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"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There are no respiratory infective symptoms, such as cough or shortness of breath, to suggest chest infections. This may be a part of the initial investigations to identify signs of any lung pathologies like Tuberculosis (fever in returning travellers) or malignancies like lymphoma (fever). However, the investigation is not diagnostic and the cyclical fever pattern is more indicative of malaria than a respiratory cause.",
"id": "10002993",
"label": "c",
"name": "Chest X-Ray",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is generally a part of the initial investigations for fever in a returning traveller. Raised CRP is a sign of inflammation and elevated white cells may be seen in other causes of fever like neutrophils in TB etc. However, this is not diagnostic of any condition and just indicates the presence of an infection. In malaria, neutrophils may be elevated and lymphocytes may be reduced.",
"id": "10002992",
"label": "b",
"name": "CRP and WCC",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This can be conducted to identify any viral causes of fever in returning travellers like dengue. However, the presentation of dengue fever would not be cyclical, so this investigation is less likely to be diagnosing the cause of the fever.",
"id": "10002995",
"label": "e",
"name": "Serology and viral PCR",
"picture": null,
"votes": 136
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "For fever in a returning traveller from the tropics, Malaria is an important diagnosis to rule out. A pattern of cyclical fever over 24-48 hours, chills, night sweats and muscle aches is characteristic of Malaria, with an incubation period <7 days typical for *Plasmodium falciparum*. The diagnosis is made by analysing thick film for the presence of parasites, and thin film to identify the species causing the infection.",
"id": "10002991",
"label": "a",
"name": "Thick and thin blood films",
"picture": null,
"votes": 132
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This may be a probable investigation to rule out fatal causes of fever in returning travellers like Japanese encephalitis (JE). However, the patient does not present with any symptoms like headache, neck stiffness or seizures. Also, the risk of contracting JE is very low, so it is less likely to be the cause of the fever.",
"id": "10002994",
"label": "d",
"name": "Lumbar Puncture",
"picture": null,
"votes": 9
}
],
"comments": [],
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"id": "4100",
"name": "Fever in the returning traveller",
"status": null,
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"__typename": "Topic",
"id": "194",
"name": "Infectious Diseases",
"typeId": 7
},
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"question": "A 21-year-old male presents to A&E with on-and-off fevers and chills for the past 36 hours. He complains of muscle aches and waking up in a pool of sweat last night.\n\nHe just returned from Malaysia a week ago from a business trip. He did not take any vaccinations before travelling. What is the best investigation to diagnose the ongoing condition?",
"sbaAnswer": [
"a"
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"totalVotes": 309,
"typeId": 1,
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173,460,883 | false | 2 | null | 6,495,039 | null | false |
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{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is inflammatory arthritis usually occurring after an infection like food poisoning or STIs like chlamydia. It is generally characterised by the triad of arthritis, conjunctivitis and urethritis.",
"id": "10002999",
"label": "d",
"name": "Reactive arthritis",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "While any bacterial infection can spread into the bloodstream, it is extremely rare for syphilis to cause sepsis. STIs like gonorrhoea if left untreated are more likely to cause a systemic life-threatening infection.",
"id": "10003000",
"label": "e",
"name": "Sepsis",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Tertiary syphilis appears 20-40 years after primary infection if it is left untreated. This tends to present with loss of proprioception, vibration and fine touch due to degeneration of dorsal columns in the spinal cord. Patients present with paraesthesia, absent reflexes and progressive ataxia.",
"id": "10002996",
"label": "a",
"name": "Tabes dorsalis",
"picture": null,
"votes": 120
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is conjunctivitis of the newborn baby contracted during birth due to contact with the maternal birth canal which is infected with an STI like chlamydia or gonorrhoea.",
"id": "10002998",
"label": "c",
"name": "Ophthalmia neonatorum",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a more common complication of sexually transmitted infections (STI) like chlamydia or gonorrhoea. These bacterial infections, if untreated, spread upwards from the vagina or cervix and cause infection of the upper reproductive tract.",
"id": "10002997",
"label": "b",
"name": "Pelvic inflammatory disease",
"picture": null,
"votes": 91
}
],
"comments": [],
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"id": "4101",
"name": "Stages of Syphilis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "194",
"name": "Infectious Diseases",
"typeId": 7
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"topicId": 194,
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"question": "A 32-year-old female presents to\nthe sexual health clinic with painless round ulceration on the vulva.\n\nOn further investigation, she is diagnosed with primary syphilis. If left untreated, what is a complication that can develop in the long term?",
"sbaAnswer": [
"a"
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"totalVotes": 271,
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"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is unlikely as there are no left-sided symptoms and the presentation does not fulfil all the requirements of an anterior infarct.",
"id": "10003002",
"label": "b",
"name": "Right Total Anterior Circulation Infarct (TACI)",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is unlikely as the patient does not present with any left-sided symptoms, which would be more likely in a right PACI",
"id": "10003003",
"label": "c",
"name": "Right Partial Anterior Circulation Infarct (PACI)",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is unlikely as a patient with a LACI would present with one of the following; pure motor stroke OR pure sensory stroke OR mixed sensorimotor stroke OR ataxic hemiparesis",
"id": "10003004",
"label": "d",
"name": "Left Lacunar Infarct (LACI)",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the most likely type of stroke as it fulfils two out of three requirements of an anterior infarct according to the Bamford criteria. This includes contralateral hemiparesis and aphasia. There is no homonymous hemianopia present in this patient.",
"id": "10003001",
"label": "a",
"name": "Left Partial Anterior Circulation Infarct (PACI)",
"picture": null,
"votes": 138
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is unlikely as the patient's presentation does not fulfil all the requirements for an anterior infarct. The patient has a normal visual examination and so there is no sign of homonymous hemianopia.",
"id": "10003005",
"label": "e",
"name": "Left Total Anterior Circulation Infarct (TACI)",
"picture": null,
"votes": 75
}
],
"comments": [],
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"id": "3743",
"name": "Ischaemic Stroke",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
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"topicId": 141,
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"question": "66y/o female, tells A&E doctor about a recent fall, on examination unable to lift up her right arm and leg, neglecting her right visual field, identify the type of stroke\n\nA 66 year old female is brought into A&E in an ambulance after a recent fall. She has a past medical history of hypertension and a previous MI at 62.\n\nOn examination, she has slurred speech and is unable to raise her right upper and lower limb. There are no visual changes. What is the most probable type of stroke?",
"sbaAnswer": [
"a"
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"totalVotes": 244,
"typeId": 1,
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MarksheetMark
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173,460,885 | false | 4 | null | 6,495,039 | null | false |
[] | null | 13,148 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The first line of treatment for suspected meningococcal disease while being transferred to hospital in an ambulance is an intramuscular or intravenous dose of benzylpenicillin. In the hospital, treatment is by intravenous cefotaxime or ceftriaxone based on local guidelines.",
"id": "10003010",
"label": "e",
"name": "Nitrofurantoin IV",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Viral encephalitis will also be a differential for the presentation, and this can be covered with intravenous aciclovir till the confirmation of diagnosis. However, this cannot be administered in an ambulance setting, and is hence, not the most appropriate management.",
"id": "10003007",
"label": "b",
"name": "Aciclovir IV",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "A presentation of fever, lethargy, non-blanching rash and bulging fontanelle in a 3-month-old infant is meningitis with meningococcal septicaemia. This requires urgent treatment with antibiotics. As this infant is being transferred in an ambulance, the best initial treatment is an intramuscular (or intravenous) dose of benzylpenicillin.",
"id": "10003006",
"label": "a",
"name": "Benzylpenicillin IM",
"picture": null,
"votes": 91
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The first line of treatment for suspected meningococcal disease while being transferred to a hospital in an ambulance is an intramuscular or intravenous dose of benzylpenicllin. Cefotaxime is the alternative given if the patient has a penicillin allergy, however, this is not indicated in the question.",
"id": "10003008",
"label": "c",
"name": "Cefotaxime IM",
"picture": null,
"votes": 53
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The first line of treatment for suspected meningococcal disease while being transferred to a hospital in an ambulance is an intramuscular or intravenous dose of benzylpenicillin. In the hospital, treatment is by intravenous cefotaxime or ceftriaxone based on local guidelines.",
"id": "10003009",
"label": "d",
"name": "Amoxicillin IV",
"picture": null,
"votes": 59
}
],
"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": "4102",
"name": "Meningitis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "194",
"name": "Infectious Diseases",
"typeId": 7
},
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"question": "A 3-month-old male is being transported to A&E in an ambulance. He is presenting with a 4 day history of fever and lethargy.\n\nOn examination, he has a non-blanching rash on his legs and a bulging fontanelle. He has no known allergies. What is the best initial management in the most probable condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 246,
"typeId": 1,
"userPoint": null
}
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MarksheetMark
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173,460,886 | false | 5 | null | 6,495,039 | null | false |
[] | null | 13,149 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as group Ia afferent fibres are involved in carrying signals from the muscle spindle fibres to the spinal cord.",
"id": "10003013",
"label": "c",
"name": "Muscle spindle fibres → sensory IIa fibres → dorsal root ganglion → anterior horn of spinal cord → alpha-motor neuron → quadriceps muscle → contraction",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as the alpha-motor neuron fibres carry signals to the quadriceps muscle for contraction. Hamstrings are also involved in the patellar reflex, as there is reciprocal inhibition which causes relaxation of the hamstrings, allowing quadriceps to contract freely.",
"id": "10003014",
"label": "d",
"name": "Muscle spindle fibres → sensory Ia fibres → dorsal root ganglion → anterior horn of spinal cord → alpha-motor neuron → hamstring muscles → contraction",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as there is no interneuron involved in the transmission of the stretch reflex. It is a monosynaptic reflex and the afferent Ia fibres directly synapse on the efferent alpha-motor neurons.",
"id": "10003015",
"label": "e",
"name": "Muscle spindle fibres → sensory Ia fibres → dorsal root ganglion → anterior horn of spinal cord → interneuron → alpha-motor neuron → quadriceps muscles → contraction",
"picture": null,
"votes": 65
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Muscle spindle fibres are involved in detecting the stretch of muscles and causing reflex contraction. This pathway is known as the stretch reflex, which is elicited when the tendon hammer strikes the patellar tendon. Muscle spindle fibres detect the stretch and send afferent signals via the group Ia fibres. These synapse on the alpha-motor neurons in the anterior horn of the spinal cord directly. The alpha-motor neuron then sends efferent signals to quadriceps muscle to flex, resulting in the involuntary knee jerk.",
"id": "10003011",
"label": "a",
"name": "Muscle spindle fibres -> sensory Ia fibres -> dorsal root ganglion -> anterior horn of spinal cord -> alpha-motor neuron -> quadriceps muscle -> contraction",
"picture": null,
"votes": 108
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Golgi tendon organs are involved in detecting excess stretch in muscles and causing a reflex relaxation. This pathway is known as the golgi tendon reflex. It occurs when muscles are under excess tension for a long time, for example when weight lifting.",
"id": "10003012",
"label": "b",
"name": "Golgi tendon organ → sensory Ib fibres → dorsal root ganglion → anterior horn of spinal cord → alpha-motor neuron → quadriceps muscle → relaxation",
"picture": null,
"votes": 8
}
],
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"id": "4103",
"name": "Properties of golgi tendon organs and muscle spindles",
"status": null,
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"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
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"question": "A GP is testing the patellar reflexes of 4year old girl with a tendon hammer.\n\nWhich of these is the right pathway of signal transmission when eliciting the patellar tendon reflex?",
"sbaAnswer": [
"a"
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"totalVotes": 231,
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MarksheetMark
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173,460,887 | false | 6 | null | 6,495,039 | null | false |
[] | null | 13,150 |
{
"__typename": "QuestionSBA",
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "Pacinian corpuscles are skin mechanoreceptors present in the dermis of skin. They detect pressure changes and vibrations in the skin. When pressure is applied, the deformation of the receptor membrane causes sodium channels to open and depolarisation to occur.",
"id": "10003016",
"label": "a",
"name": "Pressure-sensitive sodium ion channels",
"picture": null,
"votes": 158
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as Pacinian corpuscles are pressure-sensitive sodium channels. The sodium channels open and cause depolarisation when the membrane is deformed by external pressure.",
"id": "10003020",
"label": "e",
"name": "Pressure-sensitive calcium ion channels",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as Pacinian corpuscles are pressure sensitive sodium channels. The sodium channels open and cause depolarisation when the membrane is deformed by external pressure.",
"id": "10003017",
"label": "b",
"name": "Pressure-sensitive potassium ion channels",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as Pacinian corpuscles are mechanoreceptors, not free nerve endings that detect pain.",
"id": "10003018",
"label": "c",
"name": "Nociceptors",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as Pacinian corpuscles are mechanoreceptors, not thermoreceptors.",
"id": "10003019",
"label": "d",
"name": "Heat-sensitive sodium ion channels",
"picture": null,
"votes": 5
}
],
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"id": "4104",
"name": "Properties of sensory mechanoreceptors",
"status": null,
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"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
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"question": "A 32-year-old female comes in with second-degree burns to her fingertips. She is unable to feel fine touch at the ends of her fingers, but can feel pressure and vibration.\n\nWhat type of sensory receptors are Pacinian corpuscles?",
"sbaAnswer": [
"a"
],
"totalVotes": 229,
"typeId": 1,
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MarksheetMark
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173,460,888 | false | 7 | null | 6,495,039 | null | false |
[] | null | 13,151 |
{
"__typename": "QuestionSBA",
"choices": [
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "This refers to a fluid filled cyst forming within the centre of the spinal cord. It presents gradually with neurological signs as the cyst grows bigger and compresses nerve fibres. It leads to back pain, loss of pain and temperature sensation and weakness in the upper extremities.",
"id": "10003025",
"label": "e",
"name": "Syringomyelia",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is an incomplete spinal cord injury from hemisection to the spinal cord, usually due to trauma. It leads to ipsilateral weakness or paralysis and loss of fine touch, vibration and proprioception below the level of injury. It also causes contralateral loss of pain and temperature sensation below the level of injury. There is also total ipsilateral loss of sensation at the level of injury.",
"id": "10003021",
"label": "a",
"name": "Brown-Séquard syndrome",
"picture": null,
"votes": 188
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an incomplete spinal cord injury resulting from an infarction of the anterior spinal artery affecting the anterior two-thirds of the spinal cord. This results in complete bilateral paralysis and loss of pain and temperature sensation below the level of the lesion.",
"id": "10003023",
"label": "c",
"name": "Anterior Cord Syndrome",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This refers to tertiary syphilis which appears 20-40 years after primary infection if left untreated. This tends to present with loss of proprioception, vibration and fine touch due to degeneration of dorsal columns in the spinal cord.",
"id": "10003022",
"label": "b",
"name": "Tabes dorsalis",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a serious condition referring to the compression of the Cauda equina (lumbar and sacral nerve roots). It results in symptoms of bilateral weakness or paralysis, pain in the lower extremities. It also causes saddle anaesthesia, urinary retention and faecal incontinence.",
"id": "10003024",
"label": "d",
"name": "Cauda equina syndrome",
"picture": null,
"votes": 8
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"id": "4105",
"name": "Brown-Séquard Syndrome",
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"name": "Neurology",
"typeId": 7
},
"topicId": 141,
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"question": "A 33-year-old male was brought into A&E after a stabbing incident. He has a knife embedded on the right side of the spinal cord at L2.\n\nOn examination, he has weakness in the right lower limb, loss of d touch, vibration and proprioception in the right lower limb. He also has a loss of pain and temperature sensation in the left lower limb. There is also total loss of sensation in his right thigh. He has no other signs or symptoms.\n\nWhat is this type of spinal cord injury called?",
"sbaAnswer": [
"a"
],
"totalVotes": 236,
"typeId": 1,
"userPoint": null
}
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MarksheetMark
|
173,460,889 | false | 8 | null | 6,495,039 | null | false |
[] | null | 13,152 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the most suitable imaging for examining soft tissue like the brain and spinal cord in MS. It can help rule out any fractures in the skull.",
"id": "10003029",
"label": "d",
"name": "X-Ray Head",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the most suitable imaging for examining soft tissue like brain and spinal cord in MS. It can help rule out more emergent conditions like intracranial haemorrhages.",
"id": "10003027",
"label": "b",
"name": "CT Head",
"picture": null,
"votes": 69
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the most suitable imaging for examining soft tissue like the brain and spinal cord in MS. It can help rule out more emergent conditions like intracranial haemorrhages.",
"id": "10003028",
"label": "c",
"name": "Ultrasound Head",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Given the patient's age group, presentation of sensory and motor loss, with previous episodes of unilateral painful vision loss, the most likely diagnosis is multiple sclerosis (MS). This refers to auto-inflammatory demyelination of neurones in the central nervous system. MRI is more suitable for scanning the central nervous system as it is sensitive to soft tissue changes. In an MRI, these appear as periventricular white matter lesions. With her presentation with 2 episodes, a finding of 2 or more lesions will lead to a diagnosis of MS",
"id": "10003026",
"label": "a",
"name": "MRI of the Head and Spine",
"picture": null,
"votes": 149
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "While this is sensitive to soft tissue and neurological problems, it is not the first line investigation used to diagnose MS. In MS, it will show increased activation of inflammatory cells in white matter and periventricular lesions.",
"id": "10003030",
"label": "e",
"name": "PET scan Head",
"picture": null,
"votes": 6
}
],
"comments": [],
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"explanation": null,
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"demo": null,
"entitlement": null,
"id": "3745",
