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"answer": false,
"explanation": "Increased hormone exposure is a risk factor for breast cancer.\nThe intrauterine device is a non-hormonal method of contraception and so does not contribute to hormone exposure.",
"id": "10005504",
"label": "d",
"name": "Use of intrauterine device/ copper coil",
"picture": null,
"votes": 24
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Late menopause is a risk factor for breast cancer for the same reason as early menarche- there is increased exposure to sex hormones.",
"id": "10005505",
"label": "e",
"name": "Premature menopause",
"picture": null,
"votes": 49
},
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer as this increases hormone exposure. It also reduces the chance of having multiple separate pregnancies.",
"id": "10005501",
"label": "a",
"name": "Late first pregnancy",
"picture": null,
"votes": 63
},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Early menarche is a risk factor for development of breast cancer due to longer exposure to oestrogen.",
"id": "10005502",
"label": "b",
"name": "Late menarche",
"picture": null,
"votes": 42
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Nulliparity is a risk factor for development of breast cancer due to increased hormone exposure, so having multiple pregnancies reduces this.",
"id": "10005503",
"label": "c",
"name": "Multiparity",
"picture": null,
"votes": 21
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"name": "Breast Cancer",
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"id": "151",
"name": "Breast Disease",
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"question": "A 55-year-old woman is suspected to have oestrogen receptor-positive breast cancer.\n\nWhich of the following is a risk factor for the development of this type of cancer?",
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"a"
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"choices": [
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Damage to the right optic nerve causes right-sided monocular vision loss, meaning the patient is unable to see anything from the right eye.",
"id": "10005508",
"label": "c",
"name": "Right optic nerve",
"picture": null,
"votes": 2
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "This causes contralateral (right) homonymous hemianopia.",
"id": "10005510",
"label": "e",
"name": "Left optic tract",
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"votes": 2
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"__typename": "QuestionChoice",
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"explanation": "This causes contralateral (left) homonymous hemianopia.",
"id": "10005509",
"label": "d",
"name": "Right optic tract",
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"votes": 0
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"__typename": "QuestionChoice",
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"explanation": "Damage to the left optic nerve causes left-sided monocular vision loss, meaning the patient is unable to see anything from the left eye.",
"id": "10005507",
"label": "b",
"name": "Left optic nerve",
"picture": null,
"votes": 0
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "The optic chiasm is where the fibres of the left and right nasal retina cross over, correlating to the vision from the temporal visual fields. Therefore damage to this area causes temporal field loss on both sides. The easiest way to understand this concept is to learn the optic tract diagram and draw it out in exam questions.",
"id": "10005506",
"label": "a",
"name": "Optic chiasm",
"picture": null,
"votes": 197
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"name": "Visual pathway anatomy",
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"question": "A 67-year-old gentleman with a known pituitary adenoma presents with bitemporal hemianopia visual field loss.\n\nWhich part of the optic tract is most likely to be affected?",
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although the parathyroid gland has 'thyroid' in the name, it does not contribute to the production of thyroid hormones. Therefore unless there was co-existent thyroid disease, thyroid function tests would be normal.",
"id": "10005515",
"label": "e",
"name": "High serum thyroxine",
"picture": null,
"votes": 15
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "In primary hyperparathyroidism, there is excess production of PTH which causes bone resorption, increased calcium reabsorption in kidneys and increased absorption of calcium from the small intestine indirectly via vitamin D synthesis which raises serum calcium.",
"id": "10005511",
"label": "a",
"name": "High serum calcium",
"picture": null,
"votes": 156
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "In primary hyperparathyroidism, there is excessive production of parathyroid hormone(PTH) which increases serum calcium. There is low serum calcium in secondary hyperparathyroidism.",
"id": "10005513",
"label": "c",
"name": "Low serum calcium",
"picture": null,
"votes": 17
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "In primary hyperparathyroidism serum phosphate is typically low as PTH decreases renal reabsorption of phosphate, lowering serum levels.",
"id": "10005514",
"label": "d",
"name": "High serum phosphate",
"picture": null,
"votes": 8
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would suggest Stage 3b chronic kidney disease, which causes secondary and then tertiary hyperparathyroidism due to chronically low calcium.",
"id": "10005512",
"label": "b",
"name": "eGFR 30ml/min/1.73m^2",
"picture": null,
"votes": 1
}
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173,462,201 | false | 5 | null | 6,495,079 | null | false | [] | null | 13,650 | {
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"choices": [
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "Trimethoprim reduces folic acid synthesis. Adequate levels of folic acid are required to ensure the closure of the neural tube in embryological development in the first trimester. Therefore taking trimethoprim during this time increases the risk of neural tube defects, such as spina bifida.",
"id": "10005516",
"label": "a",
"name": "Neural tube",
"picture": null,
"votes": 181
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Paramesonephric ducts develop into the female reproductive system. Folic acid is not important in this process.",
"id": "10005517",
"label": "b",
"name": "Paramesonephric ducts",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Mesonephric ducts develop into the male reproductive system. Folic acid is not important in this process.",
"id": "10005520",
"label": "e",
"name": "Mesonephric ducts",
"picture": null,
"votes": 4
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The foregut forms the oesophagus, stomach, liver, gallbladder, bile ducts, pancreas and proximal duodenum. This does not depend on folic acid.",
"id": "10005519",
"label": "d",
"name": "Foregut",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The primitive heart tube is the first structure in the formation of the heart. This process is not dependent on folic acid.",
"id": "10005518",
"label": "c",
"name": "Primitive heart tube",
"picture": null,
"votes": 6
}
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"name": "Teratogenic drugs",
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"id": "222",
"name": "General pharmacology",
"typeId": 7
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"question": "A pregnant woman at eight weeks gestation rings the GP requesting antibiotics for a suspected UTI. She asks for Trimethoprim, as she had it four months ago and it worked well. Trimethoprim inhibits folic acid formation.\n\nWhich of the following structures in the foetus is at risk if she was to take it?",
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"a"
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"typeId": 1,
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173,462,202 | false | 6 | null | 6,495,079 | null | false | [] | null | 13,651 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This receives its own blood supply from the sigmoidal branches of the inferior mesenteric artery.",
"id": "10005525",
"label": "e",
"name": "Sigmoid colon",
"picture": null,
"votes": 39
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is part of the small intestine and is supplied by the ileocolic artery which is a branch of the superior mesenteric artery. The superior mesenteric artery is most likely to be affected by a thrombus. However, due to the watershed region created by the blood supply of the splenic flexure, the splenic flexure is more likely to be affected.",
"id": "10005524",
"label": "d",
"name": "Ileum",
"picture": null,
"votes": 31
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is supplied by the superior mesenteric artery, which is where the thrombus is most likely to affect. However, due to the watershed region created by the blood supply of the splenic flexure, the splenic flexure is more likely to be affected.",
"id": "10005522",
"label": "b",
"name": "Hepatic flexure",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is supplied by the ileocolic artery which is a branch of the superior mesenteric artery, which is where the thrombus is most likely to affect. However, due to the watershed region created by the blood supply of the splenic flexure, the splenic flexure is more likely to be affected.",
"id": "10005523",
"label": "c",
"name": "Caecum",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. The splenic flexure is where the transverse colon becomes the descending colon. Although the most common cause of mesenteric ischaemia is occlusion of the superior mesenteric artery, the splenic flexure is supplied by terminal branches of both the superior and inferior mesenteric arteries. However, this creates a watershed region and so as it lacks its own blood supply it is more susceptible to ischaemia.",
"id": "10005521",
"label": "a",
"name": "Splenic flexure",
"picture": null,
"votes": 82
}
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"id": "4418",
"name": "Acute mesenteric ischaemia",
"status": null,
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"id": "135",
"name": "General surgery",
"typeId": 7
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"question": "A 75-year-old man with known atrial fibrillation presents with sudden onset central abdominal pain. He is diagnosed with acute mesenteric ischaemia.\n\nWhich part of the bowel is most commonly affected by acute bowel ischaemia?",
"sbaAnswer": [
"a"
],
"totalVotes": 186,
"typeId": 1,
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173,462,203 | false | 7 | null | 6,495,079 | null | false | [] | null | 13,652 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is what the LH surge stimulates - ovulation.",
"id": "10005528",
"label": "c",
"name": "Release of the ovum from the ovary into the fallopian tube",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a role of oestrogen in the proliferative phase of the menstrual cycle. It allows sperm to enter the uterus and fertilise the ovum.",
"id": "10005527",
"label": "b",
"name": "Production of thin alkaline cervical mucus",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the role of inhibin, which is produced by granulosa cells.",
"id": "10005530",
"label": "e",
"name": "Selective inhibition of FSH production",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "During the secretory phase, progesterone stimulates production of thick and acidic cervical mucus to prevent more than one sperm from fertilising the ovum.",
"id": "10005526",
"label": "a",
"name": "Production of thick acidic cervical mucus",
"picture": null,
"votes": 103
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "During the follicular phase, LH and FSH stimulate follicle growth.",
"id": "10005529",
"label": "d",
"name": "Follicle growth",
"picture": null,
"votes": 14
}
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"name": "Menstrual cycle",
"status": null,
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"name": "Reproductive Physiology",
"typeId": 7
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"question": "Progesterone plays an important role in the menstrual cycle, which of these changes occurs as a result of progesterone release?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
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173,462,204 | false | 8 | null | 6,495,079 | null | false | [] | null | 13,653 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This epithelial lining is found in ducts and secretory tissue e.g. kidney tubules.",
"id": "10005533",
"label": "c",
"name": "Simple cuboidal",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the epithelial lining of the stomach and other parts of the digestive tract, bronchi, uterine tubes, and uterus. It secretes mucus and enzymes",
"id": "10005535",
"label": "e",
"name": "Simple columnar",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is often ciliated epithelium, and it lines the trachea and most of the upper respiratory tract. It allows mucus to be moved.",
"id": "10005534",
"label": "d",
"name": "Pseudostratified columnar",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the lining of the air sacs of the lungs, heart, blood vessels and lymphatic vessels.",
"id": "10005532",
"label": "b",
"name": "Simple squamous",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "It also lines the mouth and vagina as well - protecting against abrasion.",
"id": "10005531",
"label": "a",
"name": "Stratified squamous",
"picture": null,
"votes": 91
}
],
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"question": "You are watching a 60-year-old woman who presented with persistent dysphagia and reflux undergoing endoscopy for suspected oesophageal cancer. The consultant asks you about oesophageal histology.\n\nWhich of these is the normal epithelial lining of the lower oesophagus?",
"sbaAnswer": [
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173,462,205 | false | 9 | null | 6,495,079 | null | false | [] | null | 13,654 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would typically result in a left-sided subcostal scar - diagonal or parallel to the costal margin.",
"id": "10005540",
"label": "e",
"name": "Splenectomy",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Abdominal aortic aneurysm repair is typically done through a midline laparotomy, an incision that goes from the xiphoid process to just above or just below the umbilicus.",
"id": "10005538",
"label": "c",
"name": "Abdominal aortic aneurysm repair",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
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"explanation": "This would typically result in a right-sided subcostal scar - diagonal or parallel to the costal margin.",
"id": "10005539",
"label": "d",
"name": "Cholecystectomy",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Caesarean section is typically done via a Pfannenstiel incision, which is a central incision along the suprapubic crease/bikini line.",
"id": "10005537",
"label": "b",
"name": "Elective caesarean section",
"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Appendicectomy is done via a McBurney incision, which is located two-thirds of the way from the umbilicus to the right anterior superior iliac spine.",
"id": "10005536",
"label": "a",
"name": "Appendicectomy",
"picture": null,
"votes": 168
}
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"question": "You are examining a female patient's abdomen and you identify a scar in the right iliac fossa.\n\nWhat is the most likely surgery she has undergone in the past?",
"sbaAnswer": [
"a"
],
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173,462,206 | false | 10 | null | 6,495,079 | null | false | [] | null | 13,655 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would indicate genital candidiasis/thrush infection.",
"id": "10005542",
"label": "b",
"name": "Blastospores, pseudohyphae and neutrophils",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer, allowing diagnosis of Gonorrhoea.",
"id": "10005541",
"label": "a",
"name": "Gram-negative diplococci",
"picture": null,
"votes": 124
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Neisseria gonorrhoea would be seen on microscopy. You would expect no microscopy findings in chlamydia infection.",
"id": "10005544",
"label": "d",
"name": "No abnormalities would be seen on microscopy",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
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"explanation": "There are multiple gram-positive diplococci bacteria. One of the most important ones to be aware of is streptococcus pneumoniae.",
"id": "10005545",
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"name": "Gram-positive diplococci",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would indicate Trichomonas vaginalis infection.",
"id": "10005543",
"label": "c",
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"picture": null,
"votes": 3
}
],
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"question": "Which of these microscopic findings would suggest a diagnosis of Gonorrhoea infection?",
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"a"
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"typeId": 1,
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173,462,207 | false | 11 | null | 6,495,079 | null | false | [] | null | 13,656 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Haloperidol blocks dopamine receptors in the central nervous system, specifically D2 receptors.",
"id": "10005546",
"label": "a",
"name": "Dopamine receptors",
"picture": null,
"votes": 102
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Anti-emetics, such as cyclizine are histamine receptor antagonists. They also have no antipsychotic effect.",
"id": "10005547",
"label": "b",
"name": "Histamine receptors",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Anti-emetics such as Ondansetron are 5HT3 receptor antagonists, and have no antipsychotic effect.",
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"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are not involved in nausea and vomiting and so there is no antiemetic that acts on the GABA receptors. Benzodiazepines (e.g. diazepam) act on GABA receptors, as does alcohol.",
"id": "10005550",
"label": "e",
"name": "GABA receptors",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Antimuscarinics, such as hyoscine hydrobromide act on muscarinic receptors. They are used as anti-emetics, but also to reduce respiratory secretions (especially in palliative care).",
"id": "10005549",
"label": "d",
"name": "Muscarinic acetylcholine receptors",
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}
],
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"name": "End of Life Care Medications",
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"question": "Haloperidol is an antipsychotic but is sometimes used in palliative care as an anti-emetic, which receptors in the brain does this drug work on?",
"sbaAnswer": [
"a"
],
"totalVotes": 176,
"typeId": 1,
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173,462,208 | false | 12 | null | 6,495,079 | null | false | [] | null | 13,657 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is factor I, and is affected in disseminated intravascular coagulation. It is not a vitamin K-dependent factor.",
"id": "10005553",
"label": "c",
"name": "Fibrinogen",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is involved in platelet aggregation for clot formation. It is not dependent on vitamin K.",
"id": "10005555",
"label": "e",
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"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Warfarin is a vitamin K antagonist and so affects the vitamin K-dependant clotting factors, which are II, VII, IX and X (often remembered using by '1972').",
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"label": "a",
"name": "Factor X",
"picture": null,
"votes": 127
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is factor III and a co-factor of factor VII, which is not dependent on vitamin K.",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is affected in haemophilia A, and is not a vitamin K-dependant clotting factor.",
"id": "10005552",
"label": "b",
"name": "Factor VIII",
"picture": null,
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}
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"question": "A patient presents to ED with persistent epistaxis (nose bleed). He says he currently takes warfarin.\n\nAs warfarin inhibits vitamin K, which of the following clotting factors will be affected by taking warfarin?",
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"a"
],
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173,462,209 | false | 13 | null | 6,495,079 | null | false | [] | null | 13,658 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This drains the splenic, superior mesenteric and inferior mesenteric veins.",
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"label": "e",
"name": "Hepatic portal vein",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The left testicular vein drains into the left renal vein, which then drains into the inferior vena cava. Hence, it is possible for a left-sided renal cancer to present as a left-sided varicocele.",
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"label": "a",
"name": "Left renal vein",
"picture": null,
"votes": 91
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These drain the right common iliac vein and then drain into the inferior vena cava directly.",
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"label": "d",
"name": "Lumbar veins",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The left testicular vein branches off higher up (more proximally) than the common iliac due to embryological origins.",
"id": "10005558",
"label": "c",
"name": "Left common iliac vein",
"picture": null,
"votes": 54
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The right testicular vein drains straight into the inferior vena cava, but the left drains into the left renal vein first.",
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"label": "b",
"name": "Inferior vena cava",
"picture": null,
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}
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"question": "A 60-year-old gentleman has a left-sided varicocele.\n\nWhat does the left testicular vein drain into?",
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"a"
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173,462,210 | false | 14 | null | 6,495,079 | null | false | [] | null | 13,659 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the vertebral level of the pelvic brim and bifurcation of the abdominal aorta into the right and left common iliac arteries, which is another common site for renal stones to become stuck.",
"id": "10005565",
"label": "e",
"name": "L4",
"picture": null,
"votes": 45
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The pelvic-ureteric junction (PUJ) is one of the three most common sites for renal stones to become lodged. The PUJ is located at the hilum of the kidneys which is at the L2 vertebral level.",
"id": "10005561",
"label": "a",
"name": "L2",
"picture": null,
"votes": 64
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the vertebral level of the superior pole of the kidneys.",
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"label": "b",
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"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the vertebral level of the inferior pole of the kidneys.",
"id": "10005563",
"label": "c",
"name": "L3",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the vertebral level of the sacral promontory.",
"id": "10005564",
"label": "d",
"name": "S1",
"picture": null,
"votes": 12
}
],
"comments": [
{
"__typename": "QuestionComment",
"comment": "does it not depend if its the right or left one?",
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"question": "A patient presenting with renal colic has a CT KUB, showing a renal stone at the pelvic-ureteric junction.\n\nWhat vertebral level is this located at?",
"sbaAnswer": [
"a"
],
"totalVotes": 172,
"typeId": 1,
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} | MarksheetMark |
173,462,211 | false | 15 | null | 6,495,079 | null | false | [] | null | 13,660 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These cells produce mucus.",
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"label": "b",
"name": "Goblet cells",
"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These cover most of the alveolar surface and allow gas exchange to occur.",
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"label": "c",
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"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are the macrophages of the alveoli.",
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"label": "d",
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},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "These are a type of epithelial cells that produce surfactant, starting at 24-28 weeks gestation.",
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"label": "a",
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"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These cells are located in the airways and propel mucus up the airway to remove pathogens and particulate matter.",
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"label": "e",
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"picture": null,
"votes": 2
}
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"question": "A neonate born 3 hours ago at 33 weeks gestation develops an increased respiratory rate, subcostal recessions and nasal grunting. He is assessed by the on-call doctor who suspects neonatal respiratory distress syndrome due to surfactant deficiency.\n\nWhich cells produce surfactant?",
"sbaAnswer": [
"a"
],
"totalVotes": 171,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,212 | false | 16 | null | 6,495,079 | null | false | [] | null | 13,661 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are cells of the ovaries, which produce oestrogen and progesterone during the menstrual cycle.",
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"label": "c",
"name": "Granulosa cells",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
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"explanation": "These cells are located in the anterior pituitary and produce the gonadotropins - FSH and LH.",
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"label": "a",
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"picture": null,
"votes": 109
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These cells are present in males in the testes and secrete testosterone.",
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"label": "e",
"name": "Leydig cells",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These cells are located in the anterior pituitary, but they produce growth hormone.",
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"label": "b",
"name": "Somatotropes",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These cells are located in the anterior pituitary, but they produce prolactin which promotes milk secretion.",
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"label": "d",
"name": "Lactotropes",
"picture": null,
"votes": 0
}
],
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"question": "Menopause can be confirmed by a blood test comparing the levels of LH and FSH.\n\nWhich cells produce these two hormones?",
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"a"
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"typeId": 1,
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173,462,213 | false | 17 | null | 6,495,079 | null | false | [] | null | 13,662 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the last section of the bowel and mainly stores faeces until it is evacuated.",
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"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the only part of the small intestine where B12 is absorbed and so removal of this results in B12 deficiency.",
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"label": "a",
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"picture": null,
"votes": 116
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This connects the terminal ileum and the ascending colon. Here, fluid and electrolytes are absorbed in preparation for faeces formation.",
"id": "10005578",
"label": "c",
"name": "Caecum",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This has mainly digestive functions including neutralisation of the acidic gastric contents, mixing bile and pancreatic enzymes, absorption of water, and absorption of some electrolytes and nutrients. B12 is not one of these.",
"id": "10005577",
"label": "b",
"name": "Duodenum",
"picture": null,
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},
{
"__typename": "QuestionChoice",
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"explanation": "This is located between the duodenum and ileum. It is where sugars, amino acids and fatty acids are absorbed.",
"id": "10005580",
"label": "e",
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"picture": null,
