId": 7
},
"topicId": 179,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3932,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12839",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 66-year-old female presents to A&E with sudden onset pain in her right foot. On examination, the foot is cold and pale, and the posterior tibial pulse is absent. Her past medical history includes hypertension and diabetes. She takes statins once daily and has a 15-pack-year smoking history.\n\nWhat is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 99,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,348 | false | 46 | null | 6,495,020 | null | false | [] | null | 12,840 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient has a CHADS-VASc score of 3.",
"id": "10001470",
"label": "d",
"name": "1",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient has a CHADS-VASc score of 3.",
"id": "10001471",
"label": "e",
"name": "6",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The CHADS2VASc score is based on the following components:\n\n* C: 1 point for congestive cardiac failure.\n* H: 1 point for hypertension.\n* A2: 2 points if the patient is aged 75 or over.\n* D: 1 point if the patient has diabetes mellitus.\n* S2: 2 points if the patient has previously had a stroke or transient ischaemic attack (TIA).\n* V: 1 point if the patient has known vascular disease.\n* A: 1 point if the patient is aged 65-74.\n* Sc: 1 point if the patient is female.\n\nThis patient scores 1 for being aged 65-74, 1 for hypertension and 1 for diabetes.",
"id": "10001467",
"label": "a",
"name": "3",
"picture": null,
"votes": 48
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient has a CHADS-VASc score of 3.",
"id": "10001469",
"label": "c",
"name": "4",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient has a CHADS-VASc score of 3.",
"id": "10001468",
"label": "b",
"name": "2",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3714",
"name": "Atrial fibrillation",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3714,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12840",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 66-year-old male presents to his GP with a 6-month history of intermittent palpitations and breathlessness. He has a past medical history of hypertension and type 2 diabetes. On examination, his vitals are normal apart from a blood pressure of 142/84. An ECG is done which shows atrial fibrillation.\n\nWhat is this patient's CHADS-VASc?",
"sbaAnswer": [
"a"
],
"totalVotes": 93,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,349 | false | 47 | null | 6,495,020 | null | false | [] | null | 12,841 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Anterior inferior cerebellar artery occlusion would result in lateral pontine syndrome. Patients also tend to experience facial paralysis and deafness.",
"id": "10001474",
"label": "c",
"name": "Right anterior inferior cerebellar artery",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Posterior cerebral artery occlusion would result in visual field defects such as contralateral homonymous hemianopia, and sensory impairment such as facial numbness.",
"id": "10001475",
"label": "d",
"name": "Left posterior cerebral artery",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Basilar artery occlusion would result in locked-in syndrome, characterised by quadriparesis with preserved consciousness and ocular movements.",
"id": "10001473",
"label": "b",
"name": "Basilar artery",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Occlusion in the ophthalmic artery would result in amaurosis fugax.",
"id": "10001476",
"label": "e",
"name": "Ophthalmic artery",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is having a stroke, specifically a lateral medullary syndrome (Wallenberg's syndrome). The features of Wallenberg's syndrome can be remembered using the DANVAH mnemonic: **D**ysphagia, ipsilateral **a**taxia, ipsilateral **n**ystagmus, **v**ertigo, **a**naesthesia (ipsilateral facial numbness and contralateral loss of pain sensation in the body), and ipsilateral **H**orner's syndrome.",
"id": "10001472",
"label": "a",
"name": "Right posterior inferior cerebellar artery",
"picture": null,
"votes": 38
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3933",
"name": "stroke",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3933,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12841",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 60-year-old female presents to A&E with sudden onset right-sided facial numbness. On examination, her gait is unsteady and she has right-sided ptosis, meiosis and anhidrosis. She also reports dizziness with the sensation of the room spinning. She has a past medical history of hypertension and hypercholesterolaemia. Her vital signs are within normal ranges.\n\nBased on the most likely diagnosis, which of the following arteries is most likely to be affected?",
"sbaAnswer": [
"a"
],
"totalVotes": 98,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,350 | false | 48 | null | 6,495,020 | null | false | [] | null | 12,842 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the most likely causative organism in patients with poor dental hygiene or following a dental procedure.",
"id": "10001480",
"label": "d",
"name": "*Streptococcus viridans *",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the most likely causative organism in patients with adenomas/adenocarcinomas of the colon and IBD.",
"id": "10001479",
"label": "c",
