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"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Loop diuretics increase the amount of NaCl delivered to the distal nephron through inhibition of the Na/2Cl/K transporter. NaCl remains in the tubule of the thick ascending loop of Henley, reducing the osmotic concentration of the renal medulla. This therefore causes more water to be excreted as urine.",
"id": "10008250",
"label": "a",
"name": "Loop Diuretics",
"picture": null,
"votes": 140
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Thiazide diuretics inhibit the Na+/Cl- co-transporter within the early distal tubule. These drugs are weaker and produce only a moderate diuresis, but are typically well tolerated. They last longer than loop diuretics but exert a lesser effect on the concentration gradient of the medulla.",
"id": "10008252",
"label": "c",
"name": "Thiazide Diuretics",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Carbonic anhydrase inhibitors block the reabsorption of HCO3, Na, and prevent the exchange and secretion of H+. Preventing the reabsorption of Na induces diuresis and there is decreased H+ formation inside the cell. This reduces the activity of the Na/H antiporter, and increases Na and HCO3 concentration in the lumen.",
"id": "10008254",
"label": "e",
"name": "Carbonic Anhydrase Inhibitors",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Osmotic diuretics increase the osmolality of the filtrate and reduce water reabsorption. They act best where most osmotic reabsorption occurs (i.e. the proximal tubule and descending loop of Henle). They do not work on a transporter.",
"id": "10008253",
"label": "d",
"name": "Osmotic Diuretics",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Potassium-sparing diuretics act on principle cells in the late distal and cortical collecting tubule. They inhibit either sodium channels or mineralocorticoid receptors, reducing potassium secretion into the tubular lumen. They do not affect the osmotic gradient of the medulla, or the transporter associated with it.",
"id": "10008251",
"label": "b",
"name": "Potassium-sparing Diuretics",
"picture": null,
"votes": 7
}
],
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"id": "4655",
"name": "Effect of Loop Diuretics on Calcium Excretion",
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"__typename": "Topic",
"id": "188",
"name": "Renal Pharmacology",
"typeId": 7
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"question": "A 76-year-old woman with a history of congestive heart failure and hypertension presents with dyspnoea and orthopnoea. She denies having chest pain, chills, or fever. On examination you note pitting oedema in her ankles. A diuretic is prescribed to relieve her symptoms.\n\nWhich of the following classes of diuretics inhibits the action of the transporter that is primarily involved in generating the osmotic gradient in the medulla?",
"sbaAnswer": [
"a"
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"totalVotes": 192,
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173,463,773 | false | 3 | null | 6,495,128 | null | false | [] | null | 14,198 | {
"__typename": "QuestionSBA",
"choices": [
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The lesser sac is located behind the stomach and lesser omentum, the only entrance and exit being through the epiploic foramen. In cases of pancreatitis and certain perforated gastric ulcers, fluid can collect in the lesser sac. However, it would not typically cause pain in the right hypochondrium.",
"id": "10008257",
"label": "c",
"name": "Lesser Sac",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The vesico-uterine pouch is located between the uterus and the bladder. It is rarely a site of fluid collection in supine patients, and would not cause right upper quadrant pain.",
"id": "10008259",
"label": "e",
"name": "Vesico-uterine pouch",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The subphrenic space is a peritoneal space between the anterior part of the liver and the diaphragm. It is separated into the right and left sides by the falciform ligament. The subphrenic spaces can be sites of fluid collection following procedures. However, the presence of an abscess here would not cause pain to radiate to the right back and shoulder.",
"id": "10008256",
"label": "b",
"name": "Left Subphrenic Space",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - The hepatorenal recess is a common site of fluid collection in unwell or postoperative patients who are supine. Fluid collection and subsequent abscess formation would cause pain in the right hypochondrium which radiates to the back and shoulder.",
"id": "10008255",
"label": "a",
"name": "Hepatorenal recess",
"picture": null,
"votes": 103
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Fluid in the pouch of Douglas can accumulate due to menstrual blood refluxing through the fallopian tubes, or from the release of fluids from ruptured cysts. The pouch of Douglas is located posteriorly to the uterus and anteriorly to the rectum. Fluid can collect here following surgical procedures, however, it would not cause pain in the right hypochondrium.",
"id": "10008258",
"label": "d",
"name": "Pouch of Douglas",
"picture": null,
"votes": 34
}
],
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"id": "4656",
"name": "Ascites",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
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"question": "A 68-year-old female patient suffered a peritoneal infection following abdominal surgery. She later complains of pain in her right hypochondrium, which radiates to the right side of her back and shoulder.\n\nThe patient was primarily supine both during and in the days following the operation.\n\nIn which of the following anatomical sites is the infected fluid most likely to have collected?",
"sbaAnswer": [
"a"
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173,463,774 | false | 4 | null | 6,495,128 | null | false | [] | null | 14,199 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Cholecystokinin stimulates the exocrine pancreas to release enzymes and stimulates the gallbladder to contract -releasing bile into the small intestine- in response to fat entering the duodenum.",
"id": "10008261",
"label": "b",
"name": "Cholecystokinin",
"picture": null,
"votes": 55
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Gastric inhibitory peptide stimulates insulin release, inhibits gastric secretion, and elicits pyloric sphincter constriction. It does not stimulate the pancreas to release bicarbonate",
"id": "10008263",
"label": "d",
"name": "Gastric Inhibitory Peptide",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Gastrin is secreted by gastric glands and does not act on the pancreas. Its function is to control gastric acid secretion.",
"id": "10008262",
"label": "c",
"name": "Gastrin",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Secretin is secreted by the small intestine and stimulates the pancreas to secrete bicarbonate ions and the liver to secrete bile. It also elicits pyloric sphincter constriction.",
"id": "10008260",
"label": "a",
"name": "Secretin",
"picture": null,
"votes": 110
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Glucagon is secreted from alpha cells in the islets of Langerhans, in response to drops in blood glucose concentration. It does not stimulate the pancreas to release bicarbonate",
"id": "10008264",
"label": "e",
"name": "Glucagon",
"picture": null,
"votes": 0
}
],
"comments": [],
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"chapterId": 2693,
"demo": null,
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"id": "4657",
"name": "Pancreatic Bicarbonate Production",
"status": null,
"topic": {
"__typename": "Topic",
"id": "149",
"name": "Gastro-intestinal physiology",
"typeId": 7
},
"topicId": 149,
"totalCards": null,
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"question": "A 45-year-old woman presents to A&E with epigastric pain radiating through to her back. She reports nausea, but has not vomited. On examination, she does not appear jaundiced but has a temperature of 38.1 degrees Celsius. It is suspected she has gallstone pancreatitis.\n\nWhich of the following hormones directly stimulates the pancreas to secrete bicarbonate ions?",
"sbaAnswer": [
"a"
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"typeId": 1,
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173,463,775 | false | 5 | null | 6,495,128 | null | false | [] | null | 14,200 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Sacral splanchnic nerves arise from the sacral sympathetic chain. They provide both motor and sensory innervation to the posterior thigh, part of the pelvis, and the majority of the lower leg and foot. They do not typically innervate the bladder, and damage to these nerves is not associated with urinary retention.",
"id": "10008266",
"label": "b",
"name": "Damage to sacral splanchnic nerves",
"picture": null,
"votes": 40
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - The pelvic splanchnic nerve is made up of preganglionic parasympathetic fibres that arise from the S2-4 nerve roots of the sacral plexus. The internal urethral sphincter is supplied by the pelvic splanchnic nerves. The pelvic splanchnic nerves can trigger contraction in the detrusor muscle of the bladder and trigger micturition. As the patient is able to sense his bladder is full but unable to void urine voluntarily, his pelvic splanchnic nerves are likely damaged.",
"id": "10008265",
"label": "a",
