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173,460,355 | false | 1 | null | 6,495,022 | null | false | [] | null | 12,845 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a good broad-spectrum antibiotic and is used first-line in conditions such as sepsis, where the offending pathogen is unknown, or if cultures and sensitivities are pending. It covers both aerobic and anaerobic bacteria. However, this question asks specifically about anaerobic cover used in c.diff infection, of which metronidazole is the antibiotic of choice according to NICE guidelines. This patient is also allergic to penicillin. Therefore, this antibiotic should be avoided.",
"id": "10001493",
"label": "b",
"name": "Piperacillin with tazobactam (tazocin)",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Monotherapy with either nitrofurantoin or trimethoprim is used first-line in the management of urinary tract infections. Nitrofurantoin covers gram-negative and some gram-positive aerobic bacteria. However, this question asks specifically about anaerobic cover used in c.diff infection, of which metronidazole is the antibiotic of choice according to NICE guidelines.",
"id": "10001494",
"label": "c",
"name": "Nitrofurantoin",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "IV metronidazole is used alongside oral vancomycin in the management of severe *c.difficile* infection. Metronidazole is that it is the mainstay treatment for anaerobic bacteria due to its mechanism of action of being cytotoxic to anaerobic microbes. It is therefore used in conditions such as *c.difficile* and also diverticulitis.",
"id": "10001492",
"label": "a",
"name": "Metronidazole",
"picture": null,
"votes": 112
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Flucloxacillin is the first-line management for cellulitis in non-penicillin allergic patients. It has activity against gram-positive and gram-negative aerobic and anaerobic bacteria. However, this question asks specifically about anaerobic cover used in c.diff infection, of which metronidazole is the antibiotic of choice according to NICE guidelines. This patient is also allergic to penicillin therefore this antibiotic should be avoided.",
"id": "10001496",
"label": "e",
"name": "Flucloxacillin",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ceftriaxone is used first-line in the management of meningococcal meningitis. Although ceftriaxone has coverage against both gram-positive and gram-negative aerobic and anaerobic bacteria, β-lactam antibiotics such as ceftriaxone should be used with caution in patients with known anaphylaxis to penicillins due to structural similarities. In addition, this question asks specifically about anaerobic cover used in c.diff infection, of which metronidazole is the antibiotic of choice according to NICE guidelines.",
"id": "10001495",
"label": "d",
"name": "Ceftriaxone",
"picture": null,
"votes": 45
}
],
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"id": "3935",
"name": "Clostridium difficile",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
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"question": "A 78-year-old man has severe clostridium difficile (*c.difficile*) and is prescribed an antibiotic that specifically targets anaerobic bacteria. He has previously had an anaphylactic reaction to amoxicillin.\n\nWhich antibiotic is he most likely to have been prescribed?",
"sbaAnswer": [
"a"
],
"totalVotes": 198,
"typeId": 1,
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173,460,356 | false | 2 | null | 6,495,022 | null | false | [] | null | 12,846 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Monotherapy with either trimethoprim or nitrofurantoin is first-line in the management of urinary tract infection according to NICE guidelines. Pivmecillinam is used second-line if no improvement is seen in lower UTI symptoms after taking the first-line antibiotic taken for at least 48 hours, or when the first choice is not suitable.",
"id": "10001500",
"label": "d",
"name": "Pivmecillinam",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Monotherapy with either trimethoprim or nitrofurantoin is first-line in the management of urinary tract infections according to NICE guidelines. Trimethoprim works by inhibiting folic acid production. This patient is already established on methotrexate for rheumatoid arthritis. Methotrexate is an anti-folate drug, and therefore other anti-folate drugs should be avoided. Examples of anti-folate drugs include methotrexate, trimethoprim, pemetrexed and proguanil (anti-malarial). Patients taking anti-folate medication should be counselled on their medication and have supplemental folic acid on a different day to their methotrexate dose.",
"id": "10001497",
"label": "a",
"name": "Trimethoprim",
"picture": null,
"votes": 110
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Monotherapy with either trimethoprim or nitrofurantoin is first-line in the management of urinary tract infection according to NICE guidelines. Common side effects of gentamicin include ototoxicity and nephrotoxicity. Gentamicin is not used in the treatment of a simple urinary tract infection.",
"id": "10001499",
"label": "c",
"name": "Gentamicin",
"picture": null,
"votes": 44
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Monotherapy with either trimethoprim or nitrofurantoin is first-line in the management of urinary tract infection according to NICE guidelines. Cefalexin is used second-line in pregnant women aged 12+ if no improvement is seen in lower UTI symptoms on first-line antibiotic taken for at least 48 hours, or when the first choice is not suitable.",
"id": "10001501",
"label": "e",
"name": "Cefalexin",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Monotherapy with either trimethoprim or nitrofurantoin is first-line in the management of urinary tract infections according to NICE guidelines. This patient is likely to be commenced on nitrofurantoin for management of her UTI.",
"id": "10001498",
"label": "b",
"name": "Nitrofurantoin",
"picture": null,
"votes": 26
}
],
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3936",
"name": "Methotrexate",
"status": null,
"topic": {
"__typename": "Topic",
"id": "146",
"name": "Rheumatology",
"typeId": 7
},
"topicId": 146,
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"question": "A 57-year-old female attends the rheumatology outpatient department for a review of her methotrexate. She mentions that she has been experiencing burning when passing urine. She is diagnosed with a urinary tract infection (UTI). The doctor is aware that caution must be taken when prescribing a specific antibiotic.\n\nTo which antibiotic is he referring?",
"sbaAnswer": [
"a"
],
"totalVotes": 188,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,357 | false | 3 | null | 6,495,022 | null | false | [] | null | 12,847 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Glucagon is a hormone involved in blood sugar regulation, but it is not deficient in type 1 diabetes. In fact, it actually counteracts the actions of insulin by stimulating hepatic glucose production and thereby increasing blood glucose levels.",
"id": "10001504",
"label": "c",
"name": "Glucagon",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Lipase is an enzyme secreted by the pancreas and transferred to the duodenum to participate in the hydrolysis and digestion of fat, cholesterol esters, and fat-soluble vitamins. It is not involved in the regulation or transport of glucose from the blood into cells.",
"id": "10001506",
"label": "e",
"name": "Lipase",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Glucose is not a hormone. It is the breakdown molecule of food such as carbohydrates. It is the molecule on which insulin acts. Glucose levels in the blood are high in type 1 diabetes due to the absolute deficiency of insulin and the subsequent inability of the body to transport glucose intracellularly.",
"id": "10001503",
"label": "b",
"name": "Glucose",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The diagnosis for this patient is Type 1 Diabetes Mellitus. In type 1 diabetes, the immune system targets and destroys the insulin-producing cells of the pancreas. When food is eaten, the body breaks down food into molecules, one of which is glucose. Insulin is responsible for stimulating cells to take up this glucose from the bloodstream into insulin-dependent cells/tissues, such as the liver, muscle, and adipose tissue.",
"id": "10001502",
"label": "a",
"name": "Insulin",
"picture": null,
"votes": 192
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Amylase is an enzyme produced by the pancreas. It hydrolyzes the glycosidic bonds in starch molecules, converting complex carbohydrates to simple sugars. It is not involved in the regulation or transport of glucose from the blood into cells.",
"id": "10001505",
"label": "d",
"name": "Amylase",
"picture": null,
"votes": 0
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3937",
"name": "Type 1 Diabetes",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
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"question": "A 14-year-old boy presents with weight loss and increased thirst. He is diagnosed with an autoimmune condition affecting his body's ability to regulate blood sugar.\n\nGiven the likely diagnosis, which hormone is deficient in this condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 193,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,358 | false | 4 | null | 6,495,022 | null | false | [] | null | 12,848 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Vitamin B12 is needed to form red blood cells and DNA. It is also a key player in the function and development of brain and nerve cells. In a clinical context, B12 deficiency usually gives rise to a macrocytic anaemia, but does not have a role as an inflammatory marker.",
"id": "10001508",
"label": "b",
"name": "Vitamin B12",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Troponin is a protein involved in cardiac muscle contractility. It is raised in the context of cardiac muscle damage such as during a myocardial infarction (MI). However, it is not measured as an inflammatory marker in polymyalgia rheumatica.",
"id": "10001511",
"label": "e",
"name": "Troponin",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Potassium, along with sodium, has a key role in regulating the level of fluid within our cells. It may be raised in kidney injury, however it is not measured as an inflammatory marker in polymyalgia rheumatica.",
"id": "10001510",
"label": "d",
"name": "Potassium",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "C-reactive Protein (CRP) is an acute-phase protein (APP) released from the liver in response to interleukin-6 (IL-6) secretion by macrophages and T-cells during inflammatory processes in the body.",
"id": "10001507",
"label": "a",
"name": "CRP",
"picture": null,
"votes": 178
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Creatinine is released into the bloodstream as a skeletal muscle waste product. The kidneys then filter the creatinine out of the blood and into the urine. Creatinine may be elevated in kidney injury, but it is not measured as an inflammatory marker in polymyalgia rheumatica.",
"id": "10001509",
"label": "c",
"name": "Creatinine",
"picture": null,
"votes": 8
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3938",
"name": "Polymyalgia Rheumatica",
"status": null,
"topic": {
"__typename": "Topic",
"id": "146",
"name": "Rheumatology",
"typeId": 7
},
"topicId": 146,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"difficulty": 1,
"dislikes": 0,
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"question": "A patient presents with pain in her shoulders and hips which is worse in the morning but relieved on exercise. The doctor diagnoses polymyalgia rheumatica.\n\nWhich of the following markers is the GP most likely to measure in order to assess inflammation?",
"sbaAnswer": [
"a"
],
"totalVotes": 190,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,359 | false | 5 | null | 6,495,022 | null | false | [] | null | 12,849 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This option does not contain the correct combination of parameters for the MDRD equation. Another parameter used in the calculation of the glomerular filtration rate is \"inulin clearance\" which is considered the gold standard in estimating the GFR. It depends on measuring the clearance of inulin from the bloodstream which is 100% excreted via the glomeruli and, although gold standard, it has its own practical challenges as it requires an inulin infusion and urine collection for hours.",
"id": "10001515",
"label": "d",
"name": "Sex, serum potassium, inulin, age",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This option has substituted \"serum creatinine\" for \"serum potassium\" so therefore does not contain the correct combination of parameters for the MDRD equation.",
"id": "10001516",
"label": "e",
"name": "Age, sex, serum potassium and race",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This option has substituted \"serum creatinine\" for \"weight\" so therefore does not contain the correct combination of parameters for the MDRD equation. Another equation used in the calculation of the glomerular filtration rate is the Cockcroft-Gualt equation which uses age, weight, sex, creatinine and race. However, its use is inaccurate in pregnancy, amputation, extremes of weight and low/high protein diets.",
"id": "10001513",
"label": "b",
"name": "Weight, age, race and sex",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The Modification of Diet in Renal Disease Study Group (MDRD) equation is a method used for estimating kidney function in patients. It involves four parameters - age, sex, serum creatinine and race. It is important to note that it will be inaccurate in pregnancy, amputation, extremes of weight and low/high protein diets.",
"id": "10001512",
"label": "a",
"name": "Age, sex, serum creatinine and race",
"picture": null,
"votes": 88
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This option has substituted \"race\" for \"weight\" therefore does not contain the correct combination of parameters for the MDRD equation. Another equation used in the calculation of the glomerular filtration rate is the Cockcroft-Gualt equation which uses age, weight, sex, creatinine and race. However, its use is inaccurate in pregnancy, amputation, extremes of weight and low/high protein diets.",
"id": "10001514",
"label": "c",
"name": "Weight, sex, serum creatinine, age",
"picture": null,
"votes": 65
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
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},
"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,
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"question": "The GP decides to calculate the eGFR of a patient with known chronic kidney disease (CKD). He uses the MDRD equation.\n\nWhich parameters are included in this equation?",
"sbaAnswer": [
"a"
],
"totalVotes": 176,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,360 | false | 6 | null | 6,495,022 | null | false | [] | null | 12,850 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Amlodipine is a calcium-channel blocker (CCB) used to treat high blood pressure and coronary artery disease. It is taken by mouth. Common side effects include peripheral oedema, feeling tired, abdominal pain, and nausea. Electrolyte disturbances to be aware of, although rare, are hyponatraemia and hyperkalaemia. Hyperkalaemia has only been known to occur in patients who have known kidney disease which this patient does not have.",
"id": "10001520",
"label": "d",
"name": "Amlodipine",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Atorvastatin is a statin medication taken by mouth. It is used as both primary and secondary prevention of cardiovascular disease in those at high risk of ischaemia and to treat abnormal lipid levels. It is known to increase creatine kinase (CK) levels in patients also taking macrolide antibiotics due to the interaction that causes myopathy. The most reported electrolyte abnormalities related to statins are hypokalemia, hypomagnesemia, and hypocalcemia.",
"id": "10001518",
"label": "b",
"name": "Atorvastatin",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The patient is presenting with hyperkalaemia. Spironolactone is a potassium-sparing diuretic which is used to offload fluid for patients with oedema and also has antihypertensive effects. Spironolactone competitively inhibits aldosterone-dependant sodium-potassium exchange channels in the distal convoluted tubule. This action leads to increased sodium and water excretion, but more potassium retention, which predisposes patients to hyperkalaemia.",
"id": "10001517",
"label": "a",
"name": "Spironolactone",
"picture": null,
"votes": 147
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cetirizine is a second-generation antihistamine used to treat allergic rhinitis, dermatitis, and urticaria. Non-sedating antihistamines such as cetirizine hydrochloride cause less sedation and psychomotor impairment than the older antihistamines. They have not been reported to affect the concentration of electrolytes within the body.",
"id": "10001521",
"label": "e",
"name": "Cetirizine",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Paracetamol is a medication used to treat fever and mild to moderate pain. Adverse effects include liver impairment, particularly if taken in excessive quantities or if a patient has a body weight <50kg. It is not known to cause electrolyte disturbances.",
"id": "10001519",
"label": "c",
"name": "Paracetamol",
"picture": null,
"votes": 0
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"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,
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"question": "A patient has an ECG performed which shows tall tented T-waves. He is currently on maximum treatment for hypertension and his drug history includes atorvastatin, amlodipine, paracetamol, cetirizine and spironolactone. He has no significant past medical history.\n\nGiven the most likely electrolyte abnormality, which of these medications is most likely to be causing this side effect?",
"sbaAnswer": [
"a"
],
"totalVotes": 175,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,361 | false | 7 | null | 6,495,022 | null | false | [] | null | 12,851 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These produce mucus to protect the stomach lining.",
"id": "10001526",
"label": "e",
"name": "Goblet cells",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These secrete pepsinogen which helps break down proteins.",
"id": "10001524",
"label": "c",
"name": "Chief cells",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "These produce somatostatin which works to inhibit gastric acid secretion.",
"id": "10001522",
"label": "a",
"name": "D-cells",
"picture": null,
"votes": 121
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These secrete gastric acid (hydrochloric acid) to maintain the acidity of the stomach crucial to its role in digestion.",
"id": "10001525",
"label": "d",
"name": "Parietal cells",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These produce gastrin which works in the opposite way to somatostatin. Gastrin stimulates acid secretion.",
"id": "10001523",
"label": "b",
"name": "G-cells",
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"question": "Within the wall of the stomach are the gastric pits.\n\nWhich of the following cells are involved in secreting the enzyme somatostatin which is responsible for inhibiting gastric acid secretion?",
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"a"
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173,460,362 | false | 8 | null | 6,495,022 | null | false | [] | null | 12,852 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an example of a primary protein structure. Amino acid chains are held together by peptide bonds.",
"id": "10001528",
"label": "b",
"name": "Amino acid chain",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an example of a tertiary protein structure. Tertiary structures consist of four bonds - ionic bonds, disulfide bridges, hydrophobic forces and hydrogen bonds.",
"id": "10001530",
"label": "d",
"name": "Myoglobin",
"picture": null,
"votes": 5
},
{
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"answer": true,
"explanation": "Beta-sheets are an example of a secondary protein structure. Both beta sheets and alpha helices are examples of secondary protein structures, and these are held together by hydrogen bonds.",
"id": "10001527",
"label": "a",
"name": "Beta-sheets",
"picture": null,
"votes": 130
},
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"answer": false,
"explanation": "This is an example of a quaternary protein structure. Quaternary structures are proteins consisting of more than one amino acid chain.",
"id": "10001529",
"label": "c",
"name": "Haemoglobin",
"picture": null,
"votes": 10
},
{
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"answer": false,
"explanation": "This is an example of a quaternary protein structure. Quaternary structures are proteins consisting of more than one amino acid chain.",
"id": "10001531",
"label": "e",
"name": "Actin microfilament",
"picture": null,
"votes": 4
}
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"question": "The secondary class of protein structure is held together by hydrogen bonds.\n\nWhich of the following structures is an example of this class of protein?",
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173,460,363 | false | 9 | null | 6,495,022 | null | false | [] | null | 12,853 | {
"__typename": "QuestionSBA",
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oxygen is utilised for aerobic respiration.",
"id": "10001533",
"label": "b",
"name": "Oxygen",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "During anaerobic respiration, muscle cells use glucose to form ATP. In anaerobic respiration, they do not use oxygen to do this. This process produces lactate, which in a very short time gets converted to lactic acid, which is responsible for the burn felt during exercise.",
"id": "10001532",
"label": "a",
"name": "Lactic acid",
"picture": null,
"votes": 164
},
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"__typename": "QuestionChoice",
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"explanation": "This is a byproduct of anaerobic respiration that occurs in plants via alcoholic fermentation.",
"id": "10001536",
"label": "e",
"name": "Ethanol",
"picture": null,
"votes": 0
},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a byproduct of anaerobic respiration that occurs in plants via alcoholic fermentation and in animals via aerobic respiration.",
"id": "10001534",
"label": "c",
"name": "Carbon dioxide",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a byproduct of aerobic respiration.",
"id": "10001535",
"label": "d",
"name": "Water",
"picture": null,
"votes": 1
}
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"a"
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173,460,364 | false | 10 | null | 6,495,022 | null | false | [] | null | 12,854 | {
"__typename": "QuestionSBA",
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "This combination is missing the three phosphate groups.",
"id": "10001538",
"label": "b",
"name": "Carbon, hydrogen, nitrogen and oxygen",
"picture": null,
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},
{
"__typename": "QuestionChoice",
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"explanation": "This combination is missing the oxygen and nitrogen molecules.",
"id": "10001541",
"label": "e",
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"__typename": "QuestionChoice",
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"explanation": "This combination is missing the nitrogen and phosphate molecules.",
"id": "10001539",
"label": "c",
"name": "Carbon, hydrogen and oxygen",
"picture": null,
"votes": 2
},
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"__typename": "QuestionChoice",
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"explanation": "The structure of ATP is a nucleoside triphosphate. It consists of a nitrogenous base (adenine), a ribose sugar, and three serially bonded phosphate groups. Its molecular formula is - C10H16N5O13P3.",
"id": "10001537",
"label": "a",
"name": "Carbon, hydrogen, nitrogen, oxygen and phosphate",
"picture": null,
"votes": 97
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This combination is missing the oxygen, nitrogen and phosphate molecules.",
"id": "10001540",
"label": "d",
"name": "Carbon and hydrogen",
"picture": null,
"votes": 1
}
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"question": "The universal energy currency of the cell, produced by anaerobic respiration is termed \"ATP\".\n\nWhat components constitute this molecule?",
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"a"
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"__typename": "QuestionChoice",
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"explanation": "This structure is derived from two structures: the ureteric bud (which branches from the nephric duct) and a region of spatially defined intermediate mesoderm termed the metanephric mesenchyme. It goes on to form the adult kidney. It provides large quantities of dilute urine for the maintenance of amniotic and allantoic fluid volumes, essential for normal placentation and development.",
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"explanation": "The epiblast is derived from the inner cell mass and lies above the hypoblast. The epiblast gives rise to the three primary germ layers (ectoderm, definitive endoderm, and mesoderm) and to the extraembryonic mesoderm of the visceral yolk sac, the allantois, and the amnion.",
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"explanation": "This gives rise to muscle, skeleton, kidneys and the reproductive system.",
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"label": "a",
"name": "Mesoderm",
"picture": null,
"votes": 89
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This gives rise to the nervous system, the cornea and lens of the eye, and the skin.",
"id": "10001543",
"label": "b",
"name": "Ectoderm",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This gives rise to the majority of the internal organs. As an overview, it gives rise to the endocrine glands, liver, lungs and digestive tract.",
"id": "10001544",
"label": "c",
"name": "Endoderm",
"picture": null,
"votes": 43
}
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"a"
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173,460,366 | false | 12 | null | 6,495,022 | null | false | [] | null | 12,856 | {
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"__typename": "QuestionChoice",
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"explanation": "Pulmonary stenosis, not pulmonary regurgitation is part of TOF. TOF is a cyanotic disease seen in newborns. The four defects are a ventricular septal defect (VSD), pulmonary stenosis, a misplaced aorta and a thickened right ventricular wall (right ventricular hypertrophy). They usually result in a lack of oxygen-rich blood reaching the body.",
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"label": "d",
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"__typename": "QuestionChoice",
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"explanation": "TOF is a cyanotic disease seen in newborns. The four defects are a ventricular septal defect (VSD), pulmonary stenosis, a misplaced aorta and a thickened right ventricular wall (right ventricular hypertrophy). They usually result in a lack of oxygen-rich blood reaching the body.",
"id": "10001547",
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"name": "Ventricular septal defect (VSD), pulmonary stenosis, overriding aorta and right ventricular hypertrophy (RVH)",
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"__typename": "QuestionChoice",
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"explanation": "ASD is not part of TOF. TOF is a cyanotic disease seen in newborns. The four defects are a ventricular septal defect (VSD), pulmonary stenosis, a misplaced aorta and a thickened right ventricular wall (right ventricular hypertrophy). They usually result in a lack of oxygen-rich blood reaching the body.",
"id": "10001548",
"label": "b",
"name": "Ventricular septal defect (VSD), atrial septal defect (ASD), pulmonary stenosis and an overriding aorta",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Aortic stenosis is not part of TOF. TOF is a cyanotic disease seen in newborns. The four defects are a ventricular septal defect (VSD), pulmonary stenosis, a misplaced aorta and a thickened right ventricular wall (right ventricular hypertrophy). They usually result in a lack of oxygen-rich blood reaching the body.",
"id": "10001549",
"label": "c",
"name": "Ventricular septal defect (VSD), aortic stenosis, overriding aorta and right ventricular hypertrophy (RVH)",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "RVH not LVH is part of TOF. TOF is a cyanotic disease seen in newborns. The four defects are a ventricular septal defect (VSD), pulmonary stenosis, a misplaced aorta and a thickened right ventricular wall (right ventricular hypertrophy). They usually result in a lack of oxygen-rich blood reaching the body.",
"id": "10001551",
"label": "e",
"name": "Ventricular septal defect (VSD), pulmonary stenosis, overriding aorta and left ventricular hypertrophy (LVH)",
"picture": null,
"votes": 27
}
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"question": "The tetralogy of Fallot (TOF) is a combination of which four heart defects?",
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173,460,367 | false | 13 | null | 6,495,022 | null | false | [] | null | 12,857 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the blood supply to the midgut.",
"id": "10001556",
"label": "e",
"name": "Superior mesenteric artery",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the blood supply to the foregut.",
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},
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"__typename": "QuestionChoice",
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"explanation": "The foregut is from the oral cavity to the initial part of the duodenum.",
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},
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"__typename": "QuestionChoice",
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"explanation": "The hindgut is from the later one-third transverse colon to the upper portion of the anus.",
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"picture": null,
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},
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"__typename": "QuestionChoice",
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"explanation": "The midgut is from the mid-duodenum to the initial two-thirds of the transverse colon.",
"id": "10001552",
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"picture": null,
"votes": 119
}
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"a"
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173,460,368 | false | 14 | null | 6,495,022 | null | false | [] | null | 12,858 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Type II hypersensitivity reactions are cytotoxic/antibody-mediated. Type II hypersensitivity reactions include haemolytic reactions, hyperacute graft rejections and Goodpasture syndrome.",
"id": "10001558",
"label": "b",
"name": "Type II",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Type 3 hypersensitivity reactions are immune-complex-mediated. Type III hypersensitivity reactions include hypersensitivity pneumonitis, systemic lupus erythematosus and polyarteritis nodosa.",
"id": "10001559",
"label": "c",
"name": "Type III",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