"votes": 12
}
],
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"question": "You visit a patient on the general surgery ward. They have just undergone a bowel resection of some kind, and they ask you which part of their bowel has been removed. However, all they can recall is that the surgeon said they would need to have their vitamin B12 regularly checked and replaced.\n\nWhich part of their bowel is most likely to have been removed?",
"sbaAnswer": [
"a"
],
"totalVotes": 168,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,214 | false | 18 | null | 6,495,079 | null | false | [] | null | 13,663 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are mainly found in blood vessels and the bladder. When activated, they cause vasoconstriction, raised blood pressure and closure of bladder sphincters.",
"id": "10005583",
"label": "c",
"name": "Alpha-1 adrenergic receptors",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are located at skeletal muscle neuromuscular junctions. Stimulation causes muscle excitation.",
"id": "10005584",
"label": "d",
"name": "Nicotinic acetylcholine receptors",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are located in the heart, and increase heart rate and contractility when activated.",
"id": "10005582",
"label": "b",
"name": "Beta-1 adrenergic receptors",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are located in smooth muscles, cardiac muscle and glands. They cause bronchoconstriction in the lungs when activated.",
"id": "10005585",
"label": "e",
"name": "Muscarinic acetylcholine receptors",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "These receptors are located in the bronchioles. Activation of them causes bronchodilation. The location of beta-1 and beta-2 adrenergic receptors can be remembered by the fact that beta-1 receptors are located in the heart, and humans have one heart. However, beta-2 receptors are located in the lungs, and humans have two lungs.",
"id": "10005581",
"label": "a",
"name": "Beta-2 adrenergic receptors",
"picture": null,
"votes": 161
}
],
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"id": "3723",
"name": "Asthma in children",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
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"question": "A 10-year-old girl presents with an acute asthma attack. She is given back-to-back salbutamol nebulisers to open up her airways.\n\nWhich of the following receptors does salbutamol act on?",
"sbaAnswer": [
"a"
],
"totalVotes": 170,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,215 | false | 19 | null | 6,495,079 | null | false | [] | null | 13,664 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although miscarriage is a potential sensitising event where maternal blood can come into contact with fetal blood, the mother is rhesus-positive herself and so will not produce anti-rhesus antibodies.",
"id": "10005587",
"label": "b",
"name": "Rhesus-positive woman with a rhesus-negative baby on a background of a past miscarriage",
"picture": null,
"votes": 43
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Rhesus-negative mothers have no anti-rhesus antibodies. However, if exposed to the rhesus antigens of a rhesus-positive baby they will develop these antibodies. Therefore, in future pregnancies, there is a risk that these maternal antibodies can attack the rhesus antigens on the red blood cells of a future rhesus-positive fetus - causing haemolysis. To prevent this, anti-D immunoglobulin.",
"id": "10005586",
"label": "a",
"name": "Rhesus-negative mother after delivery of a rhesus-positive baby",
"picture": null,
"votes": 84
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although amniocentesis is a potential sensitising event where maternal blood can come into contact with fetal blood, the mother is rhesus-positive and so will not produce anti-rhesus antibodies.",
"id": "10005589",
"label": "d",
"name": "Rhesus-positive woman with a rhesus-negative baby who underwent an amniocentesis",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "As the fetus has no rhesus antigens in its blood even if the mother's blood is exposed to fetal blood, there will be no antibodies formed.",
"id": "10005590",
"label": "e",
"name": "Rhesus-negative woman pregnant with a rhesus-negative baby",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although miscarriage is a potential sensitising event where maternal blood can come into contact with fetal blood, the mother is rhesus-positive and so will not produce anti-rhesus antibodies.",
"id": "10005588",
"label": "c",
"name": "Rhesus-positive woman with a rhesus-positive baby on a background of a past miscarriage",
"picture": null,
"votes": 11
}
],
"comments": [],
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},
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"id": "4426",
"name": "Rhesus isoimmunisation",
"status": null,
"topic": {
"__typename": "Topic",
"id": "174",
"name": "Obstetrics",
"typeId": 7
},
"topicId": 174,
"totalCards": null,
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"question": "Which of these women would need an injection of anti-D to prevent haemolytic disease of the newborn?",
"sbaAnswer": [
"a"
],
"totalVotes": 161,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,216 | false | 20 | null | 6,495,079 | null | false | [] | null | 13,665 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are associated with allergies and parasitic infections and so will not be prominent in the immune response to a bacterial infection.",
"id": "10005592",
"label": "b",
"name": "Eosinophils",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are present in the tissues and activate the adaptive immune response. They are predominantly involved after the acute inflammatory stage to clear debris and foreign substances.",
"id": "10005594",
"label": "d",
"name": "Macrophages",
"picture": null,
"votes": 38
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are involved in the day-to-day regeneration of the layers of the epidermis and are involved in the wound-healing process after an infection.",
"id": "10005595",
"label": "e",
"name": "Epidermal stem cells",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These cells are part of the adaptive immune response which takes four to seven days to occur, and are not predominant in the acute inflammatory stage.",
"id": "10005593",
"label": "c",
"name": "B lymphocytes",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Neutrophils are predominantly involved in inflammation, as well as for phagocytosis of bacteria as part of the innate immune response, occurring immediately following the initial infection.",
"id": "10005591",
"label": "a",
"name": "Neutrophils",
"picture": null,
"votes": 115
}
],
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4427",
"name": "Soft tissue infections",
"status": null,
"topic": {
"__typename": "Topic",
"id": "164",
"name": "Physiology and pathology of bone",
"typeId": 7
},
"topicId": 164,
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},
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"question": "You see a patient with suspected bacterial cellulitis of the leg. There are signs of acute inflammation.\n\nWhich of the following cells is most likely to be predominant at this stage?",
"sbaAnswer": [
"a"
],
"totalVotes": 172,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,217 | false | 21 | null | 6,495,079 | null | false | [] | null | 13,666 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of action of penicillins, cephalosporins and carbapenems.",
"id": "10005597",
"label": "b",
"name": "Inhibits cell wall synthesis",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of action of macrolides - such as clarithromycin.",
"id": "10005598",
"label": "c",
"name": "Inhibition of bacterial protein synthesis by binding to the 50S subunit of the ribosome",
"picture": null,
"votes": 41
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of action of Quinolones, such as ciprofloxacin.",
"id": "10005599",
"label": "d",
"name": "Inhibition of topoisomerases",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Doxycycline is a tetracycline antibiotic, which binds to the 30S subunit of the bacterial ribosome and prevents tRNA from binding, and therefore protein synthesis is inhibited.",
"id": "10005596",
"label": "a",
"name": "Inhibition of bacterial protein synthesis by binding to the 30S subunit of the ribosome",
"picture": null,
"votes": 85
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of action of metronidazole, which is a specific antibiotic for anaerobic bacterial infections.",
"id": "10005600",
"label": "e",
"name": "Inhibition of bacterial DNA synthesis",
"picture": null,
"votes": 16
}
],
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},
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"id": "4428",
"name": "Tetracyclines",
"status": null,
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"__typename": "Topic",
"id": "223",
"name": "Antibiotic pharmacology",
"typeId": 7
},
"topicId": 223,
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"question": "You take a history from a patient on the respiratory who came in due to an acute infective exacerbation of COPD. He says he was treated with doxycycline.\n\nWhat is the mechanism of action of doxycycline?",
"sbaAnswer": [
"a"
],
"totalVotes": 162,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,218 | false | 22 | null | 6,495,079 | null | false | [] | null | 13,667 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a mucosal antibody which is secreted into mucus, saliva, tears and colostrum.",
"id": "10005603",
"label": "c",
"name": "IgA",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This acts as a B cell antigen receptor but its full function is unclear, and so it is not used to indicate primary infection.",
"id": "10005605",
"label": "e",
"name": "IgD",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the main antibody that occurs in primary immune responses. Its presence indicates primary infection.",
"id": "10005601",
"label": "a",
"name": "IgM",
"picture": null,
"votes": 112
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This antibody is involved in allergies and fighting parasitic infections. It binds to mast cells and basophils.",
"id": "10005604",
"label": "d",
"name": "IgE",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the main antibody in secondary responses.",
"id": "10005602",
"label": "b",
"name": "IgG",
"picture": null,
"votes": 34
}
],
"comments": [],
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},
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"id": "3854",
"name": "Antibodies",
"status": null,
"topic": {
"__typename": "Topic",
"id": "158",
"name": "Immunology",
"typeId": 7
},
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},
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"question": "You are going through a patient's blood results and are concerned they may have an acute infection of hepatitis B.\n\nThe presence of which antibody in the blood would suggest an acute primary infection?",
"sbaAnswer": [
"a"
],
"totalVotes": 168,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,219 | false | 23 | null | 6,495,079 | null | false | [] | null | 13,668 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is much too old for a baby's first smile and this would be very concerning. By this age, a baby should be able to hold objects in their hands.",
"id": "10005610",
"label": "e",
"name": "Six months",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This may be the age a baby is when they have their first smile and this would not be concerning. However, many babies will smile before this age.",
"id": "10005609",
"label": "d",
"name": "Eight weeks",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Typically babies smile between the ages of 6-12 weeks, unless there is something preventing them from doing this.",
"id": "10005606",
"label": "a",
"name": "Six weeks",
"picture": null,
"votes": 83
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the age at which a referral to paediatrics would be made if a baby has still not yet smiled to investigate for causes.",
"id": "10005607",
"label": "b",
"name": "10 weeks",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is younger than would be expected for a typical baby's first smile.",
"id": "10005608",
"label": "c",
"name": "Three weeks",
"picture": null,
"votes": 15
}
],
"comments": [],
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"demo": null,
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"id": "4125",
"name": "Developmental milestones - fine motor and vision",
"status": null,
"topic": {
"__typename": "Topic",
"id": "153",
"name": "Paediatrics",
"typeId": 7
},
"topicId": 153,
"totalCards": null,
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},
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"question": "A 30-year-old woman brings her baby in for her post-natal check. She is concerned because the baby has not smiled yet and wants to know the youngest age at which a baby should do this.\n\nWhat is the most appropriate response?",
"sbaAnswer": [
"a"
],
"totalVotes": 161,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,220 | false | 24 | null | 6,495,079 | null | false | [] | null | 13,669 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This provides sensory innovation to the lateral forearm, and motor innervation to biceps brachii, brachialis and coracobrachialis.",
"id": "10005615",
"label": "e",
"name": "Musculocutaneous nerve",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This supplies sensory innervation to the dorsal aspects of the arm and forearm.",
"id": "10005613",
"label": "c",
"name": "Radial nerve",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This provides sensory input to lateral three fingers (including the thumb) and is also at risk of injury in a supracondylar fracture. However, the tingling and numbness would be in the lateral three fingers.",
"id": "10005612",
"label": "b",
"name": "Median nerve",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would cause reduced sensation over the lateral aspect of the deltoid muscle and the lateral shoulder, known as the \"soldier's badge\" region. It is susceptible to injury in a humeral neck fracture.",
"id": "10005614",
"label": "d",
"name": "Axillary nerve",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The ulnar nerve supplies sensation over the little finger and the medial side of the ring finger. It is also susceptible to injury in a supracondylar fracture due to its anatomical course.",
"id": "10005611",
"label": "a",
"name": "Ulnar nerve",
"picture": null,
"votes": 147
}
],
"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": "3866",
"name": "Ulnar nerve injuries",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
"totalCards": null,
"typeId": null,
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"videos": []
},
"conceptId": 3866,
"conditions": [],
"difficulty": 1,
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"question": "A six-year-old boy is reviewed following surgical management of a supracondylar humeral fracture. He is complaining of tingling and numbness in his little and ring fingers.\n\nWhich nerve is most likely to have been damaged?",
"sbaAnswer": [
"a"
],
"totalVotes": 164,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,221 | false | 25 | null | 6,495,079 | null | false | [] | null | 13,670 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the role of the atrioventricular valves (tricuspid and mitral valves).",
"id": "10005619",
"label": "d",
"name": "Prevents blood from following backwards into the atria",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The atrioventricular node delays the transmission of the action potential between the atria and the ventricles to allow the ventricles to efficiently fill with blood. It also prevents abnormal atrial rhythms from being transmitted to the ventricles.",
"id": "10005616",
"label": "a",
"name": "Delays the conduction of action potentials from the atria to the ventricles",
"picture": null,
"votes": 122
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the role of the left and right bundle branches, which form from the Bundle of His.",
"id": "10005620",
"label": "e",
"name": "Transmits the action potential up through the ventricles causing ventricular contraction",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the role of the Bundle of His.",
"id": "10005618",
"label": "c",
"name": "Conducts action potentials through the ventricles",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the role of the sinoatrial node in the heart. It is known as the \"pacemaker\" of the heart.",
"id": "10005617",
"label": "b",
"name": "Spontaneously generates action potentials to cause contraction of the heart",
"picture": null,
"votes": 18
}
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"id": "3699",
"name": "Heart Block",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
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"question": "A patient is awaiting an ECG for suspected heart block, which is most likely due to a problem with the AV node.\n\nWhich of these is a role of the atrioventricular node?",
"sbaAnswer": [
"a"
],
"totalVotes": 163,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,222 | false | 26 | null | 6,495,079 | null | false | [] | null | 13,671 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Calcium is not typically affected by ACTH and cortisol. Hypercalcaemia is more common in squamous cell carcinoma of the lung due to PTHrp production.",
"id": "10005625",
"label": "e",
"name": "Hypercalcaemia",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ectopic ACTH release causes increased cortisol secretion and therefore Cushing's syndrome. Increased cortisol increases sodium retention and potassium excretion so hypernatraemia would be more likely.",
"id": "10005622",
"label": "b",
"name": "Hyponatraemia",
"picture": null,
"votes": 46
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Ectopic ACTH release causes increased cortisol secretion and therefore Cushing's syndrome. Increased cortisol increases sodium retention and potassium excretion.",
"id": "10005621",
"label": "a",
"name": "Hypokalaemia",
"picture": null,
"votes": 47
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ACTH causes increased cortisol secretion. Cortisol is responsible for stimulating gluconeogenesis and lipolysis. Therefore, blood glucose levels are usually increased.",
"id": "10005624",
"label": "d",
"name": "Low blood glucose",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ACTH stimulates the adrenal cortex to produce cortisol and so there would be high cortisol.",
"id": "10005623",
"label": "c",
"name": "Low morning cortisol",
"picture": null,
"votes": 34
}
],
"comments": [],
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"id": "3702",
"name": "Lung Cancer",
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"topic": {
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"id": "132",
"name": "Respiratory",
"typeId": 7
},
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},
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"question": "Small cell lung cancer can cause ectopic ACTH production.\n\nIf this occurs, which of the following biochemical abnormalities is most likely to be present?",
"sbaAnswer": [
"a"
],
"totalVotes": 167,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,223 | false | 27 | null | 6,495,079 | null | false | [] | null | 13,672 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Immobility is a known risk factor for DVT and other types of venous thromboembolism due to venous stasis. Venous stasis is one of the three elements of Virchow's triad.",
"id": "10005626",
"label": "a",
"name": "Recent immobility",
"picture": null,
"votes": 148
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Liver failure causes clotting factor deficiency and, as a result, makes a person more susceptible to bleeding rather than clotting.",
"id": "10005627",
"label": "b",
"name": "Liver failure",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Dehydration increases the risk of DVT, not overhydration.",
"id": "10005630",
"label": "e",
"name": "Fluid overload",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These reduce the stasis of venous blood in the legs, reducing the risk of DVT formation.",
"id": "10005628",
"label": "c",
"name": "Use of compression stockings",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a recognised risk factor for DVT, although some of the risk factors for MIs and DVTs will overlap. Additionally, if someone has had an MI they are likely to be on antiplatelets/anticoagulation which will reduce the risk of DVT formation",
"id": "10005629",
"label": "d",
"name": "History of myocardial infarction (MI)",
"picture": null,
"votes": 11
}
],
"comments": [],
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"demo": null,
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"id": "3795",
"name": "Deep Vein Thrombosis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "161",
"name": "Emergency Medicine",
"typeId": 5
},
"topicId": 161,
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"question": "A patient in ED is asking about why they have developed a deep vein thrombosis (DVT). You explain Virchow's Triad.\n\nWhich of the following is a risk factor for DVT?",
"sbaAnswer": [
"a"
],
"totalVotes": 166,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,224 | false | 28 | null | 6,495,079 | null | false | [] | null | 13,673 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The atria release atrial natriuretic peptide in response to being stretched due to increased blood pressure - this actually inhibits renin production.",
"id": "10005635",
"label": "e",
"name": "Atria",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is where sodium delivery to the distal convoluted tubule is detected.",
"id": "10005632",
"label": "b",
"name": "Macula densa cells of the kidney",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is where aldosterone is produced in response to angiotensin II.",
"id": "10005634",
"label": "d",
"name": "Adrenal cortex",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is where the majority of angiotensin I is converted by angiotensin-converting enzyme (ACE) into angiotensin II.",
"id": "10005633",
"label": "c",
"name": "Vascular endothelial cells of the lungs",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Renin is released by granular cells which are located in the juxtaglomerular apparatus in the kidneys. Renin is released in response to reduced sodium in the distal convoluted tubule, reduced perfusion to the kidneys or sympathetic stimulation.",
"id": "10005631",
"label": "a",
"name": "Juxtaglomerular apparatus of the kidney",
"picture": null,
"votes": 120
}
],
"comments": [],
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"id": "4429",
"name": "The effect of the renin-angiotensin-aldosterone system",
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"name": "Renal Physiology",
"typeId": 7
},
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"question": "Many antihypertensives work on the renin-angiotensin-aldosterone system.\n\nWhere in the body is renin produced?",
"sbaAnswer": [
"a"
],
"totalVotes": 164,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,225 | false | 29 | null | 6,495,079 | null | false | [] | null | 13,674 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes prominence of the eyes out of the skull and it occurs in graves disease (hyperthyroidism). It is not typically associated with pancoast lung tumours",
"id": "10005638",
"label": "c",
"name": "Exophthalmos",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Pancoast tumours can compress the sympathetic chain, causing a collection of symptoms (Horner's syndrome). Sympathetic innervation to the pupil causes dilation and so if damaged there is paralysis of the dilator pupillae muscle and so the pupil is constricted.",
"id": "10005636",
"label": "a",
"name": "Miosis",
"picture": null,
"votes": 112
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the opposite of what is expected and would occur if parasympathetic innervation to the pupils was damaged or in response to raised intracranial pressure.",
"id": "10005637",
"label": "b",
"name": "Fixed and dilated pupils",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "As the sympathetic chain is damaged, there is usually decreased sweating.",
"id": "10005639",
"label": "d",
"name": "Increased sweating",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This occurs in a facial nerve palsy, such as Bell's palsy. In Pancoast tumours, there is typically partial ptosis/drooping of the upper eyelid.",
"id": "10005640",
"label": "e",
"name": "Unilateral full facial drop/paralysis",
"picture": null,
"votes": 13
}
],
"comments": [],
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"__typename": "Chapter",
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"typeId": 7
},
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"demo": null,
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"id": "4430",
"name": "Horner's syndrome",
"status": null,
"topic": {
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"id": "140",
"name": "Ophthalmology",
"typeId": 7
},
"topicId": 140,
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"question": "A 68-year-old male with a known pancoast tumour (apical lung cancer) presents with symptoms that have occurred due to compression of the sympathetic chain.\n\nWhich of these signs/symptoms is the patient most likely to have?",
"sbaAnswer": [
"a"
],
"totalVotes": 158,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,226 | false | 30 | null | 6,495,079 | null | false | [] | null | 13,675 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is known as Cushing's triad and occurs in response to raised intracranial pressure to try and maintain cerebral perfusion.",
"id": "10005641",
"label": "a",
"name": "Bradycardia, widened pulse pressure and irregular respiratory rate",
"picture": null,
"votes": 47
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not Cushing's triad, as hypotension would reduce cerebral perfusion rather than improve it.",
"id": "10005644",
"label": "d",
"name": "Hypotension, irregular respirations and bradycardia",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Headaches and vomiting are symptoms of raised intracranial pressure and would make you suspicious of raised intracranial pressure, but they are not as specific or indicative of raised intracranial pressure.",
"id": "10005645",
"label": "e",
"name": "Headache, hypertension and vomiting",
"picture": null,
"votes": 82
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is known as Charcot's triad, which is associated with ascending cholangitis.",
"id": "10005643",
"label": "c",
"name": "Fever, right upper quadrant pain and fever",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This triad occurs in hypovolaemic and distributive shock, such as sepsis, anaphylaxis and major haemorrhage.",
"id": "10005642",
"label": "b",
"name": "Hypotension, tachycardia and tachypnoea",
"picture": null,
"votes": 13
}
],
"comments": [],
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"__typename": "Concept",
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},
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"demo": null,
"entitlement": null,
"id": "4431",
"name": "Brain tumours in children",
"status": null,
"topic": {
"__typename": "Topic",
"id": "153",
"name": "Paediatrics",
"typeId": 7
},
"topicId": 153,
"totalCards": null,
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"question": "A child with a brain tumour starts developing signs of raised intracranial pressure.\n\nWhich of the following triads is indicative of raised intracranial pressure?",
"sbaAnswer": [
"a"
],
"totalVotes": 164,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,227 | false | 31 | null | 6,495,079 | null | false | [] | null | 13,676 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are the dominant cells involved in the immune response against bacterial infections. They may be slightly raised as part of the immune response, but it is the eosinophils that are likely to be the most pronounced.",
"id": "10005647",
"label": "b",
"name": "Neutrophils",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are part of the adaptive immune response, and are dominant in the response against viral infections.",
"id": "10005648",
"label": "c",
"name": "Lymphocytes",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Schistosomiasis is a parasitic infection. These are the subtype of white blood cells involved in the immune response against parasites.",
"id": "10005646",
"label": "a",
"name": "Eosinophils",
"picture": null,
"votes": 112
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are red blood cells and are typically not affected in parasitic infections but schistosomiasis can cause anaemia - therefore red blood cells would be low.",
"id": "10005650",
"label": "e",
"name": "Erythrocytes",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These differentiate into macrophages, which are involved in the innate immune response but not specific to parasitic infections.",
"id": "10005649",
"label": "d",
"name": "Monocytes",
"picture": null,
"votes": 13
}
],
"comments": [],
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},