"name": "Damage to pelvic splanchnic nerve",
"picture": null,
"votes": 73
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The phrenic nerve provides motor innervation to the diaphragm. It does not supply the bladder, and therefore damage to the phrenic nerve would not lead to urinary retention.",
"id": "10008267",
"label": "c",
"name": "Damage to the phrenic nerve",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - It is unlikely that a bladder stone is the cause of this patient's inability to void given the history of recent trauma. Bladder stones typically present with suprapubic pain and haematuria, making this option highly unlikely.",
"id": "10008268",
"label": "d",
"name": "Bladder stone",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Damage to the pudendal nerve is likely to cause urinary incontinence rather than an inability to void. The pudendal nerve controls the external urethral sphincter and is responsible for maintaining continence.",
"id": "10008269",
"label": "e",
"name": "Pudendal Nerve",
"picture": null,
"votes": 59
}
],
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"pictures": [],
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"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4414",
"name": "Acute Urinary Retention",
"status": null,
"topic": {
"__typename": "Topic",
"id": "142",
"name": "Nephrology",
"typeId": 7
},
"topicId": 142,
"totalCards": null,
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"question": "A 25-year-old male motorcyclist suffered a road traffic accident, sustaining multiple fractures to the lower part of his sacrum from S2 inferiorly. Whilst in the emergency department after the accident, he is able to sense that his bladder is full but is unable to void urine.\n\nWhich of the following is the most likely cause of his urinary retention?",
"sbaAnswer": [
"a"
],
"totalVotes": 180,
"typeId": 1,
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173,463,776 | false | 6 | null | 6,495,128 | null | false | [] | null | 14,201 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Pseudostratified columnar is found in areas where secretion and protection are the primary functions. For example, the respiratory tract. It does not form the filtration barrier in the renal glomerulus.",
"id": "10008273",
"label": "d",
"name": "Pseudostratified Columnar",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Simple squamous epithelium facilitates exchange functions, including the exchange of gases or chemicals. It is found in the alveoli of the lungs, glomerulus of the kidneys, and capillaries.",
"id": "10008270",
"label": "a",
"name": "Simple Squamous",
"picture": null,
"votes": 104
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Stratified squamous epithelium is designed for protection. It is the epithelium found at many of the body openings, such as the vagina, anal canal, and mouth. It does not form the filtration barrier in the renal glomerulus.",
"id": "10008271",
"label": "b",
"name": "Stratified Squamous",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Transitional epithelium lines the bladder, urethra, and ureters. It has multiple layers and allows tissues to stretch. It does not form the filtration barrier in the renal glomerulus.",
"id": "10008274",
"label": "e",
"name": "Transitional",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Simple columnar epithelium is designed to facilitate motility, absorption, and processing. It has a high organelle density and potential for energy reserves. It does not form the filtration barrier in the renal glomerulus.",
"id": "10008272",
"label": "c",
"name": "Simple Columnar",
"picture": null,
"votes": 29
}
],
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"demo": null,
"entitlement": null,
"id": "4658",
"name": "Glomerulus Structure",
"status": null,
"topic": {
"__typename": "Topic",
"id": "168",
"name": "Renal Physiology",
"typeId": 7
},
"topicId": 168,
"totalCards": null,
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"question": "A 55-year-old man with chronic kidney disease presents to his GP with increased swelling in his legs. He also reports a loss of appetite and persistent nausea, but no vomiting.\n\nWhich of the following types of epithelium forms the filtration barrier in the glomerulus?",
"sbaAnswer": [
"a"
],
"totalVotes": 183,
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173,463,777 | false | 7 | null | 6,495,128 | null | false | [] | null | 14,202 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - A direct inguinal hernia would not remain reduced when pressure is applied to the deep inguinal ring. Direct inguinal hernias occur due to weakness of the conjoint tendon or the transversalis fascia.",
"id": "10008277",
"label": "c",
"name": "Direct Inguinal Hernia",
"picture": null,
"votes": 78
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The root of an umbilical hernia would begin superior to this location, although with time it could grow and protrude.",
"id": "10008278",
"label": "d",
"name": "Umbilical Hernia",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Femoral hernias are inferior and lateral to the pubic tubercle, rather than superior and medial. Femoral hernias are more commonly found in women.",
"id": "10008276",
"label": "b",
"name": "Femoral Hernia",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - A saphena varix is a dilation of the saphenous vein, typically at its junction to the femoral vein within the groin. Saphena varices can sometimes be mistaken for femoral hernias: the key differentiation is that a saphena varix is reducible, whereas femoral hernias are not.",
"id": "10008279",
"label": "e",
"name": "Saphena Varix",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - This presentation has all the classic characteristics of an indirect inguinal hernia. Remember, indirect inguinal hernias pass through both the deep and superficial inguinal ring, rather than bursting through the fascia of the abdominal wall. The key feature in identifying this as an indirect inguinal hernia is that it remains reduced whilst pressure is applied to the deep inguinal ring.",
"id": "10008275",
"label": "a",
"name": "Indirect inguinal hernia",
"picture": null,
"votes": 78
}
],
"comments": [],
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"demo": null,
"entitlement": null,
"id": "4554",
"name": "Direct and indirect inguinal hernias",
"status": null,
"topic": {
"__typename": "Topic",
"id": "135",
"name": "General surgery",
"typeId": 7
},
"topicId": 135,
"totalCards": null,
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"question": "A 67-year-old male presents to his GP with a swelling in his groin. On examination, the swelling originates superiorly and medially to the pubic tubercle. It is painless, soft, and reducible. The swelling remains reduced whilst pressure is applied to the deep inguinal ring.\n\nWhich of the following is the most likely underlying diagnosis?",
"sbaAnswer": [
"a"
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"totalVotes": 169,
"typeId": 1,
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173,463,778 | false | 8 | null | 6,495,128 | null | false | [] | null | 14,203 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This patient demonstrates signs and symptoms of hyperthyroidism. The presence of exophthalmos specifically points towards Grave's disease. By contrast, reduced T4 levels are seen in cases of hypothyroidism such as Hashimoto's thyroiditis.",
"id": "10008283",
"label": "d",
"name": "Reduced T4, Raised TSH",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This patient demonstrates signs and symptoms of hyperthyroidism. The presence of exophthalmos specifically points toward Grave's disease. A normal T4 and reduced TSH may be seen in a patient with subclinical hyperthyroidism.",
"id": "10008284",
"label": "e",
"name": "Normal T4, Reduced TSH",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This patient demonstrates signs and symptoms of hyperthyroidism. The presence of exophthalmos specifically points toward Grave's disease. By contrast, reduced T4 levels are seen in cases of hypothyroidism. Both reduced T4 and reduced TSH is indicative of a central/secondary cause of hypothyroidism such as a pituitary malfunction.",
"id": "10008282",
"label": "c",
"name": "Reduced T4, Reduced TSH",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This patient demonstrates signs and symptoms of hyperthyroidism. The presence of exophthalmos specifically points toward Grave's disease. In Grave's disease the auto-antibody TSI (thyroid stimulating immunoglobulin) is produced. This mimics the action of TSH, stimulating the TSH receptor, and therefore increasing T4 levels. TSH levels fall as part of a negative feedback cycle. Failure of TSH to fall in response to raised T4 indicates a central cause, such as a problem with the pituitary gland.",
"id": "10008281",
"label": "b",
"name": "Raised T4, Raised TSH",
"picture": null,
"votes": 31
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - This patient demonstrates signs and symptoms of hyperthyroidism. The presence of exophthalmos specifically points towards Grave's disease. This is a hypersensitivity reaction involving autoimmune activation of the TSH receptor. In Grave's disease the auto-antibody TSI (thyroid stimulating immunoglobulin) is produced. This mimics the action of TSH, stimulating the TSH receptor, and therefore increasing T4 levels. TSH levels fall as part of a negative feedback cycle.",
"id": "10008280",
"label": "a",
"name": "Raised T4, Reduced TSH",