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"explanation": "Type I hypersensitivity reactions are IgE-allergy mediated and includes allergic reactions such as anaphylaxis. Type I hypersensitivity reactions occur suddenly after exposure. Common triggers are nuts, bee stings, latex and certain medications e.g. penicillins. Patients should be monitored for potential biphasic reactions. It is also important to distinguish these from non-IgE-mediated anaphylactoid reactions.",
"id": "10001557",
"label": "a",
"name": "Type I",
"picture": null,
"votes": 137
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Type IV hypersensitivity reactions are delayed/cell-mediated. Type IV hypersensitivity reactions include chronic graft rejections, latex, nickel and poison ivy reactions.",
"id": "10001560",
"label": "d",
"name": "Type IV",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There is no type V hypersensitivity reaction.",
"id": "10001561",
"label": "e",
"name": "Type V",
"picture": null,
"votes": 1
}
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"typeId": 5
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"question": "An eight-year-old boy with known anaphylaxis to nuts attends a birthday party. After eating some brownies he suddenly develops a wheeze. His mum administers adrenaline via her son's epipen.\n\nGiven that this is an anaphylactic reaction, what type of hypersensitivity reaction is this?",
"sbaAnswer": [
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"typeId": 1,
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173,460,369 | false | 15 | null | 6,495,022 | null | false | [] | null | 12,859 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "An antigen is a molecular structure that is deemed foreign to the body. When an antibody binds an antigen it causes an immune response to be mounted by the body.",
"id": "10001562",
"label": "a",
"name": "Antigens",
"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The variable region includes the ends of the light and heavy chains. The primary role of the antibody variable region is to bind to the target antigen.",
"id": "10001566",
"label": "e",
"name": "Variable region",
"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are also known as immunoglobulins and are proteins which identify antigens on foreign pathogens.",
"id": "10001563",
"label": "b",
"name": "Antibodies",
"picture": null,
"votes": 45
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are components of antibodies. Antibodies/immunoglobulins are formed when light chains link up with heavy chains, another type of protein.",
"id": "10001565",
"label": "d",
"name": "Light chain",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are components of antibodies. Antibodies/immunoglobulins are formed when light chains link up with heavy chains, another type of protein.",
"id": "10001564",
"label": "c",
"name": "Heavy chain",
"picture": null,
"votes": 2
}
],
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"question": "To identify a specific pathogen, our cells contain proteins on their surfaces which allows the body to recognise and fight the infection.\n\nWhat is the term used to describe these surface proteins?",
"sbaAnswer": [
"a"
],
"totalVotes": 163,
"typeId": 1,
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173,460,370 | false | 16 | null | 6,495,022 | null | false | [] | null | 12,860 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are part of the innate immune system. They work in a similar way to neutrophils in that they phagocytose bacteria and secrete both pro-inflammatory and antimicrobial mediators. Once they have phagocytosed material, they then undergo programmed cell death.",
"id": "10001568",
"label": "b",
"name": "Macrophage",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are part of the innate immune system. They are one of the first immune cells to respond to pathogens. They destroy these pathogens via phagocytosis and degranulation.",
"id": "10001569",
"label": "c",
"name": "Neutrophil",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Natural killer T-cells are part of both the innate and adaptive immune systems.",
"id": "10001571",
"label": "e",
"name": "Natural killer T-cell",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Also known as \"T-Helper\" cells, CD4 t-cells have multiple functions. They are part of the adaptive immune system and activate both innate response cells and B-lymphocytes. They also play a role in suppressing the immune reaction when necessary.",
"id": "10001567",
"label": "a",
"name": "CD4 T-cell",
"picture": null,
"votes": 130
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are part of the innate immune system. They are found in tissues such as the skin and boost the immune response by acting as antigen-presenting cells (APCs) and presenting the antigens to the other cells of the immune system.",
"id": "10001570",
"label": "d",
"name": "Dendritic cell",
"picture": null,
"votes": 11
}
],
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"question": "Our adaptive immune system allows us to fight infections relating to specific pathogens.\n\nWhich of the following cell types is specific to the adaptive immune system?",
"sbaAnswer": [
"a"
],
"totalVotes": 165,
"typeId": 1,
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173,460,371 | false | 17 | null | 6,495,022 | null | false | [] | null | 12,861 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "As an antibody binds antigens, and recognises the bacteria/viruses as foreign, pathogens and triggers the cascade of the immune response.",
"id": "10001575",
"label": "d",
"name": "Antibody",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An antigen is a foreign particle that induces an immune response when bound to antibodies on the surface of the cells of the innate immune system.",
"id": "10001574",
"label": "c",
"name": "Antigen",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The major histocompatibility (MHC) class I antigen presentation pathway plays an important role in alerting the immune system to virally infected cells.",
"id": "10001572",
"label": "a",
"name": "MHC Class I",
"picture": null,
"votes": 111
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Classical MHC class I molecules are ubiquitously expressed on all mammalian cells including cells of epithelial origin while MHC class II molecules are selectively expressed on antigen-presenting cells (APC) including dendritic cells (DC), macrophages, and B cells.",
"id": "10001573",
"label": "b",
"name": "MHC Class II",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The hepatitis b surface antigen (HBsAg) is the antigen expressed by the hepatitis B virus specifically. It does not have a role in the cell lysis immune response.",
"id": "10001576",
"label": "e",
"name": "HBsAg",
"picture": null,
"votes": 3
}
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"question": "The adaptive immune system includes both the CD4 and CD8 T cells. CD8 T cells are also known as \"cytotoxic t cells\" and induce cell death of virus-infected cells through cell lysis or apoptosis. A specific molecule is required for this process to occur.\n\nWhat is the name given to this molecule?",
"sbaAnswer": [
"a"
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173,460,372 | false | 18 | null | 6,495,022 | null | false | [] | null | 12,862 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the % chance of the child being a carrier.",
"id": "10001578",
"label": "b",
"name": "50%",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect- there is a 25% chance given that CF is autosomal recessive.",
"id": "10001579",
"label": "c",
"name": "75%",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The inheritance pattern of CF is autosomal recessive. This means that both copies of the gene in each cell must have a mutation for the individual to be affected rather than just a carrier of the gene. There is also a 25% chance that the child would be neither affected nor a carrier.",
"id": "10001577",
"label": "a",
"name": "25%",
"picture": null,
"votes": 125
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect- there is a 25% chance given that CF is autosomal recessive.",
"id": "10001581",
"label": "e",
"name": "0%",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect- there is a 25% chance given that CF is autosomal recessive.",
"id": "10001580",
"label": "d",
"name": "100%",
"picture": null,
"votes": 1
}
],
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"name": "Genetic Inheritance",
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"question": "A couple attends the GP for the wife's antenatal appointment. They would like to know the risk of their child having cystic fibrosis (CF).\n\nWhat is the % risk of their child having CF given that both parents are carriers of the CF gene?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
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} | MarksheetMark |
173,460,373 | false | 19 | null | 6,495,022 | null | false | [] | null | 12,863 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Duchenne muscular dystrophy (DMD) is inherited in an X-linked recessive pattern. Examples of X-linked recessive disorders include red-green colour blindness, Beckers muscular dystrophy and haemophilia A and haemophilia B.",
"id": "10001586",
"label": "e",
"name": "X-linked recessive",
"picture": null,
"votes": 62
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Duchenne muscular dystrophy (DMD) is inherited in an X-linked recessive pattern. Huntington's disease and Marfan syndrome are two examples of autosomal dominant disorders.",
"id": "10001583",
"label": "b",
"name": "Autosomal Dominant (AD)",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Duchenne muscular dystrophy (DMD) is inherited in an X-linked recessive pattern. Mitochondrial inherited disorders are inherited from the mother as the father's DNA is destroyed when the sperm and egg fuse. Examples of mitochondrial inherited disorders include Leigh syndrome and Pearson syndrome.",
"id": "10001585",
"label": "d",
"name": "Mitochondrial",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Duchenne muscular dystrophy (DMD) is inherited in an X-linked recessive pattern. Males have only one copy of the X chromosome from their mother and one copy of the Y chromosome from their father. If their X chromosome has a DMD gene mutation, they will have Duchenne muscular dystrophy. Due to X-inactivation, it is rare that females (XX) suffer from DMD as this process means that all X chromosomes but one are silenced.",
"id": "10001582",
"label": "a",
"name": "X-linked recessive",
"picture": null,
"votes": 45
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Duchenne muscular dystrophy (DMD) is inherited in an X-linked recessive pattern. Examples of autosomal recessive disorders include cystic fibrosis and sickle cell anaemia.",
"id": "10001584",
"label": "c",
"name": "Autosomal recessive (AR)",
"picture": null,
"votes": 19
}
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"question": "A 13-year-old boy has just become wheelchair bound having suffered with progressive weakness since he was a young child. He was diagnosed with Duchenne muscular dystrophy (DMD).\n\nWhat is the inheritance pattern of this disease?",
"sbaAnswer": [
"a"
],
"totalVotes": 148,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,374 | false | 20 | null | 6,495,022 | null | false | [] | null | 12,864 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Haemophilia B (also known as Factor IX deficiency) is a type of clotting disorder.",
"id": "10001588",
"label": "b",
"name": "Factor IX",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Haemophilia A (also known as Classic Haemophilia or Factor VIII deficiency) is the most well-known type of clotting disorder.",
"id": "10001587",
"label": "a",
"name": "Factor VIII",
"picture": null,
"votes": 104
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Haemophilia C (also known as Factor XI deficiency) is an extremely rare form of haemophilia clotting disorder.",
"id": "10001590",
"label": "d",
"name": "Factor XI",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Factor V Leiden is a mutation of one of the clotting factors in the blood. This mutation can increase your chance of developing abnormal blood clots, most commonly in the legs or lungs. This is in contrast to haemophilia where patients bleed into muscles, joints and tissues. Patients with Factor V Leiden are pro-thrombotic.",
"id": "10001591",
"label": "e",
"name": "Factor V",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Factor X deficiency (previously known as the Stuart-Prower factor) deficiency is a type of clotting disorder. However, Factor X deficiency does not cause haemophilia.",
"id": "10001589",
"label": "c",
"name": "Factor X",
"picture": null,
"votes": 22
}
],
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"name": "haemophilia",
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"name": "Haematology",
"typeId": 7
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"question": "A 24-year-old male presents to the GP with a painful knee. On analysis of joint fluid following aspiration and subsequent genetic testing, he is diagnosed with haemophilia A.\n\nWhat factor is defective in this condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 149,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,375 | false | 21 | null | 6,495,022 | null | false | [] | null | 12,865 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The L5 dermatome is tested on the area of the skin on the plantar aspect of the foot and the posterior leg. The L5 myotome is responsible for great toe extension.",
"id": "10001593",
"label": "b",
"name": "L5",
"picture": null,
"votes": 43
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The L4 dermatome is tested on the area of the skin overlying the knee. The L4 myotome is responsible for ankle dorsiflexion.",
"id": "10001595",
"label": "d",
"name": "L4",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The L1 dermatome supplies the area of the groin near the inguinal ligament. The L1 myotome supplies the hip flexors.",
"id": "10001596",
"label": "e",
"name": "L1",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The T10 dermatome is tested on the area of skin overlying the navel.",
"id": "10001594",
"label": "c",
"name": "T10",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The S1 dermatome is tested on the area of the skin on the lateral aspect of the foot and the posterior leg. The S1 myotome is responsible for ankle plantarflexion.",
"id": "10001592",
"label": "a",
"name": "S1",
"picture": null,
"votes": 73
}
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"typeId": 7
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"question": "A patient presents to his GP with recurrent falls. He mentions that he feels his foot dragging across the floor and his partner often has to tell him \"to pick his feet up\". On examination, the GP is able to identify a particular affected area of sensory loss over lateral the aspect of the foot.\n\nTo which root value is the GP referring?",
"sbaAnswer": [
"a"
],
"totalVotes": 151,
"typeId": 1,
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173,460,376 | false | 22 | null | 6,495,022 | null | false | [] | null | 12,866 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although a SAH could present with weakness, given the patient history and antibody findings, the likely diagnosis is GBS.",
"id": "10001601",
"label": "e",
"name": "Subarachnoid haemorrhage (SAH)",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Miller-Fisher Syndrome (MFS) is one of the rare forms of a spectrum of Guillain-Barré syndrome (GBS). In contrast to GBS, which typically affects the lower body first (as seen in this case), MFS tends to affect the upper body first. Anti-ganglioside antibodies are associated with several immunologically mediated peripheral neuropathies e.g. anti-GM1 (IgM) with multifocal motor neuropathy, GQ1b (IgG) with Miller-Fisher syndrome, and GM1 (IgG) with Guillain-Barre syndrome.",
"id": "10001598",
"label": "b",
"name": "Miller-Fisher Syndrome (MFS)",
"picture": null,
"votes": 36
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although a TIA could present with weakness, given the patient history and antibody findings, the likely diagnosis is GBS.",
"id": "10001599",
"label": "c",
"name": "Transient ischaemic attack (TIA)",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Infection with Campylobacter jejuni, commonly infecting individuals who consume undercooked poultry, is one of the most common causes of Guillian-Barre syndrome (GBS). Given this patient's holiday history and anti-ganglioside antibodies, GBS is the correct diagnosis. Anti-ganglioside antibodies are associated with several immunologically mediated peripheral neuropathies e.g. anti-GM1 (IgM) with multifocal motor neuropathy, GQ1b (IgG) with Miller-Fisher syndrome, and GM1 (IgG) with Guillain-Barre syndrome.",
"id": "10001597",
"label": "a",
"name": "Guillian-Barre syndrome (GBS)",
"picture": null,
"votes": 106
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although a stroke could present with weakness, given the patient's history and antibody findings, the likely diagnosis is GBS.",
"id": "10001600",
"label": "d",
"name": "Ischaemic stroke",
"picture": null,
"votes": 0
}
],
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"name": "Guillian-Barre Syndrome",
"status": null,
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"__typename": "Topic",
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"name": "Neurology",
"typeId": 7
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"topicId": 141,
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"question": "A 27-year-old man presents to ED with leg weakness having travelled back from meeting family in America two weeks ago. He had several outdoor parties and barbecues whilst away, but since coming home he has not felt quite himself. Investigations have shown the presence of anti-ganglioside antibodies.\n\nWhat is the most likely diagnosis given his history and investigation findings?",
"sbaAnswer": [
"a"
],
"totalVotes": 145,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,377 | false | 23 | null | 6,495,022 | null | false | [] | null | 12,867 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Scalp tenderness is commonly seen in giant cell arteritis (GCA).",
"id": "10001606",
"label": "e",
"name": "Scalp tenderness",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Nasal congestion is commonly seen in cluster headaches.",
"id": "10001605",
"label": "d",
"name": "Nasal congestion",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Features of a migraine can be remembered by the mnemonic \"POUND\" - pulsatile, onset (sudden), unilateral, nausea + neurological symptoms, and disabling (patients often have photophobia and phonophobia).",
"id": "10001602",
"label": "a",
"name": "Unilateral",
"picture": null,
"votes": 80
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Migraines typically last 4-72 hours. A severe headache lasting longer than this warrants further investigation to rule out other causes such as subarachnoid haemorrhage or meningitis.",
"id": "10001604",
"label": "c",
"name": "Duration of more than two weeks",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Migraines are typically unilateral.",
"id": "10001603",
"label": "b",
"name": "Bilateral",
"picture": null,
"votes": 36
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"id": "3948",
"name": "Headache",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
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"question": "A 21-year-old woman presents to the GP with a headache. She mentions that these attacks are becoming more frequent. The GP takes a thorough history to rule out sinister causes and diagnoses the patient as having migraines.\n\nWhich of the following factors is most consistent with this diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 148,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,378 | false | 24 | null | 6,495,022 | null | false | [] | null | 12,868 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The area of skin overlying the navel is innervated by the T10 dermatome.",
"id": "10001607",
"label": "a",
"name": "T10",
"picture": null,
"votes": 137
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The C5 dermatome supplies the area of skin overlying the shoulder area, clavicular area, and upper scapular area.",
"id": "10001610",
"label": "d",
"name": "C5",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The C7 dermatome supplies the area of skin overlying the lateral arm and forearm to the index, long, and ring fingers.",
"id": "10001609",
"label": "c",
"name": "C7",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The C2 dermatome supplies the area of skin overlying the temple, forehead, and occiput.",
"id": "10001611",
"label": "e",
"name": "C2",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The T4 dermatome supplies the area of skin overlying the nipple.",
"id": "10001608",
"label": "b",
"name": "T4",
"picture": null,
"votes": 10
}
],
"comments": [],
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"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,
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"question": "An 84-year-old woman presents with pain at the level of her belly button. She mentions that the pain has been present since she was diagnosed with shingles. She is diagnosed with post-herpetic neuralgia and is commenced on appropriate treatment.\n\nGiven the distribution of the pain, what dermatome is likely to have been affected by the herpes zoster virus?",
"sbaAnswer": [
"a"
],
"totalVotes": 152,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,379 | false | 25 | null | 6,495,022 | null | false | [] | null | 12,869 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Osteocytes regulate local mineral deposition and chemistry of the bone matrix. Evidence shows that bisphosphonates may indirectly promote osteocyte activity and have direct anti-apoptotic effects on these cells.",
"id": "10001615",
"label": "d",
"name": "Inhibit osteocyte activity",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Osteoclasts are the cells that degrade bone to initiate normal bone remodelling and mediate bone loss in pathologic conditions such as osteoporosis by increasing their resorptive activity. Bisphosphonates work to inhibit osteoclast activity thus aiming to maintain bone structure and density.",
"id": "10001612",
"label": "a",
"name": "Inhibit osteoclast activity",
"picture": null,
"votes": 130
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Osteoblasts are the bone cells that are primarily responsible for synthesizing bone matrix proteins and minerals. Evidence shows that bisphosphonates have anti-apoptotic effects on osteoblasts and thus are likely to promote rather than inhibit their activity.",
"id": "10001613",
"label": "b",
"name": "Inhibit osteoblast activity",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Osteoclasts are the cells that degrade bone to initiate normal bone remodelling and mediate bone loss in pathologic conditions such as osteoporosis by increasing their resorptive activity. Bisphosphonates work to inhibit osteoclast activity thus aiming to maintain bone structure and density.",
"id": "10001614",
"label": "c",
"name": "Promote osteoclast activity",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a function of bisphosphonates.",
"id": "10001616",
"label": "e",
"name": "Stimulates blood vessel formation",
"picture": null,
"votes": 0
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"id": "2693",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3949",
"name": "Bone pathology",
"status": null,
"topic": {
"__typename": "Topic",
"id": "164",
"name": "Physiology and pathology of bone",
"typeId": 7
},
"topicId": 164,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3949,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12869",
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"question": "A 76-year-old woman is commenced on bisphosphonates. The GP explains the mechanism of action of this drug.\n\nWhich of the following is correct?",
"sbaAnswer": [
"a"
],
"totalVotes": 152,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,380 | false | 26 | null | 6,495,022 | null | false | [] | null | 12,870 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The patient presents with signs of a radial nerve injury. A common injury that causes this is a broken midshaft humerus. The name given to the midshaft is the diaphysis. The growth plate is the area of tissue near the ends of long bones in children and teens that determines the future length and shape of the mature bone. The growth plate is usually fused by the age of 13-15 years in females.",
"id": "10001620",
"label": "d",
"name": "Growth plate",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The patient presents with signs of a radial nerve injury. A common injury that causes this is a broken midshaft humerus. The name given to the midshaft is the diaphysis. The epiphysis is located at the narrow end of long bones.",
"id": "10001618",
"label": "b",
"name": "Epiphysis",
"picture": null,
"votes": 62
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The patient presents with signs of a radial nerve injury. A common injury that causes this is a broken midshaft humerus. The name given to the midshaft is the diaphysis. The metaphyses are the wide portions of long bones and the regions of the bone where growth occurs.",
"id": "10001619",
"label": "c",
"name": "Metaphysis",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The talus is a bone in the foot. A talus fracture often occurs during a high-energy event, such as a car collision.",
"id": "10001621",
"label": "e",
"name": "Talus",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The patient presents with signs of a radial nerve injury. A common injury that causes this is a broken midshaft humerus. The name given to the midshaft is the diaphysis.",
"id": "10001617",
"label": "a",
"name": "Diaphysis",
"picture": null,
"votes": 48
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3950",
"name": "Radial 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": 3950,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
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"highlights": [],
"id": "12870",
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"likes": 1,
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"question": "A 75-year-old woman with known osteoporosis presents to A+E with wrist drop and reduced sensation over the anatomical snuffbox on her left side. She recalls falling earlier that day. An x-ray shows a fracture of a specific area of the humerus.\n\nGiven the clinical picture, which area of bone is most likely to have been affected?",
"sbaAnswer": [
"a"
],
"totalVotes": 146,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,381 | false | 27 | null | 6,495,022 | null | false | [] | null | 12,871 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Tidal volume is the amount of air that moves in or out of the lungs with each respiratory cycle. It measures around 500 mL in an average healthy adult male, and approximately 400 mL in a healthy female.",
"id": "10001623",
"label": "b",
"name": "Tidal volume (TV)",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Residual volume is the amount of air that remains in a person's lungs after fully exhaling. RV is needed to keep the lungs from collapsing.",
"id": "10001622",
"label": "a",
"name": "Residual volume (RV)",
"picture": null,
"votes": 117
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the total amount of air exhaled after maximal inhalation. The value is about 4800mL and it varies according to age and body size. It is calculated by summing tidal volume, inspiratory reserve volume, and expiratory reserve volume. VC = TV+IRV+ERV.",
"id": "10001626",
"label": "e",
"name": "Vital capacity (VC)",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The inspiratory reserve volume is the amount of air a person can inhale forcefully after normal tidal volume inspiration.",
"id": "10001625",
"label": "d",
"name": "Inspiratory reserve volume (IRV)",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The expiratory reserve volume is the amount of air a person can exhale forcefully after a normal exhalation.",
"id": "10001624",
"label": "c",
"name": "Expiratory reserve volume (ERV)",
"picture": null,
"votes": 27
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3726",
"name": "Spirometry",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3726,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
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"question": "What is the name given to the amount of air left in the lungs after maximal expiration?",
"sbaAnswer": [
"a"
],
"totalVotes": 149,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,382 | false | 28 | null | 6,495,022 | null | false | [] | null | 12,872 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ventilation/perfusion (V/Q) mismatch does occur in PE, however this is not the name given to the dead space where the mismatch occurs.",
"id": "10001630",
"label": "d",
"name": "V/Q mismatch",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Anatomical dead space is the volume of air that is in the conducting zone of the lung",
"id": "10001628",
"label": "b",
"name": "Anatomical dead space",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Alveolar dead space is the volume of air that fills the gas-exchanging regions of the lung but does not participate in gas exchange. A number of factors can contribute to elevations in pulmonary dead space, including excessive PEEP (intrinsic or extrinsic), low cardiac stroke volume, hypovolemia, and pulmonary embolism.",
"id": "10001627",
"label": "a",
"name": "Alveolar dead space",
"picture": null,
"votes": 43
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Physiological dead space is the combination of anatomical dead space plus alveolar dead space.",
"id": "10001629",
"label": "c",
"name": "Physiological dead space",
"picture": null,
"votes": 63
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Mechanical dead space is dead space in an external breathing apparatus in which the breathing gas must flow in both directions as the user breathes in and out. It increases the necessary respiratory effort to get the same amount of usable air or breathing gas, and risks accumulation of carbon dioxide from shallow breaths.",
"id": "10001631",
"label": "e",
"name": "Mechanical dead space",
"picture": null,
"votes": 8
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3951",
"name": "Pulmonary embolism",
"status": null,
"topic": {
"__typename": "Topic",
"id": "150",
"name": "Respiratory physiology",
"typeId": 7
},
"topicId": 150,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
"conceptId": 3951,
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"dislikes": 0,
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"likes": 0,
"multiAnswer": null,
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"question": "A patient presents to ED with pain in her chest and haemoptysis. She is diagnosed with a pulmonary embolism (PE) following a CTPA. The consultant mentions that her left lung had no perfusion and subsequently no gas exchange.\n\nWhat is the name given to the space to which he is referring?",
"sbaAnswer": [
"a"
],
"totalVotes": 147,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,383 | false | 29 | null | 6,495,022 | null | false | [] | null | 12,873 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Renal tubular epithelial cells are involved in the immune response in the kidney through the production of pro-inflammatory cytokines/chemokines and via interactions with immune cells.",
"id": "10001634",
"label": "c",