"name": "Multiple Sclerosis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
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"question": "A 21 year old female presents to A&E with a 2-day history of worsening pins and needles down her right arm and hand. She reveals she has had a previous self-limiting episode of left eye pain with loss of vision mainly affecting her colour vision. She has a past medical history of Coeliac disease which is well-controlled with diet.\n\nOn examination there is also reduced power in her right upper limb. There are no other examination findings.\n\nGiven the most likely diagnosis, what is the best imaging investigation to confirm it?",
"sbaAnswer": [
"a"
],
"totalVotes": 225,
"typeId": 1,
"userPoint": null
}
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MarksheetMark
|
173,460,890 | false | 9 | null | 6,495,039 | null | false |
[] | null | 13,153 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hyporeflexia is a sign of lower motor neuron lesions. Weakness can be associated with upper or lower motor neuron lesions.",
"id": "10003032",
"label": "b",
"name": "Hyporeflexia and weakness",
"picture": null,
"votes": 63
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "While hyperreflexia is a sign of upper motor neuron lesions, downward plantar reflexes are considered normal. Upper motor neuron disease would present with upward plantar reflexes.",
"id": "10003033",
"label": "c",
"name": "Hyperreflexia and downward plantar reflexes",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Primary lateral sclerosis (PLS) is a type of motor neurone disease (MND) which only causes upper motor neuron features. This includes hyperreflexia and rigidity.",
"id": "10003031",
"label": "a",
"name": "Hyperreflexia and rigidity",
"picture": null,
"votes": 74
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hyporeflexia is a sign of lower motor neuron lesions, while spasticity is a sign of upper motor neuron lesions.",
"id": "10003034",
"label": "d",
"name": "Hyporeflexia and spasticity",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "While hyperreflexia is a sign of upper motor neuron lesions, fasciculations are observed in lower motor neuron disease.",
"id": "10003035",
"label": "e",
"name": "Hyperreflexia and fasciculations",
"picture": null,
"votes": 44
}
],
"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": "4009",
"name": "Motor Neurone Disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
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},
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"question": "A 66 year old male has recently been diagnosed with a type of motor neurone disease called primary lateral sclerosis.\n\nWhich of these are signs that will be observed on examination?",
"sbaAnswer": [
"a"
],
"totalVotes": 220,
"typeId": 1,
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}
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MarksheetMark
|
173,460,891 | false | 10 | null | 6,495,039 | null | false |
[] | null | 13,154 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would present with the sudden onset thunderclap headache. On CT scan, this would appear as hyperdensity in the subarachnoid space including the ventricles and cerebral cortical lining.",
"id": "10003039",
"label": "d",
"name": "Subarachnoid haemorrhage",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The presentation of the patient is suggestive of a chronic subdural haemorrhage. On a CT scan, this appears as a hypodense crescent-shaped lesion which extends across the sutures of the skull. Sometimes, there may be mass effect causing midline shift or sulcal effacement.",
"id": "10003036",
"label": "a",
"name": "Subdural haemorrhage",
"picture": null,
"votes": 177
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would present more acutely, especially after trauma. On a CT scan, this would appear as a hyperdense lentiform or lemon-shaped hyperdense lesion, not crossing the skull sutures.",
"id": "10003037",
"label": "b",
"name": "Extradural haemorrhage",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ischaemic stroke can be a differential diagnosis, given the patient's presentation. On CT scan, a chronic ischaemic stroke would appear as a hypodense lesion in the cerebral cortex, with associated mass effect.",
"id": "10003038",
"label": "c",
"name": "Ischaemic stroke",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This refers to an intracerebral haemorrhage and would present more acutely with stroke-like symptoms. On a CT scan, this would appear as a hyperdense collection in the cerebral cortex with surrounding hypodense oedema.",
"id": "10003040",
"label": "e",
"name": "Intraparenchymal haemorrhage",
"picture": null,
"votes": 2
}
],
"comments": [],
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},
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"demo": null,
"entitlement": null,
"id": "4017",
"name": "Subdural haemorrhage",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
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"question": "A 70-year-old male is brought into A&E by his wife due to behavioural changes observed for the last 1 month. This was preceded by a fall down the stairs. The patient appears to have slurred speech and also complains of dull headache and appears confused.\n\nHe has a past medical history of hypertension and atrial fibrillation, for which he takes ramipril and warfarin.\n\nA CT scan of his head shows a left-sided crescent-shaped hypodense lesion crossing the sutures of the skull. What is the most likely type of pathology?",
"sbaAnswer": [
"a"
],
"totalVotes": 216,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,892 | false | 11 | null | 6,495,039 | null | false |
[] | null | 13,155 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be due to a lesion in the right occipital cortex",
"id": "10003044",
"label": "d",
"name": "Left homonymous hemianopia with macular sparing",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be due to a lesion in the right optic tract",
"id": "10003045",
"label": "e",
"name": "Left homonymous hemianopia",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be due to a lesion in the right temporal homonymous quadrantanopia",
"id": "10003042",
"label": "b",
"name": "Left inferior homonymous quadrantonopia",
"picture": null,
"votes": 41
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The left-sided parietal optic radiation carries information from the right lower visual field. Hence, a lesion in this would lead to right inferior homonymous quadrantanopia",
"id": "10003041",
"label": "a",
"name": "Right inferior homonymous quadrantanopia",
"picture": null,
"votes": 109
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be due to a lesion in the left optic nerve",
"id": "10003043",
"label": "c",
"name": "Left monocular blindness",
"picture": null,
"votes": 6
}
],
"comments": [],
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"demo": null,
"entitlement": null,
"id": "4106",
"name": "Right inferior homonymous quadrantonopia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
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},
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"question": "A man is being tested for visual field loss with an MRI. This reveals a lesion on the left parietal optic radiation.\n\nWhat type of visual field defect is he experiencing?",
"sbaAnswer": [
"a"
],
"totalVotes": 204,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,893 | false | 12 | null | 6,495,039 | null | false |
[] | null | 13,156 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Stroke in the posterior inferior cerebellar artery causes cerebellar dysfunction, bilateral motor and sensory deficits, or visual movement or field defects. It rarely affects speech",
"id": "10003050",
"label": "e",
"name": "Posterior inferior cerebellar artery",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This artery supplies the temporal cortex which contains the Wernicke's area. The type of aphasia this man is presenting with is receptive or Wernicke's aphasia, typically presenting with the inability to understand information and production of fluent jargon.",
"id": "10003046",
"label": "a",
"name": "Middle cerebral artery",
"picture": null,
"votes": 144
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Stroke in the lenticulostriate arteries leads to pure sensory or motor symptoms, and rarely affects the speech. Typically, it would present with dysarthria or difficulty articulating words.",
"id": "10003049",
"label": "d",
"name": "Lenticulostriate arteries",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Stroke in ACA leads to mixed contralateral motor and sensory symptoms, and expressive or Broca's aphasia, typically presenting with difficulty forming and completing sentences.",
"id": "10003047",
"label": "b",
"name": "Anterior cerebral artery",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Stroke in the basilar artery leads to locked-in syndrome with motor and sensory symptoms, and dysarthria, typically presenting with difficulty articulating words.",
"id": "10003048",
"label": "c",
"name": "Basilar artery",
"picture": null,
"votes": 5
}
],
"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": "4107",
"name": "Aphasia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
"totalCards": null,
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"question": "A 55-year-old male presents in A&E with his family due to altered speech for the last 3 hours. He is noted to have non-sensical speech that sounds like fluent jargon. He has a past medical history of atrial fibrillation.\n\nOn examination, he is not able to follow instructions well. There are no other neurological signs. What artery is most likely to have been affected?",
"sbaAnswer": [
"a"
],
"totalVotes": 208,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,894 | false | 13 | null | 6,495,039 | null | false |
[] | null | 13,157 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "E3: eyes open to painful stimulus\nV2: only moans and groans\nM4: normal flexion to painful stimulus",
"id": "10003052",
"label": "b",
"name": "E2 V2 M4",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "E2: eyes opening to painful stimulus\nV3: intelligible single words\nM4: normal flexion to painful stimulus",
"id": "10003055",
"label": "e",
"name": "E2 V3 M4",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "E1: no eye opening at any time\nV2: only moans and groans\nM3: abnormal flexion to painful stimulus",
"id": "10003053",
"label": "c",
"name": "E1 V2 M3",
"picture": null,
"votes": 100
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "E1: no eye opening at any time\nV2: only moans and groans\nM4: normal flexion to painful stimulus",
"id": "10003051",
"label": "a",
"name": "E1 V2 M4",
"picture": null,
"votes": 51
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "E1: no eye opening at any time\nV3: intelligible single words\nM4: normal flexion to painful stimulus",
"id": "10003054",
"label": "d",
"name": "E1 V3 M4",
"picture": null,
"votes": 16
}
],
"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": "4108",
"name": "Glasgow Coma Scale (GCS)",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"conditions": [],
"difficulty": 1,
"dislikes": 1,
"explanation": null,
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"question": "A 20year old male presents to A&E after falling down 2 flights of stairs. He has no significant past medical history.\n\nOn assessment, his eyes remain closed on painful stimuli. He also moans to the painful stimulus and his arms are in a flexed position away from body.\n\nWhat is his Glasgow Coma Scale?",
"sbaAnswer": [
"a"
],
"totalVotes": 195,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,895 | false | 14 | null | 6,495,039 | null | false |
[] | null | 13,158 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would indicate bone conduction is better than air conduction in the unaffected ear.",
"id": "10003059",
"label": "d",
"name": "Weber's lateralises to left ear",
"picture": null,
"votes": 51
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Otitis media is a form of conductive hearing loss, that affects air conduction. In this type of hearing loss, Weber's lateralises to the affected ear as bone conduction is better than air conduction.",
"id": "10003056",
"label": "a",
"name": "Weber's lateralises to right ear",
"picture": null,
"votes": 111
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would indicate air conduction is better than bone conduction in the affected ear.",
"id": "10003058",
"label": "c",
"name": "Rinne's positive in right ear",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would indicate there is no conductive hearing loss in the affected ear, which is unlikely.",
"id": "10003060",
"label": "e",
"name": "No lateralisation with Weber's test",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would indicate air conduction is better than bone conduction in the affected ear.",
"id": "10003057",
"label": "b",
"name": "Rinne's positive in the right ear",
"picture": null,
"votes": 14
}
],
"comments": [],
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"__typename": "Concept",
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4109",
"name": "Rinne's and Weber's test",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
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"question": "An 8-year-old boy is brought into GP with 2 day history of ear pain in his right ear and reduced hearing. On examination, he has a red swollen tympanic membrane in the right ear, normal examination of left ear.\n\nThe GP diagnoses him with otitis media. What will be the observations on doing Weber’s and Rinne’s tests on him?",
"sbaAnswer": [
"a"
],
"totalVotes": 200,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
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173,460,896 | false | 15 | null | 6,495,039 | null | false |
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is used as a prophylaxis for cluster headaches.",
"id": "10003063",
"label": "c",
"name": "Verapamil",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not shown to be effective in cluster headaches.",
"id": "10003062",
"label": "b",
"name": "Paracetamol",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Given the most likely diagnosis of cluster headaches, 100% oxygen and sumatriptan are used to acutely treat them.",
"id": "10003061",
"label": "a",
"name": "100% Oxygen",
"picture": null,
"votes": 112
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is used as a prophylaxis for cluster headaches.",
"id": "10003065",
"label": "e",
"name": "Prednisolone",
"picture": null,
"votes": 31
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not shown to be effective in cluster headaches.",
"id": "10003064",
"label": "d",
"name": "Ibuprofen",
"picture": null,
"votes": 20
}
],
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"name": "Cluster headaches",
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"question": "A 27 year old male presents to his GP with a 1 month history of sharp right-sided headaches. On taking a history, he reports the pain to be a 10/10, coming on suddenly at night and lasting about 30 minutes. He also mentions that his right eye waters when he has the headache.\n\nHe is known to smoke 10 cigarettes a day. Given the most likely type of headache, what is a definitive treatment when he has an acute attack?",
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"a"
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MarksheetMark
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173,460,897 | false | 16 | null | 6,495,039 | null | false |
[] | null | 13,160 |
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"__typename": "QuestionSBA",
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is unlikely as the patient would present with symptoms of loss of balance, vertigo, nausea and vomiting, along with hearing loss.",
"id": "10003070",
"label": "e",
"name": "Labyrinthitis",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would present with symptoms of ear fullness and tinnitus, in younger patients. The audiogram would also have shown loss of hearing at low frequency.",
"id": "10003068",
"label": "c",
"name": "Meniere's disease",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is unlikely as an ear examination would have shown fluid behind the tympanic membrane. The audiogram would also have indicated conductive hearing loss.",
"id": "10003067",
"label": "b",
"name": "Otitis media with effusion",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The audiogram is indicative of bilateral sensorineural hearing loss. Given the age and presentation of the patient, it is most likely to be age-related hearing loss due to degeneration of cochlea or auditory nerves, known as presbyacusis.",
"id": "10003066",
"label": "a",
"name": "Presbycusis",
"picture": null,
"votes": 147
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would present with symptoms of ear pain and discomfort, rather than hearing loss. An ear examination would show inflammation of the ear canal.",
"id": "10003069",
"label": "d",
"name": "Otitis externa",
"picture": null,
"votes": 9
}
],
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"id": "4111",
"name": "Sensorineural Hearing Loss",
"status": null,
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"__typename": "Topic",
"id": "138",
"name": "Ear, Nose & Throat",
"typeId": 7
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"question": "A 78 year old male is seen in the ENT clinic for bilateral hearing loss. The man complains it is worse in the left ear and does not report any ear pain, fullness, tinnitus, discharge, nausea and vomiting, or loss of balance.\nThere are no findings on examining the ears.\n\nOn performing audiometry, the audiogram shows two overall downward sloping lines indicating loss of hearing at high frequencies.\n\nWhat is the most likely cause of hearing loss?",
"sbaAnswer": [
"a"
],
"totalVotes": 191,
"typeId": 1,
"userPoint": null
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MarksheetMark
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173,460,898 | false | 17 | null | 6,495,039 | null | false |
[] | null | 13,161 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the function of the bony ossicles, malleus, incus and stapes in the middle ear.",
"id": "10003072",
"label": "b",
"name": "Transmit sound waves from the tympanic membrane to the inner ear",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the function of the cochlea.",
"id": "10003075",
"label": "e",
"name": "Converts sound waves into electrical signals for auditory transduction",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the function of the auricle or pinna.",
"id": "10003073",
"label": "c",
"name": "Collect sound waves from outside and channel them into the external auditory meatus for amplification",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The Eustachian tube is a space connecting the middle ear cavity of both ears to the nasopharynx. It is involved in equalising the air pressure on the inner and outer sides of both the tympanic membranes. It also helps drain fluids and secretions from the middle ear and prevents middle ear infections.",
"id": "10003071",
"label": "a",
"name": "Normalise the air pressure on both sides of each tympanic membrane",
"picture": null,
"votes": 146
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the function of the vestibule.",
"id": "10003074",
"label": "d",
"name": "Provide a sense of balance and spatial awareness for coordination",
"picture": null,
"votes": 10
}
],
"comments": [],
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"id": "4112",
"name": "Middle ear anatomy",
"status": null,
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"__typename": "Topic",
"id": "138",
"name": "Ear, Nose & Throat",
"typeId": 7
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"question": "Children with Down's syndrome are at risk of Eustachian tube dysfunction, which can cause conductive hearing loss.\n\nWhat is the function of the Eustachian tube?",
"sbaAnswer": [
"a"
],
"totalVotes": 189,
"typeId": 1,
"userPoint": null
}
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MarksheetMark
|
173,460,899 | false | 18 | null | 6,495,039 | null | false |
[] | null | 13,162 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as a branch of the facial nerve supplies the stapedius.",
"id": "10003079",
"label": "d",
"name": "Hypoglossal nerve",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Facial nerve branches into the chorda tympani and nerve to stapedius after the internal auditory meatus. This supplies the stapedius muscle in the middle ear.",
"id": "10003076",
"label": "a",
"name": "Facial nerve",
"picture": null,
"votes": 98
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as a branch of the facial nerve supplies the stapedius.",
"id": "10003077",
"label": "b",
"name": "Vagal nerve",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as a branch of the facial nerve supplies the stapedius.",
"id": "10003078",
"label": "c",
"name": "Vestibulocochlear nerve",
"picture": null,
"votes": 81
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as branch of the facial nerve supplies the stapedius.",
"id": "10003080",
"label": "e",
"name": "Trigeminal nerve",
"picture": null,
"votes": 12
}
],
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"__typename": "Topic",
"id": "138",
"name": "Ear, Nose & Throat",
"typeId": 7
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"topicId": 138,
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"dislikes": 0,
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"question": "Stapedius muscle acts on the stapedius to stabilise it and prevent oscillation. Damage to the muscle or innervation can lead to hyperacusis or hypersensitivity to loud noises.\n\nPalsy of which cranial nerve will lead to this hyperacusis?",
"sbaAnswer": [
"a"
],
"totalVotes": 193,
"typeId": 1,
"userPoint": null
}
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MarksheetMark
|
173,460,900 | false | 19 | null | 6,495,039 | null | false |
[] | null | 13,163 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would present with a step-wise decline in cognitive function, with minimal effect on motor function.",
"id": "10003084",
"label": "d",
"name": "Vascular dementia",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There is no drug history mentioned that may indicate drug-induced dementia. It would also lead to bilateral symptoms.",