"picture": null,
"votes": 112
}
],
"comments": [],
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"demo": null,
"entitlement": null,
"id": "4659",
"name": "Patterns of Thyroid Disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
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"dislikes": 0,
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"question": "A 35-year-old woman presents to her GP with unexplained weight loss over the past few months. She states she has recently missed several periods and has noticed her heart beating faster.\n\nOn examination, she appears agitated and sweaty with noticeable bilateral exophthalmos. Her thyroid gland appears to be enlarged but is smooth and symmetrical to palpation. There is also evidence of pretibial myxoedema. The doctor orders a thyroid function blood test.\n\nWhich of the following findings is most likely?",
"sbaAnswer": [
"a"
],
"totalVotes": 168,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,779 | false | 9 | null | 6,495,128 | null | false | [] | null | 14,204 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - In adults the spinal cord commonly terminates at the L1 vertebral level. The dural sac terminates between S1 and S2. The lumbar cistern is found below the point at which the spinal cord terminates.",
"id": "10008285",
"label": "a",
"name": "L1",
"picture": null,
"votes": 112
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - In adults, the spinal cord commonly terminates at the L1 vertebrae. Sympathetic nerves come off the spinal cord at vertebral levels T11-T12.",
"id": "10008289",
"label": "e",
"name": "T12",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - In adults the spinal cord commonly terminates at the L1 vertebral level. L3-4 and L5-S1 is the region in which lumbar punctures are typically performed in order to avoid nerve damage.",
"id": "10008287",
"label": "c",
"name": "L4",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The dural sac terminates at S1/S2. In adults the spinal cord commonly terminates at the L1 vertebral level.",
"id": "10008286",
"label": "b",
"name": "S1/S2",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The spinal cord typically terminates at L3 in children, not adults. In adults, the spinal cord commonly terminates at the L1 vertebral level.",
"id": "10008288",
"label": "d",
"name": "L3",
"picture": null,
"votes": 19
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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},
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"demo": null,
"entitlement": null,
"id": "4660",
"name": "Spinal Cord Compression",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
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},
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"question": "A 23-year-old female patient is brought to Accident and Emergency after falling off a horse. She reports severe lower back pain, and is unable to feel her legs. The team is worried about the possibility of a spinal cord injury.\n\nAt which of the following vertebral levels does the spinal cord commonly terminate in adults?",
"sbaAnswer": [
"a"
],
"totalVotes": 180,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,780 | false | 10 | null | 6,495,128 | null | false | [] | null | 14,205 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - 18-year-olds are adults. Even when patients are aged under 18, as long as they are deemed Gillick competent to make their own decisions, confidentiality would still be respected. This is not sufficient justification to break confidentiality.",
"id": "10008294",
"label": "e",
"name": "The patient is 18-years-old",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Just like other medical consultations, discussions around contraception should be kept confidential unless there is a specific reason to disclose information. The subject of contraception is not sufficient reason in itself.",
"id": "10008293",
"label": "d",
"name": "The consultation relates to contraception",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Having a learning disability does not usually necessitate the sharing of patient information. As long as the patient is able to understand, retain, weigh, and communicate information relating to their decision, they would be deemed to have the capacity to make their own decisions. Such decisions would be kept confidential.",
"id": "10008292",
"label": "c",
"name": "Patient has a learning disability",
"picture": null,
"votes": 52
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Being a first degree relative does not give individuals the right to access the medical records of others. In this case, there is no reason to suggest the patient's information should be shared with family members, particularly as she specifically asks for it not to be. Her confidentiality should be respected.",
"id": "10008291",
"label": "b",
"name": "If the person making the request is a first-degree relative",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - If disclosure is required by law then an individual's medical records can be disclosed. However, it is important the the minimum necessary amount of information should be released.",
"id": "10008290",
"label": "a",
"name": "Disclosure is required by law",
"picture": null,
"votes": 106
}
],
"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": "4140",
"name": "Situations in which the law obliges doctors to breach confidentiality",
"status": null,
"topic": {
"__typename": "Topic",
"id": "184",
"name": "Ethics and Law",
"typeId": 7
},
"topicId": 184,
"totalCards": null,
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},
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"question": "An 18-year-old woman consults her GP about starting the oral contraceptive pill. She lives at home with her parents, and is concerned they would disapprove if they found out about her request.\n\nWhich of the following circumstances would necessitate the disclosure of patient information?",
"sbaAnswer": [
"a"
],
"totalVotes": 172,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,781 | false | 11 | null | 6,495,128 | null | false | [] | null | 14,206 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - FSH acts only indirectly on Leydig cells through increased androgen production.",
"id": "10008296",
"label": "b",
"name": "Leydig Cells",
"picture": null,
"votes": 52
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - FSH acts directly on Sertoli cells to stimulate spermatogenesis within the testes.",
"id": "10008295",
"label": "a",
"name": "Sertoli Cells",
"picture": null,
"votes": 91
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Granular cells are found in the juxtaglomerular apparatus in the kidney. FSH does not directly act upon them.",
"id": "10008299",
"label": "e",
"name": "Granular Cells",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Lacis cells, also known as mesangial cells, are found in the juxtaglomerular apparatus in the kidney. FSH does not directly act upon them.",
"id": "10008298",
"label": "d",
"name": "Lacis Cells",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Myoid cells aid in transport of the spermatozoa and testicular fluid within the seminiferous tubules of the testes. FSH does not directly act upon them.",
"id": "10008297",
"label": "c",
"name": "Myoid Cells",
"picture": null,
"votes": 4
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3964",
"name": "Testosterone",
"status": null,
"topic": {
"__typename": "Topic",
"id": "175",
"name": "Reproductive Physiology",
"typeId": 7
},
"topicId": 175,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"question": "A 14-year-old boy attends the GP surgery with his mother, who is concerned that he has been 'moody' lately. He is prone to outbreaks of acne on his face and back, and has undergone a growth spurt over the last 6 months. The GP suggests he is going through puberty.\n\nWhich of the following cells does follicle-stimulating hormone (FSH) directly act upon within the testes?",
"sbaAnswer": [
"a"
],
"totalVotes": 159,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,782 | false | 12 | null | 6,495,128 | null | false | [] | null | 14,207 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The external laryngeal nerve innervates the cricothyroid muscle and is at risk during thyroid surgery. It provides mucosal sensation above the vocal folds. Damage to the external laryngeal nerve would cause a reduced range in pitch and a monotonous voice. It would not cause vocal cord palsy, and therefore patients would not present with stridor or breathlessness.",
"id": "10008302",
"label": "c",
"name": "Bilateral damage to the external laryngeal nerve",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The recurrent laryngeal nerve only supplies its respective signs of the larynx. The right recurrent laryngeal nerve recurs under the right subclavian artery at the apex of the lung. A right recurrent laryngeal nerve injury would therefore cause unilateral vocal fold paralysis, which typically presents as a weak or hoarse voice.",
"id": "10008301",
"label": "b",
"name": "Damage to the right recurrent laryngeal nerve",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The recurrent laryngeal nerve only supplies its respective side of the larynx. The left recurrent laryngeal nerve recurs under the aortic arch. A left recurrent laryngeal nerve injury would therefore cause unilateral vocal fold paralysis, which typically presents as a weak or hoarse voice. Patients would not immediately present with stridor or breathlessness.",