"name": "Renal tubular epithelial cell",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Podocytes cooperate with mesangial cells to support the structure and function of the glomerulus.",
"id": "10001633",
"label": "b",
"name": "Podocyte",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The macula densa, mesangium extraglomerular cells and granular cells together make up the juxtaglomerular apparatus. The mesangium extraglomerular cells are a type of smooth muscle cell, and although their function is yet to be fully clarified, they play a role in autoregulation of blood flow to the kidney and regulation of systemic blood pressure through the renin-angiotensin system.",
"id": "10001636",
"label": "e",
"name": "Mesangium extraglomerular cells",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Macula densa (MD) cells are chief cells within the kidney, playing key sensory and regulatory functions in the maintenance of body fluid, electrolyte homeostasis, and blood pressure. The macula densa, mesangium extraglomerular cells and granular cells together make up the Juxtaglomerular apparatus.",
"id": "10001632",
"label": "a",
"name": "Macula densa (MD) cells",
"picture": null,
"votes": 110
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The macula densa, mesangium extraglomerular cells and granular cells together make up the juxtaglomerular apparatus. Granular cells are cells in the kidney that synthesize, store, and secrete the enzyme renin. They are specialized smooth muscle cells mainly in the walls of the afferent arterioles (and some in the efferent arterioles) that deliver blood to the glomerulus.",
"id": "10001635",
"label": "d",
"name": "Granular cells",
"picture": null,
"votes": 15
}
],
"comments": [],
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"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3952",
"name": "Endocrine function of the kidney",
"status": null,
"topic": {
"__typename": "Topic",
"id": "168",
"name": "Renal Physiology",
"typeId": 7
},
"topicId": 168,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3952,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12873",
"isLikedByMe": null,
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"likes": 0,
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"question": "The kidney has several valuable roles, one of which is regulating blood pressure.\n\nWhat is the name of the cells within the kidney that maintain blood pressure homeostasis?",
"sbaAnswer": [
"a"
],
"totalVotes": 149,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,384 | false | 30 | null | 6,495,022 | null | false | [] | null | 12,874 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The DCT regulates pH by absorbing bicarbonate and secreting protons (H+) into the filtrate.",
"id": "10001639",
"label": "c",
"name": "Distal convoluted tubule (DCT)",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the filtering unit of the kidney. It filters small solutes from the blood.",
"id": "10001640",
"label": "d",
"name": "Glomerulus",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Afferent arterioles have two functions: they serve to connect the renal artery to the glomerular capillaries and they take an active role in controlling not only the local blood pressure inside the kidney but also the body's overall blood pressure. An efferent arteriole is a blood vessel in the urinary system that brings filtered blood from the glomerulus to the rest of the kidney and back to the general circulation.",
"id": "10001641",
"label": "e",
"name": "Afferent arteriole",
"picture": null,
"votes": 0
},
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "The proximal convoluted tubule avidly reabsorbs filtered glucose into the peritubular capillaries so that it is all reabsorbed by the end of the proximal tubule. The PCT secretes acids and bases e.g. bile salts, oxalate and catecholamines (waste products of metabolism), and hydrogen ions (H+) – important in maintaining acid/base balance in the body. H+ secretion allows the reabsorption of bicarbonate via the use of the enzyme carbonic anhydrase.",
"id": "10001637",
"label": "a",
"name": "Proximal convoluted tubule (PCT)",
"picture": null,
"votes": 85
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The collecting ducts are the last opportunity to resorb H2O and concentrate urine before they lead urine to the minor calyces. Antidiuretic Hormone (ADH, from the hypothalamus) directs the collecting ducts to concentrate urine.",
"id": "10001638",
"label": "b",
"name": "Collecting duct",
"picture": null,
"votes": 53
}
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"name": "Water and solute absorption",
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"id": "168",
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"question": "Where does the majority of water reabsorption occur within the kidney?",
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173,460,385 | false | 31 | null | 6,495,022 | null | false | [] | null | 12,875 | {
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"explanation": "Constriction of the afferent arteriole would reduce the eGFR as less blood reaches the kidney. NSAIDs reduce the eGFR by constricting the afferent arteriole. ACEis reduce the eGFR by dilating the efferent arteriole. Both of these mechanisms reduce the filtration pressure in the Bowman's capsule, thus reducing the eGFR.",
"id": "10001643",
"label": "b",
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"explanation": "Dilation of the efferent arteriole would reduce the eGFR. This is the mechanism whereby ACEis reduce eGFR rather than NSAIDs. NSAIDs reduce the eGFR by constricting the afferent arteriole. ACEis reduce the eGFR by dilating the efferent arteriole. Both of these mechanisms reduce the filtration pressure in the Bowman's capsule, thus reducing the eGFR.",
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"id": "10001645",
"label": "d",
"name": "Increase eGFR, occurring due to constriction of the efferent arteriole",
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"explanation": "NSAIDs reduce the eGFR by constricting the afferent arteriole. ACEis reduce the eGFR by dilating the efferent arteriole. Both of these mechanisms reduce the filtration pressure in the Bowman's capsule, thus reducing the eGFR.",
"id": "10001642",
"label": "a",
"name": "Reduce eGFR, occurring due to constriction of the afferent arteriole",
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},
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"explanation": "NSAIDs reduce the eGFR by constricting the afferent arteriole. ACEI reduce the eGFR by dilating the efferent arteriole. Both of these mechanisms reduce the filtration pressure in the Bowman's capsule, thus reducing the eGFR.",
"id": "10001646",
"label": "e",
"name": "No change",
"picture": null,
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Exposure of tubular cells to cisplatin activates signalling pathways that are cell death-promoting (p53, and reactive oxygen species).",
"id": "10001650",
"label": "d",
"name": "Cisplatin",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "ACEis are renoprotective in CKD. The renoprotective mechanism of ACEis is that they reduce systemic vascular resistance in patients with hypertension, heart failure or chronic renal disease.",
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"label": "a",
"name": "Angiotensin-converting enzyme inhibitors (ACEis)",
"picture": null,
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"explanation": "NSAIDs are nephrotoxic as they constrict the afferent arteriole, thus reducing blood flow to the kidney.",
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"picture": null,
"votes": 5
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "The most commonly described mechanism of MTX nephrotoxicity is the crystallization of MTX in the renal tubular lumen. Other mechanisms have also been proposed such as constriction of the afferent capillary and direct effects on the mesangial or tubular epithelial cells.",
"id": "10001651",
"label": "e",
"name": "Methotrexate (MTX)",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gentamicin induces nephrotoxicity by inhibiting protein synthesis in renal cells that specifically causes necrosis of cells in the renal proximal tubule, resulting in acute tubular necrosis, followed by acute renal failure.",
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"label": "c",
"name": "Gentamicin",
"picture": null,
"votes": 6
}
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Type 1 fibres are slow-twitch fibres. Slow oxidative fibres contract relatively slowly and use aerobic respiration (oxygen and glucose) to produce ATP. They produce low-power contractions over long periods and are slow to fatigue.",
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"label": "b",
"name": "Type 1 fibres",
"picture": null,
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},
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"__typename": "QuestionChoice",
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"explanation": "A type 1a sensory fibre, otherwise known as a primary afferent fibre, is a type of afferent nerve fibre. It is the sensory fibre of a stretch receptor called the muscle spindle found in muscles, which constantly monitors the rate at which a muscle stretch changes.",
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"label": "c",
"name": "Type 2a fibres",
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173,460,388 | false | 34 | null | 6,495,022 | null | false | [] | null | 12,878 | {
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"__typename": "QuestionChoice",
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"explanation": "A-alpha fibres carry proprioception signals. These are myelinated and thus the conduction speed is fast. In fact, they have the quickest conduction speed of all the nerve fibres listed.",
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"label": "d",
"name": "A-alpha",
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"explanation": "A-delta fibres carry pain (mechanical and thermal) signals. These are myelinated and thus the conduction speed is much quicker than C fibres, which also carry these signals, but are non-myelinated. A-delta fibres also have a much larger diameter than C fibres, allowing signals to be transmitted quicker along the nerve fibre.",
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"explanation": "C fibres carry pain (mechanical, chemical and thermal) signals. These are non-myelinated and thus the conduction speed is much slower than A-delta fibres, which also carry these signals, but are myelinated. C fibres also have a much smaller diameter than A-delta fibres.",
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"label": "c",
"name": "C fibres",
"picture": null,
"votes": 29
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"__typename": "QuestionChoice",
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"explanation": "A-gamma fibres are typically motor neurons that control the intrinsic activation of the muscle spindle.",
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"label": "e",
"name": "A-gamma",
"picture": null,
"votes": 9
},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "A-beta fibres carry touch signals. These are myelinated fibres.",
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"label": "b",
"name": "A-beta",
"picture": null,
"votes": 13
}
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173,460,389 | false | 35 | null | 6,495,022 | null | false | [] | null | 12,879 | {
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"__typename": "QuestionChoice",
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"explanation": "Also known as the soma, the cell body contains ribosomes and is the site of virtually all protein production in the neuron, apart from a small amount which is produced in the dendrites. The cell body maintains the neuronal structure.",
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"label": "c",
"name": "Cell body",
"picture": null,
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},
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"explanation": "Dendrites receive input from many other neurons and carry those signals to the cell body.",
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"explanation": "The myelin sheath functions by allowing signals to propagate down the axon faster than non-myelinated axons, as the signal is able to jump between myelinated sections into sections known as the nodes of Ranvier.",
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"picture": null,
"votes": 25
},
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"explanation": "The Schwann cells are a type of glial cell of the peripheral nervous system that surrounds neurons. They function in myelinating the axon, allowing signals to propagate down the axon faster than non-myelinated axons, as the signal is able to jump between myelinated sections into sections known as the nodes of Ranvier. They are a major glial cell type in the peripheral nervous system.",
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"name": "Schwann cell",
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173,460,390 | false | 36 | null | 6,495,022 | null | false | [] | null | 12,880 | {
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"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the structure that is responsible for capturing the gram stain.",
"id": "10001671",
"label": "e",
"name": "Periplasmic space",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
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"explanation": "This is not the structure that is responsible for capturing the gram stain.",
"id": "10001668",
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},
{
"__typename": "QuestionChoice",
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"explanation": "This is not the structure that is responsible for capturing the gram stain.",
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"explanation": "The cell wall (thick peptidoglycan layer) is responsible for staining gram-positive cells purple.",
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"picture": null,
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},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gram-positive bacteria do not have an outer membrane due to the thickness of the peptidoglycan layer. Only gram-negative bacteria have an outer membrane.",
"id": "10001670",
"label": "d",
"name": "Outer membrane",
"picture": null,
"votes": 19
}
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"question": "A sample is taken to the lab and gram-staining is carried out. The organism stains purple and is subsequently recorded as gram +ve.\n\nWhat is the name of the cellular structure responsible for this colour staining?",
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173,460,391 | false | 37 | null | 6,495,022 | null | false | [] | null | 12,881 | {
"__typename": "QuestionSBA",
"choices": [
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gram-negative cocci include the Neisseria species (arranged in pairs).",
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"label": "b",
"name": "Gram-negative coccus",
"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gram-negative bacilli include Escherichia coli (E.coli).",
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"label": "d",
"name": "Gram-negative bacillus",
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},
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "Staphylococcus aureus is a gram-positive coccus which grows in clusters. Other examples of gram-positive cocci include streptococcus, but these are usually arranged in chains.",
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"name": "Gram-positive coccus",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Examples of gram-positive bacilli include the Listeria and Clostridium species.",
"id": "10001674",
"label": "c",
"name": "Gram-positive bacillus",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gram-negative coccobacilli include Haemophilus influenzae and Bordetella pertussis.",
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"label": "e",
"name": "Gram-negative coccobacillus",
"picture": null,
"votes": 0
}
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"question": "A patient is diagnosed with cellulitis. A culture is sent to look for the offending micro-organism, which is identified as Staphylococcus aureus.\n\nWhat is the most likely finding on the gram stain?",
"sbaAnswer": [
"a"
],
"totalVotes": 150,
"typeId": 1,
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173,460,392 | false | 38 | null | 6,495,022 | null | false | [] | null | 12,882 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Neoplasia is new, uncontrolled growth of cells which is not under physiological control. This abnormal growth is termed a neoplasm and the resulting mass can be benign or malignant.",
"id": "10001680",
"label": "d",
"name": "Neoplasia",
"picture": null,
"votes": 57
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hyperplasia is an increase in the number of cells. However, the cells appear normal under a microscope and have not changed.",
"id": "10001681",
"label": "e",
"name": "Hyperplasia",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Dysplasia is the presence of abnormal cells within a tissue or organ.",
"id": "10001678",
"label": "b",
"name": "Dysplasia",
"picture": null,
"votes": 33
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypertrophy is the increase and growth of muscle cells. The cells themselves have not mutated.",
"id": "10001679",
"label": "c",
"name": "Hypertrophy",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Metaplasia is a change of the orginal cells to a form that does not normally occur in the tissue in which it is found.",
"id": "10001677",
"label": "a",
"name": "Metaplasia",
"picture": null,
"votes": 52
}
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"id": "3958",
"name": "Cancer pathology",
"status": null,
"topic": {
"__typename": "Topic",
"id": "182",
"name": "Cancer Biology",
"typeId": 7
},
"topicId": 182,
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"question": "A patient is diagnosed with lung cancer. He is told by his consultant that the underlying mechanism for this is cellular change.\n\nWhat is the correct descriptor for the change that has taken place?",
"sbaAnswer": [
"a"
],
"totalVotes": 150,
"typeId": 1,
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173,460,393 | false | 39 | null | 6,495,022 | null | false | [] | null | 12,883 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Increasing size over time would signify a higher chance of malignant melanoma.",
"id": "10001686",
"label": "e",
"name": "Increasing size over time",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Heterogeneity in colour would signify a higher chance of malignant melanoma.",
"id": "10001683",
"label": "b",
"name": "Heterogenous colour",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Diameter >6mm would signify a higher chance of malignant melanoma.",
"id": "10001684",
"label": "c",
"name": "Diameter >6mm",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Bleeding would signify a higher chance of malignant melanoma.",
"id": "10001685",
"label": "d",
"name": "Bleeding",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Following the ABCDE rule of melanoma. The GP would have looked for \"asymmetry\". However, a lesion that is symmetrical is much more likely to be benign. He would also have looked at the \"border\" for regularity, where irregular borders would indicate a higher chance of malignant melanoma. Colour would be the next indicator, and a heterogenous colour would indicate a higher chance of malignant melanoma. Diameter >6mm would indicate a higher chance of malignant melanoma. Evolution of the lesion in any way to comprise bleeding, itching or increasing size would also indicate a higher chance of a malignant rather than benign lesion.",
"id": "10001682",
"label": "a",
"name": "Symmetrical",
"picture": null,
"votes": 126
}
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"chapterId": 2693,
"demo": null,
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"id": "3758",
"name": "Malignant Melanoma",
"status": null,
"topic": {
"__typename": "Topic",
"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
"totalCards": null,
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"question": "A patient presents with a pigmented skin lesion. The GP undertakes a thorough examination and believes the lesion to be benign.\n\nWhat feature distinguishes this lesion as most likely benign rather than malignant?",
"sbaAnswer": [
"a"
],
"totalVotes": 147,
"typeId": 1,
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173,460,394 | false | 40 | null | 6,495,022 | null | false | [] | null | 12,884 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Weight loss, palpitations and heat intolerance are all symptoms of HYPERthyroidism. As these are all consistent with the same diagnosis, this is the correct combination of answers.",
"id": "10001687",
"label": "a",
"name": "Weight loss, palpitations and heat intolerance",
"picture": null,
"votes": 132
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although palpitations are commonly associated with HYPERthyroidism, weight gain and constipation are associated with HYPOthyroidism. Therefore, this is not the correct combination of symptoms.",
"id": "10001690",
"label": "d",
"name": "Palpitations, weight gain and constipation",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although a lump in the neck (goitre) is seen in both HYPER and HYPO thyroidism, weight gain and low mood are commonly seen in HYPOthyroidism. Therefore, this is not the correct combination of symptoms.",
"id": "10001689",
"label": "c",
"name": "Weight gain, neck lump and low mood",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although irritability is seen in both HYPER and HYPO thyroidism, weight gain and cold intolerance are symptoms of HYPOthyroidism. Therefore, this is not the correct combination of symptoms.",
"id": "10001688",
"label": "b",
"name": "Weight gain, irritability and cold intolerance",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "All of the symptoms listed above are indicative of HYPOthyroidism.",
"id": "10001691",
"label": "e",
"name": "Menorrhagia, low mood, constipation",
"picture": null,
"votes": 2
}
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"name": "Hyperthyroidism",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
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"question": "A woman presents to her GP complaining of a myriad of symptoms. She is diagnosed with hyperthyroidism with the results of her blood tests showing elevated T4 and reduced TSH.\n\nWhich of the following symptoms would she be most likely to report?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,395 | false | 41 | null | 6,495,022 | null | false | [] | null | 12,885 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oxytocin and vasopressin are the hormones released from the posterior pituitary gland. FSH is secreted from the anterior pituitary. Therefore this is the incorrect combination of answers.",
"id": "10001693",
"label": "b",
"name": "Oxytocin and follicle-stimulating hormone (FSH)",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oxytocin and vasopressin are the hormones released from the posterior pituitary gland. LH is secreted from the anterior pituitary. Therefore this is the incorrect combination of answers.",
"id": "10001696",
"label": "e",
"name": "Oxytocin and luteinizing Hormone (LH)",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Oxytocin and Vasopressin (antidiuretic hormone) are the two hormones released from the posterior pituitary gland.",
"id": "10001692",
"label": "a",
"name": "Oxytocin and Vasopressin",
"picture": null,
"votes": 133
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oxytocin and vasopressin are the hormones released from the posterior pituitary gland. FSH is secreted from the anterior pituitary. Therefore this is the incorrect combination of answers.",
"id": "10001694",
"label": "c",
"name": "Vasopressin and follicle-stimulating hormone (FSH)",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oxytocin and vasopressin are the hormones released from the posterior pituitary gland. LH is secreted from the anterior pituitary. Therefore this is the incorrect combination of answers.",
"id": "10001695",
"label": "d",
"name": "Vasopressin and luteinizing Hormone (LH)",
"picture": null,
"votes": 2
}
],
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"id": "3960",
"name": "Hormones of the posterior pituitary gland",
"status": null,
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"__typename": "Topic",
"id": "167",
"name": "Endocrine physiology",
"typeId": 7
},
"topicId": 167,
"totalCards": null,
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"question": "Which of the following combination of hormones is released from the posterior pituitary gland?",
"sbaAnswer": [
"a"
],
"totalVotes": 149,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,396 | false | 42 | null | 6,495,022 | null | false | [] | null | 12,886 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Amiodarone belongs to the Class 3 antiarrhythmic agents. Class 2 antiarrhythmics are beta-blockers. A good mnemonic to use in order of the classes 1-4 is \"some block potassium channels\" whereby S = sodium blockers, B = beta blockers, P = potassium blockers, C = calcium blockers.",
"id": "10001701",
"label": "e",
"name": "Class 2, potassium channel blocker",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Amiodarone belongs to the Class 3 antiarrhythmic agents. Class 3 antiarrhythmics block potassium channels. A good mnemonic to use in order of the classes 1-4 is \"some block potassium channels\" whereby S = sodium blockers, B = beta blockers, P = potassium blockers, C = calcium blockers.",
"id": "10001697",
"label": "a",
"name": "Class 3, potassium channel blocker",
"picture": null,
"votes": 71
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Amiodarone belongs to the Class 3 antiarrhythmic agents. Class 4 antiarrhythmics block calcium channels. A good mnemonic to use in order of the classes 1-4 is \"some block potassium channels\" whereby S = sodium blockers, B = beta blockers, P = potassium blockers, C = calcium blockers.",
"id": "10001699",
"label": "c",
"name": "Class 3, calcium channel blocker",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Amiodarone belongs to the Class 3 antiarrhythmic agents. Class 1 antiarrhythmics block sodium channels. A good mnemonic to use in order of the classes 1-4 is \"some block potassium channels\" whereby S = sodium blockers, B = beta blockers, P = potassium blockers, C = calcium blockers.",
"id": "10001698",
"label": "b",
"name": "Class 3, sodium channel blocker",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Amiodarone belongs to the Class 3 antiarrhythmic agents. Class 1 antiarrhythmics block sodium channels. A good mnemonic to use in order of the classes 1-4 is \"some block potassium channels\" whereby S = sodium blockers, B = beta blockers, P = potassium blockers, C = calcium blockers.",
"id": "10001700",
"label": "d",
"name": "Class 1, potassium channel blocker",
"picture": null,
"votes": 10
}
],
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3961",
"name": "Class III anti-arrhythmics: Potassium channel blockers",
"status": null,
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"__typename": "Topic",
"id": "169",
"name": "Cardiovascular pharmacology",
"typeId": 7
},
"topicId": 169,
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"typeId": null,
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},
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"question": "A patient is prescribed amiodarone to help control his ventricular arrhythmia.\n\nTo which antiarrhythmic class does this drug belong and what is its mechanism of action?",
"sbaAnswer": [
"a"
],
"totalVotes": 137,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,397 | false | 43 | null | 6,495,022 | null | false | [] | null | 12,887 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The correct order of the electrical signal conduction through the heart is: SA node → AV node → Bundle of His → Bundle branches → Purkinje fibres.",
"id": "10001702",
"label": "a",
"name": "SA node → AV node → Bundle of His → Bundle branches → Purkinje fibres",
"picture": null,
"votes": 104
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The correct order of the electrical signal conduction through the heart is: SA node → AV node → Bundle of His → Bundle branches → Purkinje fibres.",
"id": "10001705",
"label": "d",
"name": "SA node → AV node → Bundle branches → Bundle of His → Purkinje fibres",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The correct order of the electrical signal conduction through the heart is: SA node → AV node → Bundle of His → Bundle branches → Purkinje fibres.",
"id": "10001703",
"label": "b",
"name": "AV node → SA node → Bundle of His → Bundle branches → Purkinje fibres",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The correct order of the electrical signal conduction through the heart is: SA node → AV node → Bundle of His → Bundle branches → Purkinje fibres.",
"id": "10001704",
"label": "c",
"name": "SA node → AV node → Bundle of His → Purkinje fibres → Bundle branches",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The correct order of the electrical signal conduction through the heart is: SA node → AV node → Bundle of His → Bundle branches → Purkinje fibres.",
"id": "10001706",
"label": "e",
"name": "AV node → SA node → Bundle of His → Purkinje fibres → Bundle branches",
"picture": null,
"votes": 3
}
],
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"demo": null,
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"id": "3962",
"name": "Cardiac Action Potential Generation and Conduction",
"status": null,
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"__typename": "Topic",
"id": "159",
"name": "Cardiovascular physiology",
"typeId": 7
},
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"question": "What is the order that the electrical conduction travels through the heart?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
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173,460,398 | false | 44 | null | 6,495,022 | null | false | [] | null | 12,888 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Testosterone is essential in the production of oestrogen.",
"id": "10001709",
"label": "c",
"name": "Testosterone",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Progesterone serves a number of functions, but predominantly, it is there to get the body ready for pregnancy. When an egg is released by an ovary, progesterone encourages the thickening of the uterine lining, ready for a fertilised egg to implant into.",
"id": "10001710",
"label": "d",
"name": "Progesterone",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Ovulation is spontaneously triggered about 36-40 hours after blood levels of a hormone called luteinizing hormone (LH) rise. This is termed the LH surge.",
"id": "10001707",
"label": "a",
"name": "LH",
"picture": null,
"votes": 113
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oestrogen thickens the lining of the uterus (endometrium) to prepare it for pregnancy.",
"id": "10001711",
"label": "e",
"name": "Oestrogen",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "FSH functions to stimulate the growth of eggs in the ovaries. The levels are at their highest just before ovulation.",
"id": "10001708",
"label": "b",
"name": "FSH",
"picture": null,
"votes": 24
}
],
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"demo": null,
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"id": "3841",
"name": "Menstrual cycle",