"id": "10003083",
"label": "c",
"name": "Drug-induced Parkinsonism",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would present with cognitive decline >1 year after the onset of Parkinsonism.",
"id": "10003085",
"label": "e",
"name": "Parkinson's disease",
"picture": null,
"votes": 62
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The woman has presented with features of Parkinsonism with the onset of fluctuating cognition and visual hallucinations in <1 year. This is characteristic of Parkinson's disease dementia",
"id": "10003081",
"label": "a",
"name": "Parkinson's disease dementia",
"picture": null,
"votes": 57
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In this, the woman would have presented with the Parkinsonism >1 year after onset of cognitive decline.",
"id": "10003082",
"label": "b",
"name": "Dementia with Lewy body",
"picture": null,
"votes": 66
}
],
"comments": [
{
"__typename": "QuestionComment",
"comment": "I don't think your definition for PDD is correct, and is actually the definition for LBD",
"createdAt": 1683151523,
"dislikes": 0,
"id": "23342",
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"questionId": 13163,
"replies": [],
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"__typename": "User",
"accessLevel": "subscriber",
"displayName": "Heart throbs",
"id": 33763
}
}
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"demo": null,
"entitlement": null,
"id": "4043",
"name": "Dementia with Lewy bodies",
"status": null,
"topic": {
"__typename": "Topic",
"id": "191",
"name": "Geriatrics",
"typeId": 7
},
"topicId": 191,
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"question": "A 76-year-old female comes into GP with a 6 month history of visual hallucinations and fluctuating cognition. She also mentions she has noticed a tremor in her right hand for the last year.\n\nOn examination, she has a resting tremor and cog wheeling rigidity in her right hand. Her gait is slow with a stooped posture and she is slow to turn.\n\nWhat is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 187,
"typeId": 1,
"userPoint": null
}
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MarksheetMark
|
173,460,901 | false | 20 | null | 6,495,039 | null | false |
[] | null | 13,164 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Carbidopa is given along with levodopa for symptomatic relief in Parkinson's disease. It reduces the conversion of L-dopa to dopamine in the periphery and prevent side effects. This increases the central effect of dopamine and reduces symptoms.",
"id": "10003086",
"label": "a",
"name": "Peripheral dopamine decarboxylase inhibitor",
"picture": null,
"votes": 118
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are drugs like rasagiline and selegiline. These reduce breakdown of dopamine in the CNS and reduce symptoms of Parkinson's.",
"id": "10003089",
"label": "d",
"name": "Monoamine oxidase inhibitor",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are drugs like tolcapone, entacapone. These reduce breakdown of dopamine in the CNS and reduce symptoms of Parkinson's.",
"id": "10003090",
"label": "e",
"name": "COMT inhibitors",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is levodopa. This is converted to dopamine in the CNS and reduces symptoms of Parkinson's.",
"id": "10003088",
"label": "c",
"name": "Dopamine precursor",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are drugs like retigabine and pramipexole. These stimulate the central nervous syndrome and reduce symptoms in Parkinson's.",
"id": "10003087",
"label": "b",
"name": "Dopamine agonist",
"picture": null,
"votes": 32
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"typeId": 7
},
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"demo": null,
"entitlement": null,
"id": "4113",
"name": "Parkinson's Disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "191",
"name": "Geriatrics",
"typeId": 7
},
"topicId": 191,
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"question": "A 82 year is on levodopa and carbidopa for Parkinson's disease.\n\nWhat is the mechanism of action of carbidopa?",
"sbaAnswer": [
"a"
],
"totalVotes": 185,
"typeId": 1,
"userPoint": null
}
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MarksheetMark
|
173,460,902 | false | 21 | null | 6,495,039 | null | false |
[] | null | 13,165 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect, spinal blocks are injected in the epidural space.",
"id": "10003095",
"label": "e",
"name": "Subdural space",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect, spinal blocks are injected in the epidural space.",
"id": "10003094",
"label": "d",
"name": "Dura mater",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect, spinal blocks are injected in the epidural space.",
"id": "10003093",
"label": "c",
"name": "Pia mater",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the space between the dura mater and arachnoid mater. Local anaesthetic is injected into the epidural space at the L2-3 or L3-4 vertebral level.",
"id": "10003091",
"label": "a",
"name": "Epidural space",
"picture": null,
"votes": 134
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect, spinal blocks are injected in the epidural space.",
"id": "10003092",
"label": "b",
"name": "Subarachnoid space",
"picture": null,
"votes": 28
}
],
"comments": [],
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"__typename": "Chapter",
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},
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"demo": null,
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"id": "4114",
"name": "Epidural anaesthesia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "202",
"name": "Anesthetics and Intensive Care Medicine",
"typeId": 7
},
"topicId": 202,
"totalCards": null,
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},
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"difficulty": 1,
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"id": "13165",
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"qaAnswer": null,
"question": "A 23-year-old woman is in labour and is getting a spinal block for pain relief.\n\nWhich layer of the meninges is the spinal block administered during childbirth?",
"sbaAnswer": [
"a"
],
"totalVotes": 192,
"typeId": 1,
"userPoint": null
}
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MarksheetMark
|
173,460,903 | false | 22 | null | 6,495,039 | null | false |
[] | null | 13,166 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect, warfarin inhibits factors II, VII, IX, and X.",
"id": "10003097",
"label": "b",
"name": "Factor II only",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Warfarin inhibits vitamin K reductase which prevents the activation of factors II, VII, IX, X in the clotting cascade.",
"id": "10003096",
"label": "a",
"name": "Factors II, VII, IX and X",
"picture": null,
"votes": 163
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect, warfarin inhibits factors II, VII, IX, X.",
"id": "10003098",
"label": "c",
"name": "Factors IX and X only",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect, warfarin inhibits factors II, VII, IX, X",
"id": "10003100",
"label": "e",
"name": "Factors II, IX, XI and XII",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect, warfarin inhibits factors II, VII, IX, X",
"id": "10003099",
"label": "d",
"name": "Factors IX, XI and XII",
"picture": null,
"votes": 6
}
],
"comments": [],
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"__typename": "Chapter",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4115",
"name": "Warfarin",
"status": null,
"topic": {
"__typename": "Topic",
"id": "203",
"name": "Pharmacology of Haemostasis and Thrombosis",
"typeId": 7
},
"topicId": 203,
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"question": "A man is on an anticoagulant, warfarin, for Atrial Fibrillation.\n\nWhich clotting factors does warfarin act upon?",
"sbaAnswer": [
"a"
],
"totalVotes": 190,
"typeId": 1,
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}
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MarksheetMark
|
173,460,904 | false | 23 | null | 6,495,039 | null | false |
[] | null | 13,167 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Muscle weakness is not a side effect of aspirin.",
"id": "10003102",
"label": "b",
"name": "Aspirin",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "One of the most common side effects of statin use is muscle pain. Rarely, it may lead to myopathy or myositis, especially in larger muscles like the quadriceps in the thighs. The patient's presentation with bilateral thigh weakness and pain is more suggestive of statin-induced myositis. This requires urgent blood and cessation of statins.",
"id": "10003101",
"label": "a",
"name": "Simvastatin",
"picture": null,
"votes": 90
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Muscle weakness is not a side effect of ticagrelor.",
"id": "10003103",
"label": "c",
"name": "Ticagrelor",
"picture": null,
"votes": 47
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Muscle weakness is not a common side effect of ramipril.",
"id": "10003105",
"label": "e",
"name": "Ramipril",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Muscle weakness is not a side effect of bisoprolol.",
"id": "10003104",
"label": "d",
"name": "Bisoprolol",
"picture": null,
"votes": 25
}
],
"comments": [
{
"__typename": "QuestionComment",
"comment": "Patient is not prescribed simvastatin in question",
"createdAt": 1684156698,
"dislikes": 0,
"id": "24615",
"isLikedByMe": 0,
"likes": 0,
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"replies": [],
"user": {
"__typename": "User",
"accessLevel": "subscriber",
"displayName": "Chronic Bradykinin",
"id": 15646
}
}
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"chapterId": 2693,
"demo": null,
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"id": "4116",
"name": "Statins",
"status": null,
"topic": {
"__typename": "Topic",
"id": "169",
"name": "Cardiovascular pharmacology",
"typeId": 7
},
"topicId": 169,
"totalCards": null,
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"question": "A 78-year-old male has come to his GP for a review after having a myocardial infarction 3 weeks ago. He has newly been started on aspirin, ticagrelor, ramipril, atorvastatin and bisoprolol.\n\nHe complains of pain in his thighs. On examination, there is bilateral weakness in the thighs.\n\nWhat is the most likely cause of this weakness and pain in his thighs?",
"sbaAnswer": [
"a"
],
"totalVotes": 183,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,905 | false | 24 | null | 6,495,039 | null | false |
[] | null | 13,168 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a conjugate vaccine, not a live vaccine. Hence, it is not contraindicated in this immunosuppressed patient.",
"id": "10003107",
"label": "b",
"name": "Pneumococcal vaccine",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a conjugate vaccine, not a live vaccine. Hence, it is not contraindicated in this immunosuppressed patient.",
"id": "10003108",
"label": "c",
"name": "Haemophilus influenza B",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The child has a primary immunodeficiency, which means he is immunosuppressed. MMR is a live vaccine which is contraindicated in this group of patients.",
"id": "10003106",
"label": "a",
"name": "Measles, Mumps and Rubella (MMR)",
"picture": null,
"votes": 120
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an inactivated toxin vaccine, not a live vaccine. Hence, it is not contraindicated in this immunosuppressed patient.",
"id": "10003110",
"label": "e",
"name": "Tetanus",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a conjugate vaccine, not a live vaccine. Hence, it is not contraindicated in this immunosuppressed patient.",
"id": "10003109",
"label": "d",
"name": "Meningitis",
"picture": null,
"votes": 9
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3849",
"name": "Vaccinations",
"status": null,
"topic": {
"__typename": "Topic",
"id": "158",
"name": "Immunology",
"typeId": 7
},
"topicId": 158,
"totalCards": null,
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"qaAnswer": null,
"question": "A 2-year-old is diagnosed with a primary immunodeficiency.\n\nWhich vaccine can he not take?",
"sbaAnswer": [
"a"
],
"totalVotes": 187,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,906 | false | 25 | null | 6,495,039 | null | false |
[] | null | 13,169 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Osteopenia refers to weakening of bone without risk of fragility fractures. She may have osteopenia, however, her symptoms of bone pain and muscle weakness are characteristic of osteomalacia.",
"id": "10003115",
"label": "e",
"name": "Osteopaenia",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Osteomalacia refers to inadequate levels of vitamin D and calcium in the body that result in softening of bones in adults. It increases the likelihood of fractures. Given this woman's history of Coeliac disease and stay in Iceland, it is likely that she has a vitamin D and calcium deficiency. Her symptoms of bone pain and muscle weakness are also characteristic of it.",
"id": "10003111",
"label": "a",
"name": "Osteomalacia",
"picture": null,
"votes": 91
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This refers to weaker bones resulting in fragility fractures and increased likelihood of fractures. She may have osteoporosis, however, her symptoms of bone pain and muscle weakness are characteristic of osteomalacia.",
"id": "10003112",
"label": "b",
"name": "Osteoporosis",
"picture": null,
"votes": 73
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Osteopetrosis refers to abnormal bone growth causing overly dense bones and increased likelihood of fractures. This is more common in childhood and does not present with symptoms of bone pain and muscle weakness.",
"id": "10003113",
"label": "c",
"name": "Osteopetrosis",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is osteomalacia in children, characterised by bow legs, poor growth and bone pain.",
"id": "10003114",
"label": "d",
"name": "Rickets",
"picture": null,
"votes": 6
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4117",
"name": "Osteomalacia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
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"qaAnswer": null,
"question": "A 43-year-old female comes into A&E with pain in her hip following a fall from standing height. On conducting an X-Ray of her hip, there is found to be a fractured neck of the femur.\n\nShe has recently moved from Iceland, and has a past medical history of poorly controlled Coeliac disease. She complains that she has recently been experiencing pain and weakness in her lower back and legs.\n\nWhat condition is she highly likely to have?",
"sbaAnswer": [
"a"
],
"totalVotes": 188,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,907 | false | 26 | null | 6,495,039 | null | false |
[] | null | 13,170 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Myasthenia gravis is not a T cell-mediated delayed hypersensitivity reaction. This is classically in dermatitis and the Mantoux test.",
"id": "10003118",
"label": "c",
"name": "Type IV hypersensitivity",
"picture": null,
"votes": 53
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Myasthenia gravis is not an antigen-antibody immune complex-mediated hypersensitivity reaction. This is classically in rheumatoid arthritis, post-streptococcal glomerulonephritis",
"id": "10003120",
"label": "e",
"name": "Type III hypersensitivity",
"picture": null,
"votes": 51
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Myasthenia gravis is not an antibody-mediated stimulatory hypersensitivity reaction. This is classically in Grave's disease.",
"id": "10003119",
"label": "d",
"name": "Type V hypersensitivity",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient most likely has myasthenia gravis characterised by increasing weakness during the day, drooping eyelids and muscle fatiguability. Myasthenia gravis is an autoimmune condition wherein auto-antibodies bind to acetylcholine receptors in the neuromuscular junction leading to their IgG-mediated immune destruction. This type of hypersensitivity reaction with IgG antibody-mediated cytotoxic reaction is classically a type II hypersensitivity reaction",
"id": "10003116",
"label": "a",
"name": "Type II hypersensitivity",
"picture": null,
"votes": 72
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Myasthenia gravis is not an immediate IgE-mediated hypersensitivity reaction. This is classically in allergic and atopic diseases.",
"id": "10003117",
"label": "b",
"name": "Type I hypersensitivity",
"picture": null,
"votes": 8
}
],
"comments": [],
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"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3859",
"name": "Myasthenia Gravis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "158",
"name": "Immunology",
"typeId": 7
},
"topicId": 158,
"totalCards": null,
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},
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"multiAnswer": null,
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"psaSectionId": null,
"qaAnswer": null,
"question": "A 29-year-old female presents to her GP with tiredness and fatigue. On further assessment, she is found to have a drooping eyelid with double vision which worsens through the day. She is getting increasingly tired and weak as well.\nThrough further investigations, she gets diagnosed with an autoimmune condition.\n\nWhat type of hypersensitivity reaction is involved in this condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 195,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,908 | false | 27 | null | 6,495,039 | null | false |
[] | null | 13,171 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This may be seen in rheumatoid arthritis, but it is mostly a sign seen on X-Ray of joints with osteoarthritis.",
"id": "10003125",
"label": "e",
"name": "Subarticular sclerosis",
"picture": null,
"votes": 38
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Rheumatoid arthritis is associated with loss of joint space.",
"id": "10003124",
"label": "d",
"name": "Increased joint space",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This man is likely to have Rheumatoid arthritis. On X-Ray, there will be subarticular osteopenia due to a decrease in bone mineral density near affected joint due to an autoimmune-mediated attack.",
"id": "10003121",
"label": "a",
"name": "Subarticular osteopaenia",
"picture": null,
"votes": 66
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a sign seen on X-Ray of joints with osteoarthritis.",
"id": "10003122",
"label": "b",
"name": "Osteophytes",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a sign seen on an X-Ray of joints with osteoarthritis.",
"id": "10003123",
"label": "c",
"name": "Subchondral cysts",
"picture": null,
"votes": 35
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4118",
"name": "Rheumatoid arthritis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "158",
"name": "Immunology",
"typeId": 7
},
"topicId": 158,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
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"difficulty": 1,
"dislikes": 0,
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"question": "A 62 year old male is brought into GP with joint pain in his hands that improves on movement. He also mentions occasionally getting painful red eyes.\n\nOn examination, there are bilateral red swollen stiff MCP joints associated with reduced range of movement.\n\nGiven the likely diagnosis, what sign will be seen on the X-Ray of his hands?",
"sbaAnswer": [
"a"
],
"totalVotes": 184,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,909 | false | 28 | null | 6,495,039 | null | false |
[] | null | 13,172 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although both methotrexate and cefotaxime increase likelihood of nephrotoxicity, it is not contraindicated.",
"id": "10003128",
"label": "c",
"name": "Cefotaxime",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There are no drug-drug interactions between nitrofurantoin and methotrexate.",
"id": "10003127",
"label": "b",
"name": "Nitrofurantoin",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Both trimethoprim and methotrexate inhibit dihydrofolate reductase in folic acid metabolism. When prescribed together, they can lead to bone marrow suppression. Hence, trimethoprim is absolutely contraindicated in this patient.",
"id": "10003126",
"label": "a",
"name": "Trimethoprim",
"picture": null,
"votes": 120
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There are no drug-drug interactions between clarithromycin and methotrexate.",
"id": "10003130",
"label": "e",
"name": "Clarithromycin",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although both methotrexate and vancomycin increase the likelihood of nephrotoxicity, it is not absolute contraindicated.",
"id": "10003129",
"label": "d",
"name": "Vancomycin",
"picture": null,
"votes": 18
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3936",
"name": "Methotrexate",
"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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"conditions": [],
"difficulty": 1,
"dislikes": 0,
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"id": "13172",
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"question": "A 27-year-old female is on methotrexate for rheumatoid arthritis.\n\nWhich of the following medications is absolutely contraindicated in this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 183,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,910 | false | 29 | null | 6,495,039 | null | false |
[] | null | 13,173 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not an observation in pseudogout. The crystals are usually rhomboid-shaped, not circular.",
"id": "10003135",
"label": "e",
"name": "Positively birefringent circular crystals",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "These are the typical crystals of calcium pyrophosphate observed under polarised light microscopy in pseudogout.",
"id": "10003131",
"label": "a",
"name": "Positively birefringent rhomboid crystals",
"picture": null,
"votes": 109
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not an observation in pseudogout. The crystals are positively birefringent, not negatively.",
"id": "10003133",
"label": "c",