"id": "10008303",
"label": "d",
"name": "Damage to the left recurrent laryngeal nerve",
"picture": null,
"votes": 42
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The external laryngeal nerve innervates the cricothyroid muscle and is at risk during thyroid surgery. It provides mucosal sensation above the vocal folds. Damage to the external laryngeal nerve would cause a reduced range in pitch and a monotonous voice. It would not cause vocal cord palsy, and therefore patients would not present with stridor or breathlessness.",
"id": "10008304",
"label": "e",
"name": "Damage to the right external laryngeal nerve",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - In contrast to unilateral vocal cord paralysis, where hoarseness or shortness of breath may not manifest for days to weeks after the damage has occurred, bilateral vocal cord paralysis usually manifests immediately after extubation. Patients may present with biphasic stridor, respiratory distress, or both, due to dysfunctional vocal cords narrowing and obstructing the airway.",
"id": "10008300",
"label": "a",
"name": "Bilateral damage to the recurrent laryngeal nerve",
"picture": null,
"votes": 58
}
],
"comments": [],
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4661",
"name": "Hoarseness",
"status": null,
"topic": {
"__typename": "Topic",
"id": "139",
"name": "Ear, Nose, and Throat",
"typeId": 7
},
"topicId": 139,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4661,
"conditions": [],
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"dislikes": 0,
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"question": "A 34-year-old man underwent a thyroidectomy. Shortly after the procedure, he was noted to be extremely breathless, with an increased respiratory rate and audible stridor.\n\nWhich of the following is the most likely underlying pathophysiology?",
"sbaAnswer": [
"a"
],
"totalVotes": 157,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,783 | false | 13 | null | 6,495,128 | null | false | [] | null | 14,208 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct- The elevated serum pH indicates alkalosis. This elevated pH is caused by a decreased concentration of CO2 in the bloodstream. It is uncompensated as her bicarbonate levels are still within normal range. Hyperventilation is a common cause of respiratory alkalosis.",
"id": "10008305",
"label": "a",
"name": "Uncompensated respiratory alkalosis",
"picture": null,
"votes": 129
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This is not an acidosis as the pH is elevated. The elevated pH is caused by a decreased concentration of CO2 in the blood stream. It is uncompensated as her bicarbonate levels are still within normal range.",
"id": "10008309",
"label": "e",
"name": "Compensated respiratory acidosis",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The bicarbonate levels are within normal range which indicates this is not a metabolic alkalosis. Instead, it is the decreased CO2 concentration driving the alkalosis.",
"id": "10008308",
"label": "d",
"name": "Uncompensated metabolic alkalosis",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The woman's pH is elevated, which is consistent with alkalosis. This elevated pH is caused by a decreased concentration of CO2 in the blood stream. It is not a compensated alkalosis as her bicarbonate levels are still within normal range.",
"id": "10008306",
"label": "b",
"name": "Compensated respiratory alkalosis",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The bicarbonate levels are within normal range which indicates this is not a metabolic alkalosis. Instead, it is the decreased CO2 concentration driving the alkalosis.",
"id": "10008307",
"label": "c",
"name": "Compensated metabolic alkalosis",
"picture": null,
"votes": 7
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4662",
"name": "Acid-Base Balance",
"status": null,
"topic": {
"__typename": "Topic",
"id": "150",
"name": "Respiratory physiology",
"typeId": 7
},
"topicId": 150,
"totalCards": null,
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},
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"dislikes": 0,
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"highlights": [],
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"question": "A 29-year-old woman with asthma presents to the Emergency Department in extreme respiratory distress. An arterial blood gas is taken:\n\n\n||||\n|--------------|:-------:|------------------|\n|pH|7.54|7.35 - 7.45|\n|PaO₂|6.8 kPa|11 - 15|\n|PaCO₂|3.8 kPa|4.6 - 6.4|\n|Bicarbonate|27 mmol/L|22 - 30|\n\n\n - FiO2 0.21\n\n\n\nWhich of the following acid-base disturbances does this patient have?",
"sbaAnswer": [
"a"
],
"totalVotes": 169,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,784 | false | 14 | null | 6,495,128 | null | false | [] | null | 14,209 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The left bundle branch receives its blood supply from the left anterior descending artery, a branch of the left coronary artery. As the blood supply to this area during the myocardial infarction would not have been disrupted, it is unlikely that any damage occurred.",
"id": "10008314",
"label": "e",
"name": "Left Bundle Branch",
"picture": null,
"votes": 31
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - The posterior interventricular artery is typically a branch of the right coronary artery. It runs along the posterior sulcus of the heart and supplies area in which the sinoatrial node is located.",
"id": "10008310",
"label": "a",
"name": "Atrioventricular Node",
"picture": null,
"votes": 40
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The sinoatrial nodal artery supplies the sinoatrial node and is not associated with the posterior interventricular artery. As blood supply to this area during the myocardial infarction would not have been disrupted, it is unlikely that any damage occurred.",
"id": "10008311",
"label": "b",
"name": "Sinoatrial node",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The purkinjie fibres receive their blood supply from the circumflex branch of the left coronary artery. As the blood supply to this area during the myocardial infarction would not have been disrupted, it is unlikely that any damage occurred.",
"id": "10008312",
"label": "c",
"name": "Purkinje Fibres",
"picture": null,
"votes": 53
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The right bundle branch receives its blood supply from the left anterior descending artery, a branch of the left coronary artery. As the blood supply to this area during the myocardial infarction would not have been disrupted, it is unlikely that any damage occurred.",
"id": "10008313",
"label": "d",
"name": "Right Bundle Branch",
"picture": null,
"votes": 28
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3802",
"name": "Myocardial Infarction",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
"conceptId": 3802,
"conditions": [],
"difficulty": 1,
"dislikes": 1,
"explanation": null,
"highlights": [],
"id": "14209",
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"question": "A 83-year-old male presents to A&E with central chest pain. An ECG reveals ST elevation across the inferior leads. He undergoes a percutaneous coronary intervention (PCI), which identifies blockage of the posterior interventricular artery.\n\nWhich of the following cardiac structures is most likely to have been damaged?",
"sbaAnswer": [
"a"
],
"totalVotes": 163,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,785 | false | 15 | null | 6,495,128 | null | false | [] | null | 14,210 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Increased inspiratory capacity and tidal volume, and decreased residual volume result in expiratory reserve volume becoming decreased during pregnancy.",
"id": "10008317",
"label": "c",
"name": "Expiratory Reserve Volume",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Elevation of the diaphragm decreases the total capacity of the lungs during pregnancy.",
"id": "10008319",
"label": "e",
"name": "Total Capacity",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Increased lung expansion, engorgement of the respiratory mucosa, and an elevated diaphragm all contribute to a decrease, rather than an increase, in functional residual capacity during pregnancy.",
"id": "10008316",
"label": "b",
"name": "Functional Residual Capacity",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Elevation of the diaphragm and decreased total lung capacity contribute to a decrease in residual volume during pregnancy.",
"id": "10008318",
"label": "d",
"name": "Residual Volume",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Tidal volume, or the amount of air that passes in or out of the lungs with each breath, is expected to increase during pregnancy. This helps to compensate for the decreased residual volume and functional residual capacity. Vital capacity also increases slightly in late pregnancy due to decreased residual volume.",
"id": "10008315",
"label": "a",
"name": "Tidal Volume",
"picture": null,
"votes": 72
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4212",
"name": "Lung volumes",
"status": null,
"topic": {
"__typename": "Topic",
"id": "150",
"name": "Respiratory physiology",
"typeId": 7
},
"topicId": 150,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14210",