"status": null,
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"__typename": "Topic",
"id": "175",
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"typeId": 7
},
"topicId": 175,
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"question": "What hormone is released that triggers ovulation?",
"sbaAnswer": [
"a"
],
"totalVotes": 152,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,399 | false | 45 | null | 6,495,022 | null | false | [] | null | 12,889 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cortical granules prevent polyspermy during fertilisation. Cortical granules are secretory vesicles poised at the cortex of an egg that, upon stimulation by sperm contact at fertilization, secrete their contents. These contents modify the extracellular environment and block additional sperm from reaching the egg.",
"id": "10001716",
"label": "e",
"name": "Cortical granule",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The Zona pellucida is a thick extracellular matrix that surrounds the oocyte and pre-implantation embryo. The acrosome reaction occurs after sperm capacitation/ calcium ion influx causes the exocytotic event where the spermatozoa can then penetrate the zona pellucida and fuse with the egg plasma membrane.",
"id": "10001712",
"label": "a",
"name": "Zona pellucida",
"picture": null,
"votes": 127
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The perivitelline space is the space between the zona pellucida and the cell membrane of an oocyte or fertilized ovum. In the slow block to polyspermy, the cortical granules released from the ovum are deposited in the perivitelline space.",
"id": "10001715",
"label": "d",
"name": "Perivitalline space",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Granulosa cells are a population of somatic cells whose role after ovulation is progesterone production.",
"id": "10001713",
"label": "b",
"name": "Granulosa cells",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The corona radiata surrounds the egg and consists of up to three layers of cells from the follicle. They are attached to the zona pellucida and their main purpose is to supply vital proteins to the cell.",
"id": "10001714",
"label": "c",
"name": "Corona radiata",
"picture": null,
"votes": 14
}
],
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"id": "3963",
"name": "Mechanisms of Fertilisation",
"status": null,
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"id": "175",
"name": "Reproductive Physiology",
"typeId": 7
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"question": "For fertilisation to occur, what is the name of the layer of the egg that the sperm must penetrate?",
"sbaAnswer": [
"a"
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173,460,400 | false | 46 | null | 6,495,022 | null | false | [] | null | 12,890 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Myoid cells are contractile and thus are involved in the transport of mature spermatozoa and testicular fluid in the seminiferous tubules.",
"id": "10001719",
"label": "c",
"name": "Myoid cells",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Sertoli cells are somatic cells found within the testes. They are necessary for facilitating spermatogenesis within the seminiferous tubules of the testes.",
"id": "10001718",
"label": "b",
"name": "Sertoli cells",
"picture": null,
"votes": 40
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Leydig cells are the primary source of testosterone in males. They produce testosterone under the pulsatile control of luteinizing hormone from the anterior pituitary.",
"id": "10001717",
"label": "a",
"name": "Leydig cells",
"picture": null,
"votes": 99
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Spermatocytes divide and produce immature sperm called spermatids. Spermatids then undergo spermiogenesis and mature into spermatozoa (sperm) which are then able to fertilise a female ovum.",
"id": "10001720",
"label": "d",
"name": "Spermatocyte",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Dendritic cells are also found within the testes. They function as antigen-presenting cells (APCs) to the immune system, boosting the immune response when a foreign pathogen is recognised.",
"id": "10001721",
"label": "e",
"name": "Dendritic cell",
"picture": null,
"votes": 0
}
],
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"id": "3964",
"name": "Testosterone",
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"question": "What cells within the testicles are responsible for male androgen production?",
"sbaAnswer": [
"a"
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173,460,401 | false | 47 | null | 6,495,022 | null | false | [] | null | 12,891 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The humerus forms via endochondral ossification. Endochondral ossification is the process whereby all long bones of the axial skeleton, and all the bones of the appendicular skeleton form. The process begins with mesenchymal cells derived from the mesoderm differentiating into chondrocytes. Chondrocytes then proliferate and secrete extracellular matrix (ECM) to form the cartilage model on which bone forms.",
"id": "10001726",
"label": "e",
"name": "Humerus",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Flat bones of the body e.g. the skull are formed via intramembranous ossifcation. This process occurs whereby mesenchymal cells derived from the neural crest differentiate into osteoblasts.",
"id": "10001722",
"label": "a",
"name": "Skull",
"picture": null,
"votes": 100
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The ribs form via endochondral ossification. Endochondral ossification is the process whereby all long bones of the axial skeleton, and all the bones of the appendicular skeleton form. The process begins with mesenchymal cells derived from the mesoderm differentiating into chondrocytes. Chondrocytes then proliferate and secrete extracellular matrix (ECM) to form the cartilage model on which bone forms.",
"id": "10001724",
"label": "c",
"name": "Ribs",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The femur forms via endochondral ossification. Endochondral ossification is the process whereby all long bones of the axial skeleton, and all the bones of the appendicular skeleton form. The process begins with mesenchymal cells derived from the mesoderm differentiating into chondrocytes. Chondrocytes then proliferate and secrete extracellular matrix (ECM) to form the cartilage model on which bone forms.",
"id": "10001725",
"label": "d",
"name": "Femur",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Vertebrae form via endochondral ossification. Endochondral ossification is the process whereby all long bones of the axial skeleton, and all the bones of the appendicular skeleton form. The process begins with mesenchymal cells derived from the mesoderm differentiating into chondrocytes. Chondrocytes then proliferate and secrete extracellular matrix (ECM) to form the cartilage model on which bone forms.",
"id": "10001723",
"label": "b",
"name": "T12 vertebrae",
"picture": null,
"votes": 8
}
],
"comments": [],
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"id": "3965",
"name": "Cartilage and Endochondral Ossification",
"status": null,
"topic": {
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"id": "183",
"name": "Physiology & Pathology of Bone",
"typeId": 7
},
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"question": "Which of the following bones are formed through intramembranous ossification?",
"sbaAnswer": [
"a"
],
"totalVotes": 141,
"typeId": 1,
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} | MarksheetMark |
173,460,402 | false | 48 | null | 6,495,022 | null | false | [] | null | 12,892 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Muscles allow the body to move. Muscles attach to bone via tendons.",
"id": "10001729",
"label": "c",
"name": "Muscle",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Ligaments connect bones to other bones.",
"id": "10001727",
"label": "a",
"name": "Ligament",
"picture": null,
"votes": 110
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Tendons connect the ends of muscles to bones.",
"id": "10001728",
"label": "b",
"name": "Tendon",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cartilage has many functions, including the ability to resist compressive forces, enhance bone resilience, and provide support in bony areas where there is a need for flexibility.",
"id": "10001731",
"label": "e",
"name": "Cartilage",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Bursae are small fluid-filled sacs that reduce friction between moving parts in your body's joints.",
"id": "10001730",
"label": "d",
"name": "Bursae",
"picture": null,
"votes": 2
}
],
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"name": "Muscle physiology",
"status": null,
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"name": "Physiology & Pathology of Bone",
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},
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"question": "What is the name given to the structure that attaches bone to bone?",
"sbaAnswer": [
"a"
],
"totalVotes": 147,
"typeId": 1,
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173,460,403 | false | 49 | null | 6,495,022 | null | false | [] | null | 12,893 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The lamina is not a specific anatomical structure of the cervical vertebrae. The lamina is the roof of the spinal canal that provides support and protection for the backside of the spinal cord.",
"id": "10001733",
"label": "b",
"name": "Lamina",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although cervical vertebrae have a specific spinous process which is bifid in shape, the spinous process as an anatomical structure is not a specific feature of the cervical vertebrae. The spinous process functions as an important anatomical and biomechanical structure. It protects the neural structures in the spinal canal, and acts as an anchor for the interspinous and supraspinous ligaments, and the intersegmental paraspinal muscles.",
"id": "10001736",
"label": "e",
"name": "Spinous process",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Each vertebra has a vertebral body anteriorly. The size of this vertebral body increases as you descend the spinal cord.",
"id": "10001734",
"label": "c",
"name": "Vertebral Body",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The pedicle is not specific to cervical vertebrae. The pedicle functions as a structural buttress, providing support to the posterior wall of the vertebral body when constrained through the posterior arch.",
"id": "10001735",
"label": "d",
"name": "Pedicle",
"picture": null,
"votes": 31
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Only the cervical vertebrae possess the transverse foramina. The reason for this is that the transverse foramina function as a canal for the vertebral artery, vertebral vein and sympathetic nerves to reach the skull.",
"id": "10001732",
"label": "a",
"name": "Transverse foramen",
"picture": null,
"votes": 90
}
],
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},
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"entitlement": null,
"id": "3967",
"name": "Assessment and management of C-spine injury",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
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"question": "Which of the following is specific to cervical vertebrae?",
"sbaAnswer": [
"a"
],
"totalVotes": 146,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,404 | false | 50 | null | 6,495,022 | null | false | [] | null | 12,894 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Type 1 collagen is the most common type of collagen.",
"id": "10001739",
"label": "c",
"name": "Type 1",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Type 5 collagen is found in some layers of skin, but is mostly found in the cornea of the eyes, hair, and placental tissue.",
"id": "10001740",
"label": "d",
"name": "Type 5",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Type 3 collagen is found in muscles, arteries and organs.",
"id": "10001738",
"label": "b",
"name": "Type 3",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Type 4 collagen is found in the skin layers.",
"id": "10001741",
"label": "e",
"name": "Type 4",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Type 2 collagen is found in elastic cartilage. It helps to provide support to joints. Hyaline cartilage is found between the ribs and this is comprised of type 2 collagen.",
"id": "10001737",
"label": "a",
"name": "Type 2",
"picture": null,
"votes": 70
}
],
"comments": [],
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},
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"name": "Cartilage and Endochondral Ossification",
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"typeId": 7
},
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"question": "What is the main collagen type found within the cartilage of the ribcage?",
"sbaAnswer": [
"a"
],
"totalVotes": 136,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,501 | false | 1 | null | 6,495,027 | null | false | [] | null | 12,895 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Noradrenaline receptors are responsible for producing an adrenergic effect when stimulated. These effects include an increase in heart rate, increased blood pressure, bronchodilation, and constriction of the pupils. Noradrenaline does not affect the eyelid muscles or the jaw - therefore damaging these receptors is unlikely to cause isolated symptoms of eye and jaw muscle weakness.",
"id": "10001746",
"label": "e",
"name": "Noradrenaline (NA) receptors",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is experiencing weakness in her skeletal muscles - specifically her eye and jaw muscles. This is what is causing the drooping of her eyelids. This is the classical presentation of myasthenia gravis, an autoimmune condition.\n\nACh (acetylcholine) receptors are found at the neuromuscular junction and are responsible for skeletal muscle contraction. An autoimmune attack in the form of autoantibodies against these receptors would be consistent with the signs and symptoms reported by this patient.",
"id": "10001742",
"label": "a",
"name": "Acetylcholine receptor",
"picture": null,
"votes": 105
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "GABA receptors are responsible for inhibiting the stimulation of nerves in the central nervous system. If GABA receptors are damaged, you would expect to see an increased level of excitation in the nervous system - the opposite of what this patient is reporting.",
"id": "10001744",
"label": "c",
"name": "GABA Receptors",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Histamine receptors are responsible for vasodilation, bronchoconstriction, and the recruitment of inflammatory cells. Histamine receptors do not affect the skeletal muscles in the body - therefore this is not the correct choice.",
"id": "10001745",
"label": "d",
"name": "Histamine Receptors",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Serotonin (5-HT) receptors, are G-protein coupled receptors, that are activated by the neurotransmitter serotonin. Serotonin controls neurological processes such as anxiety, appetite, cognition, memory, mood and sleep. This patient is not reporting a change in any of these - this is not the correct answer.",
"id": "10001743",
"label": "b",
"name": "Serotonin (5-HT) Receptors",
"picture": null,
"votes": 8
}
],
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"name": "Myasthenia Gravis",
"status": null,
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"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
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"topicId": 141,
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"question": "A 27-year-old woman presents to General Practice with double vision, difficulty smiling and drooping of both of her eyelids. She is alert and her cognition is intact. She is presenting with the classical symptoms of an autoimmune condition.\n\nWhich receptors are being attacked by autoantibodies in this condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 131,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,502 | false | 2 | null | 6,495,027 | null | false | [] | null | 12,896 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A left MCA lesion would not produce left arm paralysis (ipsilateral) - the paralysis would be contralateral instead.",
"id": "10001748",
"label": "b",
"name": "Inability to understand or produce speech, left arm paralysis",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A left MCA lesion would produce **right**-sided arm and leg paralysis, not left-sided paralysis.",
"id": "10001749",
"label": "c",
"name": "Left arm and leg paralysis",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A left MCA lesion would also produce contralateral visual-field defects - therefore we would expect right-sided visual-field defects. However, we would expect right-sided motor dysfunction instead of left-sided dysfunction as the left middle cerebral artery supplies blood to the left primary motor cortex, which controls motor function on the right side of the body.",
"id": "10001751",
"label": "e",
"name": "Right visual-field defect, left arm and leg paralysis",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A left MCA lesion would also produce contralateral visual-field defects - therefore we would expect right-sided visual-field defects instead of left-sided ones.",
"id": "10001750",
"label": "d",
"name": "Left visual-field defects, inability to understand speech",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The left middle cerebral artery (MCA) supplies Broca's area (production of speech) and Wernicke's area (understanding of speech).\n\nIt also supplies blood to the left primary motor cortex, which controls motor function on the right side of the body.\n\nA lesion in these areas would therefore produce impairments in producing and understanding speech, and contralateral paralysis.",
"id": "10001747",
"label": "a",
"name": "Inability to understand or produce speech, right arm paralysis",
"picture": null,
"votes": 65
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"id": "2693",
"pictures": [],
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"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3743",
"name": "Ischaemic Stroke",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
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"topicId": 141,
"totalCards": null,
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"question": "A 78-year-old woman presents with an ischaemic stroke in the left middle cerebral artery territory.\n\nWhich of the following signs and symptoms could she present with?",
"sbaAnswer": [
"a"
],
"totalVotes": 90,
"typeId": 1,
"userPoint": null
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173,460,503 | false | 3 | null | 6,495,027 | null | false | [] | null | 12,897 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The limbic lobe is responsible for regulating behaviour and emotional responses.",
"id": "10001756",
"label": "e",
"name": "Limbic lobe",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Broca's area is **most likely** to be found in the left frontal cortex rather than the right, where it has a 3% chance of being.",
"id": "10001753",
"label": "b",
"name": "Right Frontal Cortex",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The occipital lobe is responsible for processing visual input from the eyes.",
"id": "10001755",
"label": "d",
"name": "Occipital lobe",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The left parietal lobe is responsible for sensory perception, such as taste, touch, smell, and sound.",
"id": "10001754",
"label": "c",
"name": "Left parietal lobe",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The area affected in this man is Broca's area (responsible for production of speech). This is found in the frontal cortex, behind the eye in 97% of people.",
"id": "10001752",
"label": "a",
"name": "Left Frontal Cortex",
"picture": null,
"votes": 46
}
],
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"demo": null,
"entitlement": null,
"id": "3743",
"name": "Ischaemic Stroke",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
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"question": "A 52-year-old man presents to the Emergency Department unable to produce coherent speech, however, his ability to understand speech is preserved. You are concerned about an ischaemic stroke.\n\nWhich area of his brain is most likely to be affected?",
"sbaAnswer": [
"a"
],
"totalVotes": 86,
"typeId": 1,
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173,460,504 | false | 4 | null | 6,495,027 | null | false | [] | null | 12,898 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The arachnoid mater is the middle layer of the meninges (three layers of membranes that protect the central nervous system), between the dura mater and the pia mater. Although the subarachnoid space has fluid and blood vessels, the arachnoid mater itself does not contain any CSF or blood vessels.",
"id": "10001759",
"label": "c",
"name": "Arachnoid mater",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The extradural space is found between the cranium and the dura mater - in healthy individuals, nothing is found in this area. However, sometimes a haemorrhage can occur here when the head undergoes traumatic injury.",
"id": "10001758",
"label": "b",
"name": "Extradural space",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The subarachnoid space is the space just underneath the arachnoid mater, between the arachnoid mater and the pia mater. This is filled with cerebrospinal fluid (CSF) and blood vessels.",
"id": "10001757",
"label": "a",
"name": "Subarachnoid space",
"picture": null,
"votes": 83
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The dura mater is the outermost layer of the meninges - it also does not contain CSF.",
"id": "10001761",
"label": "e",
"name": "Dura mater",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The pia mater is the innermost layer of the meninges - it does not contain CSF.",
"id": "10001760",
"label": "d",
"name": "Pia mater",
"picture": null,
"votes": 4
}
],
"comments": [],
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"id": "3969",
"name": "Neuroanatomy",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
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"question": "Of the following options, where would you expect to find cerebrospinal fluid (CSF)?",
"sbaAnswer": [
"a"
],
"totalVotes": 98,
"typeId": 1,
"userPoint": null
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173,460,505 | false | 5 | null | 6,495,027 | null | false | [] | null | 12,899 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Beta-receptors are responsible for activating the sympathetic nervous system, whilst alpha-receptors are responsible for activating the parasympathetic nervous system. Antagonising the alpha receptors increases the release of hormones such as serotonin and noradrenaline. This has nothing to do with the excitation of neurones, and would not be appropriate for the treatment of epilepsy, in which you see an inappropriate increase in neurone excitation.",
"id": "10001763",
"label": "b",
"name": "Mirtazapine (Alpha receptor antagonist)",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Epilepsy is a disorder diagnosed when someone has more than 2 unprovoked seizures - this is thought to be caused by increased neurone excitability.\n\nLamotrigine binds to voltage-gated sodium channels and inhibits them, preventing neurone excitation (sodium influx initiates action potentials in neurones).",
"id": "10001762",
"label": "a",
"name": "Lamotrigine (inhibits voltage-gated sodium channels)",
"picture": null,
"votes": 59
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Serotonin does not affect nerve excitation - therefore, Ondansetron does not help in the management of epilepsy.",
"id": "10001766",
"label": "e",
"name": "Ondansetron (serotonin 5-HT3 receptor blocker)",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Amphetamines increase monoamines in the brain, which increases the excitability of neurones in the brain - this is the opposite of what we want, as epilepsy itself is due to overexcitation of these neurones, leading to unprovoked seizures.",
"id": "10001765",
"label": "d",
"name": "Amphetamines (increases excitatory neurotransmission)",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Epilepsy is characterised by an overexcitation of neurones. Serotonin is a neurotransmitter which does not affect nerve excitation - it controls other neurological functions such as mood, appetite and sleep.",
"id": "10001764",
"label": "c",
"name": "Pizotifen (serotonin (5-HT2) receptor antagonist)",
"picture": null,
"votes": 2
}
],
"comments": [],
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"explanation": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3749",
"name": "Epilepsy",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
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},
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"question": "Which of the following drugs would be appropriate for the treatment of epilepsy?",
"sbaAnswer": [
"a"
],
"totalVotes": 77,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,506 | false | 6 | null | 6,495,027 | null | false | [] | null | 12,900 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be symptomatic of a loss of function in the superior oblique, which would be responsible for deviating the eye down and inwards.",
"id": "10001770",
"label": "d",
"name": "The affected eye is deviated up and out",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The abducens (6th) cranial nerve is responsible for the motor control of the lateral rectus, which is responsible for the abduction (outward movement) of the eye. Loss of abducens function means the eye cannot be pulled outward, so it will deviate inwards instead.",
"id": "10001767",
"label": "a",
"name": "The affected eye deviates inwards",
"picture": null,
"votes": 48
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be symptomatic of an injury to the superior rectus, which allows the eye to move upwards - it is unlikely for the superior rectus to be affected in isolation. This is not consistent with a lesion in the abducens nerve.",
"id": "10001769",
"label": "c",
"name": "The affected eye is deviated down",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are the classic symptoms you would find in a third cranial nerve palsy, affecting the oculomotor nerve. The third nerve innervates all the ocular muscles except the lateral rectus (pulling the eye out) and the superior oblique (pulling the eye down) - these are therefore the direction the eye will go when the oculomotor nerve function is lost.",
"id": "10001768",
"label": "b",
"name": "The affected eye deviates down and out",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be due to a lesion in the inferior rectus, which pulls the eye downwards.",
"id": "10001771",
"label": "e",
"name": "The affected eye is deviated up",
"picture": null,
"votes": 3
}
],
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"id": "3970",
"name": "Isolated cranial nerve palsies affecting the eye",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
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"question": "A 79-year-old presents to the Emergency Department. Upon examination, you are worried that he may have a sixth cranial nerve palsy.\n\nWhich of the following signs and symptoms are likely to be found in a sixth nerve palsy?",
"sbaAnswer": [
"a"
],
"totalVotes": 77,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,507 | false | 7 | null | 6,495,027 | null | false | [] | null | 12,901 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The presentation described is consistent with a third nerve palsy - a lesion affecting the oculomotor nerve. When this nerve is affected, there is unopposed movement of the superior oblique (controlled by the trochlear nerve) and the lateral rectus (controlled by the abducens nerve). These two muscles pull the eye down and out respectively.",
"id": "10001772",
"label": "a",
"name": "Oculomotor nerve",
"picture": null,
"votes": 49
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The trigeminal nerve (fifth cranial nerve) is responsible for the motor and sensory function of the masseter and the temporalis muscles (muscles of mastication). A lesion in the trigeminal nerve would not produce ocular muscle palsies.",
"id": "10001775",
"label": "d",
"name": "Trigeminal nerve",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The facial nerve (seventh cranial nerve), controls muscles of facial expression and receives sensory information from the anterior 2/3 of the tongue. A lesion in the facial nerve would not result in ocular muscle palsies either.",
"id": "10001776",
"label": "e",
"name": "Facial nerve",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The abducens nerve (sixth cranial nerve) innervates the lateral rectus, which pulls the eye outwards. A lesion in the abducens nerve would present as an eye that deviates inwards.",
"id": "10001773",
"label": "b",
"name": "Abducens nerve",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The trochlear nerve (fourth cranial nerve) innervates the superior oblique, which pulls the eye down and inwards. A lesion in the trochlear nerve would result in an eye that is deviated up and out.",
"id": "10001774",
"label": "c",
"name": "Trochlear nerve",
"picture": null,
"votes": 14
}
],
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"name": "Isolated cranial nerve palsies affecting the eye",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
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"question": "A 73-year-old woman presents to the Emergency Department with an eye that is deviated down and out.\n\nA lesion to which cranial nerve would cause these symptoms?",
"sbaAnswer": [
"a"
],
"totalVotes": 80,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,508 | false | 8 | null | 6,495,027 | null | false | [] | null | 12,902 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "A change in appetite (either an increase or a decrease) is a typical physical change found in patients with MDD. A diurnal variation in mood, such as waking up at 4 am with very low mood that improves as the day progresses is also a classic sign of MDD.",
"id": "10001777",
"label": "a",
"name": "Loss of appetite, diurnal variation in mood",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Loss of appetite is a physical symptom that can be found in MDD, however, double vision is not.",
"id": "10001779",
"label": "c",
"name": "Increased appetite, double vision",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hair loss, constipation and cold intolerance are symptoms consistent with hypothyroidism. Although hypothyroidism can also cause depressive symptoms, these symptoms are not consistent with a diagnosis of major depressive disorder (MDD) on their own.",
"id": "10001778",
"label": "b",
"name": "Hair loss, constipation, cold intolerance",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are symptoms consistent with a diagnosis of MDD, however, these are **psychological** symptoms, not **physical** ones that the question is asking for.",
"id": "10001781",
"label": "e",
"name": "Feelings of guilt, suicidal ideation",
"picture": null,
"votes": 42
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The presence of tactile hallucinations would be pointing towards a level of psychosis in this patient - perhaps psychotic depression, not MDD. Insomnia on its own can be a physical symptom of MDD.",
"id": "10001780",
"label": "d",
"name": "Tactile hallucinations, insomnia",
"picture": null,
"votes": 3
}
],
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3971",