"name": "Negatively birefringent rhomboid crystals",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an observation in gout.",
"id": "10003134",
"label": "d",
"name": "Negatively birefringent needle-shaped crystals",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not an observation in pseudogout. The crystals are rhomboid-shaped, not needle shaped.",
"id": "10003132",
"label": "b",
"name": "Positively birefringent needle-shaped crystals",
"picture": null,
"votes": 34
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3905",
"name": "pseudogout",
"status": null,
"topic": {
"__typename": "Topic",
"id": "146",
"name": "Rheumatology",
"typeId": 7
},
"topicId": 146,
"totalCards": null,
"typeId": null,
"userChapter": null,
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"videos": []
},
"conceptId": 3905,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "13173",
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"likes": 0,
"multiAnswer": null,
"pictures": [],
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"qaAnswer": null,
"question": "A 77-year-old male comes in with recurrent episodes of hot, swollen, stiff, painful knee. He is diagnosed with pseudogout on analysing the joint aspirate under a polarised light microscope.\n\nWhat were the most likely findings of his joint aspirate?",
"sbaAnswer": [
"a"
],
"totalVotes": 181,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,911 | false | 30 | null | 6,495,039 | null | false |
[] | null | 13,174 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The extracellular matrix in cartilage consists of fibrous proteins of mostly type II collagen fibres which provides mechanical stability. It is also made of type IX, X and XI collagen fibres",
"id": "10003136",
"label": "a",
"name": "Type II collagen fibres",
"picture": null,
"votes": 111
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are major component of the basal lamina in structures like alveoli and glomeruli for membrane transport.",
"id": "10003139",
"label": "d",
"name": "Type IV collagen fibres",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are major components in bone extracellular matrix. They are also present in tendons and ligaments.",
"id": "10003137",
"label": "b",
"name": "Type I collagen fibres",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are major components in hollow organs like blood vessels, bowels etc.",
"id": "10003138",
"label": "c",
"name": "Type III collagen fibres",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are major components of the skin and are associated with type I collagen fibres.",
"id": "10003140",
"label": "e",
"name": "Type V collagen fibres",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3965",
"name": "Cartilage and Endochondral Ossification",
"status": null,
"topic": {
"__typename": "Topic",
"id": "183",
"name": "Physiology & Pathology of Bone",
"typeId": 7
},
"topicId": 183,
"totalCards": null,
"typeId": null,
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},
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"question": "The epiglottis is a flap of tissue in the larynx below the tongue that is involved in preventing food from entering the airways. It is made of cartilage, a special form of connective tissue with many functions.\n\nWhat type of collagen is cartilage mostly comprised of?",
"sbaAnswer": [
"a"
],
"totalVotes": 181,
"typeId": 1,
"userPoint": null
}
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MarksheetMark
|
173,460,912 | false | 31 | null | 6,495,039 | null | false |
[] | null | 13,175 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not usually observed with any neck or femur pathology.",
"id": "10003143",
"label": "c",
"name": "Flexed and internally rotated leg",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This may be observed with a posterior hip dislocation.",
"id": "10003142",
"label": "b",
"name": "Shortened flexed leg",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is usually associated with a posterior hip dislocation.",
"id": "10003144",
"label": "d",
"name": "Shortened internally rotated leg",
"picture": null,
"votes": 38
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not usually observed with any neck or femur pathology.",
"id": "10003145",
"label": "e",
"name": "Flexed and externally rotated leg",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "A fractured neck of femur causes this appearance due to discontinuity in the hip flexors and extensors. This shortens the leg and leads to the unopposed pull of the iliopsoas muscle attached to lesser trochanter on the femur, leading to external rotation.",
"id": "10003141",
"label": "a",
"name": "Shortened externally rotated leg",
"picture": null,
"votes": 117
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
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},
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"demo": null,
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"id": "3907",
"name": "fractured neck of femur",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
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"question": "An 88 year old female comes into A&E after a fall, with a suspected fracture of the neck of the femur.\n\nWhich of the following is a sign seen most commonly observed in a fractured neck of femur?",
"sbaAnswer": [
"a"
],
"totalVotes": 181,
"typeId": 1,
"userPoint": null
}
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MarksheetMark
|
173,460,913 | false | 32 | null | 6,495,039 | null | false |
[] | null | 13,176 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This involves the radial nerve and causes weakness in the forearm and wrist and leads to wrist drop. This is not observed with shoulder dystocia.",
"id": "10003150",
"label": "e",
"name": "Radial nerve palsy",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This involves C8-T1 nerve roots that usually causes sensory loss and weakness in the intrinsic muscles of the hand. This is not usually observed with shoulder dystocia.",
"id": "10003147",
"label": "b",
"name": "Klumpke's palsy",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This involves the ulnar nerve and causes sensory loss and weakness in the medial wrist and leads to clawing the hand. This is not observed with shoulder dystocia.",
"id": "10003149",
"label": "d",
"name": "Cubital tunnel syndrome",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Shoulder dystocia is most associated with Erb's palsy, involving C5-C6 nerve roots in the brachial plexus. This leads to shoulder adduction, elbow extension, forearm pronation and wrist flexion, which is seen in the neonate.",
"id": "10003146",
"label": "a",
"name": "Erb's palsy",
"picture": null,
"votes": 130
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This involves the median nerve and causes sensory loss and weakness in the lateral wrist. This is not observed with shoulder dystocia.",
"id": "10003148",
"label": "c",
"name": "Carpal tunnel syndrome",
"picture": null,
"votes": 2
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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},
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"entitlement": null,
"id": "3909",
"name": "brachial plexus injuries",
"status": null,
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"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
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"question": "A woman undergoes prolonged labour along with shoulder dystocia. The new born is found to have an internally rotated arm.\n\nWhat is the most likely type of nerve injury?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,914 | false | 33 | null | 6,495,039 | null | false |
[] | null | 13,177 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The mechanism of injury to the back of the knee and the positive anterior draw test indicate laxity in the anterior cruciate ligament. This is most likely to have been damaged in this injury.",
"id": "10003151",
"label": "a",
"name": "Anterior cruciate ligament",
"picture": null,
"votes": 146
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is less likely as the injury was not to the lateral side of the knee.",
"id": "10003155",
"label": "e",
"name": "Medial cruciate ligament",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is less likely as the injury was not to the medial side of the knee.",
"id": "10003154",
"label": "d",
"name": "Lateral cruciate ligament",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is less likely as the injury was to the back of the knee.",
"id": "10003152",
"label": "b",
"name": "Patella",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is less likely as the injury was not to the front of the knee and anterior draw test was positive.",
"id": "10003153",
"label": "c",
"name": "Posterior cruciate ligament",
"picture": null,
"votes": 22
}
],
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"__typename": "Concept",
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"__typename": "Chapter",
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"name": "Cruciate ligament injuries",
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"id": "145",
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"typeId": 7
},
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"question": "A 26-year-old female footballer is brought into A&E after taking a hit to the back of her right knee in a game. She heard a painful 'pop' sound when she got hit and has been unable to walk ever since.\n\nOn assessment, she has a tender swollen right knee and positive anterior drawer test. There are no other findings on further examination.\n\nWhat structure is the most likely to have been damaged?",
"sbaAnswer": [
"a"
],
"totalVotes": 179,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,915 | false | 34 | null | 6,495,039 | null | false |
[] | null | 13,178 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is unlikely as damage to radial nerve causes weakness in extending the arm and fingers, leading to wrist drop.",
"id": "10003157",
"label": "b",
"name": "Radial nerve",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This commonly occurs in anterior shoulder dislocation and affects motor function of the deltoid muscle. Damage to this nerve leads to weakness in shoulder abduction and sensory loss on the lateral deltoid, commonly known as the regimental patch.",
"id": "10003156",
"label": "a",
"name": "Axillary nerve",
"picture": null,
"votes": 135
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is unlikely as damage to median nerve causes the hand of benediction due to weak flexion of the lateral three fingers.",
"id": "10003159",
"label": "d",
"name": "Median nerve",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is unlikely as damage to the long thoracic nerve causes a winged scapula and affects protraction of the arm.",
"id": "10003158",
"label": "c",
"name": "Long thoracic nerve",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is unlikely as damage to the ulnar nerve causes claw hand deformity due to fixed flexion of the medial two fingers.",
"id": "10003160",
"label": "e",
"name": "Ulnar nerve",
"picture": null,
"votes": 3
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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},
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"id": "4119",
"name": "Axillary nerve injury",
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"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
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"question": "A 16-year-old male is discharged after manual reducing an anteriorly dislocated right shoulder. He attends GP after 3 weeks with difficulty lifting his arm.\n\nOn examination, there is sensory loss over the lateral proximal right arm. He is also unable to hold his right arm up when passively extended.\n\nWhich nerve is most likely to have been damaged?",
"sbaAnswer": [
"a"
],
"totalVotes": 177,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,916 | false | 35 | null | 6,495,039 | null | false |
[] | null | 13,179 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as vasectomies can be reversed. This is not routinely offered and the success rate varies, but they can be reversed under extreme circumstances.",
"id": "10003164",
"label": "d",
"name": "Vasectomies are permanently irreversible",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is needed before undergoing a vasectomy to exclude potential problems like varicocele or hydrocoele.",
"id": "10003162",
"label": "b",
"name": "Vasectomies do not require a pre-procedural scrotal examination",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect and the pre-sterilisation process is integral to identify people at risk of regret after permanent sterilisation and informing them of alternatives.",
"id": "10003165",
"label": "e",
"name": "Vasectomies do not require a pre-sterilisation assessment",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Vasectomies involve sealing the ends of the vas deferens to prevent the transport of sperm from the testis to the penis. This prevents conception but does not protect against sexually transmitted infections. Patients may be recommended to use barrier contraception if indicated.",
"id": "10003161",
"label": "a",
"name": "Vasectomies do not offer protection against sexually transmitted infections",
"picture": null,
"votes": 158
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect and azoospermia needs to be confirmed by post-vasectomy semen analysis around 12 weeks after the procedure to deem vasectomy successful.",
"id": "10003163",
"label": "c",
"name": "Vasectomies provide effective contraception immediately after surgery",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4120",
"name": "Contraception",
"status": null,
"topic": {
"__typename": "Topic",
"id": "162",
"name": "General practice",
"typeId": 5
},
"topicId": 162,
"totalCards": null,
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},
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"question": "A male has come into a sexual health clinic to get a referral for an elective vasectomy.\n\nWhat advice must he be given about vasectomies?",
"sbaAnswer": [
"a"
],
"totalVotes": 182,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,917 | false | 36 | null | 6,495,039 | null | false |
[] | null | 13,180 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This IUD releases copper ions which affect sperm motility. This prevents the sperm from entering the uterus and fallopian tubes to fertilise the egg.",
"id": "10003166",
"label": "a",
"name": "Spermicidal",
"picture": null,
"votes": 145
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Copper IUD tends to thicken cervical mucus which decreases the likelihood of fertilisation.",
"id": "10003169",
"label": "d",
"name": "Thins cervical mucus",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of hormonal contraceptions like hormonal IUDs, combined pill and so on.",
"id": "10003170",
"label": "e",
"name": "Suppresses ovulation",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of action of condoms, diaphragms and so on.",
"id": "10003168",
"label": "c",
"name": "Physical barrier",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of action of a hormonal IUD.",
"id": "10003167",
"label": "b",
"name": "Thins the uterine wall",
"picture": null,
"votes": 16
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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},
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"id": "4121",
"name": "Intra-uterine device",
"status": null,
"topic": {
"__typename": "Topic",
"id": "162",
"name": "General practice",
"typeId": 5
},
"topicId": 162,
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},
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"question": "A female has come into GP to get a copper intra-uterine device (IUD) inserted.\n\nWhat is the mechanism of action of this coil in preventing pregnancy?",
"sbaAnswer": [
"a"
],
"totalVotes": 187,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,918 | false | 37 | null | 6,495,039 | null | false |
[] | null | 13,181 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The COCP is absolutely contraindicated in smokers above 35 years.",
"id": "10003172",
"label": "b",
"name": "Smokers <35 years",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The COCP is contraindicated in patients with complications of diabetes like retinopathy, neuropathy or nephropathy.",
"id": "10003173",
"label": "c",
"name": "Diabetes",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The COCP is absolutely contraindicated in patients with current breast cancer.",
"id": "10003174",
"label": "d",
"name": "Family history of breast cancer",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The COCP is contraindicated in patients who are less than 6 weeks postpartum.",
"id": "10003175",
"label": "e",
"name": "8 weeks postpartum",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The COCP is absolutely contraindicated in patients experiencing migraines with aura as they increase the likelihood of ischaemic strokes.",
"id": "10003171",
"label": "a",
"name": "Migraine with aura",
"picture": null,
"votes": 141
}
],
"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": "4122",
"name": "Combined Oral Contraceptive Pill",
"status": null,
"topic": {
"__typename": "Topic",
"id": "162",
"name": "General practice",
"typeId": 5
},
"topicId": 162,
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},
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"question": "A female has come into GP requesting a prescription for the combined oral contraceptive pill (COCP).\n\nWhich of these is an absolute contraindication for prescribing the COCP?",
"sbaAnswer": [
"a"
],
"totalVotes": 189,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,919 | false | 38 | null | 6,495,039 | null | false |
[] | null | 13,182 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the accepted definition of infertility according to WHO and NICE guidelines.",
"id": "10003176",
"label": "a",
"name": "Failure to conceive after frequent unprotected sexual intercourse for one year",
"picture": null,
"votes": 135
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This does not specify unprotected sexual intercourse and cannot be considered the correct definition of infertility.",
"id": "10003179",
"label": "d",
"name": "Inability to conceive after frequent sexual intercourse for 2 or more years",
"picture": null,
"votes": 40
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the definition of surgical sterilisation.",
"id": "10003178",
"label": "c",
"name": "Permanent prevention in conception",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the definition of secondary infertility.",
"id": "10003180",
"label": "e",
"name": "Previously successful conception followed by inability to conceive for one year after unprotected sexual intercourse",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the definition of sub-fertility.",
"id": "10003177",
"label": "b",
"name": "Prolonged delay in conception",
"picture": null,
"votes": 0
}
],
"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": "4123",
"name": "Infertility",
"status": null,
"topic": {
"__typename": "Topic",
"id": "162",
"name": "General practice",
"typeId": 5
},
"topicId": 162,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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"question": "A young couple have come into GP with concerns about not conceiving a child.\n\nWhich of the following is the definition of infertility?",
"sbaAnswer": [
"a"
],
"totalVotes": 188,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,920 | false | 39 | null | 6,495,039 | null | false |
[] | null | 13,183 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This does not occur in LAM. It is likely to happen when using an intrauterine device.",
"id": "10003183",
"label": "c",
"name": "Thickens cervical mucus",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Breastfeeding can temporarily prevent pregnancy as suckling by an infant reduces production of gonadotrophin. This leads to suppression of ovulation, which prevents conception.",
"id": "10003181",
"label": "a",
"name": "Suppression of ovulation",
"picture": null,
"votes": 152
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This does not occur in LAM. It is associated with female sterilisation like tubectomy.",
"id": "10003185",
"label": "e",
"name": "Prevents transport of egg through fallopian tube",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This does not occur in LAM. It is likely to happen when using hormonal contraceptives like the combined pill or intra-uterine device.",
"id": "10003182",
"label": "b",
"name": "Alters vaginal pH",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This does not occur in LAM. It is likely to happen when using an intrauterine device.",
"id": "10003184",
"label": "d",
"name": "Thins uterine lining",
"picture": null,
"votes": 9
}
],
"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": "4120",
"name": "Contraception",
"status": null,
"topic": {
"__typename": "Topic",
"id": "162",
"name": "General practice",
"typeId": 5
},
"topicId": 162,
"totalCards": null,
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"qaAnswer": null,
"question": "A new mother comes into GP enquiring about lactational amenorrhoeic method (LAM) of contraception.\n\nWhat is the mechanism of LAM in preventing pregnancy?",
"sbaAnswer": [
"a"
],
"totalVotes": 184,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,921 | false | 40 | null | 6,495,039 | null | false |
[] | null | 13,184 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the shunt which connects the pulmonary artery to the aorta to bypass the lungs in foetal circulation.",
"id": "10003190",
"label": "e",
"name": "Ductus arteriosus",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This carries deoxygenated blood from the foetal peripheral circulation to the heart.",
"id": "10003187",
"label": "b",
"name": "Superior vena cava",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the shunt that allows oxygenated blood in the umbilical vein to bypass the liver when entering foetal circulation.",
"id": "10003189",
"label": "d",
"name": "Ductus venosus",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These carry deoxygenated blood from the foetus to the placenta.",
"id": "10003188",
"label": "c",
"name": "Umbilical arteries",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The umbilical vein carries oxygenated blood from the placenta to the foetal heart via the inferior vena cava.",