"name": "*Streptococcus bovis*",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "*Staphylococcus aureus* is the most common cause of infective endocarditis and is most associated with IV drug use (this patient has signs of IV drug use, indicated by her needle track marks).",
"id": "10001477",
"label": "a",
"name": "*Staphylococcus aureus*",
"picture": null,
"votes": 83
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the most likely causative organism in patients who have been in contact with farm animals, cats and dogs.",
"id": "10001481",
"label": "e",
"name": "*Coxiella burnetti*",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the most likely causative organism in patients with prosthetic valves.",
"id": "10001478",
"label": "b",
"name": "*Staphylococcus epidermis *",
"picture": null,
"votes": 9
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3710",
"name": "Infective Endocarditis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3710,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12842",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 40-year-old female presents to A&E with chest pain. She has a heart rate of 110 bpm, respiratory rate of 22 breaths per minute, blood pressure of 110/70, temperature of 38.7 and oxygen saturations are 94% on room air.\n\nOn examination, she appears drowsy but is responsive to voice. There are needle track marks in her antecubital fossae. On auscultation of her chest, an ejection systolic murmur is heard.\n\nShe is diagnosed with infective endocarditis.\n\nWhich of the following pathogens is most likely to be the cause of her infective endocarditis?",
"sbaAnswer": [
"a"
],
"totalVotes": 99,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,351 | false | 49 | null | 6,495,020 | null | false | [] | null | 12,843 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient has stable angina; a stress echocardiogram can be used as a 2nd line investigation if the results of a CTCA are not diagnostic.",
"id": "10001484",
"label": "c",
"name": "Stress echocardiography",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient has stable angina as indicated by the constriction-like chest pain brought on by exertion and relieved by rest. The first-line diagnostic investigation is CTCA.",
"id": "10001482",
"label": "a",
"name": "CT coronary angiogram (CTCA)",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient has stable angina; a myocardial perfusion scan can be used as a 2nd line investigation if the results of a CTCA are not diagnostic.",
"id": "10001486",
"label": "e",
"name": "Myocardial perfusion scan",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Based on the normal troponin levels and chest pain exacerbated by exercise and relieved by rest, it is likely that this patient has stable angina. An ECG would not be useful in confirming the diagnosis of stable angina.",
"id": "10001483",
"label": "b",
"name": "ECG",
"picture": null,
"votes": 40
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A chest x-ray would not provide a view of the heart with enough detail to be able to diagnose stable angina.",
"id": "10001485",
"label": "d",
"name": "Chest x-ray",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3721",
"name": "Stable angina",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3721,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12843",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 45-year-old male presents to his GP with a 6-month history of intermittent chest pain. He describes the pain as 'chest tightening' and explains that it is triggered on exertion and relieved by rest. He is referred to A&E where blood tests reveal a normal troponin.\n\nBased on the most likely diagnosis, what is the first-line diagnostic investigation to request?",
"sbaAnswer": [
"a"
],
"totalVotes": 99,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,352 | false | 50 | null | 6,495,020 | null | false | [] | null | 12,844 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "P waves are flat on ECG in hyperkalaemia.",
"id": "10001489",
"label": "c",
"name": "Tall P waves",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "U waves are found on ECG in hypocalcaemia and hypothermia.",
"id": "10001490",
"label": "d",
"name": "U waves",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a characteristic ECG finding in hyperkalaemia.",
"id": "10001487",
"label": "a",
"name": "Tall tented T waves",
"picture": null,
"votes": 95
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The QRS complex is widened on ECG in hyperkalaemia.",
"id": "10001488",
"label": "b",
"name": "Narrow QRS complex",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The PR interval is prolonged on ECG in hyperkalaemia.",
"id": "10001491",
"label": "e",
"name": "Shortened PR interval",
"picture": null,
"votes": 1
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3934",
"name": "hyperkalaemia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "170",
"name": "Clinical Chemistry",
"typeId": 7
},
"topicId": 170,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3934,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12844",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 60-year-old female presents to clinic with chest pain. She has a history of AKI. She reports muscle weakness in her lower limbs and intermittent palpitations. Blood results show hyperkalaemia.\n\nWhich of the following findings are most likely to be found on her ECG?",
"sbaAnswer": [
"a"
],
"totalVotes": 99,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
Subsets and Splits