"name": "Depression",
"status": null,
"topic": {
"__typename": "Topic",
"id": "173",
"name": "Psychiatry",
"typeId": 5
},
"topicId": 173,
"totalCards": null,
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"question": "A 20-year-old man presents to General Practice with anhedonia, anergia and low mood.\n\nWhich physical symptoms would you also expect to see in this patient if his symptoms are consistent with a diagnosis of major depressive disorder (MDD)?",
"sbaAnswer": [
"a"
],
"totalVotes": 76,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,509 | false | 9 | null | 6,495,027 | null | false | [] | null | 12,903 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Flight of ideas describes when a person is speaking quickly, continuously and erratically.",
"id": "10001785",
"label": "d",
"name": "Flight of ideas",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hallucinations are another hallmark of psychotic disorders - they occur when a person hears, sees, feels or smells something that does not exist in reality, though it feels like reality to them.",
"id": "10001783",
"label": "b",
"name": "Hallucinations",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Disturbed speech is a way of describing when a person jumps from one topic to another mid-sentence.",
"id": "10001786",
"label": "e",
"name": "Disturbed speech",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A formal thought disorder is when a person is unable to sustain a coherent conversation or written text.",
"id": "10001784",
"label": "c",
"name": "Formal thought disorder",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "A delusion is an unshakeable, fixed false belief that a person holds when they experience psychotic symptoms. These beliefs are inconsistent with the person's culture. This is a common symptom and a hallmark of psychotic disorders such as schizophrenia.",
"id": "10001782",
"label": "a",
"name": "Delusions",
"picture": null,
"votes": 70
}
],
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},
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"demo": null,
"entitlement": null,
"id": "3972",
"name": "Schizophrenia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "173",
"name": "Psychiatry",
"typeId": 5
},
"topicId": 173,
"totalCards": null,
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"question": "The mother of a 29-year-old man reports that her son has been acting strangely and talking to himself often. He also has a fixed false belief that aliens are about to land on earth.\n\nWhat are these fixed false beliefs known as in Psychiatry?",
"sbaAnswer": [
"a"
],
"totalVotes": 76,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,510 | false | 10 | null | 6,495,027 | null | false | [] | null | 12,904 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cervical vertebrae (C1-7) are found in the neck - a lesion in this area would affect all the structures below the patient's head.",
"id": "10001789",
"label": "c",
"name": "Cervical vertebrae",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The sacral vertebrae, S1 to S5, are found in the pelvis - this patient is having symptoms in the lower back as well, which makes a lesion in the lumbar area more likely.",
"id": "10001788",
"label": "b",
"name": "Sacral vertebrae",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The coccyx is the last segment of the spinal cord, at the end of the sacral spine. It sits in the buttock region, and would therefore produce symptoms in the legs, without any symptoms in the lower back.",
"id": "10001791",
"label": "e",
"name": "Coccygeal vertebrae",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The lumbar vertebrae contain 5 bones - L1 to L5. These are found in the lower back. The symptoms that this patient is presenting with are consistent with a lesion in this area, as the symptoms begin here and affect all the structures under the lumbar spine. This constellation of symptoms is also known as sciatica and can be caused by a slipped disc or lumbar spinal stenosis (narrowing of the space the spinal nerves pass through the lumbar spine).",
"id": "10001787",
"label": "a",
"name": "Lumbar vertebrae",
"picture": null,
"votes": 42
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Thoracic vertebrae (T1-T12) are found in the thorax - this would mean that structures above the lumbar spine would also be affected if the lesion was in the thoracic spine. This is not the case in this man - the lesion is therefore unlikely to be in the thoracic spine.",
"id": "10001790",
"label": "d",
"name": "Thoracic vertebrae",
"picture": null,
"votes": 15
}
],
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"id": "3973",
"name": "Spinal Stenosis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
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"question": "A 60-year-old man presents with pain in his back, that radiates down his left hand and foot. He also has a pins and needles sensation in his foot. Sensation above his lower back is intact.\n\nA lesion within which section of the spinal vertebrae would produce these symptoms?",
"sbaAnswer": [
"a"
],
"totalVotes": 83,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,511 | false | 11 | null | 6,495,027 | null | false | [] | null | 12,905 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The cruciate ligaments of the knee help stabilise the movements of the knee - particularly whilst it is rotating.\n\nThe anterior cruciate ligament specifically prevents the tibia from sliding in front of the femur - preventing excessive anterior translation.\n\nTests that would help confirm a diagnosis of an ACL tear include a positive Lachmann's, Anterior Drawer or Pivot Shift tests. It is worth searching for a video of these on Youtube to have an idea of what they look like.",
"id": "10001792",
"label": "a",
"name": "Excessive anterior translation of the knee",
"picture": null,
"votes": 45
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The ACL is a soft-tissue structure in the knee, being a ligament. Therefore, you would not expect to see any change to the bony structures to the knee - if there are changes, you would then be expecting to be making another diagnosis on top of the ACL tear!",
"id": "10001796",
"label": "e",
"name": "MRI changes to the patellar bone",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be a sign seen in an Achilles (calcaneal) tendon rupture. The Achilles tendon connects the calf muscles to the foot and allows for plantarflexion of the foot (i.e. pointing your feet).\n\nTherefore, you would expect someone with an Achilles tendon rupture to be unable to do a heel raise (this is the same movement as pointing their feet). This would **not** be found in an ACL injury.",
"id": "10001794",
"label": "c",
"name": "Inability to perform heel raises",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is also what you would find in an Achilles tendon rupture, not an ACL tear.\n\nThe Achilles tendon allows the foot to perform plantarflexion - essentially allowing someone to point their feet. Without an Achilles tendon, the tendons responsible for dorsiflexion (the opposite of plantarflexion) take over, keeping the affected foot held in dorsiflexion.",
"id": "10001795",
"label": "d",
"name": "Left foot held in dorsiflexion",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The cruciate ligaments of the knee also help stabilise the backwards movement of the knee - whilst the ACL prevents excessive **anterior** movement of the tibia over the femur, the posterior cruciate ligament (PCL) prevents excessive movement of the tibia under the femur.\n\nAn injury in the **posterior** cruciate ligament would result in excessive posterior subluxation, but this would not be found in an ACL injury.",
"id": "10001793",
"label": "b",
"name": "Excessive posterior subluxation of the knee",
"picture": null,
"votes": 13
}
],
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"id": "3873",
"name": "Cruciate ligament injuries",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
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"question": "A 26-year-old man presents to the Emergency Department after he fell during a game of football, twisting his knee in the process.\n\nAn MRI scan confirms a left anterior cruciate ligament (ACL) tear - which of the following signs and symptoms would you expect to find in this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 75,
"typeId": 1,
"userPoint": null
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173,460,512 | false | 12 | null | 6,495,027 | null | false | [] | null | 12,906 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The inflammatory stage is the correct beginning for the healing process, however, the reparative (proliferative stage) follows it.\n\nDuring the proliferative stage, the body sends increased growth factors, stem cells and biomaterials such as collagen to the injured limb to help the tear heal. Without this stage, the ligament cannot move onto the remodelling stages, where the healed ligament is strengthened.",
"id": "10001798",
"label": "b",
"name": "Inflammation, Remodelling (consolidation), Remodelling (maturation), Reparative (proliferative)",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The inflammation stage of the ligament healing process must come first - this is where the body reacts to the injury and increases pro-inflammatory markers, which recruit neutrophils and macrophages to the injured limb.\n\nThis is what causes swelling, redness and pain in the first 48 hours of the injury.",
"id": "10001801",
"label": "e",
"name": "Reparative (proliferative), Inflammation, Remodelling (consolidation), Remodelling (maturation)",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The inflammatory and reparative (proliferative) stages are the correct two beginnings of the ligament healing process. However, the remodelling (consolidation) stage comes before the remodelling (maturation) stage.\n\nThe consolidation stage occurs between 6 - 10 weeks after the injury and this is when the limb receives extra collagen type I to strengthen the ligament after it has healed.\n\nThe maturation stage occurs after 10 weeks and can last up to a year - this is when extra fibrous tissue is turned into scar tissue.",
"id": "10001799",
"label": "c",
"name": "Inflammation, Reparative (proliferative), Remodelling (maturation), Remodelling (consolidation)",
"picture": null,
"votes": 31
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The remodelling stage comes after the inflammation and reparative stages of ligament healing.\n\nThe remodelling stages are where the ligament is strengthened after it heals in the reparative stage.",
"id": "10001800",
"label": "d",
"name": "Remodelling (consolidation), Reparative (proliferative), Remodelling (maturation), Inflammation",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "After a ligament is injured, the first 48 hours are characterised by inflammation, during which stage the injury triggers an increase of pro-inflammatory markers, neutrophils, and macrophages to the injured area. This can produce lots of heat, pain and redness, which is why resting the limb and applying ice is essential in the first 48 hours.\n\nAfter the inflammatory process, the reparative process begins - this is where new tissue forms. Growth factors, stem cells and biomaterials now surround the injured limb - this lasts several weeks.\n\nThe two remodelling sections come last - this is where the tissue is strengthened. The consolidation phase occurs between 6 - 10 weeks of injury, where the limb produces an increased synthesis of collagen type I.\n\nAfter 10 weeks, the limb enters the maturation stage, where excess fibrous tissue is turned into scar tissue - this can last up to a year.",
"id": "10001797",
"label": "a",
"name": "Inflammation, Reparative (proliferative), Remodelling (consolidation), Remodelling (maturation)",
"picture": null,
"votes": 40
}
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"name": "Ligaments",
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"typeId": 7
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"question": "Which of the following options correctly states the stages of the ligament healing process in order?",
"sbaAnswer": [
"a"
],
"totalVotes": 75,
"typeId": 1,
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173,460,513 | false | 13 | null | 6,495,027 | null | false | [] | null | 12,907 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "TRAb is an autoantibody found in Graves' disease, which causes hyperthyroidism. Our patient is not having heat intolerance, weight loss or any other hyperthyroid symptoms. This test would be inappropriate for this patient.\n\nANA testing, although a positive marker can be indicative of RA, is mainly used in the diagnosis of Systemic Lupus Erythematosus (SLE).",
"id": "10001803",
"label": "b",
"name": "TSH receptor antibody (TRAb), Antinuclear antibody test (ANA)",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with symptoms of Rheumatoid Arthritis (RA.\n\nRA classically presents with bilateral joint pain (throbbing or aching), swelling and early morning stiffness.\n\nIn RA, the two main autoinflammatory markers that **can** be elevated are Rheumatoid Factor (Rf) and Anti-CCP (cyclic citrullinated peptide) - these are the blood markers you would test for.",
"id": "10001802",
"label": "a",
"name": "Rheumatoid factor (Rf), Anti-cyclic citrullinated peptide",
"picture": null,
"votes": 55
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Anti-La and Anti-Ro are used to diagnose Sjögren's Syndrome, a disease where the body is unable to produce an adequate amount of bodily fluids.\n\nThe patient is presenting with classical symptoms of Rheumatoid Arthritis, for which you would test for Rheumatoid Factor (Rf) and Anti-CCP first line.",
"id": "10001805",
"label": "d",
"name": "Anti-La, Anti-Ro",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Rheumatoid factor (Rf) would indeed be tested for in a patient presenting with symptoms of Rheumatoid Arthritis. However, it would be most appropriate to start with measuring Anti-cyclic citrullinated peptide before antinuclear antibodies. The latter is more commonly used for the diagnosis of systemic lupus erythematosus (SLE).",
"id": "10001804",
"label": "c",
"name": "Antinuclear antibody test (ANA), Rheumatoid factor (Rf)",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "You would measure Anti-CCP levels when investigating this patient as he is presenting with classical symptoms of Rheumatoid Arthritis.\n\nHowever, measuring TRAb levels would be inappropriate, as this is raised in Graves' Disease. Only if the patient were presenting with hyperthyroid symptoms would this be measured.",
"id": "10001806",
"label": "e",
"name": "Anti-cyclic citrullinated peptide (Anti-CCP), TSH Receptor Antibody (TRAb)",
"picture": null,
"votes": 4
}
],
"comments": [],
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},
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"name": "Rheumatoid Arthritis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "146",
"name": "Rheumatology",
"typeId": 7
},
"topicId": 146,
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"question": "A 67-year-old man presents to General Practice with early morning stiffness and bilateral pain in his hands and wrists.\n\nWhich of the following blood markers would be the next best investigations to guide you towards the diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 74,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,514 | false | 14 | null | 6,495,027 | null | false | [] | null | 12,908 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient has little mobility - telling the patient to exercise on their own, when they cannot move independently, is ineffective as they won't be able to do the exercise. If they do try to mobilise by themselves, it increases their risk of falling.\n\nPhysiotherapy - exercise guided by a specialist - is the appropriate option to increase this patient's activity.",
"id": "10001811",
"label": "e",
"name": "Exercise, weight loss",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The most likely diagnosis for this patient is Osteoarthritis. Osteoarthritis is a degenerative condition of bone cartilage occurring with old age.\n\nThis can lead to joint pain and X-ray changes.\n\nAn easy way to remember the classical X-Ray changes seen in osteoarthritis is the acronym LOSS: **L**oss of joint space, **O**steophytes (bone spurs), **S**clerosis (whitening showing up on the X-Ray), **S**ubchondral cysts (fluid-filled cysts in the bone).",
"id": "10001807",
"label": "a",
"name": "Physical therapy, paracetamol",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Whilst surgery is an appropriate management for osteoarthritis, this patient's symptoms are in the knee - therefore, a hip replacement would do little to alleviate this patient's symptoms.\n\nA Knee Replacement Surgery on the other hand may be an appropriate way of managing this patient's symptoms if he had a better functional baseline.",
"id": "10001809",
"label": "c",
"name": "Hip Replacement Surgery",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Methotrexate is a medication used to treat autoimmune arthritides such as Rheumatoid Arthritis. These would not present with the classical X-Ray changes for osteoarthritis that is seen in this patient.\n\nX-Ray changes for someone with Rheumatoid Arthritis would be fusiform soft tissue swelling or juxta-articular osteoporosis. You do not need the X-Ray changes for Rheumatoid Arthritis in much detail, bus it is important to know the changes for Osteoarthritis.",
"id": "10001808",
"label": "b",
"name": "Methotrexate",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be an appropriate choice for pain management if the patient did **not** have gastric ulcers.\n\nNSAIDs increase the stomach's acidity and are therefore contraindicated in patients who already have gastric ulcers.\n\nThis patient would be more safely managed on paracetamol or using the WHO pain ladder for his pain relief.",
"id": "10001810",
"label": "d",
"name": "NSAIDs",
"picture": null,
"votes": 13
}
],
"comments": [
{
"__typename": "QuestionComment",
"comment": "First line tx is topical NSAIDs (avoid gastic ulcer issues).",
"createdAt": 1704715127,
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"demo": null,
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"name": "Osteoarthritis",
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"name": "Rheumatology",
"typeId": 7
},
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"question": "An 85-year-old man presents to the General Practice with knee pain. An X-Ray of his knee is taken, showing loss of bone space, osteophytes, sclerosis and subchondral cysts.\n\nHe has a history of gastric ulcers and is unable to mobilise unsupported.\n\nWhich of the following would be the most appropriate way to manage this condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 69,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,515 | false | 15 | null | 6,495,027 | null | false | [] | null | 12,909 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The hormone that stimulates uterine contractions and milk ejection is oxytocin. Oxytocin is produced in the posterior pituitary, alongside arginine vasopressin (AVP), a hormone responsible for regulating the body's water content. (It is also known as anti-diuretic hormone (ADH)).",
"id": "10001812",
"label": "a",
"name": "Arginine Vasopressin (AVP)",
"picture": null,
"votes": 43
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Thyroxine is produced in the anterior pituitary gland, not the posterior pituitary gland where AVP and oxytocin (hormone causing uterine contractions and milk ejection) are produced.",
"id": "10001814",
"label": "c",
"name": "Thyroxine",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Similar to thyroxine, growth hormone is also produced in the anterior pituitary gland, not the posterior pituitary gland where AVP and oxytocin (hormone causing uterine contractions and milk ejection) are produced.",
"id": "10001815",
"label": "d",
"name": "Growth Hormone",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Prolactin is also produced in the anterior pituitary gland, not the posterior pituitary gland where AVP and oxytocin (hormone causing uterine contractions and milk ejection) are produced.",
"id": "10001816",
"label": "e",
"name": "Prolactin",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Dopamine is produced in an area known as the substantia nigra in the brain, not the posterior pituitary gland, where AVP and oxytocin are produced.\n\nOxytocin is the hormone responsible for milk ejection and uterine contractions.\n\nThe relation that dopamine has to the pituitary gland is that it inhibits the production of prolactin, from the anterior pituitary gland.",
"id": "10001813",
"label": "b",
"name": "Dopamine",
"picture": null,
"votes": 2
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3977",
"name": "Pituitary disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
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"userNote": null,
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},
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"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
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"question": "Which other hormone is produced in the same area of the pituitary gland which produces the hormone which stimulates uterine contractions to deliver a baby and milk ejection from a pregnant woman's breasts?",
"sbaAnswer": [
"a"
],
"totalVotes": 73,
"typeId": 1,
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173,460,516 | false | 16 | null | 6,495,027 | null | false | [] | null | 12,910 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a cancer found in the large bowel - this would not cause this specific visual disturbance on its own. It could cause a bitemporal hemianopia if it metastasises to the pituitary gland - however, this is extremely rare and it would not be the tumour you are **most** concerned about in this case.",
"id": "10001818",
"label": "b",
"name": "Colorectal adenocarcinoma",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The specific type of visual loss described in this question is bitemporal hemianopia.\n\nThis is a classic presenting symptom of a pituitary tumour - the tumour can get so large that it compresses the optic chiasm, causing peripheral vision loss in both eyes.",
"id": "10001817",
"label": "a",
"name": "Pituitary adenoma",
"picture": null,
"votes": 43
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A vestibular schwannoma is a tumour found in the vestibulocochlear nerve. This is the 8th Cranial Nerve and is responsible for conducting hearing information to the brain and helping the body maintain balance.\n\nA tumour in this nerve would result in symptoms such as hearing loss and/or a loss of balance. It would not result in a bitemporal hemianopia (loss of peripheral vision on both sides).",
"id": "10001819",
"label": "c",
"name": "Vestibular schwannoma",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An oligodendroglioma is a tumour in oligodendrocytes, the myelinating cells of the central nervous system. These tumours are usually found in the brain but can spread to the spinal cord as well.\n\nThis type of tumour can grow very large and is therefore likely to cause headaches, seizures, nausea/vomiting, and a loss of sensation in the limbs.\n\nIt can also cause speech, vision or memory problems. However, the visual loss associated with this type of brain tumour is likely to be gradual, with blurriness and double vision, or an increasing blind spot.\n\nIt is much less likely to cause a bitemporal hemianopia - the loss of peripheral vision on both sides - this is much **more likely** to be due to a pituitary adenoma compressing the optic chiasm.",
"id": "10001820",
"label": "d",
"name": "Oligodendroglioma",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An ocular melanoma is a tumour found in the eye - this is likely to cause visual loss in one eye only.\n\nVisual loss of both sides is more indicative of an issue in the brain - in this case, a pituitary tumour is the **most likely** cause of the tumour.",
"id": "10001821",
"label": "e",
"name": "Ocular melanoma",
"picture": null,
"votes": 10
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3977",
"name": "Pituitary disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
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"highlights": [],
"id": "12910",
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"psaSectionId": null,
"qaAnswer": null,
"question": "A 79-year-old man presents to the Emergency Department with peripheral vision loss in both eyes.\n\nYou suspect he may have a tumour - which of the following tumours are you most concerned about?",
"sbaAnswer": [
"a"
],
"totalVotes": 65,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,517 | false | 17 | null | 6,495,027 | null | false | [] | null | 12,911 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ferritin is a marker of iron stored in the body. Fatigue is a classical symptom of iron deficiency anaemia - which is due to a decrease in iron levels.\n\nThis patient is most likely suffering from a thyroid induced issue, however, even if ferritin is measured, you would expect it to be **below** the normal ranges, not above.",
"id": "10001825",
"label": "d",
"name": "Ferritin",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "T3 is similar to thyroxine (T4) - it is the precursor to T4. This patient is most likely presenting with hypothyroidism - a decrease in the thyroxine (T4) levels in the body, Since T3 is the precursor to T4, this means that we would also expect to find a **decreased** level of T3 in the body.",
"id": "10001824",
"label": "c",
"name": "Triiodothyronine (T3)",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with classical symptoms of hypothyroidism. This is a decrease in the levels of thyroxine in her body.\n\nIf this is due to the woman's thyroid not producing enough T4, there would be an **increase** in thyroid stimulating hormone (TSH) since this patient's pituitary gland will be trying to compensate for the decrease in T4 levels. This patient's thyroid gland however is not reacting to the increased TSH levels.",
"id": "10001822",
"label": "a",
"name": "Thyroid-stimulating hormone (TSH)",
"picture": null,
"votes": 58
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Transferrin is a protein produced by the liver that binds to iron. The more iron bound to transferrin, the less transferrin there is available in the body.\n\nTransferrin is a good indicator for iron deficiency anaemia, where you would expect to find an increased level of it.\n\nHowever, this patient is more likely to suffer from hypothyroidism than iron-deficiency anaemia (IDA). Despite her fatigue, which is a symptom in both hypothyroidism and IDA, her hair loss, weight gain, low mood and cold intolerance are much more indicative of hypothyroidism. TSH levels are more likely to be raised than transferrin in this patient.",
"id": "10001826",
"label": "e",
"name": "Transferrin",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This woman is presenting with classical symptoms of hypothyroidism. Hypothyroidism indicates a decrease in the levels of thyroxine in the body (hypo- means below in Latin).\n\nYou would therefore expect to find a **decreased** level of thyroxine in this patient.",
"id": "10001823",
"label": "b",
"name": "Thyroxine (T4)",
"picture": null,
"votes": 10
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3765",
"name": "Hypothyroidism",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
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"question": "A 38 year old female presents to General Practice with a 5 month history of fatigue, weight gain and hair loss. She also complains that she often feels cold on a hot summer day.\n\nAfter taking some blood from this patient, which blood marker is most likely to be raised in this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 73,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,518 | false | 18 | null | 6,495,027 | null | false | [] | null | 12,912 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are symptoms of hyperthyroidism - an overproduction of thyroxine.\n\nThyroxine regulates metabolism, and an increased level of thyroxine increases the body's metabolism, producing symptoms such as increased appetite but weight loss, sweating, agitation and always feeling hot (heat-intolerance).",
"id": "10001829",
"label": "c",
"name": "Increased appetite, heat intolerance, agitation",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are symptoms of a pituitary adenoma. A tumour in the pituitary gland can compress the optic chiasm, causing blindness in the peripheries of both eyes (bitemporal hemianopia). If the pituitary adenoma produces excess prolactin, known as a prolactinoma, it can also cause erectile dysfunction and gynaecomastia (discharge from the nipple in men).",
"id": "10001830",
"label": "d",
"name": "Bitemporal hemianopia, erectile dysfunction, gynaecomastia",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This presentation is symptomatic of a condition known as acromegaly, or gigantism if it occurs in children. This is also usually due to a pituitary tumour, but this time one that causes excess secretion of Growth Hormone (GH), which leads to increased tongue and hand size.",
"id": "10001831",
"label": "e",
"name": "Sweating, increased tongue size, increased hand size",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are symptoms that are characteristic of hypothyroidism - a decrease in thyroxine levels in the body.\n\nThyroxine is responsible for regulating the body's metabolism, and a decrease in thyroxine slows metabolism down, explaining why a person may always feel cold (cold-intolerance), be low in mood and feel tired.",
"id": "10001828",
"label": "b",
"name": "Cold intolerance, fatigue, low mood",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Cushing's syndrome is caused by an excess production of the hormone cortisol. Cortisol is produced in the early mornings to wake us up. It is also produced in times when we are stressed, to increase the levels of glucose in the bloodstream available for cells to use.\n\nAn excess of cortisol will produce the symptoms listed above, and therefore these are the symptoms you would expect to find in Cushing's syndrome.",
"id": "10001827",
"label": "a",
"name": "Red striae, central obesity, red and puffy face",
"picture": null,
"votes": 66
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3764",
"name": "Cushing's syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3764,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12912",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
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"psaSectionId": null,
"qaAnswer": null,
"question": "A 68-year-old man is diagnosed with Cushing's syndrome.\n\nWhich of the following symptoms are you most likely to find in this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 77,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,519 | false | 19 | null | 6,495,027 | null | false | [] | null | 12,913 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "FGF23 **decreases** the serum levels of Vitamin D3. FGF23's main job is to decrease serum phosphate. Vitamin D3 on the other hand increases serum phosphate by stimulating uptake in the small intestines, and reabsorption in the kidneys.\n\nFGF23 blocks the production of Vitamin D3 to prevent its effect on phosphate reabsorption - therefore, it **decreases** serum Vitamin D3.",
"id": "10001834",
"label": "c",