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"question": "A 28-year-old woman who is 32 weeks pregnant presents to her GP. She has been experiencing gradually worsening shortness of breath on exertion throughout her pregnancy and has noticed that her breathing rate has increased. However, on assessment, her observations are all within the normal limits given her current stage of pregnancy.\n\nWhich of the following lung volumes increase during late pregnancy?",
"sbaAnswer": [
"a"
],
"totalVotes": 155,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,786 | false | 16 | null | 6,495,128 | null | false | [] | null | 14,211 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Atrial septal defects are non-cyanotic but would be associated with abnormal development in either the sinus venosus or the atria. It is not associated with abnormal septation of the truncus arteriosus and bulbus cordis.",
"id": "10008321",
"label": "b",
"name": "Atrial Septal Defect",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Tetralogy of Fallot is a cyanotic congenital heart defect. It is a combination of right ventricular hypertrophy, a ventricular septal defect with an overriding aorta, and pulmonary stenosis. This results from multiple areas of abnormal development, not just the truncus arteriosus and bulbus cordis.",
"id": "10008322",
"label": "c",
"name": "Tetralogy of Fallot",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Persistent truncus arteriosus is a cyanotic defect.",
"id": "10008323",
"label": "d",
"name": "Persistent Truncus Arteriosus",
"picture": null,
"votes": 42
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Ventricular septal defects (VSDs) are non-cyanotic. The truncus arteriosus develops into the aorta and the pulmonary trunk through septum formation. Abnormal septation would lead to the development of a membranous VSD. The bulbus cordis develops into the outflow region of both ventricles",
"id": "10008320",
"label": "a",
"name": "Membranous Ventricular Septal Defect",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The foramen ovale provides a shunt in foetal circulation allowing blood to bypass the lungs. Typically it closes and becomes the fossa ovalis after birth, however it can sometimes remain open. It is not associated with an abnormal septation of the truncus arteriosus and bulbus cordis.",
"id": "10008324",
"label": "e",
"name": "Patent Foramen Ovale",
"picture": null,
"votes": 30
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3875",
"name": "Formation of heart chambers",
"status": null,
"topic": {
"__typename": "Topic",
"id": "171",
"name": "Embryology",
"typeId": 7
},
"topicId": 171,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"conditions": [],
"difficulty": 1,
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"highlights": [],
"id": "14211",
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"question": "A baby boy is born with a congenital cardiac defect associated with an abnormal septation of the truncus arteriosus and bulbus cordis. On examination he appears pink and well-perfused.\n\nWhich of the following cardiac defects is the baby most likely to have?",
"sbaAnswer": [
"a"
],
"totalVotes": 157,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,787 | false | 17 | null | 6,495,128 | null | false | [] | null | 14,212 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - A direct thrombin inhibitor works through thrombin inhibition. LMWH binds and activates antithrombin III, through induction of conformational change. Heparin-activated antithrombin III binds to factor Xa directly, inactivating it. Although this indirectly brings about a reduction in thrombin activation, LMWH does not directly inhibit it.",
"id": "10008327",
"label": "c",
"name": "Limits secondary haemostatic plug formation through thrombin inhibition",
"picture": null,
"votes": 41
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Fibrinogen is converted into fibrin by thrombin, which drives clot formation. LMWH inhibits this process.",
"id": "10008326",
"label": "b",
"name": "Converts fibrinogen into fibrin",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - LMWH binds and activates antithrombin III, through induction of a conformational change. This activated antithrombin III then binds to Factor Xa directly, preventing its activation. Factor Xa plays a role in thrombin generation, which drives platelet activation and clot formation. LMWH, therefore, inhibits this process, exerting its anticoagulant effects.",
"id": "10008325",
"label": "a",
"name": "Limits secondary haemostatic plug formation through Factor Xa inhibition",
"picture": null,
"votes": 44
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - LMWH does not inactivate Factor VIIa. LMWH binds and activates antithrombin III, through induction of conformational change. Heparin-activated antithrombin III binds to factor Xa directly, inactivating it.",
"id": "10008329",
"label": "e",
"name": "Limiting primary haemostatic plug formation through factor VIIa inhibition",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - While unfractionated heparin inactivates both thrombin and factor Xa, LMWH primarily works through factor Xa inactivation.",
"id": "10008328",
"label": "d",
"name": "Limits secondary haemostatic plug formation through thrombin and factor Xa inhibition",
"picture": null,
"votes": 61
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4608",
"name": "Low molecular weight heparin",
"status": null,
"topic": {
"__typename": "Topic",
"id": "203",
"name": "Pharmacology of Haemostasis and Thrombosis",
"typeId": 7
},
"topicId": 203,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"conditions": [],
"difficulty": 1,
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"question": "A 53-year-old man is admitted to the respiratory ward for the management of a pulmonary embolism. He is commenced on treatment dose low molecular weight heparin (LMWH).\n\nWhich of the following describes the mechanism of action of LMWH?",
"sbaAnswer": [
"a"
],
"totalVotes": 156,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,788 | false | 18 | null | 6,495,128 | null | false | [] | null | 14,213 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The transversalis fascia becomes the internal spermatic fascia. It is not the tissue from which the cremasteric fascia is derived.",
"id": "10008332",
"label": "c",
"name": "Transversalis Fascia",
"picture": null,
"votes": 38
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The pampiniform plexus is the venous plexus associated with the spermatic cord. It is not the tissue from which the cremasteric fascia is derived.",
"id": "10008331",
"label": "b",
"name": "Pampiniform Plexus",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The external oblique aponeurosis becomes the external spermatic fascia. It is not the tissue from which the cremasteric fascia is derived.",
"id": "10008334",
"label": "e",
"name": "External Oblique Muscle",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Dartos fascia originates from Scarpa's fascia. It becomes Colle's fascia upon meeting the perineal body. It is not the tissue from which the cremasteric fascia is derived.",
"id": "10008333",
"label": "d",
"name": "Dartos Fascia",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - The internal oblique muscle forms the roof of the inguinal canal and becomes the cremasteric fascia.",
"id": "10008330",
"label": "a",
"name": "Internal Oblique Muscle",
"picture": null,
"votes": 54
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4249",
"name": "Testicular Torsion",
"status": null,
"topic": {
"__typename": "Topic",
"id": "143",
"name": "Urology",
"typeId": 7
},
"topicId": 143,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"conditions": [],
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"dislikes": 0,
"explanation": null,
"highlights": [],
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"question": "A 16-year-old boy presents to Accident and Emergency with acute onset testicular pain. He denies any history of trauma. The pain is so severe that he has vomited twice. On examination, his scrotum appears swollen and erythematous. Testicular torsion is suspected.\n\nFrom which of the following tissues is the cremasteric fascia derived?",
"sbaAnswer": [
"a"
],
"totalVotes": 144,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,789 | false | 19 | null | 6,495,128 | null | false | [] | null | 14,214 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Attrition bias is the systematic difference between groups in the loss of participants from the study.",
"id": "10008339",
"label": "e",
"name": "Attrition bias",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Length time bias argues that slowly developing, asymptomatic diseases are those that are most likely to be detected in a screening programme. They are also associated with a better prognosis. This therefore exaggerates the efficacy of a screening programme, as it is these slowly developing diseases that are detected by them. Length time bias is a common type of bias within screening research, but is not relevant to the methodology described here.",
"id": "10008336",
"label": "b",
"name": "Length Time Bias",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Recall bias is the systematic difference in recall about a potential exposure by cases versus controls. Recall bias is a commonly found bias within case-control studies. Utilising the patient's medical records minimises the risk of incorrect information being obtained when collecting data.",
"id": "10008335",
"label": "a",
"name": "Recall Bias",
"picture": null,
"votes": 130