"id": "10003186",
"label": "a",
"name": "Umbilical vein",
"picture": null,
"votes": 138
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3867",
"name": "Foetal Circulation",
"status": null,
"topic": {
"__typename": "Topic",
"id": "159",
"name": "Cardiovascular physiology",
"typeId": 7
},
"topicId": 159,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
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"psaSectionId": null,
"qaAnswer": null,
"question": "A woman has recently delivered a baby followed by the placenta. She enquires about the function of the placenta.\n\nWhich structure carries oxygen from the placenta to the foetus?",
"sbaAnswer": [
"a"
],
"totalVotes": 189,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,922 | false | 41 | null | 6,495,039 | null | false |
[] | null | 13,185 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a cause of breast milk jaundice or breastfeeding jaundice, not physiological jaundice.",
"id": "10003194",
"label": "d",
"name": "Breastfeeding",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as neonates tend to have poorly developed at less effective hepatic bilirubin metabolism. This increases the likelihood of physiologic jaundice by causing unconjugated hyperbilirubinaemia.",
"id": "10003195",
"label": "e",
"name": "Highly developed hepatic metabolism",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as neonatal red cells have shorter life span. This increases the breakdown to form bilirubin and the likelihood of physiologic jaundice.",
"id": "10003192",
"label": "b",
"name": "Prolonged red cell life span",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as neonates tend to be relatively polycythaemic at birth. Anaemia in neonates is a pathological cause of jaundice.",
"id": "10003193",
"label": "c",
"name": "Physiological anaemia",
"picture": null,
"votes": 43
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Enterohepatic circulation is increased in neonates due to prolonged transit time and low bacterial levels in small intestine. This results in increased reabsorption of bilirubin, increasing the likelihood of physiologic jaundice.",
"id": "10003191",
"label": "a",
"name": "Increased enterohepatic circulation",
"picture": null,
"votes": 74
}
],
"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": "4124",
"name": "Neonatal Jaundice",
"status": null,
"topic": {
"__typename": "Topic",
"id": "153",
"name": "Paediatrics",
"typeId": 7
},
"topicId": 153,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
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"highlights": [],
"id": "13185",
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"pictures": [],
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"psaSectionId": null,
"qaAnswer": null,
"question": "A neonate is being admitted into the Special Care Baby Unit on developing jaundice 36 hours after birth.\n\nWhich of the following is a risk factor for physiologic jaundice of the neonate?",
"sbaAnswer": [
"a"
],
"totalVotes": 185,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,923 | false | 42 | null | 6,495,039 | null | false |
[] | null | 13,186 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a fine motor skill that is expected in children at age 3.",
"id": "10003199",
"label": "d",
"name": "Can only draw circles and lines",
"picture": null,
"votes": 67
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a more advanced skill and children should be able to use scissors by age 4.",
"id": "10003197",
"label": "b",
"name": "Unable to use scissors",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a red flag in their fine motor development as it shows difficulty in manipulating small objects",
"id": "10003196",
"label": "a",
"name": "Unable to help dress themselves",
"picture": null,
"votes": 66
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a gross motor developmental feature and is also a red flag by age 3.",
"id": "10003198",
"label": "c",
"name": "Unable to ride a tricycle",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a more advanced skill and children should be able to use knife and fork by age 5.",
"id": "10003200",
"label": "e",
"name": "Unable to use knife and fork",
"picture": null,
"votes": 18
}
],
"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": "4125",
"name": "Developmental milestones - fine motor and vision",
"status": null,
"topic": {
"__typename": "Topic",
"id": "153",
"name": "Paediatrics",
"typeId": 7
},
"topicId": 153,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
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"dislikes": 1,
"explanation": null,
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"question": "A mother brings in her 3 year old son to the GP with concerns regarding his development.\n\nWhich of the following is a red flag for fine motor and vision development in a 3-year-old?",
"sbaAnswer": [
"a"
],
"totalVotes": 177,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,924 | false | 43 | null | 6,495,039 | null | false |
[] | null | 13,187 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is considered in the initial screening test for Down's syndrome. It is not diagnostic.",
"id": "10003204",
"label": "d",
"name": "Serum hCG levels",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is considered diagnostic for Down's Syndrome as the sample of fluid is taken directly from the foetus' amniotic sac to undergo genetic testing. This can identify chromosomal abnormalities in the foetus like Down's Syndrome.",
"id": "10003201",
"label": "a",
"name": "Amniocentesis",
"picture": null,
"votes": 97
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is considered in the quadruple test for screening for Down's syndrome. It is not diagnostic.",
"id": "10003205",
"label": "e",
"name": "Alpha-fetoprotein",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is considered in the combined test for screening for Down's syndrome. It is not diagnostic.",
"id": "10003203",
"label": "c",
"name": "Nuchal thickness measurement",
"picture": null,
"votes": 53
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the second screening test that can be undergone to help decide whether to have the diagnostic test or not. It is not diagnostic.",
"id": "10003202",
"label": "b",
"name": "Non-invasive prenatal test (NIPT)",
"picture": null,
"votes": 30
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4126",
"name": "Down Syndrome Screening",
"status": null,
"topic": {
"__typename": "Topic",
"id": "174",
"name": "Obstetrics",
"typeId": 7
},
"topicId": 174,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"difficulty": 1,
"dislikes": 0,
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"question": "Which of the following is considered diagnostic for Down’s syndrome in the antenatal screening?",
"sbaAnswer": [
"a"
],
"totalVotes": 190,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,925 | false | 44 | null | 6,495,039 | null | false |
[] | null | 13,188 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This suppresses breast milk production during pregnancy. It is not involved in breast milk production.",
"id": "10003209",
"label": "d",
"name": "Progesterone",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is involved in the milk letdown reflex, not breast milk production. During breastfeeding, when the baby suckles, oxytocin is released from the posterior pituitary to cause smooth muscles around the alveoli to contract and eject milk from the milk duct.",
"id": "10003210",
"label": "e",
"name": "Oxytocin",
"picture": null,
"votes": 36
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Prolactin is the hormone involved in milk secretion by alveolar cells in the mammary tissue. It stimulates the growth and development of mammary tissue during pregnancy, and levels rise after delivery. During breastfeeding, when the baby suckles, the anterior pituitary increases prolactin production and secretion, which stimulates breast milk production by the alveoli.",
"id": "10003206",
"label": "a",
"name": "Prolactin",
"picture": null,
"votes": 156
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This suppresses breast milk production during pregnancy. It is not involved in breast milk production.",
"id": "10003207",
"label": "b",
"name": "Oestrogen",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Thyroid hormones are generally not involved in breast milk production.",
"id": "10003208",
"label": "c",
"name": "Thyroid hormones",
"picture": null,
"votes": 0
}
],
"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": "4127",
"name": "Breastfeeding",
"status": null,
"topic": {
"__typename": "Topic",
"id": "174",
"name": "Obstetrics",
"typeId": 7
},
"topicId": 174,
"totalCards": null,
"typeId": null,
"userChapter": null,
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"videos": []
},
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
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"id": "13188",
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"question": "A new mother is being counselled about breastfeeding at GP. During the consultation, the GP turns to you to explain the physiology of breastfeeding.\n\nWhich hormone is released during breastfeeding that triggers breastmilk production?",
"sbaAnswer": [
"a"
],
"totalVotes": 193,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,926 | false | 45 | null | 6,495,039 | null | false |
[] | null | 13,189 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Breast milk also contains lactoferrin, which enhances iron absorption in the infant.",
"id": "10003212",
"label": "b",
"name": "Helps in iron absorption",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is more likely with breast milk, as infants cannot be overfed on breast milk but can on formula milk. Formula milk increases their likelihood of being overweight and developing diabetes in their young years.",
"id": "10003214",
"label": "d",
"name": "Helps reduce risk of juvenile-onset diabetes",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Breast milk is far superior in helping boost the infant's immune system by transferring white cells, cytokines and immunoglobulins to the infant.",
"id": "10003213",
"label": "c",
"name": "Boosts infant's immunity",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Breast milk is low in Vitamin D, which is available in most formula milk. Taking vitamin D supplements is recommended for all pregnant and breastfeeding women.",
"id": "10003211",
"label": "a",
"name": "Good source of vitamin D",
"picture": null,
"votes": 91
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Formula milk is high in casein, while breast milk is high in whey protein. Whey protein is much easier to digest.",
"id": "10003215",
"label": "e",
"name": "High in whey protein",
"picture": null,
"votes": 41
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4127",
"name": "Breastfeeding",
"status": null,
"topic": {
"__typename": "Topic",
"id": "174",
"name": "Obstetrics",
"typeId": 7
},
"topicId": 174,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4127,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "13189",
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"likes": 0,
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"question": "A new mother is being counselled about breastfeeding at GP.\n\nWhich of the following is a benefit of formula feeding a baby over breastfeeding?",
"sbaAnswer": [
"a"
],
"totalVotes": 186,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,927 | false | 46 | null | 6,495,039 | null | false |
[] | null | 13,190 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Prostaglandins trigger labour by priming the cervix. Progesterone is involved in maintaining the pregnancy in the uterus.",
"id": "10003218",
"label": "c",
"name": "Prostaglandins and progesterone",
"picture": null,
"votes": 59
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "These are the main pregnancy hormones which prevent uterine contractions and initiation of labour. Oestrogen is involved in the development of the foetus throughout pregnancy. Progesterone is involved in maintaining the pregnancy in the uterus.",
"id": "10003216",
"label": "a",
"name": "Oestrogen and progesterone",
"picture": null,
"votes": 93
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oestrogen is involved in the development of the foetus throughout pregnancy. Prolactin triggers labour and breast milk production.",
"id": "10003220",
"label": "e",
"name": "Oestrogen and prolactin",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oxytocin triggers the initiation of labour and promotes uterine contractions. Prostaglandins trigger labour by priming the cervix.",
"id": "10003219",
"label": "d",
"name": "Oxytocin and prostaglandins",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oxytocin triggers the initiation of labour and promotes uterine contractions.",
"id": "10003217",
"label": "b",
"name": "Oxytocin",
"picture": null,
"votes": 9
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
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"id": "2693",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4128",
"name": "Induction of labour",
"status": null,
"topic": {
"__typename": "Topic",
"id": "174",
"name": "Obstetrics",
"typeId": 7
},
"topicId": 174,
"totalCards": null,
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"question": "A 41-week pregnant woman is being induced into labour.\n\nWhich of the following hormone(s) is involved in preventing uterine contractions before labour?",
"sbaAnswer": [
"a"
],
"totalVotes": 187,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,928 | false | 47 | null | 6,495,039 | null | false |
[] | null | 13,191 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a function of the prostate gland, but rather the epididymis.",
"id": "10003224",
"label": "d",
"name": "He is unable to store sperm",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a function of the prostate gland, but rather the testes.",
"id": "10003223",
"label": "c",
"name": "He is unable to produce sperm",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a function of the prostate gland, but rather the muscles and neuro vasculature in the penis.",
"id": "10003222",
"label": "b",
"name": "He is unable to get an erection",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a function of the prostate gland, but rather the vas deferens.",
"id": "10003225",
"label": "e",
"name": "He is unable to transport sperm",
"picture": null,
"votes": 50
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The prostate gland is involved in production of the seminal fluid that nourishes and transports sperm out of the penis. Since his prostate has been removed, he is unable to ejaculate and is hence, sub-fertile.",
"id": "10003221",
"label": "a",
"name": "He is unable to ejaculate semen",
"picture": null,
"votes": 83
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"id": "2693",
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3755",
"name": "Prostate cancer",
"status": null,
"topic": {
"__typename": "Topic",
"id": "143",
"name": "Urology",
"typeId": 7
},
"topicId": 143,
"totalCards": null,
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"question": "A 32-year-old male has had a prostatectomy after being diagnosed with prostate cancer.\n\nWhy is he considered sub-fertile?",
"sbaAnswer": [
"a"
],
"totalVotes": 182,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,929 | false | 48 | null | 6,495,039 | null | false |
[] | null | 13,192 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "PDE-5 inhibitor is not contraindicated in patients with COPD as it does not affect the lungs or airways. They can be used to treat pulmonary hypertension secondary to COPD.",
"id": "10003230",
"label": "e",
"name": "COPD",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "PDE-5 inhibitors are contraindicated in patients with recent (~6 months) history of stroke.",
"id": "10003229",
"label": "d",
"name": "Stroke 2 years",
"picture": null,
"votes": 57
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "PDE-5 inhibitor is not contraindicated in patients with previous vasectomy as they can still engage in sexual activity.",
"id": "10003228",
"label": "c",
"name": "Vasectomy 5 years ago",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "PDE-5 inhibitor is not contraindicated in patients with asthma as it does not affect the airways.",
"id": "10003227",
"label": "b",
"name": "Asthma",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The man is most likely prescribed a Phosphodiesterase type 5 inhibitor (PDE-5 inhibitor) like sildenafil. These are used in ED to aid in achieving an erection through vasodilation. This can potentiate the effect of systemic hypotension and is contraindicated if the patient has pre-existing hypotension.",
"id": "10003226",
"label": "a",
"name": "Hypotension",
"picture": null,
"votes": 104
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4129",
"name": "Erectile Dysfunction",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
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},
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"question": "A 68-year-old male is diagnosed with erectile dysfunction (ED). The GP prescribes a medicine while the cause is being investigated.\n\nWhich of the following is a contraindication for the medication ?",
"sbaAnswer": [
"a"
],
"totalVotes": 181,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,930 | false | 49 | null | 6,495,039 | null | false |
[] | null | 13,193 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This defines the third stage of labour.",
"id": "10003232",
"label": "b",
"name": "From delivery of foetus till delivery of the placenta and foetal membranes",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This defines the second stage of labour.",
"id": "10003234",
"label": "d",
"name": "From complete cervical dilation till delivery of the foetus",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This defines the first stage of labour. The cervix dilates from 0-3cm in the latent phase and then 3-10cm in the active phase. This is associated with regular painful uterine contractions and descent of the foetal head in the pelvis.",
"id": "10003231",
"label": "a",
"name": "From start of regular uterine contractions till complete dilation of the cervix (10cm)",
"picture": null,
"votes": 158
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect, regular uterine contractions start first, followed by cervical dilation till 10cm.",
"id": "10003233",
"label": "c",
"name": "From complete dilation of the cervix (10cm) till the start of regular uterine contractions",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect, the foetus is delivered first, followed by the placenta and foetal membranes",
"id": "10003235",
"label": "e",
"name": "From delivery of the placenta and foetal membranes till delivery of the foetus",
"picture": null,
"votes": 1
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4027",
"name": "First stage of labour",
"status": null,
"topic": {
"__typename": "Topic",
"id": "174",
"name": "Obstetrics",
"typeId": 7
},
"topicId": 174,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
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"qaAnswer": null,
"question": "A 30 year old woman is giving birth to her first child. A midwife comes to review her and deems her to be in the first stage of labour.\n\nWhich of the following defines the first stage of labour?",
"sbaAnswer": [
"a"
],
"totalVotes": 182,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,931 | false | 50 | null | 6,495,039 | null | false |
[] | null | 13,194 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is unlikely as there has been no variation in the symptoms over the patient's menstrual cycle. This presents as bilateral lumpy breasts.",
"id": "10003238",
"label": "c",
"name": "Fibrocystic disease",
"picture": null,
"votes": 57
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the most likely diagnosis. Fibroadenomas are benign fibrous tumours arising from breast lobules that present as small highly mobile firm non-tender round masses.",
"id": "10003236",
"label": "a",
"name": "Fibroadenoma",
"picture": null,
"votes": 110
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is unlikely as the patient would be systemically unwell. This presents as a fluctuant painful mass with overlying skin redness and swelling.",
"id": "10003239",
"label": "d",
"name": "Breast abscess",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is unlikely as there is no history of trauma. This presents as firm irregular lumps associated with overlying skin bruising.",
"id": "10003237",
"label": "b",
"name": "Fat necrosis",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "While it is important to rule out breast cancer, it is unlikely as the lump is mobile and has not grown. This presents with fixed hard lumps with associated skin and/or nipple changes.",
"id": "10003240",
"label": "e",
"name": "Breast cancer",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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},
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"demo": null,
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"id": "4130",
"name": "Fibroadenoma of the breast",
"status": null,
"topic": {
"__typename": "Topic",
"id": "151",
"name": "Breast Disease",
"typeId": 7
},
"topicId": 151,
"totalCards": null,
"typeId": null,
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},
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"question": "A 25-year-old female presents to her GP with painless breast lumps. These were discovered 2 weeks ago and have moved from the upper to the lower half of the right breast. There has been no change in size, history of trauma or systemic symptoms. There is no significant past medical or family history.\n\nOn examination, there are multiple firm, smooth, round lumps, approximately 2cm in diameter, in the right lower breast. There are no skin changes observed, and the left breast is normal.\n\nWhat is the most probable diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 185,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,988 | false | 1 | null | 6,495,042 | null | false |
[] | null | 13,195 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The “Theory of Planned Behaviour” is a clinical tool used to predict and explain why people engage in risky behaviours. It considers the influence of factors such as one’s attitude, perceived behavioural control, and intention to carry out the behaviour. This patient is not carrying out risky behaviour (e.g. smoking), so this model is not appropriate.",