"name": "Increases serum Vitamin D3 levels",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The main job of FGF23 in the body is to promote the excretion of phosphate through the urine by inhibiting the sodium-phosphate co-transporter found in the proximal convoluted tubule.\n\nIt also inhibits the production of calcitriol (Vitamin D3), which has a potent effect of causing phosphate reabsorption in the kidneys and bowels - which FGF23 is trying to stop.",
"id": "10001832",
"label": "a",
"name": "Reduces serum phosphate",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "FGF23 is responsible for regulating serum phosphate levels in the body (lowering serum phosphate levels) - it does not affect serum potassium levels.",
"id": "10001836",
"label": "e",
"name": "Decreases serum potassium levels",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "FGF23 does the exact opposite - its main role is to **decrease** the serum phosphate in the body.\n\nIt does so by increasing the excretion of phosphate through the urine and decreasing the levels absorbed from the kidneys and bowels (which it does by inhibiting the production of Vitamin D3).",
"id": "10001833",
"label": "b",
"name": "Increase serum phosphate",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "FGF23 blocks the production of Vitamin D3 to prevent its effect on phosphate reabsorption.\n\nVitamin D3 is responsible for increasing the levels of calcium absorption in the body. Therefore, a decrease in the levels of Vitamin D3 would cause a **decrease** in serum calcium levels.",
"id": "10001835",
"label": "d",
"name": "Increases serum calcium levels",
"picture": null,
"votes": 12
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3978",
"name": "Calcium homeostasis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3978,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12913",
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"likes": 0,
"multiAnswer": null,
"pictures": [],
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"psaSectionId": null,
"qaAnswer": null,
"question": "What is the role of the hormone fibroblast growth factor 23 (FGF23) in the human body?",
"sbaAnswer": [
"a"
],
"totalVotes": 60,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,520 | false | 20 | null | 6,495,027 | null | false | [] | null | 12,914 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cushing's Disease occurs when symptoms of Cushing's Syndrome are caused by a pituitary tumour.\n\nSymptoms of Cushing's Syndrome include low mood, central obesity (fat around the abdomen but not around the limbs), a red and puffy face, and red striae (stretch marks).\n\nThese symptoms are not what we are seeing in our patient - Cushing's disease is the incorrect diagnosis.",
"id": "10001838",
"label": "b",
"name": "Cushing's Disease",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hashimoto's thyroiditis is also an autoimmune condition that affects the thyroid.\n\nHowever, it causes hypothyroidism, not hyperthyroidism. This would result in symptoms such as fatigue, weight gain despite decreased appetite, low mood and cold intolerance.",
"id": "10001840",
"label": "d",
"name": "Hashimoto's Thyroiditis",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient's symptoms are consistent with a diagnosis of Graves' Disease.\n\nGraves' Disease is an autoimmune condition where the body produces high levels of antibodies binding to the TSH receptors, activating them. The body responds by increasing its production of Thyroxine, leading to symptoms of hyperthyroidism such as heat-intolerance, diarrhoea, tremors and agitation.\n\nTSH receptors are also found at the back of the eye, on the shins. Graves' disease causes an accumulation of hormone behind these structures too - leading to exophthalmos and pretibial myxoedema.",
"id": "10001837",
"label": "a",
"name": "Graves' Disease",
"picture": null,
"votes": 55
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Addison's Disease occurs when there is a decreased level of cortisol in the body.\n\nThis is the opposite of Cushing's syndrome - this can cause symptoms such as tanned skin, weight loss, decreased appetite and fatigue.",
"id": "10001839",
"label": "c",
"name": "Addison's Disease",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Conn's Syndrome occurs when a tumour produces increased levels of aldosterone in the body. This increases serum sodium, leading to hypertension (high blood pressure) and hypokalaemia (low potassium levels).",
"id": "10001841",
"label": "e",
"name": "Conn's Syndrome",
"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": "3959",
"name": "Hyperthyroidism",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3959,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12914",
"isLikedByMe": null,
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"likes": 0,
"multiAnswer": null,
"pictures": [],
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"psaSectionId": null,
"qaAnswer": null,
"question": "A 32-year-old woman presents to General Practice with exophthalmos, pretibial myxoedema and a tremor.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 69,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,521 | false | 21 | null | 6,495,027 | null | false | [] | null | 12,915 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gigantism produces similar symptoms to acromegaly - however, it is defined as a condition that affects children.\n\nWhen these symptoms affect an adult (our patient is 45), it is known as acromegaly.",
"id": "10001843",
"label": "b",
"name": "Gigantism",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Eczema is an autoimmune dermatological condition that results in dry, scaly skin that is pruritus (itchy).\n\nIt would not result in sleep apnoea, coarsening of facial features or soft tissue hypertrophy.",
"id": "10001844",
"label": "c",
"name": "Eczema",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cushing's Syndrome is caused by an increased level of serum cortisol. You would expect to see a patient complaining of symptoms such as weight gain, stretch marks, and a red and puffy face.\n\nThese symptoms are not observed in this patient.",
"id": "10001846",
"label": "e",
"name": "Cushing's Syndrome",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with symptoms of acromegaly - most likely due to a pituitary adenoma secreting excess Growth Hormone (GH).\n\nAcromegaly results in symptoms such as frontal bossing (prominent forehead), enlarged nose, prognathism (protruding jaw), and macroglossia (enlarged tongue).\n\nDue to the enlarged features, it can cause sleep apnoea (when a patient has episodes where they cannot breathe whilst sleeping). At night the muscles in the patient's neck relax, and the weight of the enlarged features results in a collapse of the patient's airway.",
"id": "10001842",
"label": "a",
"name": "Acromegaly",
"picture": null,
"votes": 48
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypothyroidism is characterised by a decrease in serum thyroxine levels. This would result in symptoms such as fatigue, cold intolerance (i.e. being cold all the time, despite hot weather), weight gain and constipation.",
"id": "10001845",
"label": "d",
"name": "Hypothyroidism",
"picture": null,
"votes": 9
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3979",
"name": "Acromegaly",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3979,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12915",
"isLikedByMe": null,
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"likes": 0,
"multiAnswer": null,
"pictures": [],
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"psaSectionId": null,
"qaAnswer": null,
"question": "A 45-year-old man presents to General Practice with a coarsening of facial features, and sleep apnoea and reports his wedding ring no longer fits.\n\nWhich of the following conditions is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 70,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,522 | false | 22 | null | 6,495,027 | null | false | [] | null | 12,916 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "You would expect to find a decreased level of oestrogen in a post-menopausal woman as her ovaries would not respond to the FSH signal anymore. This is what leads to the absence of menses.",
"id": "10001850",
"label": "d",
"name": "Elevated FSH, Elevated Oestrogen",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "You would expect to see an elevated FSH and low oestrogen in a woman who has completed the pause.\n\nDuring menopause, a woman's ovaries stop producing oestrogen. This results in an increase in FSH levels. The brain is still interpreting these low oestrogen levels and trying to stimulate an increase in oestrogen with increased levels of FSH, however, the woman's body is not responding to the raised FSH signal anymore.",
"id": "10001847",
"label": "a",
"name": "Elevated Follicle Stimulating Hormone (FSH), Low Oestrogen",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "You would expect to find a low oestrogen in a post-menopausal woman, as her ovaries are not producing oestrogen anymore, and will atrophy.\n\nThis results in an increase in FSH levels as the body compensated for the decreased oestrogen. However, the post-menopausal ovaries will not respond to this signal anymore.",
"id": "10001848",
"label": "b",
"name": "Low FSH, High Oestrogen",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "You would indeed expect to find a low oestrogen level as the woman's ovaries stop producing oestrogen.\n\nHowever, you would expect the FSH levels to be elevated. The brain is still interpreting the low oestrogen levels and will try to increase them to maintain homeostasis. However, this patient's ovaries will not respond to the high FSH levels any longer.",
"id": "10001849",
"label": "c",
"name": "Low FSH, Low Oestrogen",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "You would expect to find decreased levels of oestrogen in a post-menopausal woman as her ovaries will not be producing this hormone anymore. A high FSH level compensating for the decreased oestrogen levels would also be found.",
"id": "10001851",
"label": "e",
"name": "Fluctuating FSH, Elevated Oestrogen",
"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": "3980",
"name": "Menopause",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3980,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12916",
"isLikedByMe": null,
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"question": "Which of the following blood test results would you expect to see in a 68-year-old woman who has already undergone menopause?",
"sbaAnswer": [
"a"
],
"totalVotes": 70,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,523 | false | 23 | null | 6,495,027 | null | false | [] | null | 12,917 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with classical symptoms of type II diabetes (T2DM). To investigate for T2DM, we would test HbA1c levels, along with a fasted serum glucose level, random serum glucose and an oral glucose tolerance test (OGTT).\n\nHbA1c should be under 42mmol/mol in patients who do **not** already have diabetes. It measures the proportion of red blood cells that have glucose bound to them - giving a 3-month average of how a person's blood sugar is being controlled.\n\nIncreased blood sugar levels prompt the body to increase its water levels (to dilute the blood sugar levels), explaining the polydipsia (increased thirst).\n\nThe kidneys also compensate by excreting more glucose - bringing fluids with it - explaining the nocturia (urinating at night) and polyuria (increased urine output).",
"id": "10001852",
"label": "a",
"name": "HbA1c (Glycated haemoglobin)",
"picture": null,
"votes": 67
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Liver Function Tests are performed to investigate liver and gallbladder pathologies.\n\nThe patient's symptoms are not classically indicative of liver pathology - this would not be a first-line investigation.\n\nWe would investigate for Type II Diabetes in a patient with these symptoms.",
"id": "10001854",
"label": "c",
"name": "Liver Function Tests (LFTs)",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Iron studies (iron, ferritin, transferrin & total iron binding capacity) blood tests are done to investigate Iron Deficiency Anaemia (IDA), which can lead to fatigue.\n\nHowever, due to the urinary symptoms that this patient is also experiencing - the **most likely** diagnosis is Type II Diabetes, not IDA. We would not do an Iron Studies as a first-line investigation.",
"id": "10001853",
"label": "b",
"name": "Iron Studies",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Thyroid Function Tests investigate hypo or hyperthyroidism. The patient is not presenting with any symptoms of hyperthyroidism, and the only symptom indicative of hypothyroidism is fatigue.\n\nWe would investigate this patient for Type II Diabetes as a first-line option due to this patient's urinary symptoms.",
"id": "10001855",
"label": "d",
"name": "Thyroid Function Tests (TFTs)",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An Antinucleated antibody test investigates the presence of autoimmune conditions, such as Systemic Lupus Erythematous, Rheumatoid Arthritis, Scleroderma, and Sjögren's syndrome.\n\nThis patient's symptoms are classically indicative of Type II Diabetes - we would perform an HbA1c to investigate for this.",
"id": "10001856",
"label": "e",
"name": "Antinucleated antibody test (ANA)",
"picture": null,
"votes": 0
}
],
"comments": [],
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3761",
"name": "Type 2 Diabetes Mellitus",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
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"question": "A 58-year-old man presents to General Practice complaining of increased thirst, waking up at night to use the toilet, increased urinary frequency during the day, and feeling very tired.\n\nWhich investigation would you carry out to illicit the **most likely** diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 73,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,524 | false | 24 | null | 6,495,027 | null | false | [] | null | 12,918 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Granulosa cells are found within the inner part of the ovarian follicles. They are responsible for converting androgens such as testosterone to oestrogen.\n\nTheca cells, found on the outer part of the ovarian follicles, are the cells that produce testosterone in the ovaries.",
"id": "10001858",
"label": "b",
"name": "Granulosa cells",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Sertoli cells are found within the seminiferous tubules of the testes. They secrete the hormones inhibin, activin, androgen-binding protein (ABP) and anti-mullerian hormone (AMH).\n\nSertoli cells are not found in the ovaries. Theca cells in the ovaries are responsible for the production of testosterone.",
"id": "10001859",
"label": "c",
"name": "Sertoli cells",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Spermatocytes are premature spermatozoa that are formed as part of the gametogenesis process in males. They are not responsible for the production of testosterone.\n\nTheca cells, found on the outer lining of ovarian follicles, are responsible for the production of testosterone in females.",
"id": "10001861",
"label": "e",
"name": "Spermatocytes",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Leydig cells are found in between seminiferous tubules. They respond to LH stimulation to secrete testosterone. However - they are found in the testes, not the ovaries.\n\nThe equivalent to Leydig cells in the ovaries are the Theca cells. They produce testosterone in the ovaries.",
"id": "10001860",
"label": "d",
"name": "Leydig cells",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The theca cells are found in the outer part of the ovarian follicles.\n\nThey support folliculogenesis, providing structural and nutritional support for growing follicles.\n\nThey also respond to LH stimulation by producing androgens such as testosterone.",
"id": "10001857",
"label": "a",
"name": "Theca cells",
"picture": null,
"votes": 23
}
],
"comments": [],
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},
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"demo": null,
"entitlement": null,
"id": "3981",
"name": "Cells of the reproductive system",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
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"userChapter": null,
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},
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"difficulty": 1,
"dislikes": 0,
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"highlights": [],
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"question": "Which cells in the ovaries are responsible for the production of testosterone?",
"sbaAnswer": [
"a"
],
"totalVotes": 74,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,525 | false | 25 | null | 6,495,027 | null | false | [] | null | 12,919 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Tacrolimus is a calcineurin inhibitor, which are second-line treatments for moderate to severe eczema.\n\nIt is this patient's initial presentation, meaning that this is the first time that she has presented with this problem.\n\nWe would first try emollients to resolve her symptoms - this is the first-line treatment - before using second-line treatments for more severe symptoms.",
"id": "10001865",
"label": "d",
"name": "Topical tacrolimus",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Phototherapy is a proven procedure used to manage eczema symptoms. However, it is not the first-line option that physicians should offer patients.\n\nThis is this patient's first presentation with eczema - emollients should be trialled to control her symptoms before medication and procedures are introduced.\n\nThis prevents the patient from being over-treated for their condition, which can be both time-consuming and financially costly.",
"id": "10001863",
"label": "b",
"name": "Phototherapy",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with symptoms of Eczema (atopic dermatitis).\n\nEczema classically presents with dry, itchy skin. This is usually accompanied by erythema (redness), scaling and lichenification in skin flexures (e.g. elbow).\n\nEmollients - moisturising cream - are the first-line treatment for eczema. Topical corticosteroids are then considered if emollients insufficiently control symptoms.",
"id": "10001862",
"label": "a",
"name": "Emollients",
"picture": null,
"votes": 44
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is presenting with symptoms of eczema.\n\nSystemic corticosteroids such as prednisolone, are a second-line treatment for eczema.\n\nFirst-line treatments are emollients, followed by topical corticosteroids if symptoms are not controlled. Topical antibiotics are considered if there are signs of bacterial infection.",
"id": "10001864",
"label": "c",
"name": "Systemic corticosteroids",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is presenting with symptoms of eczema, but there are **no** indications of bacterial infection.\n\nWe would not use topical antibiotics in this case as there is no need for antibacterial therapy.",
"id": "10001866",
"label": "e",
"name": "Topical antibiotics",
"picture": null,
"votes": 2
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3982",
"name": "Atopic Dermatitis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3982,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12919",
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"question": "A 12-year-old female makes an initial presentation to General Practice with a red, itchy rash on the insides of her elbows. Upon inspection, the rash is dry, scaly, with **no** signs of infection.\n\nWhat is the first-line option to manage this patient's symptoms?",
"sbaAnswer": [
"a"
],
"totalVotes": 63,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,526 | false | 26 | null | 6,495,027 | null | false | [] | null | 12,920 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are symptoms of lower gastrointestinal cancers, such as colorectal cancer. A gastric cancer - stomach cancer - would not produce lower gastrointestinal symptoms, as it is further away from the colon and rectum.",
"id": "10001868",
"label": "b",
"name": "Change in bowel habits, fresh blood in the stool",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would indicate a more acute upper gastrointestinal lesion, such as a tear in the oesophagus, or a ruptured vein.\n\nA gastric cancer is unlikely to cause large volumes of acute blood loss. It may cause chronic blood loss, which can cause anaemia or melaena (tarry, black stool due to digested blood, which has been lost from the stomach and digested in the small bowel).",
"id": "10001870",
"label": "d",
"name": "Haematemesis (vomiting blood)",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Unintentional, rapid weight loss is always a hallmark sign of cancer.\n\nGastric cancers tend to present with epigastric pain - pain in the centre of the abdomen, just under the diaphragm - in their early stages.",
"id": "10001867",
"label": "a",
"name": "Weight loss, abdominal pain",
"picture": null,
"votes": 47
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These symptoms are indicative of renal colic, which is pain associated with kidney pathologies, such as a kidney stone.\n\nGastric cancers would not present with any renal symptoms. They classically present with weight loss and abdominal pain.",
"id": "10001869",
"label": "c",
"name": "Pain radiating from the loin to the groin",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Iron deficiency anaemia and fatigue are symptoms of gastrointestinal cancers, however, bloating would suggest a differential diagnosis such as coeliac disease or inflammatory bowel disease.",
"id": "10001871",
"label": "e",
"name": "Bloating, iron deficiency anaemia, fatigue",
"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": "3983",
"name": "Gastric Cancer",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3983,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12920",
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"psaSectionId": null,
"qaAnswer": null,
"question": "A 61-year-old man presents to General Practice with gastric cancer.\n\nWhat signs and symptoms would you expect to find in this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 73,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,527 | false | 27 | null | 6,495,027 | null | false | [] | null | 12,921 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an acronym used to remember the red flag symptoms associated with dyspepsia (difficulty/discomfort swallowing).\n\n**A**naemia (iron deficiency)\n**L**oss of weight\n**A**norexia\n**R**ecent onset of progressive symptoms\n**M**elaena / haematemesis\n**S**wallowing difficulty\n**>55**yrs?\n\nThis is not the correct criteria to use - in this patient we are assessing for acute pancreatitis, not dyspepsia.",
"id": "10001875",
"label": "d",
"name": "ALARMS55",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The CAGE Questionnaire is used to assess for harmful alcohol use. It stands for the following questions:\n\nHave you ever felt you needed to **Cut** down on your drinking?\n\nHave people **Annoyed** you by criticizing your drinking?\n\nHave you ever felt **Guilty** about drinking?\n\nHave you ever felt you needed a drink first thing in the morning **(Eye-opener)** to steady your nerves or to get rid of a hangover?\n\nThis is not the correct questionnaire used to assess the severity of acute pancreatitis, which this patient is presenting with.",
"id": "10001873",
"label": "b",
"name": "CAGE Questionnaire",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The Glasgow Coma scale is used to assess a patient's neurological function. It is measured out of a total score of 13, assessing eye movement, motor movement and speech.\n\nIt is not used to assess the severity of acute pancreatitis - the condition this patient is presenting with.",
"id": "10001876",
"label": "e",
"name": "Glasgow Coma Scale",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The Child-Pugh score is used to assess disease severity for end-stage Liver Failure. It takes into account total bilirubin, serum albumin, International Normalised Ratio (INR), ascites and hepatic encephalopathy.\n\nIt is not used to assess the severity of acute pancreatitis, which this patient is presenting with.",
"id": "10001874",
"label": "c",
"name": "Child-Pugh Score",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Nausea, vomiting, and epigastric abdominal pain are symptoms associated with acute pancreatitis. Epigastric pain is usually alleviated when leaning forward in this condition, which can be caused by gallstones and excessive alcohol consumption.\n\nThe Glasgow-Imrie Criteria are the correct criteria to assess the severity of acute pancreatitis.\n\nIt takes into account the following, which can be easily remembered with the acronym PANCREAS:\n\nP- PaO2 (<8 kPa)\nA- Age (>55 yrs)\nN- Neutrophils (Wbc > 15x10^9^/L)\nC- Calcium (<2 mmol/L)\nR- Renal (Urea >16 mmol/L)\nE- Enzymes (Liver enzymes AST (>200 iU/L)/ LDH >600 iU/L)\nA- Albumin (<32 g)\nS- Sugar (Blood Sugar >10 mmol/l)",
"id": "10001872",
"label": "a",
"name": "Glasgow-Imrie Criteria",
"picture": null,
"votes": 21
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3730",
"name": "Acute Pancreatitis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
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"userChapter": null,
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},
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"difficulty": 1,
"dislikes": 0,
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"question": "A 28-year-old man presents to the Emergency Department with severe epigastric abdominal pain, nausea and vomiting. His pain is lightly relieved if he leans forwards.\n\nThis patient has a history of gallstones and drinks 20 units of alcohol a week.\n\nWhat is the name of the criteria used to assess the severity of the disease this patient is presenting with?",
"sbaAnswer": [
"a"
],
"totalVotes": 64,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,528 | false | 28 | null | 6,495,027 | null | false | [] | null | 12,922 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The synthesis of clotting factors is the hepatocytes' job.\n\nHepatocytes make up 80% of the liver mass, synthesising albumin, clotting factors and bile salts. The bile salts are then mixed with bicarbonate and water produced by the cholangiocytes, to form bile.",
"id": "10001878",
"label": "b",
"name": "Synthesis of clotting factors",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Cholangiocytes are epithelial cells found in the hepatobiliary system.\n\nThey are responsible for modifying the bile produced by the hepatocytes in the liver, making it more alkaline, through the addition of HCO^3- (bicarbonate).",
"id": "10001877",
"label": "a",
"name": "Secrete bicarbonate into bile",
"picture": null,
"votes": 44
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Eliminating toxins is the Kuppfer cells' job. Kuppfer cells are sinusoidal macrophage cells, attached to endothelial cells.\n\nCholangiocytes are epithelial cells responsible for modifying bile produced by the hepatocytes, adding bicarbonate to it.",
"id": "10001880",
"label": "d",
"name": "Detoxifies substances arriving in the liver from the portal circulation",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Vitamin A is stored in liver cytosolic droplets in hepatic stellate cells.\n\nCholangiocytes are responsible for finalising the production of bile - they secrete bicarbonate into the bile coming from the hepatocytes.",
"id": "10001879",
"label": "c",
"name": "Storage of Vitamin A",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the job of Sinusoidal endothelial cells. The liver does not have a basement membrane - these are the cells that act as a barrier.\n\nThe cholangiocytes are not responsible for forming this barrier - instead, they add bicarbonate to the bile produced by the hepatocytes, making bile more alkaline.",
"id": "10001881",
"label": "e",
"name": "Allows lipid movement to and from hepatocytes",
"picture": null,
"votes": 9
}
],
"comments": [],
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"__typename": "Chapter",
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3984",
"name": "Cells of the Gastrointestinal tract",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
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},
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"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
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"question": "Which of the following describes the function of cholangiocyte cells?",
"sbaAnswer": [
"a"
],
"totalVotes": 67,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,529 | false | 29 | null | 6,495,027 | null | false | [] | null | 12,923 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "We are most concerned about oesophageal cancer in this patient - dysphagia (difficulty swallowing) and weight loss, are both red flag symptoms for this condition.\n\nA CT of the chest and abdomen would not be used as a diagnostic tool - it would be used to stage the cancer if one was confirmed. This would be done through an oesophagogastroduodenoscopy (OGD).",
"id": "10001883",
"label": "b",
"name": "CT of chest & abdomen",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A staging laparoscopy is used to identify liver and peritoneal metastases. This would not be a first-line investigation.\n\nThe first-line investigation for an oesophageal cancer would be an oesophagogastroduodenoscopy (OGD). We are worried about this as this patient has dysphagia, and difficulty swallowing, accompanied by unintentional weight loss.",
"id": "10001885",
"label": "d",
"name": "Staging Laparoscopy",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This procedure is used to clarify the depth of cancer invasion and the involvement of local lymph nodes. It would not be a first-line investigation.\n\nTo investigate this patient for the presence of oesophageal cancer, due to his dysphagia (difficulty swallowing) and weight loss, an oesophagogastroduodenoscopy (OGD) would be carried out.",
"id": "10001886",
"label": "e",
"name": "Endoscopic ultrasound",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A PET-CT Scan is carried out to exclude metastases of malignant primary cancers. This would not be a first-line investigation.\n\nWe are worried about this patient having an oesophageal cancer - an oesophagogastroduodenoscopy (OGD) is the first-line investigation we would carry out.",
"id": "10001884",
"label": "c",
"name": "PET-CT scan",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Dysphagia, difficulty swallowing, is the commonest symptom of oesophageal cancer.\n\nThis is a very worrying sign as significant cancer growth usually occurs before dysphagia develops.\n\nThe first-line investigation used to diagnose an oesophageal cancer is an upper gastrointestinal tract endoscopy, also known as an oesophagogastroduodenoscopy (OGD). If a lesion is found, it would be biopsied to confirm the diagnosis.",
"id": "10001882",
"label": "a",
"name": "Oesophagogastroduodenoscopy (OGD)",
"picture": null,
"votes": 49
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3985",
"name": "Oesophageal carcinoma",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3985,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12923",
"isLikedByMe": null,
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"likes": 0,
"multiAnswer": null,
"pictures": [],
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"psaSectionId": null,