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Overdiagnosis is understood to be the correct diagnosis of a disease, but one that is clinically irrelevant as the disease will never cause symptoms within the patient's lifetime. Overdiagnosis is an ethical problem, particularly in screening programmes. It is not relevant to the research methodology described here.",
"id": "10008338",
"label": "d",
"name": "Overdiagnosis",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Lead time bias states that screening will alter the time at which a diseases is detected. Through screening, a disease may be detected earlier before the patient begins showing symptoms. This therefore exaggerates the efficacy of a screening programme. It is not relevant to the methodology described here.",
"id": "10008337",
"label": "c",
"name": "Lead Time bias",
"picture": null,
"votes": 3
}
],
"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": "4470",
"name": "Selection Bias",
"status": null,
"topic": {
"__typename": "Topic",
"id": "178",
"name": "Medical Statistics",
"typeId": 7
},
"topicId": 178,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4470,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14214",
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"question": "A group of researchers are examining the correlation between depression and the development of cancer later in life. Rather than asking participants to report whether they have ever been diagnosed with depression, researchers took the history of depression from medical records.\n\nWhich of the following types of bias is minimised through this approach?",
"sbaAnswer": [
"a"
],
"totalVotes": 155,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,790 | false | 20 | null | 6,495,128 | null | false | [] | null | 14,215 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The peritoneal cavity is not related to the spinal cord and does not contain CSF. It is the space inside the abdomen that contains abdominal viscera.",
"id": "10008344",
"label": "e",
"name": "Peritoneal Cavity",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - CSF is found in the subarachnoid space, between the arachnoid mater and the pia mater, of the brain and spinal cord. This is accessed during a lumbar puncture. CSF is also found within the ventricular system of the brain.",
"id": "10008340",
"label": "a",
"name": "Subarachnoid Space",
"picture": null,
"votes": 110
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The central canal is a small canal that runs through the spinal cord. Lumbar punctures should be taken below the point of spinal cord termination and should never contact the spinal cord.",
"id": "10008342",
"label": "c",
"name": "Central Canal",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The epidural space is primarily fat-filled. It does not contain any CSF.",
"id": "10008341",
"label": "b",
"name": "Epidural Space",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The subdural space is a very small potential space between the epidural and subarachnoid space. It does not contain any CSF.",
"id": "10008343",
"label": "d",
"name": "Subdural Space",
"picture": null,
"votes": 24
}
],
"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": "3751",
"name": "Meningitis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3751,
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"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14215",
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"question": "A 47-year-old man presents to Accident and Emergency with neck stiffness, photophobia, and a non-blanching rash. A lumbar puncture is performed.\n\nFrom which of the following anatomical regions is cerebrospinal fluid (CSF) taken during a lumbar puncture?",
"sbaAnswer": [
"a"
],
"totalVotes": 158,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,791 | false | 21 | null | 6,495,128 | null | false | [] | null | 14,216 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - It is safe for patients with epilepsy to take trimethoprim, provided they are not pregnant. However the BNF should always be consulted for any potential drug interactions.",
"id": "10008346",
"label": "b",
"name": "Epilepsy",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Trimethoprim is contraindicated in patients with megaloblastic anaemia due to folate deficiency, but it is not contraindicated in patients with iron deficiency anaemia.",
"id": "10008349",
"label": "e",
"name": "Iron Deficiency Anaemia",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Trimethoprim is typically well tolerated in patients with renal impairment. The BNF recommends the dose be reduced in renal impairment, but it is not contra-indicated.",
"id": "10008347",
"label": "c",
"name": "Renal Impairment",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Trimethoprim interferes with folate which is important for foetal central nervous system development. Therefore, it is contraindicated in women in the first trimester of pregnancy.",
"id": "10008345",
"label": "a",
"name": "Pregnancy",
"picture": null,
"votes": 136
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Trimethoprim is not contraindicated in elderly patients.",
"id": "10008348",
"label": "d",
"name": "The elderly",
"picture": null,
"votes": 5
}
],
"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": "3887",
"name": "Antibiotics",
"status": null,
"topic": {
"__typename": "Topic",
"id": "148",
"name": "Microbiology",
"typeId": 7
},
"topicId": 148,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
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"dislikes": 0,
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"question": "A 34-year-old presents to her GP with pain on urination and a frequent urge to pass urine. Her GP suspects she has a urinary tract infection and prescribes trimethoprim.\n\nIn which patient group are antifolates, such as trimethoprim, contraindicated?",
"sbaAnswer": [
"a"
],
"totalVotes": 158,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,792 | false | 22 | null | 6,495,128 | null | false | [] | null | 14,217 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The subthalamic nucleus is part of the subthalamic nucleus. It is implicated in the pathogenesis of hemiballismus, or involuntary movements. This is a form of gross motor dysfunction, as opposed to the fine motor disturbance in essential tremors.",
"id": "10008353",
"label": "d",
"name": "Subthalamic Nucleus",
"picture": null,
"votes": 76
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The supraoptic nucleus is part of the hypothalamus. It regulates blood pressure through the secretion of ADH, and social bonding behaviours through oxytocin release. It is not implicated in tremors.",
"id": "10008354",
"label": "e",
"name": "Supraoptic Nucleus",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The nucleus solitarius receives special sensory information via visceral afferent fibres from cranial nerves VII, IX, and X. It is not responsible for the production of tremors.",
"id": "10008352",
"label": "c",
"name": "Nucleus Solitarius",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The nucleus ambiguus is involved in the motor supply to the branchiomotor muscles of the pharynx, palate, and larynx and parasympathetic supply to the cardiac muscle. It provides a motor nucleus for cranial nerves IX, X, and XI. It is not responsible for the production of tremors.",
"id": "10008351",
"label": "b",
"name": "Nucleus Ambiguus",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - The globus pallidus is part of the basal ganglia, a key brain region involved in motor selection and control. Disruptions to neural activation within the globus pallidus will result in decreased thalamic inhibition and hence greater excitation of the motor cortex. This produces tremors.",
"id": "10008350",
"label": "a",
"name": "Globus Pallidus",
"picture": null,
"votes": 42
}
],
"comments": [],
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"__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": "4663",
"name": "Essential Tremor",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
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"highlights": [],
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"question": "A 37-year-old woman attends the GP surgery to discuss an essential tremor that involves her right hand. It has been present for the past five years, and makes it difficult to perform fine motor activities such as drawing and sewing.\n\nWhich nucleus within the brain is associated with the generation of tremors?",
"sbaAnswer": [
"a"
],
"totalVotes": 142,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,793 | false | 23 | null | 6,495,128 | null | false | [] | null | 14,218 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Oligodendroglia cells produce myelin in the central nervous system. This affects the conduction velocity of neuronal signalling. They are damaged in patients with multiple sclerosis, thus impairing the transmission of sensory and motor neuronal signalling.",
"id": "10008355",
"label": "a",
"name": "Oligodendroglia",
"picture": null,
"votes": 75
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Ependymal cells are ciliated cuboidal epithelial cells that form the blood-cerebrospinal fluid barrier. They line the ventricles of the brain and the choroid plexus.",
"id": "10008359",
"label": "e",
"name": "Ependymal",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Schwann cells produce myelin in the peripheral nervous system. They are not damaged in patients with multiple sclerosis, which targets the central nervous system.",
"id": "10008356",
"label": "b",