"id": "10003244",
"label": "d",
"name": "Theory of Planned Behaviour",
"picture": null,
"votes": 40
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This framework looks at the factors which affect one’s beliefs about their health such as perceived susceptibility, severity, and cues to action. This patient does not see his health as a problem, so the Health Belief Model would be a good model to use to challenge his beliefs about his health.",
"id": "10003241",
"label": "a",
"name": "Health Belief Model",
"picture": null,
"votes": 460
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The ‘Biomedical Model’ is an approach that considers the influence of biological factors (e.g. hormones) on human behaviour. It has been criticized for biological reductionism as it does not consider the possible influence of environmental and cognitive factors on behaviour. This model is therefore inappropriate.",
"id": "10003245",
"label": "e",
"name": "Biomedical Model",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The ‘Stages of Change Model’ identifies which stage of behavioural change a person is currently in. The 6 stages in this model are pre-contemplation, contemplation, preparation, action, maintenance and relapse. This patient does not consider his weight to be a problem so would not even be in the pre-contemplation stage. Hence, this model is not appropriate.",
"id": "10003243",
"label": "c",
"name": "Stages of Change Model",
"picture": null,
"votes": 168
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The COM-B model looks at 3 factors - capability, opportunity and motivation - all of which affect our ability and probability of carrying out a risky behaviour. This patient is not carrying out risky behaviour (e.g. smoking), so this model is not appropriate.",
"id": "10003242",
"label": "b",
"name": "COM-B Model",
"picture": null,
"votes": 45
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"highlights": [],
"id": "2693",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4131",
"name": "Models of Health",
"status": null,
"topic": {
"__typename": "Topic",
"id": "184",
"name": "Ethics and Law",
"typeId": 7
},
"topicId": 184,
"totalCards": null,
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},
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"question": "A 54-year-old man attends his local GP practice for an annual well-man check.\n\nHe is found to have a BMI of 33 kg/m2. The GP advises him to start an exercise programme to lose weight, however, the patient does not see a problem with his weight.\n\nWhat is the most appropriate model of health to use in this situation?",
"sbaAnswer": [
"a"
],
"totalVotes": 726,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,989 | false | 2 | null | 6,495,042 | null | false |
[] | null | 13,196 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Securely attached children are likely to have better educational attainment compared to insecurely attached children. This child has an insecure attachment, so this option is incorrect.",
"id": "10003249",
"label": "d",
"name": "Good educational attainment",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This child is likely to have an insecure attachment. Insecurely attached children are likely to have a negative “Internal Working Model” which reduces their ability to form good social relationships.",
"id": "10003246",
"label": "a",
"name": "Emotional and social incompetence",
"picture": null,
"votes": 668
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This child is unlikely to have formed a secure attachment style as his attachment behaviours have developed outside the critical period of 0 to 2 ½ years. Children with insecure attachment styles typically struggle to handle grief as they become older.",
"id": "10003247",
"label": "b",
"name": "Better able to deal with grief",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Securely attached children are likely to become better parents compared to insecurely attached children. This is due to them forming a positive “Internal Working Model” in their first prime attachment (i.e. to their caregiver). The “Internal Working Model” forms a template for all future relationships including parental and romantic relationships. This child is likely to have a negative “Internal Working Model” due to his insecure attachment, so this option is incorrect.",
"id": "10003248",
"label": "c",
"name": "Likely to be a better parent",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Securely attached children are more likely to have a positive outlook on life than insecurely attached children. This results in lower rates of depression and anger in childhood and more feelings of happiness. This child has an insecure attachment, so this option is incorrect.",
"id": "10003250",
"label": "e",
"name": "Likely to be more optimistic",
"picture": null,
"votes": 3
}
],
"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": "4132",
"name": "Attachment",
"status": null,
"topic": {
"__typename": "Topic",
"id": "184",
"name": "Ethics and Law",
"typeId": 7
},
"topicId": 184,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4132,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
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"multiAnswer": null,
"pictures": [],
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"question": "A 6-year-old boy is taken to see the GP by his adopted mother.\n\nHis birth mother left him at an orphanage at the age of 2 months. He was eventually adopted at age 5 after experiencing a difficult early childhood.\n\nWhich behavioural trait is he most likely to develop as he gets older?",
"sbaAnswer": [
"a"
],
"totalVotes": 697,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,460,990 | false | 3 | null | 6,495,042 | null | false |
[] | null | 13,197 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This phase occurs in children aged 0-18 months and is based on their relationship with their parents and/or guardians. Children with a good relationship with their caregivers acquire the virtue of ‘hope’ and can progress to the next psychosocial stage.",
"id": "10003252",
"label": "b",
"name": "Trust vs mistrust",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This phase occurs in children aged 12-18 years. It is the stage in which a young person finds their identity i.e. interests, possible career options and their sense of self. The ability for one to stay true to their sense of self leads one to acquire the virtue of ‘fidelity’, whereas failure leads to confusion and a weak sense of self.",
"id": "10003251",
"label": "a",
"name": "Identity vs role confusion",
"picture": null,
"votes": 650
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This phase occurs in people aged 21-39 years old. In this stage, conflict is centred around forming long-term relationships with romantic partners, not just family members. Successful completion leads to a sense of safety and the individual acquires the virtue of ‘love’.",
"id": "10003255",
"label": "e",
"name": "Intimacy vs isolation",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This phase occurs in children aged 6-11 years and is based on their ability to cope with new challenges in life, particularly academic and social challenges. Those who are successful acquire the virtue of ‘competence’, whereas those who are not develop a sense of inferiority.",
"id": "10003253",
"label": "c",
"name": "Industry vs inferiority",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
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"label": "d",
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}
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MarksheetMark
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173,460,991 | false | 4 | null | 6,495,042 | null | false |
[] | null | 13,198 |
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"__typename": "QuestionChoice",
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"explanation": "Injury to the anterior cruciate ligament is identified via the anterior drawer test. A positive test results in anterior movement of the tibia in relation to the femur.",
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MarksheetMark
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173,460,992 | false | 5 | null | 6,495,042 | null | false |
[] | null | 13,199 |
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"explanation": "The C3-C5 nerve roots form the phrenic nerve which innervates the diaphragm.",
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"label": "a",
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"explanation": "The L4,5 and S1-S4 nerve roots form the sacral plexus which gives rise to nerves that innervate the sacral region.",
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173,460,993 | false | 6 | null | 6,495,042 | null | false |
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"answer": false,
"explanation": "L4 is the myotome for ankle dorsiflexion.",
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"label": "b",
"name": "L4",
"picture": null,
"votes": 226
},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "L5 is the myotome for great toe extension.",
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"label": "c",
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|
173,460,994 | false | 7 | null | 6,495,042 | null | false |
[] | null | 13,201 |
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"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The posterior talofibular ligament may be damaged in an inversion injury of the foot, but this is usually in conjunction with an anterior talofibular ligament injury.",
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"label": "c",
"name": "Posterior talofibular ligament",
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "The anterior talofibular ligament (ATFL) is most likely to be damaged in an inversion injury of the foot. This is due to its anatomical origins and insertions in the foot and because it carries the lowest ultimate load in the foot.",
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"label": "a",
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"__typename": "QuestionChoice",
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"label": "d",
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "The calcaneofibular ligament may be damaged in an inversion injury of the foot, but this is usually in conjunction with an anterior talofibular ligament injury.",
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"name": "Calcaneofibular ligament",
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},
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}
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|
173,460,995 | false | 8 | null | 6,495,042 | null | false |
[] | null | 13,202 |
{
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Doctors do not have the right or obligation to be fair and impartial nor to blame patients for their condition. The \"Sick Role\" states that patients are not to blame for their condition, but they have an obligation to seek competent help.",
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},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Doctors do not have the right or obligation to be fair and impartial in the \"Sick Role\", but they do have a right to examine patients.",
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"label": "b",
"name": "Right to be fair and impartial, and to examine patients",
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173,460,996 | false | 9 | null | 6,495,042 | null | false |
[] | null | 13,203 |
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "Radical feminists believe in female empowerment and strive to abolish the patriarchy. Some individuals completely discourage male involvement in life including in marriage and parenthood, but not all feminists adopt this view. This woman views her town as ‘androcentric,’ a term meaning ‘male-centred,’ so she is likely to have a radical feminist point of view.",
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},
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},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "An interactionist perspective suggests that humans learn from their environment which yields unique experiences. Thus, society is formed from people of different backgrounds coming together. Thomas Scheff was a leading sociologist that adopted this view.",
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"__typename": "QuestionChoice",
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},
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"__typename": "QuestionChoice",
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"label": "e",
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],
"totalVotes": 625,
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MarksheetMark
|
173,460,997 | false | 10 | null | 6,495,042 | null | false |
[] | null | 13,204 |
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"__typename": "QuestionChoice",
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},
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"explanation": "Karl Max was a sociologist that helped to develop the conflict perspective of society. This suggests that society marginalises people of different backgrounds, particularly those who are affected by health inequities.",
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"label": "c",
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"votes": 93
},
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"__typename": "QuestionChoice",
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"label": "d",
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},
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"label": "e",
"name": "Sigmund Freud",
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},
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"__typename": "QuestionChoice",
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"label": "a",
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}
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MarksheetMark
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173,460,998 | false | 11 | null | 6,495,042 | null | false |
[] | null | 13,205 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Section 2 of the Mental Health Act allows patients to be sectioned for 28 days in a mental health facility while further investigation is sought for their mental health. The Montgomery case did not influence this.",
"id": "10003292",
"label": "b",
"name": "Mental health Act 1983: Section 2",
"picture": null,
"votes": 33
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Valid consent is voluntary, informed, and made by someone with capacity. The Montgomery case influenced the requirement for consent to be informed, not voluntary.",
"id": "10003294",
"label": "d",
"name": "Mental Capacity Act 2005: Voluntary consent",
"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The Mental Capacity Act consists of 5 core principles, one of which is the right for a patient to make unwise decisions if they have capacity. The Montgomery case did not influence this part of the Act.",
"id": "10003295",
"label": "e",
"name": "Mental Capacity Act 2005: The right to make unwise decisions",
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},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The Mental Capacity Act is an act of law which determines how patients with or without capacity are treated. For consent to be valid, it must be informed, voluntary and with autonomy. The Montgomery case led to the requirement for consent to be informed.",
"id": "10003291",
"label": "a",
"name": "Mental Capacity Act 2005: Informed consent",
"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Section 3 of the Mental health Act allows patients to be detained for 6 months in a mental health facility for further investigation, diagnosis, and treatment of their mental health condition. The Montgomery case did not influence this.",
"id": "10003293",
"label": "c",
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}
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"question": "The Montgomery case led to the development of which of the following Acts of Law?",
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MarksheetMark
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173,460,999 | false | 12 | null | 6,495,042 | null | false |
[] | null | 13,206 |
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"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Doing no harm describes the ethical principle of ‘non-maleficence.’",
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"label": "c",
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "The right to make one's own decisions is the best description of the ethical principle of 'autonomy'.",
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The greater good for the majority is a description of the ethical principle ‘of utilitarianism.’",
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"__typename": "QuestionChoice",
"answer": true,
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"__typename": "QuestionChoice",
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}
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"question": "Which of the following best describes the ‘Justice’ principle of medical ethics?",
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MarksheetMark
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173,461,000 | false | 13 | null | 6,495,042 | null | false |
[] | null | 13,207 |
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "The Human Rights Act (1998) is the law regarding the treatment of all people. It is based on principles such as fairness, respect, equality, confidentiality and dignity.",
"id": "10003305",
"label": "e",
"name": "Human Rights Act 1998",
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{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The Bolam test is the test for clinical negligence. If a board of doctors of a similar level to the practising doctor would have made the same decision regarding patient care, then the doctor has not been clinically negligent.",
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"label": "a",
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "‘Bolitho vs Hackney’ was the law case that gave rise to the ‘Bolam’ test.",
"id": "10003302",
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"picture": null,
"votes": 83
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The Mental Capacity Act (2005) is the law regarding the treatment of patients with and without capacity. It has 5 core principles.",
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"label": "d",
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gillick competence is used to determine whether a child under 16 years can understand, retain, weigh up and communicate back decisions regarding their medical treatment. If competent, the child may consent to their treatment.",
"id": "10003303",
"label": "c",
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MarksheetMark
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173,461,001 | false | 14 | null | 6,495,042 | null | false |
[] | null | 13,208 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a principle of the Mental Capacity 2005 but is a core principle of the Mental Health Act.",
"id": "10003309",
"label": "d",
"name": "Treat all patients with respect and dignity",
"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a principle of the Mental Capacity 2005 but is a core principle of the Mental Health Act.",
"id": "10003310",
"label": "e",
"name": "Treatment must have a purpose and must be effective",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a principle of the Mental Capacity 2005. Patients have a right to make decisions which we may deem unwise; this can include the refusal of treatment.",
"id": "10003307",
"label": "b",
"name": "Right to refuse treatment",
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In the Mental Capacity Act 2005, patients aged 16 and over are presumed to have capacity, not those aged 18 and over.",
"id": "10003308",
"label": "c",
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{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "In the Mental Capacity Act 2005, patients aged 16 and over are presumed to have capacity.",
"id": "10003306",
"label": "a",
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}
],
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"question": "Which of the following is a key principle of the Mental Capacity Act 2005?",
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MarksheetMark
|
173,461,002 | false | 15 | null | 6,495,042 | null | false |
[] | null | 13,209 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The home circumstances for this child are unknown and we cannot predict her parents' reaction. We also have to be careful about breaking the child's confidentiality and trust in health care professionals. Therefore, calling her parents is inappropriate.",
"id": "10003312",
"label": "b",
"name": "Call her parents",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Giving her contraception is inappropriate. A child under 13 years should not be engaging in sexual activity, even if Gillick competent. Also, as a medical student, you must not prescribe as this is outside the limits of your competence.",
"id": "10003314",
"label": "d",
"name": "Give her contraception",
"picture": null,
"votes": 178
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Doing nothing is completely inappropriate. This will not help the situation and can result in safeguarding issues.",
"id": "10003315",
"label": "e",
"name": "Do nothing",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The safeguarding team will guide you on how to proceed and can take further action regarding this matter, so this is the most appropriate option.",
"id": "10003311",
"label": "a",
"name": "Inform the safeguarding team",
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"votes": 410
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Calling the police is inappropriate as it is unlikely to be of much benefit in this situation. It is much more appropriate to discuss this case with the local safeguarding team to come up with a safe and effective management plan.",