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"demo": null,
"entitlement": null,
"id": "4432",
"name": "Schistosomiasis",
"status": null,
"topic": {
"__typename": "Topic",
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"name": "Infectious Diseases",
"typeId": 7
},
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"question": "A 19-year-old male returns from his gap year travelling around Africa. He has contracted schistosomiasis (a parasitic infection).\n\nWhich of the following cells is most likely to be predominantly raised in the patient's blood results?",
"sbaAnswer": [
"a"
],
"totalVotes": 165,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,228 | false | 32 | null | 6,495,079 | null | false | [] | null | 13,677 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The pH is high, indicating alkalosis rather than acidosis.",
"id": "10005654",
"label": "d",
"name": "Respiratory acidosis with no metabolic compensation",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "There is raised pH indicating alkalosis. PaCO2 is low which would suggest a respiratory cause of the alkalosis. HCO3- is normal suggesting it is not contributing to or compensating for the alkalosis. This typically occurs in conditions causing hyperventilation, such as during PEs and panic attacks.",
"id": "10005651",
"label": "a",
"name": "Respiratory alkalosis with no metabolic compensation",
"picture": null,
"votes": 101
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There is raised pH indicating alkalosis. PaCO2 is low which would suggest a respiratory cause of the alkalosis. However, HCO3- is normal suggesting it is not contributing to or compensating for the alkalosis. If there was metabolic compensation the HCO3- would be lower than normal (<22).",
"id": "10005652",
"label": "b",
"name": "Respiratory alkalosis with metabolic compensation",
"picture": null,
"votes": 36
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The pH is high rather than low, which is what you would expect in acidosis, making this incorrect. Additionally, if there was metabolic compensation there would be a high HCO3-.",
"id": "10005655",
"label": "e",
"name": "Respiratory acidosis with metabolic compensation",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There is raised pH indicating alkalosis. However, CO2 is low and so this indicates a respiratory cause. Additionally, HCO3- would be high if there was a metabolic cause.",
"id": "10005653",
"label": "c",
"name": "Metabolic alkalosis with respiratory compensation",
"picture": null,
"votes": 16
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"typeId": 7
},
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"demo": null,
"entitlement": null,
"id": "3816",
"name": "Respiratory alkalosis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "170",
"name": "Clinical Chemistry",
"typeId": 7
},
"topicId": 170,
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"dislikes": 0,
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"highlights": [],
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"question": "You perform an arterial blood gas on a patient in ED, who presented with shortness of breath. The results are:\n\n| | | |\n| -------------- | :-------: | ------------------ |\n| pH | 7.51 | 7.35 - 7.45 |\n| PaO₂ | 11 kPa | 11 - 15 |\n| PaCO₂ | 2.8 kPa | 4.6 - 6.4 |\n| Lactate | 1 mmol/L | 0.6 - 1.4 |\n| Bicarbonate | 25 mmol/L | 22 - 30 |\n\nWhich of the following best describes the results?\n",
"sbaAnswer": [
"a"
],
"totalVotes": 161,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,229 | false | 33 | null | 6,495,079 | null | false | [] | null | 13,678 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is involved in adduction and internal rotation of the arm at the shoulder joint.",
"id": "10005659",
"label": "d",
"name": "Pectoralis major",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This muscle is responsible for internal rotation, adduction and extension of the arm.",
"id": "10005657",
"label": "b",
"name": "Latissimus dorsi",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is responsible for the abduction of the arm after the first 15 degrees.",
"id": "10005658",
"label": "c",
"name": "Deltoid",
"picture": null,
"votes": 5
},
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "This muscle is responsible for protraction of the scapula. Therefore, winging of the scapula is caused by damage to the long thoracic nerve which innervates the serratus anterior.",
"id": "10005656",
"label": "a",
"name": "Left serratus anterior",
"picture": null,
"votes": 123
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This muscle is responsible for arm flexion, not protraction of the scapula.",
"id": "10005660",
"label": "e",
"name": "Biceps brachii",
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"votes": 1
}
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"question": "You are performing a shoulder examination on a patient who reports weakness and pain when moving the left shoulder. Examination reveals a left winged scapula.\n\nWhich of the following muscles is most likely to be affected to cause this presentation?",
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"a"
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"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These drain the membranous and cavernous portions of the urethra and superior rectum.",
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"label": "d",
"name": "Internal iliac",
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"votes": 11
},
{
"__typename": "QuestionChoice",
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"explanation": "These drain the glans penis in males.",
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},
{
"__typename": "QuestionChoice",
"answer": true,
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},
{
"__typename": "QuestionChoice",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These drain the scrotum.",
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}
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"question": "An oncologist is concerned that a patient with testicular cancer has developed lymph node metastases.\n\nWhich of the following lymph node groups is most likely to have been affected?",
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"a"
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"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A section 136 can be extended to this if it is not possible to assess the patient properly in the 24 hours due to physical health concerns.",
"id": "10005669",
"label": "d",
"name": "36 hours",
"picture": null,
"votes": 6
},
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "This section enables patients to be admitted without consent for assessment for a maximum of 28 days.",
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},
{
"__typename": "QuestionChoice",
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"label": "b",
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"__typename": "QuestionChoice",
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"explanation": "This is the length of time a section 5(2) lasts, which allows a doctor to detain a patient who is already in hospital to be detained for an assessment to determine if they require further detention under the Mental Health Act.",
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"label": "e",
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},
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"__typename": "QuestionChoice",
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"explanation": "This is the typical duration for a section 136, which the police can use to keep a patient in a place of safety to allow proper assessment.",
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}
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"a"
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173,462,232 | false | 36 | null | 6,495,079 | null | false | [] | null | 13,681 | {
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "ACE inhibitors have no effect on bronchial dilation or constriction.",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism by which amlodipine (another antihypertensive) causes swollen ankles - a common side effect.",
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},
{
"__typename": "QuestionChoice",
"answer": true,
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"__typename": "QuestionChoice",
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"a"
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"typeId": 1,
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Aldosterone does not have a significant impact on magnesium.",
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},
{
"__typename": "QuestionChoice",
"answer": false,
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{
"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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{
"__typename": "QuestionChoice",
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"question": "There is a patient on the ward with a new diagnosis of Conn's syndrome, a cause of primary hyperaldosteronism.\n\nWhich of the following electrolytes is most likely to be low in this patient?",
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"a"
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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},
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"__typename": "QuestionChoice",
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},
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}
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"question": "The ward team are discussing a patient with Cushing's disease, which has occurred as a result of excess production of cortisol (a glucocorticoid).\n\nWhere is the usual site of cortisol production?",
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"a"
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{
"__typename": "QuestionChoice",
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"explanation": "This is more likely to occur after surgical repair of the fracture, such as due to hip replacement. It is also a risk of posterior hip dislocation.",
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{
"__typename": "QuestionChoice",
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"picture": null,
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},
{
"__typename": "QuestionChoice",
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},
{
"__typename": "QuestionChoice",
"answer": true,
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"picture": null,
"votes": 140
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This could occur, especially if this was an open fracture, but is not a common complication of neck of femur fracture.",
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}
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"a"
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"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oxytocin is released from the posterior pituitary gland in response to suckling which causes the milk to be ejected. However, it does not cause milk production.",
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"label": "d",
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},
{
"__typename": "QuestionChoice",
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},
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is involved in breast growth and development during pregnancy, but does not trigger secretion.",
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}
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"question": "A new mum is struggling with breastfeeding.\n\nWhich of the following hormones is required for milk production?",
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{
"__typename": "QuestionChoice",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are one of the proteins implicated in Alzheimer's disease.",
"id": "10005698",
"label": "c",
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},
{
"__typename": "QuestionChoice",
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"explanation": "These bind to DNA to hold it into the chromosome structure and are involved in controlling gene expression.",
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},
{
"__typename": "QuestionChoice",
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"explanation": "These are abnormally structured proteins that can trigger misfolding of normal proteins in the brain - resulting in neurodegenerative conditions.",
"id": "10005696",
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"picture": null,
"votes": 93
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are the proteins that are seen in multiple myeloma.",
"id": "10005697",
"label": "b",
"name": "Bence Jone Proteins",
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}
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"id": "4439",
"name": "Creutzfeldt-Jakob disease (CJD)",
"status": null,
"topic": {
"__typename": "Topic",
"id": "173",
"name": "Psychiatry",
"typeId": 5
},
"topicId": 173,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"dislikes": 0,
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"question": "The team are discussing a patient who they believe has Creutzfeldt-Jakob disease (CJD) which is caused by misfolded proteins.\n\nWhat are these proteins called?",
"sbaAnswer": [
"a"
],
"totalVotes": 154,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,238 | false | 42 | null | 6,495,079 | null | false | [] | null | 13,687 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This occurs in upper motor neurone lesions. Normal/absent plantar reflexes occur in lower motor neurone lesions.",
"id": "10005702",
"label": "b",
"name": "Upgoing plantar reflexes",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is similar to hyperreflexia as it is a hyperactive stretch reflex. Hyperreflexia occurs in upper motor neurone lesions. Decreased or absent reflexes occur in lower motor neurone lesions.",
"id": "10005703",
"label": "c",
"name": "Clonus",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This occurs in upper motor neurone lesions. Decreased or absent reflexes occur in lower motor neurone lesions.",
"id": "10005705",
"label": "e",
"name": "Hyperreflexia",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This occurs in upper motor neurone lesions. Decreased muscle tone and muscle weakness occur in lower motor neurone lesions.",
"id": "10005704",
"label": "d",
"name": "Increased muscle tone",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the only sign of a lower motor neurone lesion on the list.",
"id": "10005701",
"label": "a",
"name": "Fasciculations",
"picture": null,
"votes": 124
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4440",
"name": "Lower motor neurone lesions",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
"totalCards": null,
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},
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"qaAnswer": null,
"question": "A patient presents to GP with symptoms suggestive of Guilliain-Barre syndrome, affecting the lower motor neurones.\n\nWhich of the following is a sign of a lower motor neurone lesion?",
"sbaAnswer": [
"a"
],
"totalVotes": 162,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,239 | false | 43 | null | 6,495,079 | null | false | [] | null | 13,688 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These Rinne's test results are indicative of left-sided conductive hearing loss but Weber's test results would indicate normal hearing. In conductive hearing loss, Weber's test lateralises to the affected side.",
"id": "10005710",
"label": "e",
"name": "Rinne's test left: bone conduction>air conduction\nRinne's test right: air conduction>bone conduction\nWeber's test: No lateralisation",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In sensorineural hearing loss, Weber's test will lateralise to the unaffected side.",
"id": "10005708",
"label": "c",
"name": "Rinne's test left: air conduction>bone conduction\nRinne's test right: air conduction>bone conduction\nWeber's test: lateralises to left",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These would be the results in normal hearing.",
"id": "10005709",
"label": "d",
"name": "Rinne's test left: air conduction>bone conduction\nRinne's test right: air conduction>bone conduction\nWeber's test: No lateralisation",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "In sensorineural hearing loss, air conduction is still better than bone conduction, as it is in normal hearing. However, Weber's test lateralises away from the affected side.",
"id": "10005706",
"label": "a",
"name": "Rinne's test left: air conduction>bone conduction\nRinne's test right: air conduction>bone conduction\nWeber's test: lateralises to right",
"picture": null,
"votes": 81
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These would be the results if the patient has left-sided conductive hearing loss.",
"id": "10005707",
"label": "b",
"name": "Rinne's test left: bone conduction>air conduction\nRinne's test right: air conduction>bone conduction\nWeber's test: lateralises to left",
"picture": null,
"votes": 29
}
],
"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": "4111",
"name": "Sensorineural Hearing Loss",
"status": null,
"topic": {
"__typename": "Topic",
"id": "138",
"name": "Ear, Nose & Throat",
"typeId": 7
},
"topicId": 138,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
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"dislikes": 0,
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"highlights": [],
"id": "13688",
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"psaSectionId": null,
"qaAnswer": null,
"question": "You assess the hearing of a woman presenting with progressive left-sided hearing loss. The results of Rinne's and Weber's tests suggest she has left-sided sensorineural loss.\n\nWhich of these examination results would be supportive of this diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 154,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,240 | false | 44 | null | 6,495,079 | null | false | [] | null | 13,689 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This dermatomal level covers the medial aspect of the arms.",
"id": "10005715",
"label": "e",
"name": "T1",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the dermatomal level below the one of the nipples.",
"id": "10005713",
"label": "c",
"name": "T5",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This dermatomal level is approximately the level of the xiphisternum.",
"id": "10005714",
"label": "d",
"name": "T7",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The area of skin with the nipples is typically the dermatomal level T4. However, this may not always be the case in some women.",
"id": "10005711",
"label": "a",
"name": "T4",
"picture": null,
"votes": 118
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the dermatomal level associated with the umbilicus.",
"id": "10005712",
"label": "b",
"name": "T10",
"picture": null,
"votes": 12
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3780",
"name": "Dermatomes",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"difficulty": 1,
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"qaAnswer": null,
"question": "A patient with a history of renal transplant, taking immunosuppressants, presents with pain and tingling in only the left side of his chest affecting his nipple.\n\nWhich of the following dermatomes is most likely affected?",
"sbaAnswer": [
"a"
],
"totalVotes": 161,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,241 | false | 45 | null | 6,495,079 | null | false | [] | null | 13,690 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would occur in lateral epicondylitis as the wrist extensors originate from the lateral epicondyle.",
"id": "10005717",
"label": "b",
"name": "Wrist extension",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The muscles involved in supination - supinator and biceps brachii- do not originate from the medial epicondyle",
"id": "10005718",
"label": "c",
"name": "Supination",
"picture": null,
"votes": 44
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The forearm flexor muscles originate from the medial epicondyle and so overuse causes medial epicondylitis, causing pain on wrist flexion.",
"id": "10005716",
"label": "a",
"name": "Wrist flexion",
"picture": null,
"votes": 77
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is done by the rotator cuff muscles located at the shoulder joint, and so would not be impacted by medial epicondylitis.",
"id": "10005720",
"label": "e",
"name": "Shoulder external rotation",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is done by the rotator cuff muscles located at the shoulder joint, and so would not be impacted by medial epicondylitis.",
"id": "10005719",
"label": "d",
"name": "Shoulder internal rotation",
"picture": null,
"votes": 16
}
],
"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": "4441",
"name": "Medial epicondylitis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
"totalCards": null,
"typeId": null,
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"userNote": null,
"videos": []
},
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"psaSectionId": null,
"qaAnswer": null,
"question": "A patient has just been diagnosed with medial epicondylitis.\n\nWhich of the following movements will they most likely find painful?",
"sbaAnswer": [
"a"
],
"totalVotes": 158,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,242 | false | 46 | null | 6,495,079 | null | false | [] | null | 13,691 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a side effect of amiodarone, not adrenaline.",
"id": "10005725",
"label": "e",
"name": "Thyroid dysfunction",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Adrenaline acts on the beta-2 adrenergic receptors in the lungs to cause bronchodilation.",
"id": "10005723",
"label": "c",
"name": "Bronchospasm",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "It acts on the beta-1 adrenergic receptors in the heart to increase the firing rate of the sinoatrial node.",
"id": "10005721",
"label": "a",
"name": "Increased heart rate",
"picture": null,
"votes": 150
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Adrenaline increases blood glucose by stimulating glycogenolysis in the liver, and skeletal muscles and gluconeogenesis in the liver.",
"id": "10005722",
"label": "b",
"name": "Hypoglycaemia",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This can be caused by steroids. Adrenaline is more likely to cause anxiety.",
"id": "10005724",
"label": "d",
"name": "Drug-induced psychosis",
"picture": null,
"votes": 0
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4442",
"name": "Advanced Life Support",
"status": null,
"topic": {
"__typename": "Topic",
"id": "161",
"name": "Emergency Medicine",
"typeId": 5
},
"topicId": 161,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4442,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "13691",
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"multiAnswer": null,
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"psaSectionId": null,
"qaAnswer": null,
"question": "You are observing a cardiac arrest and, as part of the protocol, the patient is given IV adrenaline.\n\nWhich of these is an effect of adrenaline?",
"sbaAnswer": [
"a"
],
"totalVotes": 159,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,243 | false | 47 | null | 6,495,079 | null | false | [] | null | 13,692 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a sign of right-sided heart failure due to backing up of blood into the inferior vena cava causing fluid accumulation in the liver.",
"id": "10005728",
"label": "c",
"name": "Hepatomegaly",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a sign of macrocytic anaemia which occurs in B12 or folate deficiency, hypothyroidism and chronic alcohol use. Anaemia associated with heart failure is more likely to be microcytic or normocytic.",
"id": "10005729",
"label": "d",
"name": "Pins and needles",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a sign of pulmonary oedema, which occurs in left-sided heart failure because the blood backs up into the pulmonary veins from the left heart chambers.",
"id": "10005726",
"label": "a",
"name": "Shortness of breath worse when lying flat",
"picture": null,
"votes": 89
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a sign of right-sided heart failure due to backing up of blood into the superior and inferior vena cavas, causing fluid to leak out of blood vessels into peripheral tissues.",
"id": "10005730",
"label": "e",
"name": "Bilateral pedal oedema",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a sign of right-sided heart failure due to backing up of blood into the superior vena cava.",
"id": "10005727",
"label": "b",
"name": "Raised jugular venous pressure (JVP)",
"picture": null,
"votes": 21
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3798",
"name": "Heart Failure",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3798,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "13692",
"isLikedByMe": 0,
"learningPoint": null,
"likes": 1,
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"question": "A 70-year-old gentleman with a history of heart attack presents with symptoms suggestive of left-sided heart failure.\n\nWhich of these is a symptom more suggestive of left-sided heart failure, as opposed to right-sided heart failure?",
"sbaAnswer": [
"a"
],
"totalVotes": 160,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,244 | false | 48 | null | 6,495,079 | null | false | [] | null | 13,693 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is associated with an increased risk of breast and ovarian cancers.",
"id": "10005733",
"label": "c",
"name": "BRCA 1",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a fusion gene caused by a translocation between chromosomes 9 and 22 and is associated with chronic myeloid leukaemia.",
"id": "10005734",
"label": "d",
"name": "BCR-ABL1",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Mutation of this gene causes cystic fibrosis",
"id": "10005735",
"label": "e",
"name": "CFTR",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is associated with Lynch syndrome/hereditary non-polyposis colorectal cancer, which is also associated with colorectal cancer.",
"id": "10005732",
"label": "b",
"name": "MSH2",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This APC gene codes for a tumour suppressor protein. When the gene is mutated, this function is lost, increasing the risk of cancer.",
"id": "10005731",
"label": "a",
"name": "APC (adenomatous polyposis coli)",
"picture": null,
"votes": 127
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4443",
"name": "Colorectal cancer",
"status": null,
"topic": {
"__typename": "Topic",
"id": "225",
"name": "Oncology and Palliative Care",
"typeId": 7
},
"topicId": 225,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4443,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "13693",
"isLikedByMe": null,
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"likes": 0,
"multiAnswer": null,
"pictures": [],
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"psaSectionId": null,
"qaAnswer": null,
"question": "A 45-year-old man is on the ward with advanced colorectal cancer. He explains to you that he has an inherited condition that puts him at significantly higher risk of bowel cancer called familial adenomatous polyposis.\n\nWhich of the genes is mutated in this condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 157,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,245 | false | 49 | null | 6,495,079 | null | false | [] | null | 13,694 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This should be done during the paediatric basic life support algorithm. However, that should not be done prior to rescue breaths and should not delay starting chest compressions.",
"id": "10005740",
"label": "e",
"name": "Attach defibrillator",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the next step after five rescue breaths in paediatric basic life support. However, additionally, as this child is a neonate, it may be that the neonatal ward uses a 3:1 ratio of chest compressions to rescue breaths.",
"id": "10005738",
"label": "c",
"name": "15 chest compressions",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In the paediatric basic life support, algorithm the first step is 5 rescue breaths. Two rescue breaths are done between each set of chest compressions. However, additionally, as this child is a neonate, it may be that the neonatal ward uses a 3:1 ratio of chest compressions to rescue breaths.",
"id": "10005737",
"label": "b",
"name": "Two rescue breaths",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In paediatric basic life support, 15 chest compressions are done at a time, or three chest compressions at a time in neonatal life support.",
"id": "10005739",
"label": "d",
"name": "30 chest compressions",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "In children, the most likely trigger for cardiac arrest is due to a respiratory cause and so rescue breaths are the priority in paediatric basic life support.",
"id": "10005736",
"label": "a",
"name": "Five rescue breaths",
"picture": null,
"votes": 88
}
],