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"question": "A 72-year-old man presents to General Practice complaining that his food feels 'stuck' when he swallows. This has been gradually worsening for the past 3 months. He has also noticed his trousers getting looser, despite not trying to lose weight.\n\nWhat would be your first-line investigation for this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 71,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,530 | false | 30 | null | 6,495,027 | null | false | [] | null | 12,924 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Right-sided heart failure can cause venous insufficiency through the portal hepatic system, decreasing blood flow to the liver.\n\nThis causes chronic liver failure instead of acute liver failure.",
"id": "10001889",
"label": "c",
"name": "Right-sided heart failure",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Autoimmune hepatitis is a condition where the body's immune system attacks its own liver.\n\nThis is a cause of chronic liver failure, instead of acute liver failure.\n\nAcute liver failure is most likely to be caused by toxins, or viral hepatitis.",
"id": "10001888",
"label": "b",
"name": "Autoimmune hepatitis",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Non-alcoholic fatty liver disease is a gradual buildup of fat around the liver, not due to alcohol.\n\nThis is a gradual process and is therefore a cause for chronic liver failure, not acute liver failure.",
"id": "10001890",
"label": "d",
"name": "Non-alcoholic fatty liver disease",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Alpha-1-antitrypsin (A1aT) deficiency is a condition where the liver is unable to make normal A1aT, a protein that helps protect your lungs. Instead, it produces a faulty A1aT, which builds up in the liver and causes damage. This is a gradual process and would result in chronic liver failure.",
"id": "10001891",
"label": "e",
"name": "Alpha-1-antitrypsin deficiency",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Paracetamol overdose is responsible for almost 66% of acute liver failure cases in the United Kingdom. These can be both intentional, or unintentional overdoses.\n\nParacetamol is hepatotoxic, disrupting the liver cells' ability to function. An overdose can therefore push someone into liver failure, where the liver is unable to function normally.",
"id": "10001887",
"label": "a",
"name": "Paracetamol Overdose",
"picture": null,
"votes": 51
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3986",
"name": "Liver Failure",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3986,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12924",
"isLikedByMe": null,
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"likes": 0,
"multiAnswer": null,
"pictures": [],
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"psaSectionId": null,
"qaAnswer": null,
"question": "A 35-year-old female presents to the Emergency Department with right upper quadrant abdominal pain, nausea, vomiting, and is jaundiced. She is diagnosed with acute liver failure.\n\nWhich of the following can be a cause of acute liver failure?",
"sbaAnswer": [
"a"
],
"totalVotes": 73,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,531 | false | 31 | null | 6,495,027 | null | false | [] | null | 12,925 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Smell, thought, sight and taste of food stimulate the brainstem and begin the cephalic phase of gastric secretion.\n\nThis triggers the secretion of Gastrin into the bloodstream and induces secretion by parietal and chief cells.\n\nThe gastric phase of gastric secretion occurs after this phase - where stomach distension due to the arrival of food triggers increased gastric secretions.",
"id": "10001893",
"label": "b",
"name": "Smell, thought, sight and taste stimulate this phase",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The gastric phase is the second phase of gastric secretion.\n\nThe cephalic phase is first, followed by the gastric and the intestinal phase.",
"id": "10001896",
"label": "e",
"name": "It is the last phase of gastric secretion",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The gastric phase of gastric secretion does last 3 - 4 hours.\n\nIt occurs after food arrives in the stomach, causing distention. This sends signals via the vagus nerve to the brainstem, which in turn stimulates stomach secretions.",
"id": "10001892",
"label": "a",
"name": "This phase lasts 3 - 4 hours",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gastrin is released into the bloodstream during the cephalic phase of gastric secretion.\n\nThe cephalic phase is the first phase of gastric secretion. It is triggered by sensory inputs such as smell, thought, sight and taste of food.",
"id": "10001894",
"label": "c",
"name": "Gastrin is released into the bloodstream during this phase",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Secretin is released by the duodenum in the final phase of gastric secretion, the intestinal phase.\n\nIt is secreted to inhibit gastric secretion as food has arrived in the small bowels - there is no need for gastric (stomach) secretions anymore.",
"id": "10001895",
"label": "d",
"name": "Secretin is released",
"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": "3984",
"name": "Cells of the Gastrointestinal tract",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3984,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12925",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
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"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following statements is correct about the gastric phase of gastric secretion?",
"sbaAnswer": [
"a"
],
"totalVotes": 69,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,532 | false | 32 | null | 6,495,027 | null | false | [] | null | 12,926 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Asthma does **not** consist of three pathological features. Chronic Obstructive Pulmonary Disease (COPD) is a disease that has three pathological features - chronic bronchitis, small airway disease and emphysema.",
"id": "10001899",
"label": "c",
"name": "Asthma consists of three pathological features: chronic bronchitis, small airway disease and emphysema",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Glucocorticosteroids are generally effective in the treatment of asthma. When diagnosed, patients are prescribed inhaled corticosteroids (ICS), such as beclomethasone to use every day.\nThey are also given a bronchodilator such as salbutamol to use when their symptoms flare up.\n\nSteroids can also be used in COPD with asthma-like symptoms.",
"id": "10001900",
"label": "d",
"name": "Steroids are ineffective in the management of asthma",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A high fever is not a feature of asthma. If a child presents with a high fever along with respiratory symptoms, this would point towards an upper or lower respiratory infection.",
"id": "10001898",
"label": "b",
"name": "High fever at initial presentation",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Asthma is a disease characterised by chronic airway inflammation, leading to constriction. What differentiates asthma from Chronic Obstructive Pulmonary Disease (COPD) is the airway reversibility.\n\nIn asthma, although the airways constrict, bronchodilators are still able to reverse this constriction. This phenomenon is known as bronchodilator reversibility. In COPD, the damage to the lungs is permanent. Bronchodilators are still used in COPD to ease symptoms but they do not reverse the damage.",
"id": "10001897",
"label": "a",
"name": "Airway constriction caused by inflammation is reversible with bronchodilators",
"picture": null,
"votes": 65
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Chronic Obstructive Pulmonary Disease (COPD) is a disorder associated with prolonged cigarette smoking, not asthma.\n\nAsthma is considered a hypersensitive allergic-type condition, causing inflammation of the airways. Smoking can worsen asthma, but does not cause it.",
"id": "10001901",
"label": "e",
"name": "Asthma is caused by cigarette smoking",
"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": "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": "12926",
"isLikedByMe": null,
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"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following statements about asthma is correct?",
"sbaAnswer": [
"a"
],
"totalVotes": 76,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,533 | false | 33 | null | 6,495,027 | null | false | [] | null | 12,927 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Chronic Obstructive Pulmonary Disease (COPD) is a chronic lung condition that develops gradually over the years.\n\nThe classic symptoms of COPD include increasing breathlessness, a cough with white or grey sputum that does not get better, frequent chest infections and wheezing.\n\nThe biggest risk factor for this is smoking - our patient has been a heavy smoker for 40 years, making it very likely that they have COPD when presenting with shortness of breath.",
"id": "10001902",
"label": "a",
"name": "Chronic Obstructive Pulmonary Disease (COPD)",
"picture": null,
"votes": 69
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Heart failure can cause shortness of breath.\n\nFor example, in left-sided heart failure, the heart is unable to pump properly to the rest of the body, leading to a backlog of blood in the pulmonary system. This can cause pulmonary oedema, fluid in the lungs, which would cause shortness of breath.\n\nHowever, this is associated with sputum that is pink and frothy, and swelling in the ankles, which this patient does not have.",
"id": "10001903",
"label": "b",
"name": "Heart Failure",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An anaphylactic shock occurs when the body has a severe allergic reaction. The patient deteriorates rapidly as their airways constrict - in some patients their airway completely closes, making them unable to breathe.\n\nThe patient is much more likely to have chronic obstructive pulmonary disease (COPD), in which we see a gradual onset of shortness of breath.",
"id": "10001906",
"label": "e",
"name": "Anaphylactic Shock",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pneumonia is an acute, lower respiratory tract infection. Shortness of breath in pneumonia would worsen much more quickly, and you would find associated symptoms indicating infection. These symptoms include fever, fatigue, and coughing up yellow or green sputum, which this patient does not have.\n\nGrey sputum and a gradual onset of shortness of breath are suggestive of chronic obstructive pulmonary disease (COPD).",
"id": "10001905",
"label": "d",
"name": "Pneumonia",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The patient is complaining of a gradual worsening in shortness of breath - this is more indicative of chronic obstructive pulmonary disease (COPD) than asthma.\n\nCOPD is a chronic condition that usually develops in smokers - another red flag that our patient has - and in older patients. Asthma is usually found in younger patients, usually in children.",
"id": "10001904",
"label": "c",
"name": "Asthma",
"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": "3717",
"name": "Chronic obstructive pulmonary disease (COPD)",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3717,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12927",
"isLikedByMe": null,
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"likes": 0,
"multiAnswer": null,
"pictures": [],
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"psaSectionId": null,
"qaAnswer": null,
"question": "A 67-year-old man presents to the Emergency Department with shortness of breath.\n\nUpon questioning, he reveals that this has been gradually getting worse over the past year. He is also coughing up some grey sputum. He has been smoking 20 cigarettes daily for 40 years, drinks one pint of beer a day and has never used recreational drugs.\n\nWhich of the following is this patient's most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 74,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,534 | false | 34 | null | 6,495,027 | null | false | [] | null | 12,928 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There would be a reduced forced vital capacity (FVC) in patients with an obstructive lung disorder. The obstruction leads to a decrease in lung airway space, reducing the volume of air that is both inhaled and exhaled.\n\nYou would also find an indented exhalation curve on the flow volume loops of patients with an obstructive pulmonary disorder - a narrowed exhalation curve is a classic finding of patients with a restrictive lung disorder.",
"id": "10001910",
"label": "d",
"name": "Normal forced vital capacity (FVC) with a narrowed exhalation curve",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The forced vital capacity, FVC, is the maximum volume of air that can be exhaled from the lungs.\n\nFVC is lower in patients with an obstructive lung disorder. Obstructive disorders, such as chronic obstructive pulmonary disease (COPD), narrow the patient's airways, decreasing how much air can both enter and leave the lungs.\n\nThere is also a classic indented exhalation curve that you would find in patients with obstructive disorders, which is not found in other types of lung pathology.",
"id": "10001907",
"label": "a",
"name": "Reduced forced vital capacity (FVC) with an indented exhalation curve",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There would be a reduced forced vital capacity (FVC) in patients with an obstructive pulmonary disorder. Obstructive disorders such as asthma and chronic obstructive pulmonary disease (COPD) narrow the airways and increases the air resistance inside them - less air can enter and leave the lungs.\n\nAn indented exhalation curve is a classic finding in the flow volume loop of patients with obstructive lung disorders.",
"id": "10001909",
"label": "c",
"name": "Normal forced vital capacity with an indented exhalation curve",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There would be a reduced forced vital capacity (FVC) in patients with an obstructive disorder, as the narrowing of their airways increases resistance, decreasing the volume of air that can be expelled from the lungs.\n\nHowever, a narrowed exhalation curve is found in restrictive respiratory diseases such as pulmonary lung fibrosis. In obstructive pulmonary disorders, an indented exhalation curve would be found instead.",
"id": "10001908",
"label": "b",
"name": "Reduced forced vital capacity (FVC) with a narrowed exhalation curve",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A **decreased** forced vital capacity (FVC) would be found in patients with an obstructive lung disease. This is because airway obstruction increases the resistance to the air inside the lungs, decreasing the volume that can be both inhaled and exhaled.\n\nAn indented exhalation curve is a classic finding in a patient with an obstructive respiratory disorder.",
"id": "10001911",
"label": "e",
"name": "Increased forced vital capacity (FVC) with an indented exhalation curve",
"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": "3987",
"name": "Flow-volume loops",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3987,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12928",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
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"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following would you expect to see on the flow-volume loop of a patient with an obstructive respiratory disease?",
"sbaAnswer": [
"a"
],
"totalVotes": 73,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,535 | false | 35 | null | 6,495,027 | null | false | [] | null | 12,929 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Bladder Cancer commonly presents as painless haematuria (blood in the urine). A cancer would develop gradually, therefore we would expect to see symptoms that come on over a longer period.\n\nThe acute nature of this patient's symptoms, her age, and her fever point towards an infectious cause - such as a urinary tract infection - rather than a cancer.",
"id": "10001913",
"label": "b",
"name": "Bladder Cancer",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Renal stones are calcium and oxalate-based stones that form in the kidneys. If they are large enough, they can block the kidney tubules causing renal colic - a severe pain in the patient's back that comes in waves. Renal colic is sometimes described as 'loin to groin' pain.\n\nThis patient is not complaining of back, or 'loin to groin' pain - her symptoms point more towards a urinary tract infection than a renal stone.",
"id": "10001914",
"label": "c",
"name": "Renal Stones",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Nephritic syndrome is an autoimmune disorder where IgA antibodies attack the kidneys. This causes haematuria (blood in the urine), increased blood pressure, oedema and decreased urinary output.\n\nThe patient is not reporting any of these symptoms - her fever and pain upon urinating suggest an infection such as a urinary tract infection (UTI).",
"id": "10001916",
"label": "e",
"name": "Nephritic Syndrome",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "A urinary tract infection (UTI) is the most likely cause of this patient's symptoms. UTIs can cause symptoms such as fever, abdominal pain, increased urinary frequency, pain upon urinating. Haematuria can be associated with UTI's however urine should be re-tested after completing treatment with an appropriate antibiotic and if there is persistent haematuria, other underlying causes should be considered.\n\nThey are more common in females, especially females of reproductive age as sexual intercourse is a common cause of UTIs.",
"id": "10001912",
"label": "a",
"name": "Urinary Tract Infection",
"picture": null,
"votes": 45
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Nephrotic syndrome is a renal disorder characterised by three findings: increased protein loss from the kidneys (proteinuria), decreased serum albumin (hypoalbuminaemia) and peripheral oedema.\n\nSymptoms of nephrotic syndrome also include frothy urine, weight gain, decreased appetite and increased fatigue.\n\nThis patient is not complaining of any of these symptoms - her symptoms suggest an infection, most likely a urinary tract infection (UTI).",
"id": "10001915",
"label": "d",
"name": "Nephrotic Syndrome",
"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": "3757",
"name": "Urinary Tract Infection",
"status": null,
"topic": {
"__typename": "Topic",
"id": "142",
"name": "Nephrology",
"typeId": 7
},
"topicId": 142,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3757,
"conditions": [],
"difficulty": 1,
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"question": "A 25-year-old woman presents to the Emergency Department with increased urinary frequency, pain upon urinating and a fever for the past 2 days.\n\nOn examination, there is no renal angle tenderness.\n\nA urine dipstick is positive for blood.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 70,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,536 | false | 36 | null | 6,495,027 | null | false | [] | null | 12,930 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Urine bilirubin levels are an indicator of hepatobiliary health. Bilirubin is synthesised in the liver - when there is a blockage in the hepatobiliary system, bilirubin builds up, and begins to be excreted in the urine as the body tried to expel the excess.\n\nThis patient is having left back and abdominal pain - a lesion in the liver and gallbladder would cause right-sided abdominal pain. This patient also has a history of renal stones, making his most likely diagnosis renal colic from a stone in his ureters. You would not expect to find positive urine bilirubin in his urine dipstick.",
"id": "10001919",
"label": "c",
"name": "Urine Bilirubin",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with renal colic - a severe 'loin to groin' pain that usually results from a large renal stone being blocked in the ureters.\n\nRenal stones can cause haematuria - blood in the urine - when they get lodged in the ureters they damage the epithelial cells lining them, causing some blood loss.",
"id": "10001917",
"label": "a",
"name": "Blood in Urine",
"picture": null,
"votes": 48
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Urine glucose is positive on a urine dipstick if there is an increased level of glucose in the urine. This can happen in disorders such as Diabetes Mellitus.\n\nWe would not expect to find a positive glucose in this patient - he does not have a history of diabetes, and his symptoms are pointing towards a diagnosis of renal colic due to his history of renal stones.",
"id": "10001920",
"label": "d",
"name": "Urine Glucose",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Urine ketones are found to be positive when there are excess ketones in the urine. This can happen in a Type I Diabetes Mellitus complication known as Diabetic Ketoacidosis (DKA), where ketones are released into the blood since the body is unable to absorb any glucose.\n\nWe would not expect to see positive ketones in this patient - he does not have a history of Type I Diabetes Mellitus.",
"id": "10001921",
"label": "e",
"name": "Urine Ketones",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is presenting with renal colic, most likely due to his renal stones getting stuck in his left ureter.\n\nThis would cause blood in the urine as the renal stone is damaging epithelial cells in the ureters, but it should not cause protein loss in the urine. Proteinuria is indicative of abnormal kidney function, which should not be the case in this patient - the renal stone is what is causing pain, not a diseased kidney.",
"id": "10001918",
"label": "b",
"name": "Urine Protein",
"picture": null,
"votes": 14
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3988",
"name": "Renal Stones",
"status": null,
"topic": {
"__typename": "Topic",
"id": "143",
"name": "Urology",
"typeId": 7
},
"topicId": 143,
"totalCards": null,
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},
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"qaAnswer": null,
"question": "A 68-year-old man presents to the Emergency Department with severe left back pain, radiating to his lower abdomen. He has a history of renal stones.\n\nGiven the most likely diagnosis, what results would you expect to find positive in this patient's urine dipstick?",
"sbaAnswer": [
"a"
],
"totalVotes": 70,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,537 | false | 37 | null | 6,495,027 | null | false | [] | null | 12,931 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "These are all features you would expect to see in someone with Chronic Kidney Disease (CKD).\n\nCKD is a disease where there is a reduction in kidney function - kidney failure. You would expect to see filtration failure in the kidneys, resulting in proteinuria and haematuria.\n\nThe kidneys are also responsible for controlling blood pressure through the regulation of salt. Decreased kidney function causes the body to retain more water, leading to high blood pressure (hypertension).\n\nThe kidneys are also responsible for producing erythropoietin (EPO), which is a hormone that stimulates haemoglobin synthesis. Without adequate EPO production, insufficient haemoglobin (Hb) is produced, leading to anaemia (low Hb levels in the blood).\n\nThe kidneys are important in the synthesis of Vitamin D too - they are where 1-alpha-hydroxylation of Vitamin D occurs. This step is vital - without it Vitamin D is inactive, and cannot be used in the body, leading to a Vitamin D deficiency.",
"id": "10001922",
"label": "a",
"name": "Hypertension, Vitamin D Deficiency, Anaemia",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These symptoms are sometimes described as lower urinary tract symptoms (LUTS). These are commonly found in disorders affecting the lower urinary tract - the bladder and urethra.\n\nIn Chronic Kidney Disease (CKD), you would expect to find symptoms of kidney filtration failure. These include proteinuria, hypoalbuminaemia, haematuria, hypertension, vitamin D deficiency and anaemia.",
"id": "10001925",
"label": "d",
"name": "Increased urinary frequency, difficulty starting urination, poor urinary stream",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Peripheral oedema refers to swelling of the ankles and feet. Ketonuria refers to the presence of glucose in the urine. Ketonuria is most commonly found in patients with Type I Diabetes Mellitus, in a complication known as Diabetic Ketoacidosis (DKA). During DKA, the body released ketones as it is unable to absorb any glucose, resulting in ketonuria when these ketones are expelled from the body. You would not expect to see this in someone with CKD.\n\nCKD is a chronic condition that occurs when the kidneys are unable to filter substances effectively. This can lead to anaemia, vitamin D deficiency, proteinuria, haematuria, hypertension and peripheral oedema.",
"id": "10001926",
"label": "e",
"name": "Peripheral oedema, foamy urine, ketonuria",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Renal colic is a severe and fluctuating pain, often described as radiating from 'loin to groin'. It is most commonly caused by the presence of a renal stone lodged in the ureters.\n\nThis would also cause haematuria, as the stone would damage the epithelial cells of the ureters, and painful urination in the ureters spasm.\n\nThese symptoms would not be found in Chronic Kidney Disease (CKD), which is a chronic condition where the kidneys fail to filter substances. This condition is associated with proteinuria, hypoalbuminaemia, haematuria, hypertension, vitamin D deficiency and anaemia.",
"id": "10001924",
"label": "c",
"name": "Renal colic, haematuria, painful urination",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Fever, nausea and pain are often symptoms of infection. Flank pain suggests pain of renal origin, such as pyelonephritis.\n\nIn Chronic Kidney Disease (CKD), the kidneys gradually fail and are unable to filter substances properly. It is not due to infection - therefore, you would not expect to see these symptoms in a CKD patient.",
"id": "10001923",
"label": "b",
"name": "Fever, nausea, flank pain",
"picture": null,
"votes": 0
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3753",
"name": "Chronic kidney disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "142",
"name": "Nephrology",
"typeId": 7
},
"topicId": 142,
"totalCards": null,
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"userNote": null,
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},
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"difficulty": 1,
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"qaAnswer": null,
"question": "Which of the following phenomena would you expect to see in someone with Chronic Kidney Disease?",
"sbaAnswer": [
"a"
],
"totalVotes": 68,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,538 | false | 38 | null | 6,495,027 | null | false | [] | null | 12,932 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "GFR = (Urine Flow Rate x Urine Concentration of Inulin) / Plasma concentration of inulin\n\nGFR = (1.1mL/min x 11mmol/L) / 0.11mmol/L\nGFR = 110mL/min",
"id": "10001927",
"label": "a",
"name": "110mL/min",
"picture": null,
"votes": 52
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "GFR = (Urine Flow Rate x Urine Concentration of Inulin) / Plasma concentration of inulin\n\nGFR = (1.1mL/min x 11mmol/L) / 0.11mmol/L\nGFR = 110mL/min",
"id": "10001931",
"label": "e",
"name": "0.11mL/min",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "GFR = (Urine Flow Rate x Urine Concentration of Inulin) / Plasma concentration of inulin\n\nGFR = (1.1mL/min x 11mmol/L) / 0.11mmol/L\nGFR = 110mL/min",
"id": "10001929",
"label": "c",
"name": "1100mL/min",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "GFR = (Urine Flow Rate x Urine Concentration of Inulin) / Plasma concentration of inulin\n\nGFR = (1.1mL/min x 11mmol/L) / 0.11mmol/L\nGFR = 110mL/min",
"id": "10001930",
"label": "d",
"name": "1.1mL/min",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "GFR = (Urine Flow Rate x Urine Concentration of Inulin) / Plasma concentration of inulin\n\nGFR = (1.1mL/min x 11mmol/L) / 0.11mmol/L\nGFR = 110mL/min",
"id": "10001928",
"label": "b",
"name": "11mL/min",
"picture": null,
"votes": 4
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3989",
"name": "Glomerular Filtration Rate",
"status": null,
"topic": {
"__typename": "Topic",
"id": "142",
"name": "Nephrology",
"typeId": 7
},
"topicId": 142,
"totalCards": null,
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"userChapter": null,
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},
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"question": "The Glomerular Filtration Rate (GFR) is the volume of liquid that is filtered by the kidneys per unit of time. It is measured in mL/min, with a substance called inulin, which is freely filtered by the kidneys.\n\n\nThe equation to calculate GFR is:\n\n\nGFR x Plasma concentration of inulin = Urine Flow Rate x Urine Concentration of Inulin.\n\n\nIf a patient's plasma inulin concentration was 0.11mmol/L, their urine concentration of inulin was 11mmol/L and their urine flow rate was 1.1mL/min, what would this patient's GFR be?",
"sbaAnswer": [
"a"
],
"totalVotes": 65,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,539 | false | 39 | null | 6,495,027 | null | false | [] | null | 12,933 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Summation is a phenomenon that occurs when motor unit action potentials fire so quickly that they are not able to relax in between action potentials.",
"id": "10001933",
"label": "b",
"name": "Summation",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Rate coding is one of the two mechanisms the brain uses to control muscle force.\n\nThere are three different types of motor units - slow, fast fatiguable and fast fatigue resistant. A motor unit is capable of firing at a range of different speeds. In rate coding, slower units fire at a lower frequency and produce less force. Faster units fire at a faster frequency, producing more force.",
"id": "10001932",
"label": "a",
"name": "Rate coding",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The recruitment principle of motor unit regulation means that smaller units are recruited first, followed by larger units if more force is required. This allows for better control of muscles.",
"id": "10001934",
"label": "c",
"name": "Recruitment",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Isometric muscle contraction occurs when the muscle is contracted, but there is no movement of the muscle - no shortening or lengthening. For example, if you held a weight out in front of you and did not move.",
"id": "10001936",
"label": "e",
"name": "Isometric",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Concentric muscle contraction is a muscle contraction where the muscles shorten, such as doing a bicep curl.",
"id": "10001935",
"label": "d",
"name": "Concentric",
"picture": null,
"votes": 6
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3990",
"name": "Regulation of muscle force",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
"totalCards": null,
"typeId": null,
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},
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"highlights": [],
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"question": "The brain can regulate the force a single muscle can produce in a mechanism where, as the firing rate of a motor unit increases, the force produced by the motor unit also increases.\n\nWhich mechanism of muscle regulation is this describing?",
"sbaAnswer": [
"a"
],
"totalVotes": 64,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,540 | false | 40 | null | 6,495,027 | null | false | [] | null | 12,934 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "CO = SV x HR\nSV = 100mL - 75mL\n\nCO = 25mL x 136bpm\nCO = 3.4L/min",
"id": "10001940",
"label": "d",