"id": "10003313",
"label": "c",
"name": "Call the police",
"picture": null,
"votes": 5
}
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"question": "A 13-year-old girl visits the GP surgery whilst you are on placement.\n\nShe asks if you could prescribe her some contraception as she wants to start being sexually active with her boyfriend.\n\nWhat is the most appropriate next step?",
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MarksheetMark
|
173,461,003 | false | 16 | null | 6,495,042 | null | false |
[] | null | 13,211 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "CD4 cells are naïve T-Helper cells. They become mature CD4 cells once they have developed in the thymus.",
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"label": "a",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "CD20 receptors are found on B cells, not T cells.",
"id": "10003324",
"label": "d",
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "CD8 receptors are found on cytotoxic T-cells after they have matured in the bone marrow.",
"id": "10003322",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "CD3 receptors are involved in the activation of cytotoxic and T Helper cells.",
"id": "10003323",
"label": "c",
"name": "CD3 cells",
"picture": null,
"votes": 45
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "CD2 receptors are mainly found on natural killer (NK) cells.",
"id": "10003325",
"label": "e",
"name": "CD2 cells",
"picture": null,
"votes": 13
}
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"question": "What is the name for naïve T-helper cells with regards to their cell surface receptor?",
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MarksheetMark
|
173,461,004 | false | 17 | null | 6,495,042 | null | false |
[] | null | 13,212 |
{
"__typename": "QuestionSBA",
"choices": [
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Neutrophils do not release histamine. They are phagocytes and contain neutrophil elastase. Neutrophils are the first type of cell to arrive at sites of inflammation.",
"id": "10003328",
"label": "c",
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"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Eosinophils do not release histamine. They are granulocytes that act as phagocytes and are particularly relevant in parasitic infections, vasculitis, and allergy.",
"id": "10003327",
"label": "b",
"name": "Eosinophil",
"picture": null,
"votes": 245
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Monocytes do not release histamine. They circulate in the bloodstream and act as antigen-presenting cells as well as phagocytes. They become macrophages when they move into tissues.",
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"label": "e",
"name": "Monocyte",
"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Basophils are granulocytes that secrete histamine. Histamine stimulates vasodilation and increases vascular permeability leading to tumor (oedema), calor (heat) and rubor (redness) – all features of acute inflammation.",
"id": "10003326",
"label": "a",
"name": "Basophil",
"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Dendritic cells do not release histamine. They are phagocytes as well as antigen-presenting cells.",
"id": "10003329",
"label": "d",
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"picture": null,
"votes": 32
}
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"question": "Which cell releases histamine during the acute inflammatory response?",
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MarksheetMark
|
173,461,005 | false | 18 | null | 6,495,042 | null | false |
[] | null | 13,213 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "CD3 receptors are found on T-cells. They are not targeted by Rituximab.",
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"label": "d",
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "CD4 receptors are found on mature T-cells in the thymus. They are not targeted by Rituximab.",
"id": "10003332",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "CD2 receptors are found on natural killer (NK) cells. They are not the target of action of Rituximab.",
"id": "10003335",
"label": "e",
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"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Rituximab targets CD20 receptors on B cells.",
"id": "10003331",
"label": "a",
"name": "CD20 receptors",
"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "CD8 receptors are found on cytotoxic T-cells after they have matured in the bone marrow. They are not targeted by Rituximab.",
"id": "10003333",
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"name": "CD8 receptors",
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}
],
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"question": "What is the biochemical target of Rituximab?",
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MarksheetMark
|
173,461,006 | false | 19 | null | 6,495,042 | null | false |
[] | null | 13,214 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Half-life is the time taken for the concentration of a drug to drop by half. At 0 hours, the concentration of morphine is 100%. It becomes 50% at 1 hour.",
"id": "10003336",
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"name": "1 hour",
"picture": null,
"votes": 610
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect. At 3 hours, the concentration of morphine is roughly 12-13%.",
"id": "10003338",
"label": "c",
"name": "3 hours",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect. At 4 hours, the concentration of morphine in the blood is roughly 6-7%",
"id": "10003339",
"label": "d",
"name": "4 hours",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect. At 2 hours, the concentration of morphine is 25%.",
"id": "10003337",
"label": "b",
"name": "2 hours",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect. At 8 hours, the concentration of morphine in the blood is nil.",
"id": "10003340",
"label": "e",
"name": "8 hours",
"picture": null,
"votes": 5
}
],
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"question": "This graph represents the change in blood morphine levels over time.\n\nFrom this graph, determine the half-life of morphine.\n\n[lightgallery]",
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MarksheetMark
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173,461,007 | false | 20 | null | 6,495,042 | null | false |
[] | null | 13,215 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The amygdala and hypothalamus are part of the mesolimbic system. They play a role in managing emotions and regulating autonomic and endocrine functions respectively.",
"id": "10003343",
"label": "c",
"name": "Amygdala and hypothalamus",
"picture": null,
"votes": 185
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The occipital lobe is responsible for visual information processing. It contains the visual cortex which receives and integrates visual information from surrounding stimuli.",
"id": "10003345",
"label": "e",
"name": "Occipital lobe",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The nucleus accumbens and VTA play an important role in addiction. They release dopamine as part of the dopamine reward pathway which leads to physiological dependence.",
"id": "10003341",
"label": "a",
"name": "Nucleus accumbens and ventral tegmental area (VTA)",
"picture": null,
"votes": 193
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The amygdala and hippocampus are part of the mesolimbic system, and play a role in managing emotions and memory respectively.",
"id": "10003342",
"label": "b",
"name": "Amygdala and hippocampus",
"picture": null,
"votes": 174
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The nucleus raphe magnus plays a role in nociception (processing noxious stimuli).",
"id": "10003344",
"label": "d",
"name": "Nucleus raphe magnus",
"picture": null,
"votes": 28
}
],
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"question": "A 43-year-old woman with fibromyalgia presents to her local GP. She is on multiple medications to manage her pain including paracetamol, pregabalin and morphine.\n\nShe has found herself taking greater doses of morphine to manage her pain and feels nervous, agitated, and unwell when she misses a dose.\n\nWhich areas of the brain are likely to be responsible for her behaviour and symptoms?",
"sbaAnswer": [
"a"
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"typeId": 1,
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MarksheetMark
|
173,461,008 | false | 21 | null | 6,495,042 | null | false |
[] | null | 13,216 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Endothelial cells are a type of bone marrow stromal cell (supporting cells). They line blood vessels and provide a short diffusion distance that facilitates the rapid diffusion of nutrients and oxygen into bone marrow cells.",
"id": "10003350",
"label": "e",
"name": "Endothelial cells",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Osteoblasts build bone by secreting osteoid and helping in the synthesis of hydroxyapatite. They are not the most abundant cell type in bone.",
"id": "10003348",
"label": "c",
"name": "Osteoblasts",
"picture": null,
"votes": 84
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Osteoclasts are macrophages that break down bone by secreting collagenases and other proteases – this releases calcium and phosphate into the blood. They are not the most abundant cell type in bone.",
"id": "10003347",
"label": "b",
"name": "Osteoclasts",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Lining cells are immature cells that can differentiate into any type of bone cell. They are not the most abundant cell type in bone.",
"id": "10003349",
"label": "d",
"name": "Lining cells",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Osteocytes are the most abundant cells in bone. They are mature osteoblasts that act as mechanoreceptors in bone and are found in lacunae.",
"id": "10003346",
"label": "a",
"name": "Osteocytes",
"picture": null,
"votes": 503
}
],
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"typeId": 7
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"question": "Which of the following is the most abundant cell type in bone?",
"sbaAnswer": [
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MarksheetMark
|
173,461,009 | false | 22 | null | 6,495,042 | null | false |
[] | null | 13,217 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "‘Incomplete fracture with dorsal angulation and displacement’ is incorrect. An incomplete fracture would not result in displacement.",
"id": "10003355",
"label": "e",
"name": "Incomplete fracture with dorsal angulation and displacement",
"picture": null,
"votes": 38
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes a greenstick fracture. It is a common fracture in young children.",
"id": "10003352",
"label": "b",
"name": "Partial cortical breach with no displacement or angulation",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the description of a Colle’s fracture. The scenario describes a 'fall onto out-stretched hand (FOOSH)' injury which often results in a Colle’s fracture and a dinner fork deformity.",
"id": "10003351",
"label": "a",
"name": "Complete fracture with dorsal angulation and displacement",
"picture": null,
"votes": 518
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the description of a Smith fracture. This presents with a spade deformity and is acquired when an individual falls onto the dorsum of their hand.",
"id": "10003354",
"label": "d",
"name": "Complete fracture with ventral angulation and displacement",
"picture": null,
"votes": 42
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes a scaphoid fracture. It is commonly acquired alongside a Colle’s fracture in a 'fall onto out-stretched hand (FOOSH)' injury.",
"id": "10003353",
"label": "c",
"name": "Complete fracture with tenderness of the anatomical snuffbox",
"picture": null,
"votes": 16
}
],
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"name": "Colles fractures",
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"question": "A 73-year-old woman has a fall in which she lands on the palm of her hand.\n\nOn examination, she has a dinner fork deformity.\n\nWhat is the correct description of the injury she sustained?",
"sbaAnswer": [
"a"
],
"totalVotes": 615,
"typeId": 1,
"userPoint": null
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MarksheetMark
|
173,461,010 | false | 23 | null | 6,495,042 | null | false |
[] | null | 13,218 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "A Garden Type 3 fracture is a complete neck of femur fracture with partial displacement.",
"id": "10003356",
"label": "a",
"name": "Garden 3",
"picture": null,
"votes": 315
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A Garden Type 1 fracture is an incomplete neck of femur fracture, so this is incorrect.",
"id": "10003357",
"label": "b",
"name": "Garden 1",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A Garden Type 5 fracture does not exist. The Garden classification ranges from Types 1 to 4.",
"id": "10003360",
"label": "e",
"name": "Garden 5",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A Garden Type 4 fracture is a complete neck of femur fracture with complete displacement, so this is incorrect.",
"id": "10003359",
"label": "d",
"name": "Garden 4",
"picture": null,
"votes": 160
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A Garden Type 2 fracture is a complete neck of femur fracture with no displacement, so this is incorrect.",
"id": "10003358",
"label": "c",
"name": "Garden 2",
"picture": null,
"votes": 94
}
],
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"name": "Neck of femur fracture",
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"name": "Orthopaedics",
"typeId": 7
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"question": "This is an X-Ray of a 65 year old woman with renal failure. What is the correct garden classification of this injury?\n\n[lightgallery]\n\nFemoral neck fracture: the reliability of radiologic classifications | BMC Musculoskeletal Disorders | Full Text (biomedcentral.com)",
"sbaAnswer": [
"a"
],
"totalVotes": 604,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,461,011 | false | 24 | null | 6,495,042 | null | false |
[] | null | 13,219 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Bronchospasm is an uncommon side effect of bisphosphonate medication.",
"id": "10003365",
"label": "e",
"name": "Bronchospasm",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Stomach ulcers are an important side effect of bisphosphonates. However, it is not the most important side effect to inform patients of.",
"id": "10003362",
"label": "b",
"name": "Stomach ulcers",
"picture": null,
"votes": 75
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Oesophagitis is an important and common side effect of bisphosphonates. As a result, patients are advised to take their bisphosphonate first thing in the morning with a full glass of water, in the upright position (e.g. sitting upright or standing up), and then stay upright for at least 30 minutes afterwards.",
"id": "10003361",
"label": "a",
"name": "Oesophagitis",
"picture": null,
"votes": 471
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Muscle aches are not a recognized side effect of bisphosphonates. They are more common with statins.",
"id": "10003364",
"label": "d",
"name": "Muscle ache",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Atypical femoral fractures are a recognized side effect of bisphosphonates. However, they are relatively uncommon.",
"id": "10003363",
"label": "c",
"name": "Atypical femoral fractures",
"picture": null,
"votes": 52
}
],
"comments": [],
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},
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"demo": null,
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"id": "4150",
"name": "Side effects of bisphosphonates",
"status": null,
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"name": "Pharmacology",
"typeId": 7
},
"topicId": 195,
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"question": "What is the most important side effect to warn a patient about who is taking alendronic acid?",
"sbaAnswer": [
"a"
],
"totalVotes": 617,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,461,012 | false | 25 | null | 6,495,042 | null | false |
[] | null | 13,220 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A chondroma is a benign cartilaginous growth which commonly affects the small bones of the hands and feet, the femur and the humerus. Typically, a chondroma does not present with red flag symptoms.",
"id": "10003368",
"label": "c",
"name": "Chondroma",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Multiple myeloma is a malignant disease of bone marrow plasma cells characterised by >10% plasma cells in the bone marrow and CRAB (hyper**c**alcaemia, **r**enal failure, **a**naemia and lytic **b**one lesions) features. It is not a complication of Paget’s disease.",
"id": "10003369",
"label": "d",
"name": "Multiple myeloma",
"picture": null,
"votes": 111
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ewing sarcoma is a primary malignancy of bone commonly affecting people under 25 years old. It largely affects the diaphysis of long bones and is associated with a t(11;22) translocation. It is not a complication of Paget’s disease.",
"id": "10003367",
"label": "b",
"name": "Ewing sarcoma",
"picture": null,
"votes": 33
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Acute lymphoblastic leukaemia is a common childhood blood cancer. It is most common in children with Down’s syndrome, a history of carcinogen exposure (e.g. benzene, arsenic), and positive family history of ALL. It is not a complication of Paget’s disease.",
"id": "10003370",
"label": "e",
"name": "Acute lymphoblastic leukaemia (ALL)",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This man has Paget’s disease. A complication of Paget’s disease is malignant transformation, typically to osteosarcoma, which presents with red flag symptoms such as weight loss, night sweats and fever.",
"id": "10003366",
"label": "a",
"name": "Osteosarcoma",
"picture": null,
"votes": 412
}
],
"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": "4151",
"name": "Paget’s disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
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},
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"highlights": [],
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"likes": 1,
"multiAnswer": null,
"pictures": [],
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"psaSectionId": null,
"qaAnswer": null,
"question": "A 67-year-old man presents to the GP with pain in his right leg. He also has hearing loss. The doctor conducts some blood tests.\n\n\nThe results are shown below:\n\n||||\n|---------------------------|:-------:|--------------------|\n|Alkaline Phosphatase (ALP)|300 IU/L|25 - 115|\n|Calcium|2.3 mmol/L|2.2 - 2.6|\n|Vitamin D|30 nmol/L|>50|\n\nThe GP prescribes him paracetamol and alendronic acid.\n\n\n 8 years later, the same patient presents to his GP complaining of night sweats, fever and weight loss.\n\n\nWhat is the most likely complication of his original condition that has occurred here?",
"sbaAnswer": [
"a"
],
"totalVotes": 607,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,461,013 | false | 26 | null | 6,495,042 | null | false |
[] | null | 13,221 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This option is incorrect. The hamate is an attachment point for some muscles and ligaments of the hand. It also forms part of the Carpal tunnel and Guyon’s canal.",
"id": "10003375",
"label": "e",
"name": "Hamate",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the lunate bone. It is the carpal bone most likely to be dislocated. Lunate dislocations are typically associated with scaphoid fractures.",
"id": "10003371",
"label": "a",
"name": "Lunate",
"picture": null,
"votes": 479
},
{
"__typename": "QuestionChoice",
"answer": false,
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"label": "b",
"name": "Scaphoid",
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This option is incorrect. The triquetrum is the second most likely carpal bone to be fractured in the hand.",
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"label": "c",
"name": "Triquetrum",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This option is incorrect. The trapezoid bone is the smallest in the distal row of carpal bones of the hand. It sits lateral to the capitate bone.",
"id": "10003374",
"label": "d",
"name": "Trapezoid",
"picture": null,
"votes": 29
}
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173,461,014 | false | 27 | null | 6,495,042 | null | false |
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"answer": true,
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"label": "d",
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173,461,015 | false | 28 | null | 6,495,042 | null | false |
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173,461,016 | false | 29 | null | 6,495,042 | null | false |
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173,461,017 | false | 30 | null | 6,495,042 | null | false |
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"explanation": "Acute pseudogout is unlikely to last for 7 weeks and to be bilateral. Pseudogout presentations are typically unilateral. Chronic pseudogout (CPP disease), however, can mimic the presentation of osteoarthritis.",
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MarksheetMark
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173,461,018 | false | 31 | null | 6,495,042 | null | false |
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{
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "The glabella tap test is a neurological test used to assess the glabella reflex. It involves tapping on the forehead to elicit a blinking reflex that is eventually suppressed by the individual. A positive test (in which blinking is not suppressed) is commonly seen in patients with Parkinson’s disease.",
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"picture": null,
"votes": 4
},
{
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},
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"id": "10003396",
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"name": "Schirmer",
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},
{
"__typename": "QuestionChoice",