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"name": "Paediatric basic life support",
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"name": "Paediatrics",
"typeId": 7
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"question": "You are reviewing a neonate born two hours ago. The baby is unresponsive and floppy. You assess for danger and then approach to assess for breathing. There are no breath sounds so you call for help, and open the airway. You cannot see any obvious obstruction.\n\nWhat is the next best step?",
"sbaAnswer": [
"a"
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"totalVotes": 158,
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173,462,246 | false | 50 | null | 6,495,079 | null | false | [] | null | 13,695 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ectopic pregnancies can occur in previous caesarean-section scars, but this is much rarer than in the fallopian tubes and can only occur in women who have previously had a section.",
"id": "10005743",
"label": "c",
"name": "Caesarean-section scar",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the part of the fallopian tube closest to the uterine cavity. Ectopic pregnancies can occur in this part of the fallopian tube but less frequently than in the ampulla.",
"id": "10005744",
"label": "d",
"name": "Interstitium of the fallopian tube",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ectopic pregnancies can occur in this part of the fallopian tube but less frequently than in the ampulla. However, this is the most common site of ectopic pregnancy rupture.",
"id": "10005742",
"label": "b",
"name": "Isthmus of the fallopian tube",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the part of the fallopian tube furthest from the uterine cavity. Ectopic pregnancies can occur here, but less frequently than in the ampulla.",
"id": "10005745",
"label": "e",
"name": "Fimbrae of the fallopian tube",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The majority of ectopic pregnancies occur in this part of the fallopian tube.",
"id": "10005741",
"label": "a",
"name": "Ampulla of the fallopian tube",
"picture": null,
"votes": 116
}
],
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"id": "4445",
"name": "Ectopic pregnancy",
"status": null,
"topic": {
"__typename": "Topic",
"id": "174",
"name": "Obstetrics",
"typeId": 7
},
"topicId": 174,
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"question": "A 25-year-old female presented with sudden onset left iliac fossa pain and a transvaginal ultrasound shows an ectopic pregnancy.\n\nWhich site are ectopic pregnancies most commonly found?",
"sbaAnswer": [
"a"
],
"totalVotes": 158,
"typeId": 1,
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} | MarksheetMark |
173,462,287 | false | 1 | null | 6,495,081 | null | false | [] | null | 13,696 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is important to identify the causative organism so the most effective antibiotic can be given.",
"id": "10005748",
"label": "c",
"name": "Take blood cultures",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The aim is to keep saturations above 94%.\n\nHowever, people with moderate to severe COPD naturally have a degree of hypercapnia and are unable to respond to this as a respiratory driver. They therefore relay on hypoxia as a respiratory driver. In these cases saturations should be maintained between 88-92% to maintain a respiratory drive.\n\nOxygen is important to avoid organ damage due to hypoxia.",
"id": "10005747",
"label": "b",
"name": "Administer oxygen",
"picture": null,
"votes": 46
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Infective exacerbation of COPD is suspected due to the previous diagnosis of COPD and features of infection such as pyrexia and green sputum. Sepsis can be diagnosed as there is a suspected infection + more than 2 out of the 4 criteria for systemic inflammatory response syndrome (SIRS): fever, tachycardia and tachypnoea. The other being white blood cell count which is unknown.\n\nCRP can be performed as part of the work up to determine the degree of inflammation in the body and to monitor the response to treatment overtime but is not essential within the first hour of diagnosis.",
"id": "10005746",
"label": "a",
"name": "Take blood CRP",
"picture": null,
"votes": 182
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Lactate can be a marker of tissue hypoperfusion. The more raised the worse the prognosis.\n\nA level over 4mmol indicates severe sepsis with a poorer prognosis.",
"id": "10005750",
"label": "e",
"name": "Take blood Lactate",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Sepsis patients usually have a low blood pressure. IV fluids are important to increase the blood pressure to allow blood supply to vital organs.",
"id": "10005749",
"label": "d",
"name": "Administer IV fluids",
"picture": null,
"votes": 23
}
],
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"demo": null,
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"id": "4035",
"name": "Sepsis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "161",
"name": "Emergency Medicine",
"typeId": 5
},
"topicId": 161,
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"question": "A 75 year old male with a past medical history of COPD presents to the emergency department with worsening breathlessness, wheezing and a productive cough with green sputum.\n\nHis vital signs are taken:\n\n>Respiratory rate: 22 breaths per minute\n>\n>Oxygen Saturations 87% on air\n>\n>Blood pressure 95/60mmHg\n>\n>Heart rate 110 beats per minute\n>\n>Temperature 38.7ºC\n>\n>Alert\n\nInfective exacerbation of COPD and Sepsis is suspected.\n\nWhich of the following is least appropriate in the initial management?",
"sbaAnswer": [
"a"
],
"totalVotes": 309,
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173,462,288 | false | 2 | null | 6,495,081 | null | false | [] | null | 13,697 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the predominant antibody in a primary response to a viral or bacterial infection. It is not routinely tested for.",
"id": "10005753",
"label": "c",
"name": "IgM",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "If raised, this can indicate inflammation in the body. It can help monitor conditions with a high level of inflammation such as Inflammatory Bowel Disease and Arthritis.",
"id": "10005754",
"label": "d",
"name": "ESR",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This can help diagnose anaphylaxis but is rarely performed as the blood test must be processed extremely quickly after collection.",
"id": "10005755",
"label": "e",
"name": "Histamine",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This protein is released during activation of mast cells and levels will increase in anaphylaxis. Important to consider if this is the first episode of anaphylaxis as it can mimic other emergencies such as asthma.\n\nThis should be taken 1-2 hours after symptom onset and no longer than 4 hours after.\n\nConfirms diagnosis if positive and helps to assist in correct treatment and minimisation of risk for future infections. Negative result does not exclude diagnosis.\n\nShould be tested for in a follow-up to measure baseline.",
"id": "10005751",
"label": "a",
"name": "Mast cell tryptase",
"picture": null,
"votes": 125
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This antibody is found raised in blood in type 1 hypersensitivity reactions.\n\nThese include atopic diseases such as asthma, hayfever and eczema. It can also be raised allergies/anaphylaxis but is not specific to this.\n\nHowever, allergen-specific IgE antibodies to an allergen such as penicillin can be tested for. A positive test only indicates sensitisation and may not indicate allergy as re-exposure does not always cause symptoms.",
"id": "10005752",
"label": "b",
"name": "IgE",
"picture": null,
"votes": 125
}
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"id": "4446",
"name": "Anaphylaxis (Paediatrics)",
"status": null,
"topic": {
"__typename": "Topic",
"id": "153",
"name": "Paediatrics",
"typeId": 7
},
"topicId": 153,
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"question": "10 year old girl presents to the emergency department pale and clammy with wheeze, severe shortness of breath and some tongue swelling. This began within an hour of recieving her first dose of penecillin for a tonsolitis.\n\nMother is distressed and cannot recall whether she has had penecillin before.\n\nAnaphylaxis is suspected and 300mcg of adrenaline is given.\n\nWhich of these can be tested within 4 hours of symptom onset to confirm the diagnosis of anaphylaxis?",
"sbaAnswer": [
"a"
],
"totalVotes": 292,
"typeId": 1,
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173,462,289 | false | 3 | null | 6,495,081 | null | false | [] | null | 13,698 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Mediated by IgE. These antibodies first increase when exposed to the antigen for the first time/ known as sensitisation. They attach to mast cells so that when the allergen is encountered again histamines are released by the mast cells producing signs and symptoms of allergy.\n\nOnset within minutes.\n\nThese include allergies, and atopic diseases such as asthma, hayfever and eczema.",
"id": "10005757",
"label": "b",
"name": "Type I",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Antibody-mediated cytotoxic reaction. Antibodies are specific to a cell surface that directly bind and cause damage.\n\nOnset can be hours to days.\n\nThis can be in autoimmune haemolytic anaemia and haemolytic disease of the newborn.",
"id": "10005758",
"label": "c",
"name": "Type II",
"picture": null,
"votes": 33
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Antigen-antibody complexes deposit into tissues causing activation of the classical\ncomplement system. this activates immune cells that release enzymes and free radicals that cause tissue damage.\n\nOnset can be hours to weeks.\n\nThis can be seen in rheumatoid arthritis, post-streptococcal glomerulonephritis and serum sickness.",
"id": "10005756",
"label": "a",
"name": "Type III",
"picture": null,
"votes": 169
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There is no type 6 hypersensitivity reaction.",
"id": "10005760",
"label": "e",
"name": "Type VI",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "T- cell-mediated. When first exposed, the T cells are activated and sensitised to the antigen so that when they are exposed again there will be an inflammatory response.\n\nDelayed hypersensitivity; typically occurs 24-48 hours after exposure to the antigen.\n\nLocal inflammation and damage are caused such as in contact dermatitis and the Mantoux test for Tuberculosis.",
"id": "10005759",
"label": "d",
"name": "Type IV",
"picture": null,
"votes": 56
}
],
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4091",
"name": "Hypersensitivity reactions",
"status": null,
"topic": {
"__typename": "Topic",
"id": "158",
"name": "Immunology",
"typeId": 7
},
"topicId": 158,
"totalCards": null,
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"question": "A 60 year old female presents to the GP suffering from pain and stiffness in her hands, wrists and knees. She has noticed more weakness and fatigue that are getting her down.\n\nRheumatoid arthritis is suspected and an X-ray showing typical features along with a positive anti-CCP supports this diagnosis.\n\nShe is wanting to know more about the cause of her condition. You explain it is an autoimmune condition where immune complexes deposit onto tissues causing inflammation and the symptoms she is experiencing.\n\nWhat hypersensitivity reaction is this?",
"sbaAnswer": [
"a"
],
"totalVotes": 273,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,290 | false | 4 | null | 6,495,081 | null | false | [] | null | 13,699 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "HIV is the human immunodeficiency virus that attacks T helper cells/ CD4+ cells in the blood. Therefore the number declines in HIV.\n\nThis increases the risk for opportunistic infections such as Herpes Simplex Virus.\n\nBy increasing the T helper cells, it minimises the risk of infection and complications that can result from these.\n\nThis patient is presenting with an acute illness of HIV which usually occurs 1-6 weeks after infection. This is described as flu-like and is a result of seroconversion.",
"id": "10005761",
"label": "a",
"name": "Normal CD4+ count and undetectable viral load",
"picture": null,
"votes": 221
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Seroconversion is when antibodies are produced in the blood in response to HIV infection. This is usually between 1-6 weeks following exposure.\n\nOnce seroconversion has started HIV infection cannot be stopped/ cured. The aim is to then maintain CD4+ count and reduce HIV viral load\n\nHowever, if ART is used within 72 hours of possible exposure it is called post-exposure prophylaxis (PEP) and can prevent seroconversion and HIV infection.\n\nThe second part of the answer is correct - viral load should be undetectable so that it is not transmitted to other sexual partners.",
"id": "10005765",
"label": "e",
"name": "Stop seroconversion",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is important in anti-retroviral therapy as these are the cells targeted in HIV infection.\n\nHowever, the aim is to also lower HIV viral load completely so that it is not detected in the blood. This is so that it is not transmitted to other sexual partners.",
"id": "10005763",
"label": "c",
"name": "Normal CD4+ count",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Aims of the treatment are to increase CD4+ cells to prevent opportunistic infections.\n\nIt is important to treat infections that develop and therefore lower CRP in this way. However, anti-retroviral therapy aims to stop the attack of CD4+ cells and therefore increase these numbers.\n\nThe second part of the answer is correct - viral load should be undetectable so that it is not transmitted to other sexual partners.",
"id": "10005762",
"label": "b",
"name": "Normal CRP level and undetectable viral load",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "HIV is the human immunodeficiency virus that attacks T helper cells/ CD4+ cells in the blood, not T killer cells/ CD8+ cells.\n\nThe second part of the answer is correct - viral load should be undetectable so that it is not transmitted to other sexual partners.",
"id": "10005764",
"label": "d",
"name": "Normal CD8+ count and undetectable viral load",
"picture": null,
"votes": 25
}
],
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"__typename": "Chapter",
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"chapterId": 2693,
"demo": null,
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"id": "4447",
"name": "Primary HIV infection",
"status": null,
"topic": {
"__typename": "Topic",
"id": "163",
"name": "Genitourinary medicine",
"typeId": 7
},
"topicId": 163,
"totalCards": null,
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"question": "44 year old male attends a sexual health clinic after 30 occasions of unprotected sexual intercourse over 12 months.\n\nHe describes feeling 'not quite right' for 1 week with headaches, general body aches and a sore throat.\n\nHe undergoes a full sexual health screen and the results are shown below:\n\n>HIV NAAT test for viral load positive\n>\n>Syphilis antibody negative\n>\n>Gonorrhoea and Chlamydia urine NAAT negative\n>\n>Hepatitis B surface antigen negative\n\nHe is commenced on anti-retroviral therapy (ART) for HIV infection - what is the aim of this treatment?",
"sbaAnswer": [
"a"
],
"totalVotes": 271,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,291 | false | 5 | null | 6,495,081 | null | false | [] | null | 13,700 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is also an aerobic gram-positive bacteria. However, the cocci are arranged in pairs or 'string of beads'.\n\nJust think of strep as in strip - they arrange themselves into strips.",
"id": "10005768",
"label": "c",
"name": "*Streptococcus pyogenes*",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an aerobic, gram-positive organism which is arranged in clumps of spheres/ cocci. However, this would test negative on a coagulase test.\n\nThe coagulase test is done by identifying the presence of bound coagulase or clumping factor on the wall of the bacteria.\n\nCoagulase-negative Staphylococci commonly live on the skin and don't tend to cause infection unless someone is immunocompromised.",
"id": "10005769",
"label": "d",
"name": "*Staphylococcus Epidermis*",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a gram-negative bacteria.",
"id": "10005770",
"label": "e",
"name": "*Neisseria Gonnorhoea*",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is an Aerobic, gram-positive organism which is arranged in clumps of spheres/ cocci.\n\nThis is the most common cause of septic arthritis. The main aim of this question is to identify which bacteria are gram-negative/ positive and which are aerobic and anaerobic. You are not expected to know about septic arthritis.",
"id": "10005766",
"label": "a",
"name": "*Staphylococcus Aureus*",
"picture": null,
"votes": 231
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a gram-negative bacteria that cause UTI. This bacteria can also cause septic arthritis but is ruled out by the joint culture.",
"id": "10005767",
"label": "b",
"name": "*Escherichia coli*",
"picture": null,
"votes": 3
}
],
"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": "3956",
"name": "Gram Staining",
"status": null,
"topic": {
"__typename": "Topic",
"id": "148",
"name": "Microbiology",
"typeId": 7
},
"topicId": 148,
"totalCards": null,
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"question": "A 60 year old diabetic female presents to the GP with a 3-day history of a red, swollen, painful right knee.\n\nOn examination, there is limited movement in the knee due to the pain associated. The GP notices that it is warm to touch as he tries to mobilise it.\n\nShe is systematically well and there are no signs of sepsis.\n\nThe GP suspects septic arthritis.\n\nJoint aspiration is carried out and was sent for Gram stain, leucocyte count, polarising microscopy and fluid culture.\n\nFluid culture shows aerobic gram-positive cocci in clumps. A coagulase test is carried out which is positive. What organism is this likely to be?",
"sbaAnswer": [
"a"
],
"totalVotes": 272,
"typeId": 1,
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173,462,292 | false | 6 | null | 6,495,081 | null | false | [] | null | 13,701 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This sign of a lower motor neurone lesion.\n\nThe damage to A-motor neurones with the lower motor neurones leads to less muscle contraction and therefore decreased use of the muscle.\n\nThis can lead to loss of muscle mass due to disuse.",
"id": "10005775",
"label": "e",
"name": "Muscle Atrophy",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This sign is elicited by firmly stroking the lateral border of the plantar surface of the foot. If positive, the big toe extends and the toes fan out with abduction.\n\nA positive sign is present up until the age of 2. This is because the inhibitory neurones are not yet developed.\n\nHowever, if over the age of two and the Babinski sign is present, it is suggestive that the inhibitory neurones are damaged and therefore is a lesion in the upper motor neurones.\n\nTherefore, this is a normal finding.",
"id": "10005772",
"label": "b",
"name": "Negative Babinski sign",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Inhibitory neurones are found within the upper motor neurones which provide crucial regulation of muscle tone.\n\nWhen these are damaged, descending inhibition is lost which results in brisk reflexes.",
"id": "10005771",
"label": "a",
"name": "Brisk reflexes",
"picture": null,
"votes": 212
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This sign of a lower motor neurone lesion.\n\nThere is no damage to the inhibitory neurones found within the upper motor neurones, so these are still working optimally.\n\nA-motor neurones are found within the lower motor neurones that are essential in muscle contraction. Damage to these, causes a loss of muscle tension at rest, i.e. a loss of muscle tone.",
"id": "10005773",
"label": "c",
"name": "Loss of muscle tone",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This sign of a lower motor neurone lesion.\n\nA-motor neurones with the lower motor neurones that contribute to muscle contraction are damaged. This leads to an overall loss of tone. However, they can still fire spontaneously causing small contractions in the muscle unit which can be seen very subtly as twitching of the muscle.",
"id": "10005774",
"label": "d",
"name": "Fasciculations",
"picture": null,
"votes": 21
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4386",
"name": "Upper motor neuron lesions",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
"totalCards": null,
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"question": "56 year old female is referred to neurology due to progressive weakness in her left arm. She describes feeling numb in her hand and has recently been unable to open jars and write text messages using this hand.\n\nThe neurologist suspects amyotrophic lateral sclerosis presenting with upper motor neurone signs and symptoms.\n\nWhat is another sign of an upper motor neurone lesion that may be found in this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 266,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,293 | false | 7 | null | 6,495,081 | null | false | [] | null | 13,702 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would present similarly to the case above but the signs would be found on the other side of the body. This would be a hemisection on the other side of the cord",
"id": "10005779",
"label": "d",
"name": "Left",
"picture": null,
"votes": 56
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would cause symmetrical symptoms as the lesion would be found on both sides of the cord.\n\nDorsal columns would largely be affected so the loss of proprioception and fine touch would be found on both sides.\n\nThe spinothalamic tracts would be spared so pain and temperature would not be affected.",
"id": "10005778",
"label": "c",
"name": "Posterior",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "All tracts would be damaged and the signs would be found bilaterally.",
"id": "10005780",
"label": "e",
"name": "Complete transaction",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This question is testing your understanding of the anatomy of the spinal cord. including where the tracts decussate and where they are found in the spinal cord.\n\nThe corticospinal tract carries motor information from the frontal lobe to the LMN. The fibres decussate at the medulla and remain contralaterally down the spinal cord. Therefore, a lesion anywhere along the spinal cord will cause paralysis on the same side.\n\nThe spinothalamic tracts are found in the anterior cord and carry pain and temperature up to the cortex. The fibres decussate at the level of the spinal cord. Therefore, a lesion anywhere along the spinal cord will cause loss of pain and temperature on the opposite side.\n\nThe dorsal columns are found in the posterior cord where they carry proprioception and touch up to the cortex. The fibres decussate at the medulla and remain on the same side up the spinal cord. Therefore, a lesion anywhere along the spinal cord will cause proprioception loss on the same side.",
"id": "10005776",
"label": "a",
"name": "Right",
"picture": null,
"votes": 129
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would cause symmetrical symptoms as the lesion would be found on both sides of the cord.\n\nThe spinothalamic tracts would be largely affected. Loss of pain and temperature would be found on both sides.\n\nDorsal columns would be spared so proprioception and fine touch would still be intact.",
"id": "10005777",
"label": "b",
"name": "Anterior",
"picture": null,
"votes": 27
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4105",
"name": "Brown-Séquard Syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
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"question": "60 year old presents to the emergency department with complete paralysis on the right side.\n\nThere is a loss of proprioception and vibration on the right side and a loss of temperature and pain sensation on the left\n\nWhere is the lesion in the spinal cord?",
"sbaAnswer": [
"a"
],
"totalVotes": 263,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,294 | false | 8 | null | 6,495,081 | null | false | [] | null | 13,703 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is found within the brain and contains dopaminergic neurones.\n\nDopamine within this structure are lost in Parkinson's disease and can cause rigidity, tremor and slow movements/ bradykinesia.",
"id": "10005784",
"label": "d",
"name": "Substantia nigra",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is affected by the condition Horner's syndrome which presents with the triad of miosis, ptosis and anhidrosis.\n\nA lesion anywhere along this lesion can cause these symptoms.\n\nNot an autoimmune condition. Can be caused by a pancoast tumour in the lungs.",
"id": "10005782",
"label": "b",
"name": "Oculosympathetic pathway",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This case is describing the presentation of Myasthenia Gravis syndrome.\n\nThis is due to antibodies blocking the acetylcholine receptors at the neuromuscular junction.\n\nThis case may make you think about Bell's palsy - remember this would present asymmetrically and due to damage of the facial nerve (forehead is not spared in LMN lesion).",
"id": "10005781",
"label": "a",
"name": "Acetylcholine receptor",
"picture": null,
"votes": 179
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not targeted in this condition.\n\nGuillian Barre can cause demyelination following infections such as campylobacter. This is due to molecular mimicry - the antibodies produced in this infection can target and destroy myelin on neurones.\n\nThis presents with a symmetrical, ascending polyneuropathy (weakness and numbness).",
"id": "10005783",
"label": "c",
"name": "Myelin sheath",
"picture": null,
"votes": 45
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Calcium channels are found within the pre-synaptic terminals. Calcium channels allow the influx of calcium which causes the release of Ach into the synapse of the neuromuscular junction.\n\nThese are affected by Lambert Eaton syndrome.\n\nThis causes proximal muscle weakness and typically occurs in small-cell lung cancer where antibodies target these channels.",
"id": "10005785",
"label": "e",
"name": "Calcium channels",
"picture": null,
"votes": 18
}
],
"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": "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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"question": "40 year old female presents with symmetrical weakness of the face.\n\nHer clinic appointment was at 5pm.\n\nOn examination, she appears to have dry red eyes with ptosis and a drooping smile on both sides of her face. When asked to raise her eyebrows she is unable to do so.\n\nShe explains that she also experiences trouble chewing and swallowing and that it usually improves with rest and progressively worsens throughout the day.\n\nWhat is affected by this autoimmune condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 261,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,295 | false | 9 | null | 6,495,081 | null | false | [] | null | 13,704 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Also known as receptive aphasia.\n\nWhen the Wernicke's area is damaged in the temporal lobe, the person is unable to understand what other people are saying to them.\n\nthey speak fluently but with words that don't make sense. However, they do not realise what they are saying is nonsense.",
"id": "10005787",
"label": "b",
"name": "Wernicke's aphasia",
"picture": null,
"votes": 64
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a loss of muscle coordination which can result in difficulties in formulating speech.",
"id": "10005790",
"label": "e",
"name": "Dyspraxia",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Also known as expressive aphasia.\n\nWhen the Broca area in the frontal lobe is damaged, the person can understand what is said to them but struggles to communicate back.\n\nThey are able to form sentences that make sense but it takes them a while to select the correct words - speech is often limited.",
"id": "10005786",
"label": "a",
"name": "Broca's aphasia",
"picture": null,
"votes": 155
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This refers to swallowing difficulty.",
"id": "10005789",
"label": "d",
"name": "Dysphagia",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Dysarthria is a disorder of speech whereas dysphasia is a disorder of language.\n\nIn dysarthria, the person is able to understand language, form sentences and have no difficulty finding words.\n\nHowever, those with dysarthria may have difficulty producing speech due to weak facial muscles.",
"id": "10005788",
"label": "c",
"name": "Dysarthria",
"picture": null,
"votes": 27
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
"files": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4107",
"name": "Aphasia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