"name": "Schwann cells",
"picture": null,
"votes": 74
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Astrocytes have a homeostatic role within the nervous system. They maintain the blood brain barrier and preserve the chemical environment within the central nervous system by recycling ions and acting as transporters. They co-ordinate blood flow to match local activity, take up neurotransmitters and electrolytes such as potassium, and communicate with other astrocytes through gap junctions.",
"id": "10008357",
"label": "c",
"name": "Astrocytes",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Microglia cells act as macrophages within the nervous system. Microglia are derived from bone marrow and are activated during injury and infection. They secrete cytokines and present antigens to lymphocytes as part of an immune response.",
"id": "10008358",
"label": "d",
"name": "Microglia",
"picture": null,
"votes": 5
}
],
"comments": [],
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"__typename": "Concept",
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"demo": null,
"entitlement": null,
"id": "3745",
"name": "Multiple Sclerosis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
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"question": "A 55-year-old woman with multiple sclerosis presents to her GP after noticing a progressive worsening in her symptoms over the past 6 weeks. She reports a sensation similar to an electric shock travelling down her spine and into her legs, that occurs whenever she flexes her neck.\n\nWhich of the following cell types is damaged in patients with multiple sclerosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 160,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,794 | false | 24 | null | 6,495,128 | null | false | [] | null | 14,219 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The temporal lobe is responsible for memory formation, recall, and hearing. The hippocampus and amygdala are found within the medial aspect of the temporal lobe. Damage to the temporal lobe does not cause hemi-spatial neglect.",
"id": "10008363",
"label": "d",
"name": "Temporal lobe",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - The parietal lobe is responsible for motor and sensory input to the contralateral side of the body. It is responsible for the recognition of sensation, proprioception, sense of space and time, as well as reading and comprehension. Damage to the parietal lobe is associated with hemi-spatial neglect.",
"id": "10008360",
"label": "a",
"name": "Parietal lobe",
"picture": null,
"votes": 70
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The occipital lobe is responsible for visual information, processing, and understanding. Damage to the occipital lobe can cause visual changes and deficits in the processing of visual information such as prosopagnosia. It does not cause hemi-spatial neglect.",
"id": "10008361",
"label": "b",
"name": "Occipital lobe",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The frontal lobe is responsible for executive functions. This includes voluntary movement, the ability to plan and consider the consequences of actions, problem-solving, and impulse control. Damage to the frontal lobe does not cause hemi-spatial neglect.",
"id": "10008362",
"label": "c",
"name": "Frontal lobe",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The cerebellum is involved in the coordination and planning of movement. It modulates the activity of the motor cortex. Damage to the cerebellum does not cause hemi-spatial neglect.",
"id": "10008364",
"label": "e",
"name": "Cerebellum",
"picture": null,
"votes": 20
}
],
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"id": "4506",
"name": "Stroke",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
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"question": "A 67-year-old man is reviewed following a recent stroke. He states that he has not noticed any major problems in his activities of daily living. However, it is noted that he has shaved only the right-hand side of his face.\n\nOn examination, when asked to raise both arms in the air, he raises only the right arm. However, when his attention is brought specifically to the left arm, the sensory and motor function is intact.\n\nWhich of the following brain regions is most likely to be affected in a patient with hemi-spatial neglect?",
"sbaAnswer": [
"a"
],
"totalVotes": 141,
"typeId": 1,
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173,463,795 | false | 25 | null | 6,495,128 | null | false | [] | null | 14,220 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The patient is not planning or preparing for change; he has already made this change. Therefore, he is not in the preparation phase.",
"id": "10008369",
"label": "e",
"name": "Preparation",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The patient has already made the change and is not simply thinking about it. Therefore, he is not at the contemplation stage.",
"id": "10008366",
"label": "b",
"name": "Contemplation",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - The transtheoretical model of behaviour change describes a series of six stages through which an individual must progress when making an intentional change in their health behaviour. This patient is ongoing in his practice of new and healthier behaviour. His behaviour is being sustained. Therefore, the patient is in the maintenance phase.",
"id": "10008365",
"label": "a",
"name": "Maintenance",
"picture": null,
"votes": 125
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The patient has not recommenced smoking after temporarily quitting. Therefore, he has not relapsed.",
"id": "10008368",
"label": "d",
"name": "Relapse",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The patient is not adopting new habits, he is maintaining them. Therefore, he is not in the action stage.",
"id": "10008367",
"label": "c",
"name": "Action",
"picture": null,
"votes": 21
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"entitlement": null,
"id": "3801",
"name": "Smoking cessation",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
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"question": "A 43-year-old man attends his GP surgery to discuss his efforts to quit smoking. He proudly announces that he has now been smoke-free for six months. Although he experiences occasional cravings when stressed, he has learned to perform deep breathing exercises or chew gum when these come on.\n\nWhich of the following stages of the transtheoretical model of behaviour change best describes this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 153,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,796 | false | 26 | null | 6,495,128 | null | false | [] | null | 14,221 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Unreactive pupils means that the normal pupillary light reflex, involving cranial nerve II and cranial nerve III, has been impaired. Dilated pupils suggest that the sympathetic nervous innervation has not been affected, and the underlying pathology is likely to be a cranial nerve III lesion. This cranial nerve is situated in the midbrain.",
"id": "10008370",
"label": "a",
"name": "Midbrain",
"picture": null,
"votes": 56
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This would not affect the pupillary light reflex. If the medulla were damaged the patient would have problems with breathing and swallowing. The gag, sneeze, and cough reflexes may also be lost.",
"id": "10008372",
"label": "c",
"name": "Medulla",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Damage to the frontal lobe may produce weakness on one side of the body or the face, impaired judgement, reduced sense of taste or smell, mood changes, or increased falls. The pupillary light reflexes would not be affected.",
"id": "10008374",
"label": "e",
"name": "Frontal Lobe",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The pons is responsible for unconscious processes such as the sleep-wake cycle and breathing regulation. Damage to the pons can cause the loss of all muscle function except for eye movement. Pupillary reflexes would still be intact.",
"id": "10008371",
"label": "b",
"name": "Pons",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The occipital lobe is not responsible for pupillary light reflexes. Damage to the occipital lobe would produce visual illusions, difficulties in colour processing, faulty distance and depth perception, and prosopangosia.",
"id": "10008373",
"label": "d",
"name": "Occipital Lobe",
"picture": null,
"votes": 50
}
],
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"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4664",
"name": "Pupillary Light Reflex",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
"totalCards": null,
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"question": "A 63-year-old man is brought into the Emergency Department after being found collapsed on the floor at home. He had two transient ischaemic attacks in close succession one month ago, as a result of vertebrobasilar insufficiency. On examination, his pupils are fixed and dilated.\n\nWhich of the following lesion sites would result in dilated pupils?",
"sbaAnswer": [
"a"
],
"totalVotes": 145,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,797 | false | 27 | null | 6,495,128 | null | false | [] | null | 14,222 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - In cases of viral meningitis the CSF is often clear in appearance. The white blood cell count is made predominantly of lymphocytes. Glucose and protein levels are typically normal.",