"name": "10.2L/min",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "CO = SV x HR\nSV = 100mL - 75mL\n\nCO = 25mL x 136bpm\nCO = 3.4L/min",
"id": "10001939",
"label": "c",
"name": "13.6L/min",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Cardiac output is calculated with the following equation:\n\nCardiac output (CO) = Stroke Volume (SV) x Heart Rate (HR)\nCO = SV x HR\n\nStroke Volume (SV) = End-diastolic volume (EDV) - End-systolic volume (ESV)\nSV = EDV - ESV\n\nFor this patient:\nSV = 100mL - 75mL\nSV = 25mL\n\nCO = 25mL x 136bpm\nCO = 3400mL/min\nCO = 3.4L/min",
"id": "10001937",
"label": "a",
"name": "3.4L/min",
"picture": null,
"votes": 61
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's cardiac output is 3400mL/min, 3.4L/min\n\nCO = SV x HR\nSV = 100mL - 75mL\n\nCO = 25mL x 136bpm\nCO = 3.4L/min",
"id": "10001938",
"label": "b",
"name": "3400L/min",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "CO = SV x HR\nSV = 100mL - 75mL\n\nCO = 25mL x 136bpm\nCO = 3.4L/min",
"id": "10001941",
"label": "e",
"name": "4.1L/min",
"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": "3991",
"name": "Cardiac Output",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3991,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12934",
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"question": "A 78-year-old man presents to the Emergency Department with a heart rate of 136 bpm. After doing an echocardiogram, his end-diastolic volume is 100mL, with an end-systolic volume of 75mL.\n\nWhat is this patient's cardiac output in litres/minute?",
"sbaAnswer": [
"a"
],
"totalVotes": 72,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,541 | false | 41 | null | 6,495,027 | null | false | [] | null | 12,935 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The tendency for a tissue to distort under pressure is known as the tissue's compliance:\n\nCompliance (C) = Change in volume (mL) / Change in pressure (mmHg)",
"id": "10001946",
"label": "e",
"name": "Veins have an increased tendency to distort under pressure",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is explained by the Frank-Starling Law, which states that as the heart fills up with more blood in diastole, it contracts and pumps out more blood during systole.",
"id": "10001943",
"label": "b",
"name": "Stroke volume increases as end-diastolic volume increases",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is explained by the cardiac length-tension relationship, which states that cardiac muscle length is proportional to the force produced.",
"id": "10001944",
"label": "c",
"name": "The force of cardiac muscle contraction depends on the number of myosin-actin bridges formed",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is explained through the equation for Mean Arterial Pressure (MAP).\n\nMean Arterial Pressure (MAP) = Cardiac Output (CO) x Peripheral Vascular Resistance (PVR)",
"id": "10001945",
"label": "d",
"name": "Cardiac output is inversely proportional to peripheral vascular resistance",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The Law of LaPlace is a law in physics that states that the wall tension of a cylinder is proportional to the pressure of its contents and the radius of the cylinder:\n\nWall tension = pressure x radius\n\nArteries are like cylinders - therefore, the wall tension in arteries is dependent on the pressure of the blood flowing through it, and the radius.\n\nThis law explains why the left ventricle thickens in patients that have decreased cardiac output. The radius of a cylinder is inversely proportional to the pressure in the cylinder. This means the ventricle radius needs to decrease to maintain the same pressure through the cardiovascular system.",
"id": "10001942",
"label": "a",
"name": "Left Ventricular Hypertrophy",
"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": "3992",
"name": "Law of LaPlace",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3992,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12935",
"isLikedByMe": null,
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"multiAnswer": null,
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"psaSectionId": null,
"qaAnswer": null,
"question": "Which phenomenon can the law of LaPlace explain in terms of cardiac mechanics?",
"sbaAnswer": [
"a"
],
"totalVotes": 67,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,542 | false | 42 | null | 6,495,027 | null | false | [] | null | 12,936 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Adrenaline causes vasoconstriction - when the body is in 'fight or flight', triggered by adrenaline, vasoconstriction keeps most of the body's blood close to the major organs, ensuring they are perfused first. This also minimises blood loss should that happen.",
"id": "10001950",
"label": "d",
"name": "Decreased adrenaline",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Vasopressin, otherwise known as anti-diuretic hormone (ADH), is a potent vasoconstriction.\n\nIncreased vasopressin causes increased water retention in the body, raising the blood pressure, and causing vasoconstriction at the same time. This follows the Law of LaPlace - the pressure is inversely related to artery radius - when artery pressure increases, the radius must decrease.\n\nDecreased vasopressin, therefore, has the opposite effect - vasodilation.",
"id": "10001949",
"label": "c",
"name": "Decreased vasopressin",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Increased oxygen usage leads to vasodilation. Increased oxygen consumption indicates an increased metabolic need in the body - this can happen, for example, when someone is exercising.\n\nCells need more oxygen when this occurs, therefore, vasodilation occurs to supply all cells with enough oxygen - this is why our bodies get warmer when we exercise.",
"id": "10001951",
"label": "e",
"name": "Increased oxygen usage",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Increased blood temperature causes vasodilation. Think about having a warm shower - it would make your skin warmer from vasodilation. The opposite, such as putting an ice pack on your ankle after an injury would cause vasoconstriction, decreasing blood flow to that area.",
"id": "10001948",
"label": "b",
"name": "Increased blood temperature",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Increased angiotensin II would lead to vasoconstriction. Angiotensin II is responsible for increasing blood pressure - when blood pressure rises, vasoconstriction follows. This is due to the Law of Laplace - the blood pressure in a vessel is inversely related to vessel radius - when artery pressure increases, the radius must decrease.",
"id": "10001947",
"label": "a",
"name": "Increased Angiotensin II",
"picture": null,
"votes": 63
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3993",
"name": "Vasoconstriction",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
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"difficulty": 1,
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"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following would lead to vasoconstriction?",
"sbaAnswer": [
"a"
],
"totalVotes": 78,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,543 | false | 43 | null | 6,495,027 | null | false | [] | null | 12,937 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Atrial fibrillation is a common arrhythmia that can occur in the heart.\n\nOn ECG, there is an absence of p-waves - the atria are not working properly, and an irregularly irregular rhythm.\n\nAtrial fibrillation is also a classic cause of syncope (fainting), shortness of breath, palpitations and dizziness.\n\nThese are all signs and symptoms that our patient is reporting - therefore, her most likely diagnosis is atrial fibrillation.",
"id": "10001952",
"label": "a",
"name": "Atrial fibrillation",
"picture": null,
"votes": 64
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A non-ST elevated myocardial infarction (NSTEMI) is an occlusion of a cardiac vessel that occurs without ST elevation on the ECG. You would still expect to see p-waves, however.",
"id": "10001953",
"label": "b",
"name": "Non ST-Elevated Myocardial Infarction",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Mobitz I Heart Block is a type of secondary heart block. It can be seen on an ECG as a progressive prolongation of the PR interval until a P wave is no longer followed by a QRS complex.\n\nThis condition can cause a patient to feel faint, have shortness of breath and have chest pain.",
"id": "10001956",
"label": "e",
"name": "Mobitz I Heart Block",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Unstable angina is a condition that occurs when someone experiences chest pain, associated with cardiac ischaemia, at rest.\n\nHowever, what differentiates unstable angina from a STEMI is that there is no ST-elevation on the ECG. There may be ST depression, but you would still see p-waves.\n\nUnstable angina can be differentiated from a Non-ST-elevated myocardial infection (NSTEMI) through a troponin blood test - troponin levels are elevated in an NSTEMI.",
"id": "10001954",
"label": "c",
"name": "Unstable Angina",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In an ST-Elevated Myocardial Infarction (STEMI), you would expect to see an elevated ST segment on the ECG.\n\nA myocardial infarction is unlikely to occur in this patient demographic - risk factors for a STEMI include smoking, hyperlipidaemia, hypertension and diabetes mellitus.",
"id": "10001955",
"label": "d",
"name": "ST-Elevated Myocardial Infarction",
"picture": null,
"votes": 1
}
],
"comments": [],
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},
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"demo": null,
"entitlement": null,
"id": "3714",
"name": "Atrial fibrillation",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
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},
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"difficulty": 1,
"dislikes": 0,
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"question": "A 20-year-old female presents to the Emergency Department with a 6-day history of shortness of breath, dizziness and palpitations.\n\nAn ECG is performed, showing an irregularly irregular heartbeat, with an absence of p-waves.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 72,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,544 | false | 44 | null | 6,495,027 | null | false | [] | null | 12,938 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "You would expect to find a rapid pulse in this patient. He has experienced a large volume of blood loss, with which his blood pressure would decrease.\n\nThe body would try to compensate for this decreased blood pressure by increasing the heart rate - trying to make sure tissues are still being perfused.",
"id": "10001959",
"label": "c",
"name": "Slow pulse",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "You would expect to find a decreased urine output in this patient. Since he has lost a large volume of blood, his body will struggle to perfuse all his organs due to a drop in blood pressure.\n\nThis means his kidneys will be receiving little blood, causing only a small amount of urine production.",
"id": "10001961",
"label": "e",
"name": "Increased urine output",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "When the body undergoes a large amount of blood loss, it experiences hypovolaemic shock. During hypovolaemic shock, blood pressure drops, since there is an inadequate volume of blood in the cardiovascular system. This leads to other symptoms such as tachycardia.",
"id": "10001957",
"label": "a",
"name": "Decreased blood pressure",
"picture": null,
"votes": 63
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is likely to have a decreased body temperature.\n\nHe has lost a large volume of blood, which means his tissues will not be perfused as well as they usually are. Perfusion of the internal organs allows our bodies to be kept warm - this decrease in blood flow will decrease the body temperature as well.",
"id": "10001960",
"label": "d",
"name": "Increased body temperature",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "You would expect to see decreased blood pressure in this patient. He has had a large amount of blood loss. With decreased blood volume, the body would struggle to maintain a normal blood pressure.",
"id": "10001958",
"label": "b",
"name": "Increased blood pressure",
"picture": null,
"votes": 7
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3994",
"name": "Shock",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
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"question": "A 23-year-old man presents to the Emergency Department with a stab wound, and a large amount of blood loss.\n\nWhich of the following signs would you expect to find in this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 76,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,545 | false | 45 | null | 6,495,027 | null | false | [] | null | 12,939 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Nominal data is a categorical type of qualitative data. It is very binary - for example, you are either infected with COVID-19, or you are not infected with COVID-19.\n\nThe number of children in a family would be quantitative data, more specifically, discrete data.",
"id": "10001964",
"label": "c",
"name": "Nominal",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The number of children in a family is discrete data.\n\nDiscrete data is a quantitative form of data, which has to be a whole number. For example, you cannot have 5.7 children in a family.",
"id": "10001962",
"label": "a",
"name": "Discrete",
"picture": null,
"votes": 44
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Descriptive data is qualitative data, written in text - such as interview quotes.\n\nThe number of children in a family is discrete data, which is a type of quantitative data.",
"id": "10001966",
"label": "e",
"name": "Descriptive",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ordinal data is a type of qualitative data that assigns data into groups. Body Mass Index (BMI) is a type of ordinal data.\n\nBMI < 18 = category 1\nBMI 18 - 25 = category 2\nBMI 25 - 30 = category 3\nBMI 35+ = category 4\n\nThe number of children in a family is quantitative, discrete data.",
"id": "10001965",
"label": "d",
"name": "Ordinal",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Continuous data is a quantitative form of data, which can have any numerical value.\n\nFor example, temperature is a continuous form of data - you can have 38 degrees, 89.5 degrees, or 4536.25 degrees.\n\nThe number of children in a family has to be a whole number - you cannot have 2.5 children in a family. There are either 2 children or 3 children. This type of data is known as discrete.",
"id": "10001963",
"label": "b",
"name": "Continuous",
"picture": null,
"votes": 8
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
"files": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3995",
"name": "Research Skills",
"status": null,
"topic": {
"__typename": "Topic",
"id": "178",
"name": "Medical Statistics",
"typeId": 7
},
"topicId": 178,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3995,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "12939",
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"question": "You are gathering data about the number of children per family across the country.\n\nWhich type of variable best describes this measure?",
"sbaAnswer": [
"a"
],
"totalVotes": 71,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,546 | false | 46 | null | 6,495,027 | null | false | [] | null | 12,940 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the definition of a randomised controlled trial. Randomised controlled trials are used to compare the efficacy of a new drug or treatment on the market compared to what is already available.\n\nThese are done on real patients and are usually 'double blind', meaning both the patient themselves nor the researcher do not know which participant is getting the treatment and who is not.",
"id": "10001970",
"label": "d",
"name": "A group of participants are given a treatment for a condition, either the treatment being researched or a placebo (or what is currently being used in medicine)",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the definition of a case series. These are important in communicating the appearance of diseases that have not previously been reported - very commonly used in the field of infectious diseases.",
"id": "10001971",
"label": "e",
"name": "A collection of patient reports detailing a constellation of symptoms and how they were treated, usually describing a condition that has not been studied before",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the definition of a systematic review. These are long projects where researchers will sometimes go through all of the studies done on a particular topic. This is done in a very structured way, known as the systematic review. The end result is a written paper summarising the consensus of all of the papers.",
"id": "10001967",
"label": "a",
"name": "An analysis of multiple studies on a particular topic, usually randomised controlled trials, during which the reviewer assesses the quality, bias and confounding factors",
"picture": null,
"votes": 48
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the definition of a cohort study. For example, a group of people who have all smoked 20 cigarettes a day for 10 years, are monitored for the next 10 years to see who develops lung cancer and who does not. These studies are useful for identifying disease risk factors.",
"id": "10001968",
"label": "b",
"name": "A group of people all exposed to the same factor are followed over time to see who acquires a certain condition and who does not",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the definition of a case-control study. These are retrospective studies that help to identify risk factors for conditions.",
"id": "10001969",
"label": "c",
"name": "A group of people with a condition are compared alongside a group of people without a condition, to identify any common exposures in the group with the condition that is not present in the group without the condition",
"picture": null,
"votes": 10
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
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"id": "3995",
"name": "Research Skills",
"status": null,
"topic": {
"__typename": "Topic",
"id": "178",
"name": "Medical Statistics",
"typeId": 7
},
"topicId": 178,
"totalCards": null,
"typeId": null,
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},
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"difficulty": 1,
"dislikes": 0,
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"highlights": [],
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"question": "Which of the following statements correctly describes a systematic review?",
"sbaAnswer": [
"a"
],
"totalVotes": 65,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,547 | false | 47 | null | 6,495,027 | null | false | [] | null | 12,941 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the appropriate choice. The patient has not fully understood her situation, and whilst allowing her to go home is respecting her current wishes, this decision may have been taken due to her cognitive dysfunction. Going home is also against the best interest of this patient.\n\nTherefore, the doctor should take measures to make sure the patient understands what has happened to her before he can fully listen to the patient's wishes. Her wish to go home may change once she has fully understood what has happened.\n\nIf it is concluded that she does fully understand what is happening, and she still wishes to go home, at that point, it would be much more appropriate to allow her to return home.",
"id": "10001973",
"label": "b",
"name": "Allow her to go home as the patient is asking for this",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would not be the best option to maintain the patient's autonomy. This would be overriding this patient's autonomy even if it were in the patient's best interests.\n\nThe best approach to this situation would be to try another method to help this patient understand their condition - just because the patient has not understood the doctor the first time, does not mean they will not understand if it is explained differently. People without dementia will sometimes need things to be repeated or explained in a way that works for them - deciding on their behalf is very inappropriate in this case.",
"id": "10001976",
"label": "e",
"name": "Make a decision based on the patient's best interests",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct choice - it is clear that this patient cannot yet consent to surgery, since she has not understood what exactly has happened and what could help her.\n\nThe doctor should therefore attempt to enhance her autonomy, explaining the procedure in different ways, and involving other healthcare professionals if needed, to see whether this patient can gain the capacity to consent to her procedure.",
"id": "10001972",
"label": "a",
"name": "Explain the patient's situation to her in a different way",
"picture": null,
"votes": 38
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although the patient's family members are likely to make choices that are in the best interests of this patient - we have not yet concluded that the patient cannot decide for themselves.\n\nAlthough she does have dementia and does not currently understand what has happened to her, this can change - especially if trained healthcare professionals are consulted to try and enhance her capacity to consent to procedures. This should be attempted first before consulting the patient's family for consent.",
"id": "10001974",
"label": "c",
"name": "Ask her daughter to decide for her",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Her carer is likely to be a trained healthcare professional who has been in these situations before. However, we have not yet concluded that this patient cannot consent herself.\n\nThe doctor should first try other methods to help this patient understand her condition before allowing her decisions to be made by other people, stripping the patient of her autonomy.",
"id": "10001975",
"label": "d",
"name": "Ask her carer to consent to the procedure for her",
"picture": null,
"votes": 8
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3996",
"name": "Autonomy",
"status": null,
"topic": {
"__typename": "Topic",
"id": "184",
"name": "Ethics and Law",
"typeId": 7
},
"topicId": 184,
"totalCards": null,
"typeId": null,
"userChapter": null,
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"dislikes": 0,
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"question": "An 85-year-old female with dementia has fallen and broken her hip. She requires surgery, however, due to her dementia she is struggling to understand what the doctor is telling her, and is asking to go home.\n\nWhich of the following describes the next step that the doctor should take to maintain as much of this patient's autonomy as possible?",
"sbaAnswer": [
"a"
],
"totalVotes": 72,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,460,548 | false | 48 | null | 6,495,027 | null | false | [] | null | 12,942 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Merkel cells are non-encapsulated mechanoreceptors. These are responsible for detecting light touch. They are found in the stratum basale of the epidermis, just above the basement membrane.\n\nMerkel cells are most commonly found on the fingertips, as well as in the soles of the feet, mouth and genitals.",
"id": "10001978",
"label": "b",
"name": "Merkel Cells",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Meissner's corpuscles are encapsulated mechanoreceptors. They are responsible for detecting light touch and slow vibration of the skin.\n\nThey are most commonly found in the fingertips and lips.",
"id": "10001980",
"label": "d",
"name": "Meissner's corpuscle",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pilosebaceous units are hair follicles. Hair follicles are responsible for helping body hair grow, anchoring each hair into the skin. They are not responsible for the innervation of the skin.",
"id": "10001981",
"label": "e",
"name": "Pilosebaceous units",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ruffini corpuscles are slow-acting mechanoreceptors that are found deep in the dermis.\n\nThey are responsible for detecting skin stretching and are most commonly found in the fingertips.",
"id": "10001979",
"label": "c",
"name": "Ruffini Corpuscle",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Pacinian corpuscles are encapsulated, rapidly adapting mechanoreceptors that detect deep touch in the skin.\n\nThey also play a role in detecting the texture of objects that the skin comes into contact with. These corpuscles are found in the skin of the hands and feet.",
"id": "10001977",
"label": "a",
"name": "Pacinian Corpuscles",
"picture": null,
"votes": 45
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3997",
"name": "Innervation of the skin",
"status": null,
"topic": {
"__typename": "Topic",
"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
"totalCards": null,
"typeId": null,
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"question": "Which of the following types of cells detect deep pressure and vibration in the skin?",
"sbaAnswer": [
"a"
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173,460,549 | false | 49 | null | 6,495,027 | null | false | [] | null | 12,943 | {
"__typename": "QuestionSBA",
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A first-degree heart block occurs when there is a regular prolongation of the PR interval on ECG. Most patients with first-degree heart block are asymptomatic - they certainly would not be experiencing chest pain that radiated to their left arm and jaw. These are signs of a myocardial infarction.",
"id": "10001985",
"label": "d",
"name": "First-degree heart block",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Atrial Fibrillation (AF) is a cardiac arrhythmia that can result in a patient feeling faint, having palpitations, chest pain and shortness of breath.\n\nAlthough our patient is having chest pain, it would not radiate anywhere in AF. Our patient is also not complaining of any other AF symptoms - they are much more likely to be having a myocardial infarction than atrial fibrillation.",
"id": "10001984",
"label": "c",
"name": "Atrial Fibrillation",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Second-degree heart block can be split into Mobitz Type I and Mobitz Type II. In Mobitz Type I there is a regular pattern of gradual prolongation of the PR interval until a P wave is not followed by a QRS complex. In Mobitz Type II, there are P waves that are not followed by QRS complexes but there is no obvious pattern to which P wave will be skipped.\n\nIn second-degree heart block patients will experience symptoms such as feeling faint, palpitations, chest pain and shortness of breath.\n\nAlthough our patient is experiencing chest pain, you would not expect chest pain in a second-degree heart block to radiate - this is indicative of a myocardial infarction, which is the condition our patient is more likely to have.",
"id": "10001986",
"label": "e",
"name": "Second-degree heart block",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with a myocardial infarction. Myocardial infarctions are commonly associated with chest pain that radiates to the left arm, jaw and back, sweating, nausea and shortness of breath.\n\nWe are unable to differentiate between a Non ST-Elevated Myocardial Infarction (NSTEMI) and an ST-Elevated Myocardial Infarction (STEMI) without an ECG, however, since this is the only myocardial infarction option present we can safely choose NSTEMI as the most likely diagnosis.",
"id": "10001982",
"label": "a",
"name": "Non-ST-Elevation Myocardial Infarction (NSTEMI)",
"picture": null,
"votes": 68
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Congestive Heart Failure would present with more chronic symptoms. These symptoms include shortness of breath on exertion or lying down, peripheral oedema, palpitations and a cough with the production of pink sputum.\n\nThis patient is not presenting with any of these symptoms - he is presenting with classic symptoms of a myocardial infarction (MI).",
"id": "10001983",
"label": "b",
"name": "Congestive Heart Failure",
"picture": null,
"votes": 3
}
],
"comments": [],
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"name": "Myocardial Infarction",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
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"topicId": 134,
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"question": "A 56-year-old man presents to the Emergency Department with chest pain, radiating to the left arm and jaw. He is also sweating and reports feeling nauseous.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
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"totalVotes": 74,
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173,460,550 | false | 50 | null | 6,495,027 | null | false | [] | null | 12,944 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Wolff-Parkinson-White syndrome is a benign cardiac arrhythmia, characterised by palpitations and chest pain. It has a very specific ECG sign of QRS pre-excitation and biphasic or inverted T-waves.\n\nIt would not result in reduced ejection fraction or left ventricular hypertrophy.",
"id": "10001988",
"label": "b",
"name": "Wolf-Parkinson-White Syndrome",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is most likely suffering from heart failure. Heart failure occurs when the heart is no longer able to pump blood out of itself as much as it used to.\n\nThis results in a reduced ejection fraction because the heart is pumping out less blood compared to before. There will be less blood leaving the heart per pump.\n\nThe ejection fraction is calculated as Stroke Volume / End Diastolic Volume.\n\nDue to this reduced ejection fraction, the heart left ventricle will begin to hypertrophy, as it is working harder in an attempt to increase the volume of blood leaving the heart.",
"id": "10001987",
"label": "a",
"name": "Heart Failure",
"picture": null,
"votes": 52
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Unstable Angina is characterised by chest pain at rest. It is similar to angina in that it is chest pain. However, in angina, the chest pain is brought on through exercise. In unstable angina, it occurs even when the patient is at rest.\n\nOur patient is not complaining of chest pain - they are unlikely to have unstable angina.",
"id": "10001991",
"label": "e",
"name": "Unstable Angina",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Angina is a term used to describe chest pain upon exertion such as exercise. The patient is not experiencing angina as they are not reporting any chest pain.",
"id": "10001990",
"label": "d",
"name": "Angina",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An ST elevated myocardial infarction (STEMI) is a myocardial infarction in which there is ST elevation on the ECG.\n\nPatients suffering from a STEMI will often experience chest pain, radiating to the left arm and jaw, nausea and sweating. Our patient is not suffering from any of these symptoms, therefore they are unlikely to be having a STEMI.",
"id": "10001989",
"label": "c",
"name": "ST-Elevation Myocardial Infarction",
"picture": null,
"votes": 6
}
],
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"question": "A 70-year-old man presents to General Practice after a recent echocardiogram showed a reduced ejection fraction and left ventricular hypertrophy. He is experiencing shortness of breath on exertion but denies any pain.\n\nWhich of the following describes this patient's most likely diagnosis?",
"sbaAnswer": [
"a"
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Subsets and Splits