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"explanation": "The Coombs test is a laboratory test used in the diagnosis of autoimmune haemolytic anaemia.",
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"picture": null,
"votes": 10
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173,461,019 | false | 32 | null | 6,495,042 | null | false |
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},
{
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},
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},
{
"__typename": "QuestionChoice",
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"label": "a",
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}
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"question": "Which genetic condition is the karyotype below seen in?\n\n[lightgallery]\nZooWeb - Karyotypes, 47, XX +13 (wisc.edu)",
"sbaAnswer": [
"a"
],
"totalVotes": 612,
"typeId": 1,
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MarksheetMark
|
173,461,020 | false | 33 | null | 6,495,042 | null | false |
[] | null | 13,228 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Alpha motor neurones are motor neurones that stimulate skeletal muscle contraction.",
"id": "10003409",
"label": "d",
"name": "Alpha motor neurones",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pacinian corpuscles are sensory receptors that detect changes in pressure and vibration in the skin.",
"id": "10003408",
"label": "c",
"name": "Pacinian corpuscles",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "C fibres are non-myelinated pain fibres that are responsible for dull pain that is poorly localised.",
"id": "10003407",
"label": "b",
"name": "C fibres",
"picture": null,
"votes": 91
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are myelinated pain fibres that are responsible for sharp, localised pain.",
"id": "10003406",
"label": "a",
"name": "A-delta fibres",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Beta-adrenergic receptors are found abundantly in the body (e.g. beta-1 receptors in heart tissue, beta-2 receptors in the respiratory system), but they do not play a role in the processing or sensation of dull pain.",
"id": "10003410",
"label": "e",
"name": "Beta-adrenergic receptors",
"picture": null,
"votes": 12
}
],
"comments": [
{
"__typename": "QuestionComment",
"comment": "The unmyelinated C fibers respond to thermal, mechanical, and chemical stimuli and produce the sensation of dull, diffuse, aching, burning, and delayed pain. ????",
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"__typename": "QuestionComment",
"comment": "I agree !!",
"createdAt": 1684959025,
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{
"__typename": "QuestionComment",
"comment": "Agree C fibres dull pain A delta for sharp pain :( ",
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"comment": "i agree mo",
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"displayName": "Mohamed Mahran",
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"question": "What type of receptor is implicated in dull pain?",
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MarksheetMark
|
173,461,021 | false | 34 | null | 6,495,042 | null | false |
[] | null | 13,229 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gender bias is not likely to be implicated in this study. Although there are marginally more males than females in this study, the difference in numbers is unlikely to bias the results.",
"id": "10003412",
"label": "b",
"name": "Gender bias",
"picture": null,
"votes": 159
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Performance bias is introduced when the methodology of a trial introduces differences between the intervention and control groups other than the intervention being tested. However, due to the use of blinding, this type of bias is unlikely.",
"id": "10003413",
"label": "c",
"name": "Performance bias",
"picture": null,
"votes": 105
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Publication bias is introduced when there is a failure to publish research data based on the true findings or true intention of the study. It may occur when there is a conflict of interest. Nothing is known about the publishing of the findings in this scenario.",
"id": "10003415",
"label": "e",
"name": "Publication bias",
"picture": null,
"votes": 33
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Berkson bias is a type of bias that occurs when findings from hospital studies are not generalisable to a wider community of patients. This may occur in this study as the researcher is only using hospital patients to study the effectiveness of the new drug. His sample may not be representative of all the patients in the community, so his findings may not be generalisable.",
"id": "10003411",
"label": "a",
"name": "Berkson bias",
"picture": null,
"votes": 129
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Attrition bias is introduced when participants drop out of the study, reducing the sample size and amount of data that can be collected from the research. This study has not been carried out yet, so attrition bias cannot be assessed.",
"id": "10003414",
"label": "d",
"name": "Attrition bias",
"picture": null,
"votes": 184
}
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"id": "4158",
"name": "Types of bias",
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"typeId": 7
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"question": "An ST2 doctor in cardiology decides to conduct a study to assess the true treatment effect of a new drug for heart failure.\n\nHe consents 55 patients from the hospital to try the new drug, 29 male and 26 female. The study is a blinded randomised control trial.\n\nWhat type of bias is most likely to occur in this study?",
"sbaAnswer": [
"a"
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"typeId": 1,
"userPoint": null
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|
MarksheetMark
|
173,461,022 | false | 35 | null | 6,495,042 | null | false |
[] | null | 13,230 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect.",
"id": "10003417",
"label": "b",
"name": "0.8",
"picture": null,
"votes": 120
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Relative risk is calculated by dividing the risk of an adverse event in the exposed group by the risk in the non-exposed group. In this case, the calculation would be [(45/119)]/[(67/123)], which equals 0.69.",
"id": "10003416",
"label": "a",
"name": "0.69",
"picture": null,
"votes": 371
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect.",
"id": "10003419",
"label": "d",
"name": "1.3",
"picture": null,
"votes": 52
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect.",
"id": "10003418",
"label": "c",
"name": "1",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect.",
"id": "10003420",
"label": "e",
"name": "1.5",
"picture": null,
"votes": 44
}
],
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"typeId": 7
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"question": "A study was conducted to compare the effects of cognitive behavioural therapy versus a control therapy on the treatment of schizophrenia.\n\nThe effectiveness was assessed by measuring the incidence of psychotic episodes over 2 years (24 months).\n\nThe findings are shown below:\n\n| | Exposed group | Non-exposed group |\n| --- | --- | --- |\n| Psychotic episodes | 45 | 67 |\n| No psychotic episodes\t | 74 | 56 |\n\nCalculate the relative risk of a psychotic episode.",
"sbaAnswer": [
"a"
],
"totalVotes": 598,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,461,023 | false | 36 | null | 6,495,042 | null | false |
[] | null | 13,231 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This formula calculates the total percentage of patients that had osteopenia after 5 years so is incorrect.",
"id": "10003423",
"label": "c",
"name": "[(c+d)/ (a+b+c+d+e+f)] x 100",
"picture": null,
"votes": 98
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This formula calculates the percentage of patients that had Osteopenia after 5 years of Denosumab so is correct. Remember, osteopenia is defined as a T score between –1 and –2.5.",
"id": "10003421",
"label": "a",
"name": "[(d)/ (b+d+f)] x 100",
"picture": null,
"votes": 439
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This formula calculates the percentage of patients that had a normal bone mineral density after 5 years so is incorrect.",
"id": "10003424",
"label": "d",
"name": "[(e+f)/ (a+b+c+d+e+f)] x 100",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This formula calculates the percentage of patients that had a normal bone density after 5 years on Alendronic acid so is incorrect.",
"id": "10003425",
"label": "e",
"name": "[(e)/ (a+c+e)] x 100",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This formula calculates the total percentage of patients that had osteoporosis after 5 years. Remember a T score <-2.5 is diagnostic of osteoporosis.",
"id": "10003422",
"label": "b",
"name": "[(a+b)/ (a+b+c+d+e+f)] x 100",
"picture": null,
"votes": 39
}
],
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"id": "4160",
"name": "Percentages",
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"__typename": "Topic",
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"name": "Research methods",
"typeId": 7
},
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"question": "A researcher decides to analyse his findings comparing the effect of denosumab and alendronic acid on bone mineral density after 5 years of treatment.\n\nThe findings are detailed in the table below.\n\n| T score\t| Alendronic acid | Denosumab |\n| --- | --- | --- |\n| T < -2.5 | \ta | b |\n| –1 < T < –2.5 | c | d |\n| T > -1 | e | f |\n\nWhich of the following options is the correct formula to calculate the percentage of patients that had osteopenia after 5 years of denosumab?",
"sbaAnswer": [
"a"
],
"totalVotes": 593,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,461,024 | false | 37 | null | 6,495,042 | null | false |
[] | null | 13,232 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "‘Analysis used to compare the benefits of a decision versus the costs of the same decision’ describes a cost-benefit analysis.",
"id": "10003427",
"label": "b",
"name": "Method used to compare the benefits of a decision versus the costs of the same decision",
"picture": null,
"votes": 162
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "‘The ratio of total costs to total benefits of an intervention’ describes a cost-benefit ratio.",
"id": "10003428",
"label": "c",
"name": "The ratio of total costs to total benefits of an intervention",
"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "‘Method used to compare the costs and effects of alternative interventions’ describes a cost-utility analysis.",
"id": "10003430",
"label": "e",
"name": "Method used to compare the costs and effects of alternative interventions",
"picture": null,
"votes": 217
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "‘The net cost divided by the changes in health outcomes’ describes a cost-effectiveness ratio.",
"id": "10003429",
"label": "d",
"name": "The net cost divided by the changes in health outcomes",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct description of a cost-effective analysis. Cost-effective analyses are used to compare 2 or more interventions to determine how much it costs for each intervention to gain 1 unit of a health outcome. For example, a cancer screening programme might cost an extra £1000 per life saved compared to treating patients once they develop symptoms. It is up to institutions such as hospitals and the government to decide whether this cost is acceptable.",
"id": "10003426",
"label": "a",
"name": "Method used to assess the health and cost impacts of an intervention",
"picture": null,
"votes": 123
}
],
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"entitlement": null,
"id": "4161",
"name": "Health Economics",
"status": null,
"topic": {
"__typename": "Topic",
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"name": "Ethics and Law",
"typeId": 7
},
"topicId": 184,
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"question": "Which of the following is the correct definition of a cost-effective analysis?",
"sbaAnswer": [
"a"
],
"totalVotes": 599,
"typeId": 1,
"userPoint": null
}
|
MarksheetMark
|
173,461,025 | false | 38 | null | 6,495,042 | null | false |
[] | null | 13,233 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The first and second pharyngeal pouches give rise to the thyroid gland.",
"id": "10003435",
"label": "e",
"name": "1st and 2nd pharyngeal pouches",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The paraxial mesoderm gives rise to the axial skeleton. This consists of the bones in the midline (I.e. the skull, sternum, ribs, vertebrae, sacrum and coccyx).",
"id": "10003432",
"label": "b",
"name": "Paraxial mesoderm",
"picture": null,
"votes": 303
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The metanephric blastema gives rise to the main structures of the nephron, including the bowman’s capsule, proximal convoluted tubule, loop of Henle and distal convoluted tubule.",
"id": "10003434",
"label": "d",
"name": "Metanephric blastema",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The ureteric bud gives rise to the collecting system of the urogenital system. This includes the collecting duct, ureters and renal calyces.",
"id": "10003433",
"label": "c",
"name": "Ureteric bud",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The lateral plate mesoderm gives rise to the appendicular skeleton. This consists of all the limb bones, shoulder girdles and pelvic bones.",
"id": "10003431",
"label": "a",
"name": "Lateral plate mesoderm",
"picture": null,
"votes": 279
}
],
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},
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"id": "4162",
"name": "Bone formation",
"status": null,
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"name": "Embryology",
"typeId": 7
},
"topicId": 171,
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"question": "Which embryological structure gives rise to the appendicular skeleton?",
"sbaAnswer": [
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"typeId": 1,
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}
|
MarksheetMark
|
173,461,026 | false | 39 | null | 6,495,042 | null | false |
[] | null | 13,234 |
{
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This man likely has gout. A painful big toe (also known as podagra) is the classic presentation of gout. Negatively birefringent needle-shaped uric acid crystals are the most likely to be found on joint aspiration.",
"id": "10003436",
"label": "a",
"name": "Negatively birefringent needle-shaped uric acid crystals",
"picture": null,
"votes": 547
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This man likely has gout. Positively birefringent rhomboid-shaped crystals are characteristically found in pseudogout, whilst negatively birefringent needle-shaped crystals are seen in gout.",
"id": "10003439",
"label": "d",
"name": "Negatively birefringent rhomboid-shaped crystals",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This man likely has gout. Dumbbell-shaped calcium oxalate stones are characteristically found in renal calculi (renal stones).",
"id": "10003440",
"label": "e",
"name": "Dumbbell-shaped calcium oxalate stones",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This man likely has gout. Positively birefringent rhomboid-shaped crystals are characteristically found in pseudogout.",
"id": "10003438",
"label": "c",
"name": "Positively birefringent rhomboid-shaped crystals",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This man likely has gout. Negatively birefringent needle-shaped uric acid crystals are the most likely to be found on joint aspiration.",
"id": "10003437",
"label": "b",
"name": "Positively birefringent needle-shaped uric acid crystals",
"picture": null,
"votes": 35
}
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"name": "Acute, hot swollen joint",
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"typeId": 7
},
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173,461,028 | false | 41 | null | 6,495,042 | null | false |
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173,461,031 | false | 44 | null | 6,495,042 | null | false |
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173,461,032 | false | 45 | null | 6,495,042 | null | false |
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"__typename": "QuestionChoice",
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MarksheetMark
|
173,461,035 | false | 48 | null | 6,495,042 | null | false |
[] | null | 13,243 |
{
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"__typename": "QuestionChoice",
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},
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},
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"__typename": "QuestionChoice",
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MarksheetMark
|
173,461,036 | false | 49 | null | 6,495,042 | null | false |
[] | null | 13,244 |
{
"__typename": "QuestionSBA",
"choices": [
{
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"explanation": "*Haemophilus influenzae* is a gram-negative coccobacilli and is a commensal pathogen within the respiratory system. *Haemophilus influenzae* is associated with epiglottitis which is life-threatening if not treated promptly.",
"id": "10003489",
"label": "d",
"name": "*Haemophilus influenzae*",
"picture": null,
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},
{
"__typename": "QuestionChoice",
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"explanation": "*Staphylococcus aureus* is a gram-positive bacterium that is typically found in grape-like clusters. It is a commensal bacterium that typically causes bone infections (e.g. osteomyelitis) and skin infections (e.g. cellulitis).",
"id": "10003487",
"label": "b",
"name": "*Staphylococcus aureus*",
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{
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"id": "10003488",
"label": "c",
"name": "*Pseudomonas aureginosa*",
"picture": null,
"votes": 39
},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "*Salmonella typhi* is a gram-negative rod-shaped enterobaceteriae commonly found in raw poultry (e.g. raw chicken). It typically causes a diarrhoeal illness, but can also cause osteomyelitis in patients with sickle cell disease.",
"id": "10003490",
"label": "e",
"name": "*Salmonella typhi*",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "‘Gram-positive facultative anaerobic diplococci is the microscopic description of *streptococcus pneumoniae*, which typically causes pneumonia.",
"id": "10003486",
"label": "a",
"name": "*Streptococcus pneumoniae*",
"picture": null,
"votes": 400
}
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"question": "A 61-year-old man is referred to the hospital by his GP due to an ongoing productive cough and fever.\n\nA sputum sample is taken and sent to the lab for investigation.\n\nThe culture comes back and is positive. The following description has been provided by the microbiologist:\n\n‘Gram-positive facultative anaerobic diplococci.’\n\nWhich of the following pathogens is responsible for this man’s presentation?",
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|
MarksheetMark
|
173,461,047 | false | 1 | null | 6,495,044 | null | false |
[] | null | 13,245 |
{
"__typename": "QuestionSBA",
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"__typename": "QuestionChoice",
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"explanation": "For this patient with severe acne vulgaris, once-daily oral lymecycline 408 mg or oral doxycycline 100 mg is the recommended first-line management. Topical therapy such as azelaic acid should also be co-prescribed.",
"id": "10003491",
"label": "a",
"name": "Lymecycline with topical azelaic acid",
"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be appropriate for patients with mild-moderate acne. This patient however has presented with severe nodular acne.",
"id": "10003492",
"label": "b",
"name": "Combination of topical benzoyl peroxide with topical clindamycin",
"picture": null,
"votes": 113
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Adequate courses of standard therapy with systemic antibiotics and topical therapy should be attempted before trialling oral isotretinoin. Additionally, this patient has presented in GP and isotretinoin can only be prescribed by a dermatologist.\n\nIt is standard practice to co-prescribe two forms of contraception prior to starting isotretinoin as it is a teratogen.\n\nThere is also a reported increased risk of depression and suicide associated with systemic retinoids; any changes in mood should be closely monitored. Given that this patient has self-reported depression, we would need to be cautious when prescribing isotretinoin.",
"id": "10003494",
"label": "d",
"name": "Oral isotretinoin",
"picture": null,
"votes": 160
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Adequate courses of standard therapy with systemic antibiotics and topical therapy should be attempted before trialling the COCP.",
"id": "10003495",
"label": "e",
"name": "Combined Oral Contraceptive Pill (COCP)",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This regime is more likely to be used in patients with moderate acne. This patient however has presented with severe nodular acne. Furthermore, macrolides such as clindamycin are typically used for acne when patients cannot tolerate tetracyclines e.g. lymecycline or doxycycline. There is no indication of tetracycline intolerance in this case.",
"id": "10003493",
"label": "c",
"name": "Clindamycin with topical benzyl peroxide",
"picture": null,
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}
],
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"__typename": "QuestionComment",
"comment": "If there is extensive scarring isn't oral isotretinoin first line?",
"createdAt": 1687696144,
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},
{
"__typename": "QuestionComment",
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"question": "A 22-year-old woman presents to the GP. She mentions that she is feeling depressed due to her extensive scarring acne and painful nodules.\n\nWhat is the most appropriate management for her?",
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|
MarksheetMark
|
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