"totalCards": null,
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"question": "A 45 year old male is admitted to the hospital following an acquired traumatic brain injury.\n\nHe can speak in full sentences but it takes a while for him to do so. He is getting frustrated because he cannot find the words to express how he feels and cannot name objects around him.\n\nWhich of the following best describes the patient's presentation?",
"sbaAnswer": [
"a"
],
"totalVotes": 262,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,296 | false | 10 | null | 6,495,081 | null | false | [] | null | 13,705 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is described as a rapid, transient loss of consciousness followed by a spontaneous, complete recovery.\n\nCauses can be due to emotion or stress which is referred to as reflex syncope or fainting. Other causes include low blood pressure, bradycardia and other arrhythmias.\n\nThere is no loss of consciousness in this case so can be ruled out.",
"id": "10005792",
"label": "b",
"name": "Syncope",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This type of stroke is caused by the rupture of aneurysms within the brain. This can be spontaneous but risk factors include hypertension, drug use, age or trauma.\n\nstroke is a clinical syndrome characterised by rapid focal disturbance of cerebral function. This can include motor weakness, sensory loss, speech and swallowing impairment.\n\nWhen a patient presents with these features an urgent CT scan is required to confirm the diagnosis and guide further management. This is important as you cannot tell the difference between ischaemic strokes from haemorrhagic strokes just from the clinical picture.",
"id": "10005793",
"label": "c",
"name": "Haemorrhagic Stroke",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Presents with similar symptoms of a stroke but is less than 24 hours. The episodes usually last about an hour and have resolved by the time they seek medical attention.\n\nThese patients should be taken seriously as TIA can increase the risk of stroke in the future.\n\nRefer to a TIA stroke clinic for urgent assessment in 24 hours if this is suspected. Do not discharge with no follow-up.",
"id": "10005791",
"label": "a",
"name": "Transient Ischaemic attack (TIA)",
"picture": null,
"votes": 248
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "According to the Monro-Kellie doctrine of ICP, the skull is a fixed box and there is an equilibrium between the CSF, blood and brain. If one of these components increases in volume another would have to decrease to compensate.\n\nWhen there is too much change in volume and compensatory mechanisms fail, the ICP can quickly increase and cause displacement of the brain parenchyma.\n\nThis presentation can include headaches, stiff neck, slow pulse, weakness and loss of consciousness. This can be very serious and deteriorate quickly.\n\nFocal neurological deficits aren't usually seen.",
"id": "10005795",
"label": "e",
"name": "Brain herniation",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This refers to the inflammation of the meninges that surround the brain.\n\nThis usually presents with confusion, fevers, headache and neck stiffness.\n\nFocal neurological deficits aren't usually seen but if encephalitis has developed, this could be elicited on examination",
"id": "10005794",
"label": "d",
"name": "Meningitis",
"picture": null,
"votes": 0
}
],
"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": "4448",
"name": "Transient Ischaemic Attack",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
"typeId": null,
"userChapter": null,
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},
"conceptId": 4448,
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"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
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"question": "80 year old attends the emergency department distressed saying he has had a stroke.\n\nHe begins to explain that he has experienced an episode of facial drooping and arm weakness on the same left side. This began 2 hours ago and was resolved within 15 minutes. There was some vision loss during this time but resolved at the same time as the weakness.\n\nThere was no loss of consciousness.\n\nOn examination he seems alert and orientated, his vital signs are normal with no fever.\n\nWhat is the likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 260,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,297 | false | 11 | null | 6,495,081 | null | false | [] | null | 13,706 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This refers to a diminished response to a painful stimulus.\n\nAnalgesia is the absence of pain and hypoalgesia is reduced pain to a painful stimulus.",
"id": "10005800",
"label": "e",
"name": "Hypoalgesia",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This refers to pain resulting from a stimulus such as light touch which shouldn't normally cause pain.\n\nThis is often described as migraines and tension headaches.",
"id": "10005796",
"label": "a",
"name": "Allodynia",
"picture": null,
"votes": 121
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This refers to the absence of pain in response to a stimulus which would normally cause pain.\n\nThis is why painkillers such as morphine and paracetamol are also referred to as analgesia.",
"id": "10005797",
"label": "b",
"name": "Analgesia",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An abnormal, additional sensory response such as pins and needles can be spontaneous or provoked.",
"id": "10005799",
"label": "d",
"name": "Paraesthesia",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This refers to a disproportionately increased pain response to a painful stimulus.\n\nThis can be due to neuropathy where a specific nerve becomes more sensitive to pain.",
"id": "10005798",
"label": "c",
"name": "Hyperalgesia",
"picture": null,
"votes": 120
}
],
"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": "3825",
"name": "Pain sensation",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
"totalCards": null,
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"difficulty": 1,
"dislikes": 0,
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"question": "30 year old woman is struggling with recurrent migraines.\n\nWhen she brushes her or even touches her head it provokes the pain to worsen.\n\nWhich of the following terms defines this symptom?",
"sbaAnswer": [
"a"
],
"totalVotes": 254,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,298 | false | 12 | null | 6,495,081 | null | false | [] | null | 13,707 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In CKD, albumin is often lost in the urine.\n\nAlbuminuria and eGFR together are used to stage CKD in the KDIGO criteria.\n\nHyperalbuminaemia is uncommon and usually suggests dehydration.",
"id": "10005805",
"label": "e",
"name": "Hyperalbuminaemia",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The kidneys have a Na+/K+ pump in the DCT which results in the reabsorption of sodium and the excretion of potassium.\n\nThis pump can become faulty in CKD so sodium is not reabsorbed as it should be.\n\nHypernatraemia results when more is reabsorbed by the kidneys. This can be a response to dehydration as absorption of water will increase also.",
"id": "10005803",
"label": "c",
"name": "Hypernatraemia",
"picture": null,
"votes": 54
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The kidneys have a Na+/K+ pump in the DCT which results in the reabsorption of sodium and the excretion of potassium.\n\nThis pump can become faulty in CKD so potassium is not excreted as it should be.",
"id": "10005804",
"label": "d",
"name": "Hypokalaemia",
"picture": null,
"votes": 41
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypocalcaemia is most likely to result from CKD.\n\nThis is because there is diminished renal production of the active form of vitamin D. Vitamin D is required for increased absorption of calcium from the intestine",
"id": "10005802",
"label": "b",
"name": "Hypercalcaemia",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Chronic Kidney Disease (CKD) is the most likely diagnosis in this case as he has a risk factor of diabetes and a reduced eGFR. The vague symptoms of tiredness suggests that it has developed over a long period.\n\nIn CKD, the most common imbalances that occur are hyponatraemia (low sodium) and hyperkalaemia (high potassium).\n\nThe kidneys have a Na+/K+ pump in the DCT which results in the reabsorption of sodium and the excretion of potassium.\n\nThis pump can become faulty in CKD so sodium is not reabsorbed as it should be.",
"id": "10005801",
"label": "a",
"name": "Hyponatraemia",
"picture": null,
"votes": 98
}
],
"comments": [],
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"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4243",
"name": "Chronic Kidney Disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "168",
"name": "Renal Physiology",
"typeId": 7
},
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"question": "80 year old with diabetes has an eGFR of 50 ml/min/1.73m2 on a routine check.\n\nHe says he has felt more tired than usual but has no specific symptoms.\n\nWhich of these are you most likely to find with the further investigation?",
"sbaAnswer": [
"a"
],
"totalVotes": 249,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,299 | false | 13 | null | 6,495,081 | null | false | [] | null | 13,708 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an ultrasound scan feature that scored 1 point in the RMS.\n\nUltrasound result is based on how malignant the mass appears. Complex, multiocular has a more complex appearance with multiple septae within the cyst, this suggests it is more likely to be cancerous.\n\nBe aware that a benign lesion is more likely to be unilateral and look uniocular/ simple on ultrasound, this means that they are uniformly thin-walled with a single cavity. Benign lesions are likely to be smooth, well-circumscribed and are not able to spread.",
"id": "10005809",
"label": "d",
"name": "Complex, multiocular cysts on ultrasound scan",
"picture": null,
"votes": 39
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Levels over 35U/ml may indicate the presence of cancer within the body and are most associated with ovarian cancer.\n\nThis can be raised in pre-menopausal women due to conditions other than ovarian cancer such as endometriosis and pregnancy.\n\nThis marker should not be used in isolation when assessing the risk of ovarian cancer. Therefore is combined with menopausal status and ultrasound features to produce the risk score.",
"id": "10005807",
"label": "b",
"name": "Ca-125",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The risk of Malignancy index (RMI) is a combined score that predicts the risk of an adnexal mass being malignant.\n\nIt includes a raised Ca-125 (the ovarian cancer marker), menopausal status and ultrasound scan features. These are then multiplied together to determine the risk and best next steps for investigations of the patient.\n\nAs with most cancers, the risk of ovarian cancer does increase with age but the majority develop after menopause which is a better predictor.",
"id": "10005806",
"label": "a",
"name": "Age",
"picture": null,
"votes": 82
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Most cases of ovarian cancer happen in those that have already gone through menopause.\n\nThe definition of a post-menopausal female has not had a period for more than 12 months. The average age is 50 years old.\n\nPre-menopausal women score 1 point, post- menopausal score 3 points.",
"id": "10005808",
"label": "c",
"name": "Menopausal status",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a USS feature that is highly suggestive of malignancy.",
"id": "10005810",
"label": "e",
"name": "Metastases on ultrasound scan",
"picture": null,
"votes": 69
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3843",
"name": "Ovarian cancer",
"status": null,
"topic": {
"__typename": "Topic",
"id": "176",
"name": "Gynaecology",
"typeId": 7
},
"topicId": 176,
"totalCards": null,
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"question": "A 56 year old, post-menopausal woman presents with early satiety, bloating and weight loss.\n\nThe GP wants to rule out Ovarian cancer and intends to work out a (Risk of Malignancy Index) RMI score.\n\nWhich of these factors are not included in the Risk of Malignancy score?",
"sbaAnswer": [
"a"
],
"totalVotes": 242,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,300 | false | 14 | null | 6,495,081 | null | false | [] | null | 13,709 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These ducts arise from the seminal vesicles and ductus deferens. These pass through the central zone but are not part of the prostate itself.",
"id": "10005814",
"label": "d",
"name": "Ejaculatory ducts",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This case is suggestive of prostate cancer due to the raised PSA and a DRE suggestive of a malignant growth.\n\nYou would expect the prostate to feel smooth and spongy with a central sulcus. In prostate cancer, it tends to feel harder and nodular with a loss of the sulcus.\n\nPSA is often not very specific as it can be raised in other circumstances such as in infection, following recent ejaculation and cycling. It is therefore not routinely tested for but those over 50 can ask the GP for a test if they would like one.\n\nMost cancers arise in the peripheral zone and are further away from the urethra. The peripheral zone consists of mainly glandular tissue so often produces of adenocarcinomas. They do not always cause urinary symptoms in early disease.",
"id": "10005811",
"label": "a",
"name": "Peripheral zone",
"picture": null,
"votes": 192
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This part of the prostate surrounds the ejaculatory ducts and is a common site for BPH but not prostate cancer.",
"id": "10005813",
"label": "c",
"name": "Central zone",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "As men get older over the age of 50, the prostate gland naturally becomes larger. This is known as benign prostatic hyperplasia.\n\nThis most likely arises in the transition zone of the prostate. This is what surrounds the urethra and is most likely to cause lower urinary tract symptoms such as nocturia, frequency, urgency and post-micturition dribbling.",
"id": "10005812",
"label": "b",
"name": "Transition zone",
"picture": null,
"votes": 41
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There are four major zones of a normal prostate: the peripheral zone, the central zone, the transition zone and the anterior fibromuscular stroma.\n\nThe anterior fibromuscular stroma has no glandular tissue and is not a common site for prostate cancer or BPH.",
"id": "10005815",
"label": "e",
"name": "Anterior fibromuscular stroma",
"picture": null,
"votes": 1
}
],
"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": "3755",
"name": "Prostate cancer",
"status": null,
"topic": {
"__typename": "Topic",
"id": "143",
"name": "Urology",
"typeId": 7
},
"topicId": 143,
"totalCards": null,
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"question": "60 year old attends the GP concerned that he may have prostate cancer. He is aware that his father died from prostate cancer and is now seeing a lot about it in the media. He explains he feels as though he is going to the toilet more to empty his bladder at night.\n\nThe GP decides to measure the prostate-specific antigen (PSA) and perform a digital rectal examination (DRE).\n\nPSA is raised and DRE reveals a slightly hard, craggy prostate.\n\nWhere is the most common site for prostate cancers?",
"sbaAnswer": [
"a"
],
"totalVotes": 246,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,301 | false | 15 | null | 6,495,081 | null | false | [] | null | 13,710 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This hormone is released by the pituitary and is mainly present in the follicular phase (before ovulation).\n\nThis hormone stimulates the growth of eggs in the ovaries and triggers the release of oestrogen from the granulosa cells that surround the follicles.",
"id": "10005817",
"label": "b",
"name": "Follicle- stimulating hormone (FSH)",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This hormone rises after ovulation.\n\nProgesterone helps maintain the endometrial lining during the luteal phase after oestrogen has helped proliferation in the follicular phase.\n\nThe decrease in progesterone causes the lining to be shed and menstruation to begin.",
"id": "10005818",
"label": "c",
"name": "Progesterone",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This hormone rises during the follicular phase triggered by the FSH.\n\nIt helps the endometrium proliferate and triggers LH to be released for the initiation of ovulation.",
"id": "10005819",
"label": "d",
"name": "Oestrogen",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This surge occurs about 24-36 hours before ovulation.\n\nIt triggers the release of the egg from the ovary.",
"id": "10005816",
"label": "a",
"name": "Luteinising hormone (LH)",
"picture": null,
"votes": 191
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This hormone is produced by the corpus luteum in the ovary if fertilisation occurs.",
"id": "10005820",
"label": "e",
"name": "Human Chorionic Gonadotropin (HCG)",
"picture": null,
"votes": 6
}
],
"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": "3841",
"name": "Menstrual cycle",
"status": null,
"topic": {
"__typename": "Topic",
"id": "175",
"name": "Reproductive Physiology",
"typeId": 7
},
"topicId": 175,
"totalCards": null,
"typeId": null,
"userChapter": null,
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},
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"question": "A 38 year old woman attends a pharmacy asking for an ovulation test. She states she has a 28-day cycle.\n\nThe pharmacist explains that ovulation occurs 14 days before the menstrual period. Therefore she must take the test on days 10-14 after her menstrual period.\n\nWhat hormone spikes just before ovulation that is measured in the ovulation test?",
"sbaAnswer": [
"a"
],
"totalVotes": 247,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,302 | false | 16 | null | 6,495,081 | null | false | [] | null | 13,711 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "HSV1 and 2 are responsible for oral herpes. Also known as cold sores.\n\nHSV1 is most associated with oral herpes and HSV2 is most associated with genital herpes.\n\nHowever, they both can cause oral and genital herpes. HSV2 is most likely associated with recurrent symptoms.",
"id": "10005823",
"label": "c",
"name": "Herpes Simplex Virus (HSV)",
"picture": null,
"votes": 58
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are most responsible for HPV-related cervical cancer.\n\nThey are classed as high-risk and are screened for cervical smears.",
"id": "10005822",
"label": "b",
"name": "Human papilloma virus (HPV) 16 and 18",
"picture": null,
"votes": 50
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a type of chlamydia trachomatis infection.\n\nThis can often cause swollen lymph glands in the groin on one or both sides or an ulcer around the genitals which is painful.",
"id": "10005824",
"label": "d",
"name": "Lymphogranuloma Venereum (LGV)",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "bacterial Vaginosis is due to the overgrowth of this bacteria and reduced growth of lactobacillus. This results in increased PH with offensive, fishy-smelling discharge.",
"id": "10005825",
"label": "e",
"name": "Gardnerella vaginalis",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "HPV 6 and 11 are low-risk and cause about 90% of genital warts.\n\nWarts rarely develop into cancer.",
"id": "10005821",
"label": "a",
"name": "Human Papilloma Virus (HPV) 6 and 11",
"picture": null,
"votes": 115
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4449",
"name": "Genital warts",
"status": null,
"topic": {
"__typename": "Topic",
"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4449,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
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"question": "30 year old female attends a sexual health clinic after she noticed multiple fleshy flat, papular growths on washing.\n\nThey do not itch or cause pain.\n\nDiagnosis of genital warts is made.\n\nWhich of the following are most liklet to be responsible for this presentation?",
"sbaAnswer": [
"a"
],
"totalVotes": 241,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,303 | false | 17 | null | 6,495,081 | null | false | [] | null | 13,712 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is where there is a reduction in the volume of air the lungs can hold, this is often due to the loss of elasticity of the alveoli.\n\nThe speed of airflow out of the lungs is not impaired so FVC is reduced and FEV1 is relatively preserved.\n\nThis produces a ratio > 70% also known as a restrictive picture. Conditions that cause this include fibrosis/ scarring of the lungs or a pleural effusion.",
"id": "10005827",
"label": "b",
"name": "FEV1/FVC ratio 85%",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would support the restrictive spirometry picture.\n\nThe diagnosis of asthma would result in an obstructive spirometry finding.",
"id": "10005830",
"label": "e",
"name": "FVC is reduced, FEV1 is preserved",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Restrictive lung conditions can cause an increased FEV1/FVC ratio or can present with a normal ratio with a decreased FVC.\n\nThis is because FVC will be reduced with fibrotic or other pathological changes and FEV1 can be preserved. With worsening disease, FEV1 can decraese also and cause a normal ratio.",
"id": "10005828",
"label": "c",
"name": "FEV1/FVC ratio 70% with decreased FVC",
"picture": null,
"votes": 41
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The likely diagnosis, in this case, is asthma. This is because the patient has a past medical history of atopy (eczema and hayfever) and the symptoms are highly suggestive.\n\nSpirometry measures forced vital capacity and forced expiratory volume in one second. The normal ratio is about 70%.\n\nIn asthma, there is an increase in airway resistance due to secretions and bronchospasm and therefore expiratory flow is reduced. FVC is likely to be normal or slightly low due to air trapping but FEV1 is reduced as airway flow out is not as quick. This results in a ratio of <70%, this can be interpreted as an obstructive lung condition.",
"id": "10005826",
"label": "a",
"name": "FEV1/FVC ratio 60%",
"picture": null,
"votes": 119
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Spirometry can be normal in well-managed asthma but this is the first presentation for this symptomatic patient so is not likely.",
"id": "10005829",
"label": "d",
"name": "FEV1/FVC 70%",
"picture": null,
"votes": 53
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
"files": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3726",
"name": "Spirometry",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3726,
"conditions": [],
"difficulty": 1,
"dislikes": 1,
"explanation": null,
"highlights": [],
"id": "13712",
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"question": "18 year old who has a past medical history of hayfever and eczema presents with a night-time cough, wheezing, shortness of breath and exercise intolerance.\n\nWhat is most likely to be seen on spirometry with the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 239,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,304 | false | 18 | null | 6,495,081 | null | false | [] | null | 13,713 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The patient has a score of 1 as he is over the age of 65.\n\nPatients with a score of 3 or more have a mortality of >15% and should be admitted to ICU and monitored closely.",
"id": "10005834",
"label": "d",
"name": "4",
"picture": null,
"votes": 79
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The patient scores 1 point for his age.",
"id": "10005832",
"label": "b",
"name": "0",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The patient has a score of 1 as he is over the age of 65.\n\nPatients with a score of 2 have an intermediate risk (mortality 3-15%) and should be treated as an inpatient.",
"id": "10005833",
"label": "c",
"name": "2",
"picture": null,
"votes": 53
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There are only 5 features that are scored 1 point on the CURB- 65 scores.\n\nTherefore, you can only score 0-5 on this assessment tool.",
"id": "10005835",
"label": "e",
"name": "6",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "CURB65 stands for:\n\n> Confusion\n>\n> Urea > 7mg/dL\n>\n> Respiratory Rate > 30 breaths per minute\n>\n> Blood pressure <90mmHg systolic or <60mmHg diastolic\n>\n> Age > 65 years old\n>\n\nEach of these features scores 1. The patient is orientated and not confused, urea is normal and under 7, respiratory rate is slightly raised but under 30, blood pressure is normal and the patient is over 65.\n\nTherefore the patient only scores 1 point for 65.\n\nscores 0-1 have a low risk of mortality (<3%) and are treated as an outpatient. However, clinical judgement can overrule this decision and the patient can be treated as an inpatient.",
"id": "10005831",
"label": "a",
"name": "1",
"picture": null,
"votes": 78
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4450",
"name": "Pneumonia (infectious disease)",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4450,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
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"question": "A 66 year old male is diagnosed with community-acquired pneumonia (CAP) based on the clinical features and consolidation on chest X-ray.\n\nOn examination, he is orientated to time and place. He has a temperature of 37.8, respiratory rate of 22, blood pressure of 120/90 and oxygen saturation of 93%.\n\nBlood tests show a raised CRP, and urea of 5.\n\nWhat is her CURB-65 score?",
"sbaAnswer": [
"a"
],
"totalVotes": 236,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,305 | false | 19 | null | 6,495,081 | null | false | [] | null | 13,714 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "One of the parents has a homozygous recessive genotype so the offspring has to inherit one recessive allele.\n\nThe other parent is heterozygous so 50% chance of inheriting another recessive gene.",
"id": "10005837",
"label": "b",
"name": "0%",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In autosomal recessive conditions, if both parents are carriers (heterozygous) there is 75% that children will not have the condition.",
"id": "10005840",
"label": "e",
"name": "75%",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "CF is an autosomal recessive condition.\n\nWhen one parent has CF the genotype must be homozygous recessive and the other parent is a heterozygous carrier.\n\n50% of offspring would have CF but if the dominant allele was inherited from the carrier, 50% would be carriers.",
"id": "10005836",
"label": "a",
"name": "50%",
"picture": null,
"votes": 175
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There is still a 50% chance of inheriting a dominant allele from the heterozygous carrier so not all will have the disease.\n\nIf this was a mitochondrial inheritance and the mother was affected, all would be affected.",
"id": "10005839",
"label": "d",
"name": "100%",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "If both were heterozygous carriers, there would be a 25% of disease.\n\n50% would be carriers and 25% are not carriers.\n\nThese chances don't change depending on previous children.",
"id": "10005838",
"label": "c",
"name": "25%",
"picture": null,
"votes": 38
}
],
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"id": "4451",
"name": "Autosomal recessive conditions",
"status": null,
"topic": {
"__typename": "Topic",
"id": "156",
"name": "Medical Genetics",
"typeId": 7
},
"topicId": 156,
"totalCards": null,
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"question": "A heterosexual couple attends a fertility clinic to discuss their options for conception.\n\nOne parent has Cystic Fibrosis (CF) and one parent is a known carrier.\n\nThey have a 5 year old child who does not have the disease. If they decide to conceive naturally what is the chance the second child will have CF?",
"sbaAnswer": [
"a"
],
"totalVotes": 238,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,306 | false | 20 | null | 6,495,081 | null | false | [] | null | 13,715 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Asthma, especially uncontrolled, can lead to chronic inflammation within the lungs. This leads to an increased risk of COPD.",
"id": "10005842",
"label": "b",
"name": "Asthma",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This can cause chronic inflammation and irritation within the lungs. Therefore is a risk factor but not as significant as tobacco smoking.",
"id": "10005845",
"label": "e",
"name": "Occupational exposure to dust and chemicals",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "90% of cases of COPD are associated with smoking. However, only 10% of smokers develop the condition indicating that there may be a genetic role in the development.\n\nIt would be important to ask this patient about his smoking history calculated in pack years.\n\nPack years = number of cigarettes a day divided by 20 x number of years smoked.",
"id": "10005841",
"label": "a",
"name": "Smoking",
"picture": null,
"votes": 225
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Not a risk factor. However, smokers that are older will have a larger pack-year history and therefore will be more at risk.",
"id": "10005844",
"label": "d",
"name": "Age",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Alpha-1 antitrypsin is a protease inhibitor - this acts in the lungs to oppose elastase. Therefore, deficiency results in more breakdown of elastin which is crucial in the structure of alveoli.\n\n1-2% of those with COPD have an underlying deficiency in alpha-1 antitrypsin.\n\nIt is a risk factor and should be suspected in patients that are young and non-smokers.",
"id": "10005843",
"label": "c",
"name": "Alpha- 1 antitrypsin deficiency",
"picture": null,
"votes": 11
}
],
"comments": [],
"concept": {
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3800",
"name": "Chronic Obstructive Pulmonary Disease (COPD)",
"status": null,
"topic": {
"__typename": "Topic",
"id": "162",
"name": "General practice",
"typeId": 5
},
"topicId": 162,
"totalCards": null,
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"question": "60 year old male presents to the GP with a chronic cough and breathlessness.\n\nChronic Obstructive Pulmonary Disorder (COPD) diagnosis is made.\n\nWhat is the greatest risk factor for this condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 238,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,307 | false | 21 | null | 6,495,081 | null | false | [] | null | 13,716 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This type of lung cancer is primarily seen in smokers.\n\nIt accounts for 15-20% of lung cancers and has an aggressive nature with early metastases.",
"id": "10005847",
"label": "b",
"name": "Small cell lung cancer",
"picture": null,
"votes": 50
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This cancer develops in the lining of the lungs known as the pleura.\n\nThe only known cause is asbestos exposure.",
"id": "10005846",
"label": "a",
"name": "Mesothelioma",
"picture": null,
"votes": 155
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a type of non-small cell lung cancer that makeup 40% of lung cancers. This is seen in the periphery of the lung\n\nsmoking and asbestos exposure are both risk factors.\n\nHowever, asbestos exposure mainly leads to mesothelioma so that is the most likely diagnosis.",
"id": "10005849",
"label": "d",
"name": "Adenocarcinoma",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This can cause cannonball metastases to the lungs which can be seen on X-ray.\n\nThere is no association with asbestos exposure.",
"id": "10005848",
"label": "c",
"name": "Renal cell carcinoma",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a type of non-small cell lung cancer that makeup 20% of lung cancers. This is seen in the central parts of the lung so pneumonia secondary to obstruction is common.\n\nSmoking is the most common cause.",
"id": "10005850",
"label": "e",
"name": "Squamous cell",
"picture": null,
"votes": 16
}
],
"comments": [],
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"__typename": "Chapter",
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"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3702",
"name": "Lung Cancer",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
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},
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"question": "80 year old presents to the GP with a chronic cough, haemoptysis and weight loss.\n\nOn further questioning, he states he is a retired constructor that previously worked with asbestos.\n\nWhich cancer would be most associated with this man?",
"sbaAnswer": [
"a"
],
"totalVotes": 241,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,308 | false | 22 | null | 6,495,081 | null | false | [] | null | 13,717 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "P53 is a tumour suppressor gene. Mutation in this gene can be seen in the development of sporadic cancers.\n\nMutations in P53 genes may cause cancer cells to grow and spread in the body and are linked to a genetic condition called Li- Fraumeni Syndrome which increases the risk of various cancers including sarcomas, breast cancer, leukaemias and adrenal cancer.",
"id": "10005853",
"label": "c",
"name": "P53",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "BRCA genes are tumour suppressor genes and help repair damaged DNA that has had double-strand breaks.\n\nWhen mutations occur, they increase the risk of developing cancers such as breast, ovarian, colorectal, pancreatic and prostate cancer.",
"id": "10005851",
"label": "a",
"name": "BRCA1 and 2",
"picture": null,
"votes": 219
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a mismatch repair gene. These genes allow corrections that DNA polymerase has made. For example, insertion and deletion can be reversed to prevent frameshift mutations.\n\nThey specifically allow the detection of mistake in DNA. This allows the excision of the mistake and resynthesis of the DNA with DNA polymerase. There is a normal cell division rate but an increased mutation rate.\n\nThis is associated with Hereditary Non-polyposis Colorectal Carcinoma/ Lynch Syndrome. These patients can develop polyps which can rapidly convert to large, non-fibrous cancerous tumours in the colon.",
"id": "10005852",
"label": "b",
"name": "MLH1",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a tumour suppressor gene that regulates cell cycle progression. There is an inherited condition called Familial adenomatous polyposis (FAP) where a defective APC gene is inherited.\n\nWhen defective, there is more susceptibility that the gene will develop more mutations that can lead to colorectal cancers as there is an increased rate of cell division.\n\nColonoscopy shows multiple benign tumours - polyp.",
"id": "10005854",
"label": "d",
"name": "APC",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are also mismatch repair genes that lead to an increased mutation rate in Lynch syndrome.\n\nThe other genes associated are MLH1 and PMS1 and 2.",
"id": "10005855",
"label": "e",
"name": "MSH2 and 6",
"picture": null,
"votes": 4
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4452",
"name": "BRCA genes",
"status": null,
"topic": {
"__typename": "Topic",
"id": "226",
"name": "Cancer Genes",
"typeId": 7
},
"topicId": 226,
"totalCards": null,
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},
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"question": "38 year old female presents to the GP with a painless breast lump. She felt it when she was in the shower about a year ago and has increased in size since then.\n\nOn examination, there is a 10mm by 20mm breast lump in the upper right quadrant of the left breast. It feels hard and nodular. There are no skin changes such as erythema and dipping\n\nHer mother was diagnosed with breast cancer at 50 years of age and her grandfather on her mother's died from pancreatic cancer.\n\nWhich of these genes is likely to have contributed to the presentation in this family?",
"sbaAnswer": [
"a"
],
"totalVotes": 237,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,309 | false | 23 | null | 6,495,081 | null | false | [] | null | 13,718 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "High interstitial pressure within the tumour forms a barrier to transcapillary transport. This can result in a barrier to inefficient uptake of therapeutic agents by the tumour.\n\nTherefore lower pressures may allow better delivery of cancer-targeted medications.",
"id": "10005859",
"label": "d",
"name": "Low Interstitial Fluid Pressure within Extracellular matrix",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "When this receptor is present, it means that the tumour can be targeted with anti-oestrogen therapy to slow down the tumour growth.\n\nThis is a target for treatment and can improve prognostic outcomes",
"id": "10005857",
"label": "b",
"name": "Oestrogen Receptor positive",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "cancer-associated fibroblasts are similar to those involved in the tissue repair process.\n\nThey play a role in maintaining the extra-cellular matrix of a tumour by remodelling and depositing cells.\n\nThey communicate with cells nearby and promote invasion and metastases. They also play a role in angiogenesis and immune cell recruitment.\n\nTherefore, the presence of these cells is associated with poor prognosis.",
"id": "10005858",
"label": "c",
"name": "Absence of cancer-associated fibroblasts",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The tumour can recruit immune cells and block the CD8 T cells from proliferating and attacking the tumour.\n\nCorrelates with a poor prognosis.",
"id": "10005856",
"label": "a",
"name": "Tumour Associated macrophages",
"picture": null,
"votes": 117
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cancers with this receptor are associated with being faster growing but can be better targeted with drug treatments and can respond well and improve prognosis.",
"id": "10005860",
"label": "e",
"name": "Presence of epidermal growth receptors",
"picture": null,
"votes": 65
}
],
"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": "3958",
"name": "Cancer pathology",
"status": null,
"topic": {
"__typename": "Topic",
"id": "182",
"name": "Cancer Biology",
"typeId": 7
},
"topicId": 182,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3958,
"conditions": [],
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"highlights": [],
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"question": "71 year old female is asking about the prognosis after receiving a diagnosis of colon cancer.\n\nA combination of analytical tests is performed on the tissue biopsy to examine the tumour microenvironment and see what receptors are present within the tumour.\n\nWhich of these correlates with a poor prognosis of cancer?",
"sbaAnswer": [
"a"
],
"totalVotes": 232,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,310 | false | 24 | null | 6,495,081 | null | false | [] | null | 13,719 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In those with melanoma, 50-60% will have a mutation in the B-RAF gene. This gene plays a crucial role in activating the MAP - Kinase pathway which drives cellular proliferation.\n\nThis is activated by K-RAS upstream to promote cellular proliferation.",
"id": "10005862",
"label": "b",
"name": "B- RAF",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "TERT mutations are responsible for the transformation of the intermediate lesion to melanoma in situ.\n\nTERT works with the enzyme telomerase to increase the length of chromosomes. These are mainly inactive in adults. Mutation results in increased expression and activation of this protein. Mutations are most likely to occur in sun-exposed areas and with B-RAF and CDKN2A mutations.\n\nTERT promoter region mutations are seen in 30% of malignant melanomas.",
"id": "10005864",
"label": "d",
"name": "TERT",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "BRCA genes are tumour suppressor genes and help repair damaged DNA that has had double-strand breaks.\n\nIn homologous recombination, BRCA1 and 2 associate themselves at the terminal where the strand break is. These, along with other proteins guide them to other undamaged DNA and by the complementary pairing of the nucleotide bases the DNA strand is reformed and stuck together.\n\nWhen mutations occur, they increase the risk of developing cancers such as breast, ovarian, colorectal, pancreatic and prostate cancer.",
"id": "10005865",
"label": "e",
"name": "BRCA 1",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Responsible for 60-80% of sporadic cancers.\n\nBeta-catenin within the colonic crypt cells binds to DNA and promotes transcription. APC targets Beta-catenin for destruction to prevent transcription and proliferation.\n\nWhen APC is mutated beta-catenin is not degraded and is free to go into the nucleus and promote proliferation.\n\nAdenomas develop which are precursors for cancer.",
"id": "10005861",
"label": "a",
"name": "APC",
"picture": null,
"votes": 188
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This oncogene is the most frequently mutated gene in human cancers.\n\nRas is responsible for the downstream signalling of cellular proliferation in the MAP-kinase pathway.\n\nWhen mutated, Ras becomes permanently active resulting in uncontrolled proliferation.\n\nThis is seen in Colorectal cancer (CRC) for transforming adenoma into a late adenoma.",
"id": "10005863",
"label": "c",
"name": "K-RAS",
"picture": null,
"votes": 33
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4315",
"name": "Molecular basis of cancer",
"status": null,
"topic": {
"__typename": "Topic",
"id": "182",
"name": "Cancer Biology",
"typeId": 7
},
"topicId": 182,
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"question": "70 year old male has been diagnosed with bowel cancer in the sigmoid colon.\n\nThere is no family history of cancers and he has no significant past medical history.\n\nWhich of these is likely to mutate first to produce an early adenoma?",
"sbaAnswer": [
"a"
],
"totalVotes": 239,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,311 | false | 25 | null | 6,495,081 | null | false | [] | null | 13,720 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The father is unaffected therefore his X chromosome has the dominant allele.\n\nThis confirms that if they had a girl she may be a carrier but would not be affected by this condition",
"id": "10005869",
"label": "d",
"name": "100%",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Haemophilia is an example of an X-linked recessive condition. This means the gene is only carried on the X chromosome; females inherit 2 copies and males only inherit 1. Therefore, males only need to inherit 1 copy to have the disease and females need 2 copies.\n\nAs the father is unaffected and does not carry the gene, the X chromosome will have the dominant allele. Therefore, if the couple has a girl they will not have the disease but there is a 50% that they will be a carrier.\n\nThere is a 50% chance of having a boy and a 50% chance of a mother passing on her X chromosome with the recessive gene, therefore the overall risk is 25%.",
"id": "10005866",
"label": "a",
"name": "25%",
"picture": null,
"votes": 124
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "If they had a boy, there would be a 50% chance this child would inherit the allele from the mother and have the disease.\n\nHowever, this question is asking about the risk overall not based on the sex of the baby.",
"id": "10005867",
"label": "b",
"name": "50%",
"picture": null,
"votes": 47
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There is a 75% chance the child would NOT have the condition.",
"id": "10005870",
"label": "e",
"name": "75%",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There is a 50% chance the mother will pass on this gene. Therefore, the case of a child being affected by the condition is above 0%.",
"id": "10005868",
"label": "c",
"name": "0%",
"picture": null,
"votes": 65
}
],
"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": "4453",
"name": "X-linked Recessive conditions",
"status": null,
"topic": {
"__typename": "Topic",
"id": "205",
"name": "Genetics",
"typeId": 7
},
"topicId": 205,
"totalCards": null,
"typeId": null,
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"question": "A heterosexual couple attends a fertility clinic to discuss their options for conception.\n\nMother is a known carrier of haemophilia.\nFather is unaffected.\n\nWhat is the likelihood the child will have the disease?",
"sbaAnswer": [
"a"
],
"totalVotes": 240,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,312 | false | 26 | null | 6,495,081 | null | false | [] | null | 13,721 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Huntington's disease is inherited in an autosomal dominant manner. This means that only one allele is required for someone to have the disease.\n\nHowever, this question is asking how you can inherit a gene and not 'express' the gene. In other words not develop Huntington's disease.",
"id": "10005875",
"label": "e",
"name": "Autosomal Dominant",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Only one allele is required for the expression of the gene and development of a disease, examples include sickle cell anaemia and cystic fibrosis.\n\nHuntington's disease is autosomal dominant and is more likely to show incomplete penetrance which is what this question is describing.",
"id": "10005873",
"label": "c",
"name": "Autosomal Recessive",
"picture": null,
"votes": 38
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The mitochondrial DNA is only inherited from the mother. Therefore if the mother is affected by a condition 100% of the offspring will be affected. If the father is affected by the condition, no offspring will be affected.",
"id": "10005874",
"label": "d",
"name": "Mitochondrial inheritance",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is where a patient can have the mutation but be asymptomatic for their entire life.\n\nThis is mostly associated with autosomal dominant conditions where even though they inherit the gene, the disease may not develop.\n\nAnother example is the inheritance of a BRCA mutation. This is a dominant inheritance but not all people will develop cancer.",
"id": "10005871",
"label": "a",
"name": "Incomplete Penetrance",
"picture": null,
"votes": 161
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is seen in trinucleotide repeat expansion disorders. Examples of these could be Huntington's disease and fragile x syndrome.\n\nThis refers to the disease severity and duration worsening with each generation. This is due to the expansion of the region of triplet base repeats.\n\nEven though this can happen with Huntington's disease, this doctor is describing the possibility of offspring not expressing the gene at all. This is called incomplete penetrance.",
"id": "10005872",
"label": "b",
"name": "Anticipation",
"picture": null,
"votes": 22
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4454",
"name": "Penetrance",
"status": null,
"topic": {
"__typename": "Topic",
"id": "156",
"name": "Medical Genetics",
"typeId": 7
},
"topicId": 156,
"totalCards": null,
"typeId": null,
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"userNote": null,
"videos": []
},
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "13721",
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"question": "A family is currently being counselled on their family history of Huntington's disease.\n\nThey are told that even if the gene is inherited doesn't mean they will go on to have the disease.\n\nWhich of the following describes this genetic phenomenon?",
"sbaAnswer": [
"a"
],
"totalVotes": 240,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,313 | false | 27 | null | 6,495,081 | null | false | [] | null | 13,722 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is seen in trinucleotide repeat expansion disorders such as Fredrich's ataxia.\n\nThis case describes worsening of disease severity and duration with increasing generations. This is due to the expansion of the region of triplet base repeats.",
"id": "10005876",
"label": "a",
"name": "Anticipation",
"picture": null,
"votes": 187
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The mitochondrial DNA is only inherited from the mother. Therefore if the mother is affected by a condition 100% of offspring will be affected. If the father is affected by the condition, no offspring will be affected.",
"id": "10005880",
"label": "e",
"name": "Mitochondrial Inheritance",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is where both alleles for a gene are expressed.\n\nFor example a flower that have red and white flowers formed from a purely white flowered plant and purely red flowered plant.\n\nThis is different from incomplete dominance, where an intermediate is formed such as pink flowers.",
"id": "10005879",
"label": "d",
"name": "Codominance",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Fredrich's ataxia is inherited in an autosomal recessive way which means two alleles are required to express the gene and develop this condition.\n\nHowever, this case is describing anticipation which is where there is an earlier, more severe presentation of the disease with increasing generations due to amplification of the mutation.",
"id": "10005877",
"label": "b",
"name": "Autosomal recessive inheritance",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This refers to an autosomal dominant trait that is only partially expressed.\n\nFor example, if one parent has straight hair and one parent has curly hair, incomplete dominance in the child could be wavy hair. This is an intermediate of the two alleles.",
"id": "10005878",
"label": "c",
"name": "Incomplete dominance",
"picture": null,
"votes": 2
}
],
"comments": [],
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"__typename": "Chapter",
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},
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"demo": null,
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"id": "4455",
"name": "Genetic Mechanisms",
"status": null,
"topic": {
"__typename": "Topic",
"id": "156",
"name": "Medical Genetics",
"typeId": 7
},
"topicId": 156,
"totalCards": null,
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},
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"question": "A 7 year old child is recently diagnosed with Fredrich's ataxia and is struggling to carry out everyday activities such as washing and dressing. The parents are concerned that he may even need a wheelchair in a few years.\n\nThe father states that the child's symptoms are developing much faster than his father's.\n\nWhy is the boy's symptom onset worse than his grandfather who had the same condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 236,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,314 | false | 28 | null | 6,495,081 | null | false | [] | null | 13,723 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "If weight loss >10% or they had not regained weight by 3 weeks this would be the appropriate action.",
"id": "10005882",
"label": "b",
"name": "Refer urgently to paediatrics",
"picture": null,
"votes": 60
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "They should be offered regular health and development reviews with plenty of support on feeding and development until then.",
"id": "10005885",
"label": "e",
"name": "Reassure with no follow-up",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "<10% of birth weight loss in the first few days is normal. Therefore this would be inappropriate as the baby is otherwise healthy.",
"id": "10005883",
"label": "c",
"name": "Send straight to the emergency department",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This may be considered if the newborn is showing signs of infection such as persistent crying, irritability and fever. However, this child is otherwise well so infection seems unlikely.\n\nThis doctor should safety net and say if the baby develops any of these symptoms or weight drops below 2700g to seek medical attention.",
"id": "10005884",
"label": "d",
"name": "Prescribe antibiotics",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "A healthy newborn is expected to lose up to 10% of their body weight due to the retention of fluid.\n\nHowever, should regain this weight within the first 2 weeks. The mother should be reassured and provided support from a health professional about feeding.\n\nRegular health and development reviews should be arranged up to the age of 2 years of age.\n\nIf there are no concerns this should be every month up til the age of 6 months, then every 2 months up to 12 months and then every 3 months up to the age of 24 months.",
"id": "10005881",
"label": "a",
"name": "Reassure with follow up in one month",
"picture": null,
"votes": 143
}
],
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"__typename": "Chapter",
"explanation": null,
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4456",
"name": "Breastfeeding",
"status": null,
"topic": {
"__typename": "Topic",
"id": "153",
"name": "Paediatrics",
"typeId": 7
},
"topicId": 153,
"totalCards": null,
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},
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"question": "A concerned mother brings her 2 day old baby to the GP concerned of weight loss.\n\nWeight at birth was 3000g, today he was 2800g.\n\nWhat is the most appropriate action?",
"sbaAnswer": [
"a"
],
"totalVotes": 236,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,315 | false | 29 | null | 6,495,081 | null | false | [] | null | 13,724 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "preterm infants who receive human milk are up to 10 times less likely to develop necrotising enterocolitis.\n\nThis is a potentially fatal condition that involves inflammation of the tissues in the gut - this can lead to perforation.\n\nBreastmilk is thought to contain bacteriocidal and immune-modulating effects.",
"id": "10005887",
"label": "b",
"name": "Necrotising Enterocolitis",
"picture": null,
"votes": 100
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Breastfeeding can improve bonding between mother and baby and decrease the risk of post-partum depression.",
"id": "10005889",
"label": "d",
"name": "Reduces risk of post-partum depression",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Aspiration refers to material entering the airway and lungs by accident. This can just be due to the immaturity of the muscles in the mouth, larynx and top of the oesophagus.\n\nAspiration can occur with any food or liquid such as juice, milk or formula. Therefore, breastfeeding is not protective of this.",
"id": "10005886",
"label": "a",
"name": "Reduces risk of aspiration",
"picture": null,
"votes": 62
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There us a lower risk of SIDS in those infants that have been breastfed compared to those who were never breastfed.\n\nThere is a positive correlation between the duration of exclusive breastfeeding and decreased risk of developing SIDS.",
"id": "10005890",
"label": "e",
"name": "Reduces risk of sudden infant death syndrome (SIDS)",
"picture": null,
"votes": 31
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Breastfeeding for 12 consecutive months results in a reduction in the mother's risk of breast cancer.",
"id": "10005888",
"label": "c",
"name": "Reduces mother's risk of breast cancer",
"picture": null,
"votes": 24
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4456",
"name": "Breastfeeding",
"status": null,
"topic": {
"__typename": "Topic",
"id": "153",
"name": "Paediatrics",
"typeId": 7
},
"topicId": 153,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4456,
"conditions": [],
"difficulty": 1,
"dislikes": 1,
"explanation": null,
"highlights": [],
"id": "13724",
"isLikedByMe": 0,
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"question": "A 25 year old gives birth to a healthy boy on the labour ward.\n\nThis was her first pregnancy and first birth. She is deciding whether to breastfeed and asks you what benefits there are.\n\nWhich of these is NOT a recognised benefit?",
"sbaAnswer": [
"a"
],
"totalVotes": 231,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,316 | false | 30 | null | 6,495,081 | null | false | [] | null | 13,725 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "H.pylori is a bacteria that causes infection and inflammation of the stomach and can cause reflux.\n\nThis can be treated with a PPI and 2 antibiotics and do not warrant an urgent cancer pathway investigation.",
"id": "10005894",
"label": "d",
"name": "Positive stool test for H.pylori",
"picture": null,
"votes": 67
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cancer is most associated with weight loss.",
"id": "10005892",
"label": "b",
"name": "Weight gain",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Platelets are seen raised in infection, inflammation and blood loss.\n\nTherefore this would be important to investigate further however low platelets don't necessarily need investigating but followed up.",
"id": "10005893",
"label": "c",
"name": "low platelet count",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gaviscon is an antacid that neutralises stomach acid and reduces pain and discomfort.\n\nA proton pump inhibitor (PPI) is better at controlling the symptoms by blocking the release of acid. this should be trialled prior to calling the dyspepsia treatment-resistant.",
"id": "10005895",
"label": "e",
"name": "Symptoms not relieved by gaviscon",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Red flag symptoms is a warning symptom of cancer and warrant a 2-week referral for cancer.\n\nThis is a red flag symptom that, with being over 55 and dyspepsia warrants referral for an upper gastrointestinal endoscopy.\n\nIf this man also had weight loss, an urgent endoscopy would be required.",
"id": "10005891",
"label": "a",
"name": "Iron deficiency anaemia",
"picture": null,
"votes": 135
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4457",
"name": "Dyspepsia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4457,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "13725",
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"question": "56 year old presents to the GP with dyspepsia.\n\nThe GP discusses some lifestyle changes to improve the main presenting symptom.\n\nThe GP wants to explore more symptoms of the patient to make sure further investigations are not required.\n\nWhich of these would be seen as red flags symptoms and warrant further investigation with an upper gastrointestinal endoscopy?",
"sbaAnswer": [
"a"
],
"totalVotes": 236,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,317 | false | 31 | null | 6,495,081 | null | false | [] | null | 13,726 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Ulcerative colitis is located in the rectum and colon and does not spread past the ileum. You see continuous mucosal inflammation ascending from the colon.",
"id": "10005896",
"label": "a",
"name": "Continuous inflammation in the bowel",
"picture": null,
"votes": 158
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "superficial mucosal inflammation is seen in UC.\n\nTransmural inflammation is seen in Crohn's disease. this results in increased goblet cells and granuloma formation.",
"id": "10005899",
"label": "d",
"name": "Transmural inflammation",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Smoking is a protective factor in UC. This is not encouraged in people with UC in those that smoke, disease presentation may be later than expected.\n\nSmoking is an aggrevating factor in Crohn's disease",
"id": "10005898",
"label": "c",
"name": "History of smoking",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This can be seen in both types of IBD and can be seen in other gastrointestinal conditions such as Irritable bowel disease.\n\nTherefore, is not characteristic of UC.",
"id": "10005900",
"label": "e",
"name": "Abdominal pain",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Crohn's disease is the other subtype of IBD.\n\nThis results in patchy inflammation that can be present from the mouth to the anus.\n\nTransmural inflammation is seen.",
"id": "10005897",
"label": "b",
"name": "Patchy inflammation throughtout small and large bowel",
"picture": null,
"votes": 18
}
],
"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": "3732",
"name": "Ulcerative Colitis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3732,
"conditions": [],
"difficulty": 1,
"dislikes": 1,
"explanation": null,
"highlights": [],
"id": "13726",
"isLikedByMe": 0,
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"likes": 0,
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"question": "25 year old presents to the GP after experiencing 3 months of diarrhoea, abdominal bloating and rectal bleeding.\n\nThe GP suspects Ulcerative Colitis (UC).\n\nWhich of the following is associated with this condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 237,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,318 | false | 32 | null | 6,495,081 | null | false | [] | null | 13,727 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a risk factor. Having large meals and eating before bed and lying down can make reflux worse.\n\nHowever, eating small meals throughout the day can reduce the amount of acid produced, making it beneficial for those who suffer with this.",
"id": "10005903",
"label": "c",
"name": "Eating throughout the day",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Obesity can cause and worsen symptoms of acid reflux. Weight increases the pressure in the abdomen and causes fluid to travel up into the oesophagus.",
"id": "10005904",
"label": "d",
"name": "Weight loss",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Age is not particularly a risk factor for GORD. It can develop at any age and is mainly triggered by lifestyle choices such as large meals, drinking alcohol, coffee and soda frequently and smoking.\n\nIt is common in babies and the elderly due to the immaturity/aging of the muscles in the lower oesophageal sphincter.",
"id": "10005902",
"label": "b",
"name": "Age",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Smoking increases acid production and can worsen symptoms of acid reflux.",
"id": "10005901",
"label": "a",
"name": "Smoking",
"picture": null,
"votes": 201
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Lying down immediately after a meal can exacerbate symptoms which is why doctors recommend keeping upright while digesting meals.",
"id": "10005905",
"label": "e",
"name": "Sat down after a meal",
"picture": null,
"votes": 7
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
"files": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4051",
"name": "Gastro-oesophageal reflux disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
"conceptId": 4051,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
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"question": "50- year- old presents to GP with persistent dyspepsia.\n\nThe GP explores the patient's lifestyle and find that there are a few exacerbating factors. He discusses some changes she could make and prescribes a PPI.\n\nWhich of these is a risk factor for Gastro-oesophageal disease (GORD)?",
"sbaAnswer": [
"a"
],
"totalVotes": 237,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,319 | false | 33 | null | 6,495,081 | null | false | [] | null | 13,728 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Epigastric pain usually starts 2-3 hours after eating and the symptoms can be relieved by eating.\n\nThis is because the pyloric sphincter closes after eating to digest the food in the stomach. When the sphincter is closed, acid does not reach the duodenum to irritate the ulcer.\n\nPain can often wake people from sleep and cause weight gain.\n\nPeptic ulcers can be associated with stress which is suggested by this man's high-pressure job.",
"id": "10005906",
"label": "a",
"name": "Duodenal Ulcer",
"picture": null,
"votes": 173
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Peptic ulcer disease represented in this case is treated with proton pump inhibitors (PPIs) for up to 8 weeks. If left untreated, these can rupture.\n\nThe presentation would be sudden abdominal pain which is severe and present all over the abdomen.\n\nOn examination, they can be shocked with tachycardia and low blood pressure. They will be very still to avoid the pain in the peritoneum.",
"id": "10005910",
"label": "e",
"name": "Perforated Peptic ulcer",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "H.pylori is a bacterial infection of the stomach which erodes the mucosal layer and results in more acid production.\n\nThis can result in a gastric ulcer rather than a duodenal ulcer.\n\nThis infection with NSAID use is the main cause of gastric ulcers.",
"id": "10005908",
"label": "c",
"name": "Helicobacter pylori",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes small pouches that form from the lining of the intestine. This is a common condition that occurs with age.\n\nIt can be asymptomatic but occasionally can cause some abdominal discomfort, constipation and diarrhoea.\n\nYou would not usually expect to see this in someone as young as 45 and pain would usually be felt in the left lower quadrant of the abdomen.",
"id": "10005909",
"label": "d",
"name": "Diverticulosis",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Epigastric pain usually starts within an hour after eating.\n\nThis is because the pyloric sphincter closes after eating to digest the food in the stomach. When the sphincter is closed, acid accumulates in the stomach and causes irritation and pain.\n\nMore common in people >50 years old.\n\nAssociated with weight loss as people are reluctant to eat which makes the pain worse.\n\nCan be associated with vomiting and haematemesis.",
"id": "10005907",
"label": "b",
"name": "Gastric Ulcer",
"picture": null,
"votes": 52
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
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},
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"demo": null,
"entitlement": null,
"id": "4052",
"name": "Peptic ulcer disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
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"question": "45 year old male presents to the GP with 3-month history of epigastric pain and heartburn.\n\nHe says that the pain is constantly there but worsens when he hasn't eaten for a while.\n\nHe does not vomit and his bowels are normal.\n\nHe works as a lawyer and has been reluctant to book time off work to make this appointment. He is now getting concerned as he believes he is putting on weight.\n\nWhich is the most likely cause of his symptoms?",
"sbaAnswer": [
"a"
],
"totalVotes": 237,
"typeId": 1,
"userPoint": null
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173,462,320 | false | 34 | null | 6,495,081 | null | false | [] | null | 13,729 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Breast cancer is most commonly associated with mutations in the BRCA gene.",
"id": "10005912",
"label": "b",
"name": "Breast",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a benign tumour in the brain which can result in hormonal disruption and can press on the optic chiasm causing bitemporal hemianopia.\n\nThis can be associated with multiple endocrine neoplasia syndrome (MEN) type 1.",
"id": "10005915",
"label": "e",
"name": "Pituitary Adenoma",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are small bumps that can be found under the skin and on nerve cells.\n\nThey are associated with Neurofibromatosis which is a group of genetic disorders that cause tumours on the nerve cells. This syndrome can also be associated with cafe au lait spots on the skin usually present in childhood.",
"id": "10005914",
"label": "d",
"name": "Neurofibromas",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cancers in the small intestine can be associated with Familial adenomatous polyposis (FAP).\n\nThis syndrome is due to mutations in the APC gene that regulates cell proliferation. This results in many polyps throughout the large intestine that can turn cancerous with an additional mutation.\n\nThis syndrome can also be associated with upper gastrointestinal cancers including those within the duodenum.",
"id": "10005913",
"label": "c",
"name": "Duodenal",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The cancers associated with lynch syndrome which results from mutation from the mismatch repair genes include ovarian and uterine, urinary tract, colorectal, stomach and pancreas.\n\nOvarian along with breast and pancreatic can also be associated with inheritance of the BRCA mutations.",
"id": "10005911",
"label": "a",
"name": "Ovarian",
"picture": null,
"votes": 174
}
],
"comments": [],
"concept": {
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"__typename": "Chapter",
"explanation": null,
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"id": "2693",
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3731",
"name": "Colorectal Cancer",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
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"question": "A 30 year old attends clinic for a colonoscopy as he has a strong family history of bowel and pancreatic cancer and has recently experienced change in bowel habit with rectal bleeding.\n\nDuring the procedure, 15 polyps were found.\n\nThe consultant is concerned that the family may have a mutation in the mismatch repair genes and have hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch syndrome. This can predispose to colon cancer as well as other malignancies in men and women.\n\nWhich of these cancers in females are also associated with this syndrome?",
"sbaAnswer": [
"a"
],
"totalVotes": 231,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,321 | false | 35 | null | 6,495,081 | null | false | [] | null | 13,730 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Bilirubin is formed when red blood cells are broken down.\n\nThis can be raised when there is an increased turnover of red blood cells such as in sickle cell anaemia, the liver cannot process the protein due to liver cirrhosis or there us an obstruction from the gallbldder such as in cholelithiasis.",
"id": "10005919",
"label": "d",
"name": "Bilirubin",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a protein made by the liver that is raised in infection.",
"id": "10005918",
"label": "c",
"name": "C- reactive protein (CRP)",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "High cholesterol is a risk factor for cardiovascular disease.\n\nThis blood test is useful to carry out at presentation to aid long term management. However, in this acute setting with an MI you would most likely expect the troponin to be raised which is more sensitive adnd specific for this presentation.",
"id": "10005920",
"label": "e",
"name": "Hypercholesterolemia",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Troponin is a protein that participates in muscle contraction.\n\nMyocardial infarction is due to insufficient blood supply to myocardium causing necrosis. This leads to the release of troponin when dmaage to the myocytes have occured.",
"id": "10005916",
"label": "a",
"name": "Troponin",
"picture": null,
"votes": 220
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is secreted by cardiomyocytes in the ventricles in response to stretching.\n\nThis is released and raised in heart failure.",
"id": "10005917",
"label": "b",
"name": "Brain Natriuretic Peptide (BNP)",
"picture": null,
"votes": 15
}
],
"comments": [],
"concept": {
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"__typename": "Chapter",
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"id": "2693",
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3713",
"name": "Myocardial infarction and Acute Coronary Syndrome (ACS)",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
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"userNote": null,
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},
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"question": "70 year old presents with crushing chest pain, nausea, sweating and shortness of breath.\n\nA myocardial infarction is suspected and bloods and an ECG trace is ordered.\n\nWhich blood marker would you expect to be raised?",
"sbaAnswer": [
"a"
],
"totalVotes": 235,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,322 | false | 36 | null | 6,495,081 | null | false | [] | null | 13,731 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This medication uses nitrates to relieve the symptoms of angina by dilating coronary vessels.\n\n1-2 sprays should be used under the tongue when symptoms start. if unsuccessful, another dose can be given after 5 minutes. If symptoms persistent after three doses every 5 minutes, the patient should seek medical attention.\n\nThis is not used as secondary prevention for cardiovascular disease but as symptomatic relief for angina pain.",
"id": "10005921",
"label": "a",
"name": "Glyceryl trinitrate (GTN) spray",
"picture": null,
"votes": 141
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an antiplatelet medication; 75mg is taken once daily. This is used along with another antiplatelet such as clopidogrel for 12 months.\n\nthere is evidence that this helps prevent another such event and the current disease from worsening.\n\nThis is outdated as primary prevention and is no longer used in these cases.",
"id": "10005923",
"label": "c",
"name": "Aspirin",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Atorvastatin 80mg once daily are advised following an acute coronary syndrome. This medication aims to reduce the cholesterol and has been found to reduce the rate of recurrent disease and the need for revascularisation procedures.",
"id": "10005922",
"label": "b",
"name": "Atorvastatin",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Secondary prevention can be easily remembered by the 6As:\n\n> Aspirin 75mg daily\n>\n> Another antiplatelet such as clopidogrel for up to 12 months\n>\n> ACE Inhibitor such as ramipril\n>\n> Atenolol\n>\n> Atorvastatin 80mg once daily\n>\n> Aldosterone antagonist for those with clinical heart failure",
"id": "10005925",
"label": "e",
"name": "Atenolol",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These reduce the effects of the renin-angiotensin- aldosterone system and therefore can help treat and prevent hypertension.\n\nResearch has also shown that they improve oxidative stress, endothelial and ventricular function.",
"id": "10005924",
"label": "d",
"name": "ACE inhibitors",
"picture": null,
"votes": 18
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"id": "2693",
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},
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"demo": null,
"entitlement": null,
"id": "3713",
"name": "Myocardial infarction and Acute Coronary Syndrome (ACS)",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
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},
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"qaAnswer": null,
"question": "A 70 year old is discharged from hospital following a Myocardial Infarction (MI)\n\nHe is prescribed secondary prevention.\n\nWhat is NOT included in this?",
"sbaAnswer": [
"a"
],
"totalVotes": 233,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,323 | false | 37 | null | 6,495,081 | null | false | [] | null | 13,732 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Iron is crucial for the synthesis of haemoglobin in red blood cells. When iron is lacking, the critical haemoglobin concentration is not achieved causing the red blood cells to look smaller than they should do.",
"id": "10005926",
"label": "a",
"name": "Iron deficiency anaemia",
"picture": null,
"votes": 183
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In sickle cell disease, red blood cells formed are an unusual shape and so not transfer oxygen as efficiently and do not live as long as normal healthy red blood cells.\n\nThis results in a normocytic anaemia as there is just a reduced number of red blood cells with normal MCV.",
"id": "10005930",
"label": "e",
"name": "Sickle cell disease",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an inherited condition that results in the formation of faulty haemaglobin that doesn't function normally.\n\nThis does result in microcytic anaemia similarly to iron defiency but is not as common.",
"id": "10005928",
"label": "c",
"name": "Thalassaemia",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Folate plays a role in the synthesis of DNA and maintanence of normal erythropoiesis.\n\nSimilarly to vitamin B12,abnormal cells called megaloblasts are formed that do not divide and mature to healthy red blood cells.\n\nThis causes a macrocytic anaemia.",
"id": "10005929",
"label": "d",
"name": "Folate deficiency",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Vitamin B12 helps synthesise DNA and plays a crucial role in the formation of mature red blood cells.\n\nWhen there is a lack of vitamin B12, abnormal cells called megaloblasts are formed that do not divide and mature to healthy red blood cells.\n\nThis causes a macrocytic anaemia",
"id": "10005927",
"label": "b",
"name": "Vitamin B12 deficiency",
"picture": null,
"votes": 12
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
"files": null,
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"id": "2693",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4458",
"name": "Iron deficiency anaemia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "162",
"name": "General practice",
"typeId": 5
},
"topicId": 162,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4458,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "13732",
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"question": "A 69 year old man is diagnosed with microcytic anaemia. This is determined by the low haemaglobin count and low mean corpuscular volume (MCV).\n\nWhat is the most common cause of this finding?",
"sbaAnswer": [
"a"
],
"totalVotes": 237,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,324 | false | 38 | null | 6,495,081 | null | false | [] | null | 13,733 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes heart failure that is caused by high blood pressure.\n\nProlonged, uncontrolled hypertension can cause left ventricular diastolic dysfunction and reduced ejection fraction.\n\nThis can lead to congestive heart failure and therefore pulmonary oedema and paroxysmal nocturnal dyspnoea.",
"id": "10005935",
"label": "e",
"name": "Hypertensive Heart failure",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the sensation of shortness of breath when lying flat compared to be woken from sleep.\n\nThis occurs in heart failure due to the pulmonary oedema. The fluid covers the whole of the surface area whilst lying flat which is what causes this sensation and is relieved when upright.",
"id": "10005932",
"label": "b",
"name": "Orthopnoea",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the sensation of shortness of breath that wakes a person from sleep and is relieved by sitting upright.\n\nThis occurs in heart failure due to the pulmonary oedema. The fluid covers the whole of the surface area whilst lying flat which is what causes this sensation.",
"id": "10005931",
"label": "a",
"name": "Paroxysmal nocturnal dyspnoea (PND)",
"picture": null,
"votes": 214
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Dysphagia is defined as swallowing difficulty.\n\nThis can be caused by the impairment of the muscles of the mouth and pharynx to coordinate swallow.\n\nThis can result from a stroke, head injury and dementia.",
"id": "10005933",
"label": "c",
"name": "Dysphagia",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are dreams that feel intense and real. They can be described as pleasant, strange and even frightening.\n\nThis is a common symptom of Parkinson's disease.\n\nIn REM sleep, the patient can often act out the dream. They may leap out of bed.\n\nThis patient is unlikely to have this as there is a past medical history of heart failure and the main feature is waking up with severe shortness of breath, relieved by sitting up which is a feature of pulmonary oedema.",
"id": "10005934",
"label": "d",
"name": "A vivid dream",
"picture": null,
"votes": 0
}
],
"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": "3798",
"name": "Heart Failure",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
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},
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"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "13733",
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"question": "65 year old female with existing diagnosis of heart failure describes episodes where she will wake up suddenly with severe attack of shortness of breath and cough.\n\nWhich of the following best descibes this symptom?",
"sbaAnswer": [
"a"
],
"totalVotes": 234,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,325 | false | 39 | null | 6,495,081 | null | false | [] | null | 13,734 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "T waves on an ECG represents the repolarisation of the ventricles.\nTall tented T waves are characteristic of hyperkalaemia and can be an early sign of an acute coronary syndrome.",
"id": "10005940",
"label": "e",
"name": "Tall tented T waves",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Atrial fibrillation results from multiple chaotic impulses being generated from the inside of the atrium. This results in fibrillation of the atria and impaired contraction.\n\nA fibrillating baseline is seen and there is an absence of clear P waves.",
"id": "10005936",
"label": "a",
"name": "Absence of P waves",
"picture": null,
"votes": 164
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This suggests that there is an irregular rhythm originating from the atria.\n\nThis can be seen in sinus arrhythmia. This is a physiological change seen in heart rate due to respiratory cycle. Seen in younger people.\n\nEven though atrial fibrillation is an irregular rhythm from the atria, p waves tend to be absent from the chaotic impulses.",
"id": "10005938",
"label": "c",
"name": "Variation in P - P wave interval",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is due to atrial flutter which is a macro-reentry circuit within the atria.\n\nThis results in a high rate of depolarisation of the atria > 250 bpm.\n\nThe AV node undergoes its normal function and blocks some of these impulses and only lets some through. Therefore, a ratio can be seen between sawtooth waves and QRS complexes - this can be regular and irregular.",
"id": "10005937",
"label": "b",
"name": "Sawtooth waveform",
"picture": null,
"votes": 31
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This means that the P wave on an ECG is not followed by a QRS complex.\n\nThis is due to pathology in the AV node that relays the signal to ventricle. This is known as a heart block.",
"id": "10005939",
"label": "d",
"name": "Non propagated P wave",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3799",
"name": "ECG",
"status": null,
"topic": {
"__typename": "Topic",
"id": "159",
"name": "Cardiovascular physiology",
"typeId": 7
},
"topicId": 159,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
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"question": "A 50 year old attends the GP with palpitations, dizziness and describes his heart 'racing' at times. These episodes are worsened by exercise and have stopped running as he is scared to faint.\n\nThe GP performs an ECG and the patient is subsequently diagnosed with atrial fibrillation (AF).\n\nWhat is a feature of atrial fibrillation (AF) on an ECG?",
"sbaAnswer": [
"a"
],
"totalVotes": 234,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,326 | false | 40 | null | 6,495,081 | null | false | [] | null | 13,735 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This antibody is present in coeliac disease. This is tested for along with IgA antibodies to see the proportionate rise of anti-TTG.",
"id": "10005945",
"label": "e",
"name": "Anti- tissue transglutaminase (Anti- TTG)",
"picture": null,
"votes": 44
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are autoantibodies to the TSH receptor on the thyroid gland.\n\nThis can lead to Hashimoto's thyroiditis (hypothyroid) and Graves' disease (hyperthyroid).",
"id": "10005942",
"label": "b",
"name": "Antithyroid peroxidase (anti-TPO)",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This antibody helps to discover whether someone has either type 1 diabetes mellitus or latent autoimmune diabetes of the adulthood (LADA).\n\nGAD is present in the beta cells of the pancreas and therefore show that these are damaged in this autoimmune condition leading to little to no insulin production.\n\nThis test has a high positive predictive value.",
"id": "10005941",
"label": "a",
"name": "Anti- glutamic acid decarboxylase (anti-GAD)",
"picture": null,
"votes": 124
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This measures how much insulin is made in the body. It is not an antibody but a protein made when insulin is synthesised in the beta cells of the pancreas.\n\nIf no C-peptide is present, this suggests that the pancreas is producing little to no insulin.",
"id": "10005943",
"label": "c",
"name": "C-peptide",
"picture": null,
"votes": 58
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is positive in myasthenia gravis disease which causes muscle weakness which progressively becomes worse throughout the day.",
"id": "10005944",
"label": "d",
"name": "Acetylcholine receptor antibody",
"picture": null,
"votes": 3
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4058",
"name": "Diabetes Mellitus",
"status": null,
"topic": {
"__typename": "Topic",
"id": "167",
"name": "Endocrine physiology",
"typeId": 7
},
"topicId": 167,
"totalCards": null,
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"question": "12 year old boy presents to accident and emergency with polydipsia and polyuria. Preceding this he had 3 episodes of vomiting with abdominal pain.\n\nHe is diagnosed with diabetic ketoacidosis (DKA) and started on treatment including fluids and insulin infusion.\n\nWhich antibody is associated with Type 1 diabetes mellitus?",
"sbaAnswer": [
"a"
],
"totalVotes": 235,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,327 | false | 41 | null | 6,495,081 | null | false | [] | null | 13,736 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This woman has Addison's disease - this is an autoimmune condition that damages the adrenal gland.\n\nThis leads to a reduction in the production of aldosterone and cortisol (mineralocorticoids).\n\nCortisol is a glucocorticoid and is formed from the middle area of the adrenal gland called the zona fasiculata.\n\nThis disease can lead to symptoms as described in this case; depression, weight loss, nausea, hyperpigmentation and weight loss.",
"id": "10005946",
"label": "a",
"name": "Zona fasiculata",
"picture": null,
"votes": 194
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the outer zone of the cortex of the adrenal gland this is reponsible for secreting mineralocorticoids such as aldosterone.",
"id": "10005947",
"label": "b",
"name": "Zona glomerulosa",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The adrenal capsule surrounds the adrenal gland and ensures that the damaged cells are replaced and the integrity of the gland is maintained.",
"id": "10005949",
"label": "d",
"name": "capsule",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the inner most layer of the adrenal gland that secretes androgens such as estrogens and testosterone",
"id": "10005948",
"label": "c",
"name": "Zona reticularis",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the innermost part of the adrenal gland. This releases epinephrine (adrenaline) and norepinephrine (noradrenaline).\n\nThese hormones are important in autonomic functions such as regulating heart rate and plays a crucial role in the fight or flight response.",
"id": "10005950",
"label": "e",
"name": "Medulla",
"picture": null,
"votes": 9
}
],
"comments": [],
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"demo": null,
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"id": "3812",
"name": "Adrenal cortical hormones",
"status": null,
"topic": {
"__typename": "Topic",
"id": "167",
"name": "Endocrine physiology",
"typeId": 7
},
"topicId": 167,
"totalCards": null,
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"question": "A 40 year old woman presents to accident and emergency with severe nausea and abdominal pain.\n\nIt is noticed by the nurse that she appears dehydrated and has some tanning of the skin.\n\nThe patient says that for the past few weeks she has lost weight and feels really low and hasn't got out of bed most days.\n\nShe is found to have a low cortisol level in her blood.\n\nWhat part of the adrenal gland produces cortisol?",
"sbaAnswer": [
"a"
],
"totalVotes": 236,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,328 | false | 42 | null | 6,495,081 | null | false | [] | null | 13,737 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This results from the family's inherited short stature.\n\nThose affected may be short stature will be small for their age but they are expected to start puberty as normal with no developmental delay.",
"id": "10005955",
"label": "e",
"name": "Familial short stature",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is more commonly known as Down Syndrome.\n\nThose with this syndrome experience the same pattern of hormonal changes as they grow and develop with the development of breast buds and menstruation.\n\nThere can be a developmental delay in emotions, social communication, abstract thinking and problem-solving ability.",
"id": "10005954",
"label": "d",
"name": "Trisomy 21",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a hypogonadotrophic hypogonadism.\n\nSigns and symptoms also include delayed puberty, low libido, primary amenorrhoea and erectile dysfunction.\n\nAdditional anomalies can include impaired renal development, cleft lip and loss of sense of smell.",
"id": "10005953",
"label": "c",
"name": "Kallman Syndrome",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Puberty is expected to begin between ages 8 and 13 in girls and 9 and 14 for boys.\n\nDelayed puberty is defined as no signs of testicular development by age 14 or no signs of breast development by age 13 in girls.\n\nTurner Syndrome is a condition that. only affects females and results when one X chromosome is partially missing. This can result in a variety of developmental problems such as short stature, hart defects and failure of the development of the ovaries and therefore puberty.",
"id": "10005951",
"label": "a",
"name": "Turner Syndrome",
"picture": null,
"votes": 212
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypothyroid can result in delayed growth and delayed puberty.\n\nHowever, in this adolescent girl there are features characteristic of Turner syndrome such as widely spaced nipples and a webbed neck.\n\nShort stature and ovarian failure are the main features.",
"id": "10005952",
"label": "b",
"name": "Hypothyroidism",
"picture": null,
"votes": 4
}
],
"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": "4459",
"name": "Turner Syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "156",
"name": "Medical Genetics",
"typeId": 7
},
"topicId": 156,
"totalCards": null,
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},
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"question": "15 year old female presents to the GP with her concerned mother.\n\nThe mother states that her daughter hasn't had her period yet and hasn't noticed any breast growth.\n\nOn examination of the girl you note that she has a short stature, webbed neck, widely spaced nipples with no evidence of breast budding.\n\nWhat condition is this presentation associated with?",
"sbaAnswer": [
"a"
],
"totalVotes": 241,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,329 | false | 43 | null | 6,495,081 | null | false | [] | null | 13,738 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Osteoclasts are inhibited by calcitonin, a thyroid hormone.\n\nThis is released when there is hypercalcaemia so osteoclasts are inhibited to prevent more calcium being released into the bloodstream.\n\nDrugs such as Denosumab which prevents the RANK ligand from binding can stop the activation of the osteoclasts to prevent bone reabsorption.",
"id": "10005958",
"label": "c",
"name": "Inhibits the osteoclasts",
"picture": null,
"votes": 36
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Osteocytes are found in mature bone matrix and originate from osteoblasts.\n\nThey sense various mechanical stress on bone and regulate bone formation and reabsorption in response to this.",
"id": "10005960",
"label": "e",
"name": "Activates the osteocytes",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Osteoblasts can be activated by osteoclasts in the normal bone modelling cycle.\n\nThey can also be upregulated by thyroxine a thyroid hormone and growth hormone.",
"id": "10005957",
"label": "b",
"name": "Activates the osteoblasts",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Rank ligand is produced by osteoblasts and play a crucial role in the bone remodelling cycle by binding and activating osteoclasts.\n\nOsteoclasts are the cells that degrade bone and initiate normal bone remodelling. Osteoblasts then become activated and form new bone.\n\nIn osteoporosis where bone has become weaker, it can be beneficial to inhibit osteoclasts and bone degradation to maintain the bones strength.\n\nParathyroid also stimulates osteoclasts in response to low calcium in the blood.",
"id": "10005956",
"label": "a",
"name": "Activates the osteoclasts",
"picture": null,
"votes": 174
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "RANK ligand is released by osteoblasts when they proliferate and become active. This activates osteoclasts. Osteoclasts then send signals to osteoblasts to reactivate them\n\nThis feedback is crucial in the bone turnover and remodelling.",
"id": "10005959",
"label": "d",
"name": "Inhibits the osteoblasts",
"picture": null,
"votes": 8
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4460",
"name": "Bone remodelling",
"status": null,
"topic": {
"__typename": "Topic",
"id": "154",
"name": "Musculoskeletal physiology and disease",
"typeId": 7
},
"topicId": 154,
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"question": "A 75 year old man has recently been diagnosed with osteoporosis following hormone therapy for his prostate cancer.\n\nHe has a review in the bone clinic where they recommend starting Denosumab. This works by blocking the RANK ligand.\n\nWhat is the role of the RANKL?",
"sbaAnswer": [
"a"
],
"totalVotes": 240,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,330 | false | 44 | null | 6,495,081 | null | false | [] | null | 13,739 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a classical presentation of hyperthyroidism so is likely to have raised T3 and T4 levels.",
"id": "10005965",
"label": "e",
"name": "Normal TSH and normal T3 and T4",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the picture of secondary hypothyroidism. The decrease in thyroid hormones is in response to the lack of TSH which stimulates the release of thyroid hormones.\n\nUnder-production of TSH can be due to a non-secretory pituitary adenoma.",
"id": "10005964",
"label": "d",
"name": "Low TSH and low T3 and T4",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "TSH is released by the anterior pituitary and stimulates the release of T3 (triiodothyronine) and T4 (thyroxine).\n\nPrimary hyperthyroidism originates from the thyroid gland itself which suppresses the release of TSH by negative feedback.\n\nThe main causes of hyperthryoidism include Graves' disease, toxic multinodular goitre and toxic adenoma.\n\nWomen are more at risk than men.",
"id": "10005961",
"label": "a",
"name": "Low TSH and High T3 and T4",
"picture": null,
"votes": 211
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the picture of secondary hyperthyroidism. This is in response to the secretion of high levels of TSH which stimualates the release of thyroid hormones.\n\noverproduction of TSH can be due to a pituitary adenoma.",
"id": "10005962",
"label": "b",
"name": "High TSH and high T3 and T4",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the picture of mild or early onset hypothyroidism.\n\nThe thyroid hormones are in normal ranges but TSH is released in greater quantities to help maintain these levels.\n\nTreatment is required only if TSH is higher than >10mlU/L.",
"id": "10005963",
"label": "c",
"name": "High TSH and normal T3 and T4",
"picture": null,
"votes": 6
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"pictures": [],
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4461",
"name": "Hyperthyroidism",
"status": null,
"topic": {
"__typename": "Topic",
"id": "167",
"name": "Endocrine physiology",
"typeId": 7
},
"topicId": 167,
"totalCards": null,
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},
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"question": "A 20 year old female presents to the GP with irritability, palpitations, excessive sweating and weight loss with increased appetite.\n\nPrimary hyperthyroidism is suspected.\n\nWhat would support this on the blood test?",
"sbaAnswer": [
"a"
],
"totalVotes": 238,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,331 | false | 45 | null | 6,495,081 | null | false | [] | null | 13,740 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gout is usually an acute presentation of sudden, severe attacks of pain, swelling and tenderness of one or more joints.\n\nCommon joints affected tend to be those in the lower limb such as toes, feet, ankles and knees.\n\nDiagnosis is done by aspirating the affected joint. Microscopy identifies negatively bifringent, needle shaped crystals.\n\nXrays are not crucial for diagnosis but will show soft tissue swelling and bony erosions.",
"id": "10005968",
"label": "c",
"name": "Gout",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "NICE guidelines state that adults over the age of 45 can be diagnosed clinically with osteoarthritis.\n\nThey do not require investigations if they have no joint-related morning pain or stiffness or have joint-related morning pain and stiffness that does not persist longer than 30 minutes.\n\nAn X-ray would demonstate subchondral sclerosis, cyst formation, loss of joint space and osteophyte formation.",
"id": "10005966",
"label": "a",
"name": "Osteoarthritis",
"picture": null,
"votes": 194
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an auto-inflammatory disease so is associated with pain and stiffness in the morning that lasts for longer than 30 minutes.\n\nActivity tends to relieve the pain, whilst rest can exacerbate it.\n\nPatients tend to present with 3 or more tender, warm, swollen joints bilaterally with systemic features such as fatigue and fevers.\n\nDiagnosis is made with a combination of the clinical picture and MRI or ultrasound scan of joints.",
"id": "10005970",
"label": "e",
"name": "Rheumatoid arthritis",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an auto-inflammatory condition which is associated with the HLA-B27 gene.\n\nThis condition tends to present in young men under 45 years of age. They have morning pain and stiffness that persists over 30 minutes and is relieved by exercise.\n\nInflammation in the axial skeleton can cause new bone formation and fusion of the bones in the spine - known as a bamboo spine.\n\nSacroilitis is seen on Xray which is part of the diagnostic New York criteria.",
"id": "10005967",
"label": "b",
"name": "Ankylosing spondylitis",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Osteoporosis refers to thinning of the bone. Bone density measurement by a DEXA scan at the hip and spine is generally considered the most reliable way to diagnose the condition.\n\nOsteoporosis has no clinical features until there is a fracture and tends to be an incidental finding.",
"id": "10005969",
"label": "d",
"name": "Osteoporosis",
"picture": null,
"votes": 10
}
],
"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": "3766",
"name": "Osteoarthritis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
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"question": "70 year old male attends the orthopaedic clinic complaining of pain and stiffness in his left hip that has gradually worsened over 6 months.\n\nHe says that he wakes up feeling pain-free with no morning stiffness. However, as he carries out activities such as walking for his newspaper the pain and stiffness worsen.\n\nWhich od the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 235,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,332 | false | 46 | null | 6,495,081 | null | false | [] | null | 13,741 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "CFTR stands for cystic fibrosis transmembrane conductance regulator. This allows chlorine and salt to leave the cell so water can follow and properly hydrate the cellular surface.\n\nWhen mutated, cystic fibrosis occurs. Salt cannot leave the cells and the mucus on cells becomes thick and sticky causing infertility in men and recurrent chest infections in men and women.",
"id": "10005974",
"label": "d",
"name": "CFTR gene",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Dystrophin is a protein within muscle that plays a crucial role in the structure and function of the muscle.\n\nThe mutation in this gene leads to a faulty protein and causes changes in the muscle fibres leading to scarring and muscle dysfunction.\n\nOver time, this leads to muscle weakening and increasing disability.",
"id": "10005975",
"label": "e",
"name": "Dystrophin gene",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Ankylosing Spondylitis (AS) has a strong family history and is greatly associated with HLA B27.\n\n75-92% of patients with AS have this gene. Among those in the population who have the gene, 1-2% have AS.\n\nOther spondyloarthropathies that are associated with HLA B27 include reactive arthritis and enteropathic arthritis that is associated with IBD.",
"id": "10005971",
"label": "a",
"name": "HLA B27",
"picture": null,
"votes": 190
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These have been most consistently associated with Systemic Lupus Erythematosus (SLE).",
"id": "10005973",
"label": "c",
"name": "HLA DR2 and 3",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These genes are associated with the development of coeliac disease.",
"id": "10005972",
"label": "b",
"name": "HLA DQ8 and 2",
"picture": null,
"votes": 17
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
"files": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3911",
"name": "ankylosing spondylitis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "146",
"name": "Rheumatology",
"typeId": 7
},
"topicId": 146,
"totalCards": null,
"typeId": null,
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},
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"difficulty": 1,
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"qaAnswer": null,
"question": "21 year old male presents to the GP with prolonged morning stiffness over 30 minutes that also worsens in the evening.\n\nHe says he has taken up running and that seems to relieve the pain.\n\nHe says he is really struggling with fatigue and is finding it difficult to carry on with his office-based job.\n\nHe is subsequently diagnosed with ankylosing spondylitis.\n\nWhat gene is most associated with this?",
"sbaAnswer": [
"a"
],
"totalVotes": 235,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,333 | false | 47 | null | 6,495,081 | null | false | [] | null | 13,742 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an important differential as this can present very vague such as tiredness and fatigue.\n\nWidespread pain is less likely and bloods would show a low haemaglobin.",
"id": "10005980",
"label": "e",
"name": "Anaemia",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient likely has fibromyalgia. The main symptom is widespread pain that can vary in severity. This condition can result in extreme sensitivity to touch and painful stimuli.\n\nThis condition can cause tiredness, poor sleep quality, memory and cognitive impairment.\n\nFibromyalgia is often associated with IBS.\n\nThe pathophysiology is not fully understood but is thought to be influenced by abnormal pain signalling.",
"id": "10005976",
"label": "a",
"name": "Fibromyalgia",
"picture": null,
"votes": 193
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an auto-inflammatory disease so is associated with pain and stiffness in the morning that lasts for longer than 30 minutes.\n\nActivity tends to relieve the pain, whilst rest can exacerbate it.\n\nPatients tend to present with 3 or more tender, warm, swollen joints bilaterally with systemic features such as fatigue and fevers.",
"id": "10005977",
"label": "b",
"name": "Rheumatoid arthritis",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypothyroid is due to decreased T3 and T4 levels in the blood. Symptoms include constipation, feeling cold, dry skin and nails, fatigue and memory changes.\n\nHypothyroid can cause muscle aches and stiffness as in this case but investigations would show low T3 and T4.",
"id": "10005978",
"label": "c",
"name": "Hypothyroidism",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This condition tends to present in young men under 45 years of age. They have morning pain and stiffness that persists over 30 minutes and is relieved by exercise.\n\nPeople with AS tend to have stiffness and aching pains in the lower back which can progress up the spine.\n\n'Widespread pain' is very unique to fibromyalgia.",
"id": "10005979",
"label": "d",
"name": "Ankylosing spondylitis",
"picture": null,
"votes": 27
}
],
"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": "4462",
"name": "Fibromyalgia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "146",
"name": "Rheumatology",
"typeId": 7
},
"topicId": 146,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
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"dislikes": 0,
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"question": "A 50 year old female presents to the GP with widespread pain that is worse in her back and neck. She describes the pain as a constant ache but can be burning in nature. This has been present for 5 months.\n\nShe also struggles with fatigue and headaches.\n\nPast medical history of high blood pressure and inflammatory bowel syndrome (IBS).\n\nA full blood work up is performed which is all normal. What is the likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 234,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,334 | false | 48 | null | 6,495,081 | null | false | [] | null | 13,743 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Septic arthritis can present very similarly to this case with acute, severe pain developing over hours.\n\nPatients may have a history of a urinary tract infection or a respiratory tract infection. The bacteria may have spread to the knee leading to septic arthritis. it can also be caused by direct innoculation by a penetrating injury for example an animal bite.\n\nAspiration would be negative for crystals with a high white blood cell and neutrophil count with a positive gram stain for bacteria.",
"id": "10005982",
"label": "b",
"name": "Infection",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pseudogout is caused by the deposition of a calcium-based crystal in the joint. These are called calcium pyrophosphate dihydrate crystals that appear positively bifringent and rhomboid shape on crystal microscopy.\n\nThe presentation would be similar and the aspiration allows you to differentiate the conditions.",
"id": "10005983",
"label": "c",
"name": "Hypercalcaemia",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Aspiration of the joint along with the clinical picture supports the diagnosis of gout rather than an autoimmune pathogenesis.\n\nWith rheumatoid arthritis, it is usually a slower onset > 6 weeks with multiple joint involvements on both sides of the body.",
"id": "10005985",
"label": "e",
"name": "Autoimmunity",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "alcohol can increase uric acid in the bloodstream which increases risk of gout and increase the frequency and severity of attacks.\n\nUric acid is the direct cause of gout as this is what deposits into the joint.",
"id": "10005984",
"label": "d",
"name": "Alcohol",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Gout is caused by a build up of uric acid in the blood. This deposits in the joint as needle shaped crystals. There is an increased risk with a high purine diet, family history, renal impairment and therefore reduced clearance of uric acid.\n\nGout attacks are acute and severe in nature and usually develop over several hours.",
"id": "10005981",
"label": "a",
"name": "Hyperuricaemia",
"picture": null,
"votes": 196
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4463",
"name": "Gout",
"status": null,
"topic": {
"__typename": "Topic",
"id": "162",
"name": "General practice",
"typeId": 5
},
"topicId": 162,
"totalCards": null,
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},
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"dislikes": 0,
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"question": "65 year old male presents to accident and emergency with a very hot, swollen and extremely tender big toe that has developed over 2 hours.\n\nAspiration of the joint is undertaken and crystal microscopy shows negatively bifringent needles.\n\nWhat is the direct cause of this condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 234,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,335 | false | 49 | null | 6,495,081 | null | false | [] | null | 13,744 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the muscle that is cut first in surgery.",
"id": "10005988",
"label": "c",
"name": "External oblique",
"picture": null,
"votes": 44
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This muscle will be cut just before the transverse abdominis. A way to remember the order of the muscles (superficial to deep):\n\n> E > Elegant (External oblique)\n\n> I > Innocent (Internal oblique)\n\n> R > Rabbits (Rectus abdominis)\n\n> T > Toddled (Transverse abdominis)",
"id": "10005987",
"label": "b",
"name": "Rectus abdominis",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The peritoneum is cut after the fascia of the abdominis muscle.",
"id": "10005989",
"label": "d",
"name": "Peritoneum",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The transversus abdominis muscle is the last muscle the surgeon will cut through. After this will be the corresponding fascia deep to this structure then the perineum.\n\nThe structures that the surgeon will cut through superficial to deep are; skin, subcutaneous fat, anterior fascia, external oblique muscle, internal oblique muscle, rectus abdoiminis muscle, transverse abdominis, transversalis fascia and peritoneum.",
"id": "10005986",
"label": "a",
"name": "Transversalis fascia",
"picture": null,
"votes": 111
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This muscle is found between the external and internal oblique muscles",
"id": "10005990",
"label": "e",
"name": "Rectus abdominis",
"picture": null,
"votes": 26
}
],
"comments": [],
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"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4464",
"name": "Types of muscle",
"status": null,
"topic": {
"__typename": "Topic",
"id": "190",
"name": "Musculoskeletal",
"typeId": 7
},
"topicId": 190,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"difficulty": 1,
"dislikes": 0,
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"question": "A 35 year old woman is taken into surgery for an open appendicectomy.\n\nWhat is the next layer of the abdomen the surgeon will cut through after the transverse abdominis?",
"sbaAnswer": [
"a"
],
"totalVotes": 229,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,336 | false | 50 | null | 6,495,081 | null | false | [] | null | 13,745 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "fibrocystic breast change is a common non-cancerous condition that does not increase the risk of cancer. The changes include fibrosis, epithelial hyperplasia, dilation of ducts and apocrine metaplasia.\n\nIt is thought to arise from excessive local hormonal stimulation of the terminal duct-lobular unit. Therefore, pain can increase before menstruation.\n\nThis mainly affects premenopausal women between the ages of 20-50 years of age.",
"id": "10005991",
"label": "a",
"name": "It is benign with no increased risk of malignancy",
"picture": null,
"votes": 108
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "It is a benign, common condition in premenopausal women that does not increase the risk of malignancy.",
"id": "10005992",
"label": "b",
"name": "It is benign but has an increased risk of malignancy",
"picture": null,
"votes": 115
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Fibrocystic change is a benign condition it does not require any treatment.",
"id": "10005993",
"label": "c",
"name": "Is a malignant diagnosis",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Mastitis can be caused by infection and mainly affects breastfeeding women. The breast will likely be tender, red and sore and is more of an acute presentation.\n\nThere are no skin changes that may indicate an infection and the patient is systemically well.",
"id": "10005994",
"label": "d",
"name": "Is caused by an infection",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not always the case in those with fibrocystic changes.\n\nSymptoms tend to be hormonal-driven and cyclical and can fluctuate with time.\n\nAfter menopause, the lumps can become less noticable and even disappear completely.",
"id": "10005995",
"label": "e",
"name": "Grows and symptoms become worse with time",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4465",
"name": "Fibrocystic disease of the Breast",
"status": null,
"topic": {
"__typename": "Topic",
"id": "151",
"name": "Breast Disease",
"typeId": 7
},
"topicId": 151,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
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"question": "30 year old female presents to the GP concerned she has felt some lumps on her left breast in the left upper quadrant over a year ago. She also describes the area of the breast becoming more tender just before she is due to start her period.\n\nThe GP examines the patient and observes tht there are no skin changes but some three small lumps measuring around 2cm in the upper quadrant of the left breast which are smooth and fluctuant.\n\nShe is referred to breast clinic where an ultrasound and an ultrasound-guided biopsy are performed.\n\nThese investigations lead to a diagnosis of fibrocystic breast changes.\n\nShe is really concerned with this diagnosis and wants to know more about it.\n\nWhich of these options is correct about this condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 228,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,462,397 | false | 1 | null | 6,495,084 | null | false | [] | null | 13,746 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is how the germ layers form",
"id": "10005997",
"label": "b",
"name": "Histogenesis",
"picture": null,
"votes": 36
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the process for forming the blastocyst",
"id": "10006000",
"label": "e",
"name": "Blastulation",
"picture": null,
"votes": 51
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is how the neural tube forms",
"id": "10005998",
"label": "c",
"name": "Neurulation",
"picture": null,
"votes": 39
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This process generates \"epithelial trees\". Signaling pathways determine the branch position, orientation, and shape of the kidneys.",
"id": "10005996",
"label": "a",
"name": "Branching morphogenesis",
"picture": null,
"votes": 131
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This directs the movement of the sperm towards the ovum",
"id": "10005999",
"label": "d",
"name": "Chemotaxis",
"picture": null,
"votes": 11
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
"files": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4466",
"name": "Development of the urinary tract",
"status": null,
"topic": {
"__typename": "Topic",
"id": "171",
"name": "Embryology",
"typeId": 7
},
"topicId": 171,
"totalCards": null,
"typeId": null,
"userChapter": null,
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},
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"difficulty": 1,
"dislikes": 0,
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"psaSectionId": null,
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"question": "What is the process by which the kidneys develop?",
"sbaAnswer": [
"a"
],
"totalVotes": 268,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
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