"id": "10008376",
"label": "b",
"name": "Viral",
"picture": null,
"votes": 38
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - In fungal meningitis the CSF is typically clear or cloudy, has raised proteins, and a normal or elevated white cell count. Monocytes are the predominant white blood cell type found within the CSF.",
"id": "10008377",
"label": "c",
"name": "Fungal",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - In bacterial meningitis the CSF typically has a turbid appearance. The opening pressure tends to be raised. Within the CSF, protein levels are raised, as are white blood cells, with a predominance of neutrophils.",
"id": "10008375",
"label": "a",
"name": "Bacterial",
"picture": null,
"votes": 93
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The opening pressure and protein levels in meningitis caused by tuberculosis is often high, which matches the given presentation. However, meningitis associated with tuberculosis has a predominance of monocytes within the CSF, rather than the neutrophil predominance seen in this case.",
"id": "10008378",
"label": "d",
"name": "Tuberculosis",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This is a classic presentation of bacterial meningitis.",
"id": "10008379",
"label": "e",
"name": "Meningitis is not indicated from this history and these results",
"picture": null,
"votes": 1
}
],
"comments": [],
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"__typename": "Concept",
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"demo": null,
"entitlement": null,
"id": "3751",
"name": "Meningitis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
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"question": "An 11-year-old boy is brought to Accident and Emergency by his parents. On examination, he has a non-blanching rash. He reports that his neck feels stiff, and he is covering his eyes to avoid the light.\n\n\nA lumbar puncture is performed and his results are:\n\n\n||||\n|---------------------------------|:-------:|-------------------------|\n|Total Protein|1.9 g/L|0.15 - 0.45|\n|Glucose|0.3 mmol/L|3.2 - 4.4|\n|Cell Count|9500/μL|< 5|\n|Lymphocyte Count|50|60 - 70|\n\n\nThe cerebrospinal fluid (CSF) has a turbid appearance. The opening pressure is raised.\n\n\nWhich of the following types of meningitis is this indicative of?",
"sbaAnswer": [
"a"
],
"totalVotes": 145,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,798 | false | 28 | null | 6,495,128 | null | false | [] | null | 14,223 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Lesions affecting the occipital lobe can result in a macular sparing homonymous hemianopia. The visual field on the contralateral side is affected. As this patient has a lesion in their right occipital cortex, we would expect a macular-sparing left homonymous hemianopia, rather than a right.",
"id": "10008381",
"label": "b",
"name": "Macular-Sparing Right Homonymous Hemianopia",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Lesions affecting the occipital lobe can result in a macular-sparing homonymous hemianopia. The visual field on the contralateral side is affected. As this patient has a lesion in their right occipital cortex, we would expect a macular-sparing left homonymous hemianopia.",
"id": "10008380",
"label": "a",
"name": "Macular-Sparing Left Homonymous Hemianopia",
"picture": null,
"votes": 53
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Monocular blindness usually results from damage to the optic nerve on the affected side.",
"id": "10008384",
"label": "e",
"name": "Left Monocular Blindness",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Right homonymous hemianopias result from damage to the left optic tract. The visual field defect the patient is suffering from is macular sparing, indicating the lesion lies within the occipital lobe.",
"id": "10008382",
"label": "c",
"name": "Right Homonymous Hemianopia",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Left homonymous hemianopias result from damage to the right optic tract. The visual field defect the patient is suffering from is macular sparing, indicating the lesion lies within the occipital lobe.",
"id": "10008383",
"label": "d",
"name": "Left Homonymous Hemianopia",
"picture": null,
"votes": 45
}
],
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"entitlement": null,
"id": "4508",
"name": "Anatomy of visual pathways",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
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"question": "A 37-year-old woman suffered a traumatic brain injury after being involved in a car crash. She sustained significant trauma to the head, and has since experienced a loss of vision.\n\nWhich of the following visual field defects are expected following lesions to the right occipital cortex?",
"sbaAnswer": [
"a"
],
"totalVotes": 131,
"typeId": 1,
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173,463,799 | false | 29 | null | 6,495,128 | null | false | [] | null | 14,224 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This patient demonstrates absence seizures. Lamotrigine is the second-line in absence seizure treatment. It is also used to treat generalised seizures in pregnant women and bipolar disorder. It is a sodium channel blocker.",
"id": "10008386",
"label": "b",
"name": "Lamotrigine",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This patient demonstrates absence seizures. Vigabatrin inhibits GABA breakdown. It is used as an epilepsy adjunct and increases the available levels of GABA within the system. It is not the first-line treatment for absence seizures.",
"id": "10008388",
"label": "d",
"name": "Vigabatrin",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This patient demonstrates absence seizures. Midazolam is the treatment for status epilepticus within the community. It is a benzodiazepine. It is not the first line treatment for absence seizures.",
"id": "10008387",
"label": "c",
"name": "Midazolam",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This patient demonstrates absence seizures. Flumazenil is used to reverse the effect of benzodiazepines, and is a competitive antagonist. It is not the first line treatment for absence seizures.",
"id": "10008389",
"label": "e",
"name": "Flumazenil",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - This patient demonstrates absence seizures. Ethosuximide is the first-line drug in the treatment of absence seizures. It is an antiepileptic and calcium channel blocker. The other first-line drug for absence seizures is sodium valproate.",
"id": "10008385",
"label": "a",
"name": "Ethosuximide",
"picture": null,
"votes": 40
}
],
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4665",
"name": "Treatment of Absence Seizures",
"status": null,
"topic": {
"__typename": "Topic",
"id": "172",
"name": "Pharmacology of the Nervous System",
"typeId": 7
},
"topicId": 172,
"totalCards": null,
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"question": "A 6-year-old girl is taken to see the GP after her school teacher noticed that she seems to ‘go blank’ in lessons. These episodes last for around thirty seconds, and when they come on the child is not responsive to voice. Afterward, she resumes her normal activities as if nothing had happened.\n\nWhich of the following drugs is first-line management for this condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 127,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,800 | false | 30 | null | 6,495,128 | null | false | [] | null | 14,225 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - cranial nerve VII (the facial nerve) supplies the muscles of facial expression. It is not involved in eliciting the gag reflex, and so damage to this region would not cause deviation of the uvula.",
"id": "10008391",
"label": "b",
"name": "Right Cranial Nerve VII",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Cranial nerve X (the vagus nerve) has a range of functions in supplying sensory and motor innervation to the larynx, pharynx and abdominal viscera. In particular, it supplies the muscles of the soft palate responsible for swallowing and speech. Damage can cause characteristic deviation of the uvula. Deviation of the uvula away from the affected side (towards the left) and absence of contraction on the right are indicative of a right sided cranial nerve X lesion.",
"id": "10008390",
"label": "a",
"name": "Right Cranial Nerve X",
"picture": null,
"votes": 59
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - cranial nerve XII (the hypoglossal nerve) supplies the muscles of the tongue. It is not involved in eliciting the gag reflex. Damage to this region would not cause deviation of the uvula.",
"id": "10008392",
"label": "c",
"name": "Right Cranial Nerve XII",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - cranial nerve XI (the accessory nerve) is responsible for innervating the sternocleidomastoid and trapezius muscles. It is not involved in the elicitation of the gag reflex. Damage to this region would not cause deviation of the uvula.",
"id": "10008394",
"label": "e",
"name": "Right Cranial Nerve XI",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - cranial nerve IX (the glossopharyngeal nerve) is responsible for sensation when eliciting the gag reflex. As the patient still has sensation, cranial nerve IX is not affected. Furthermore, damage to this region would not cause deviation of the uvula.",
"id": "10008393",
"label": "d",
"name": "Right Cranial Nerve IX",
"picture": null,
"votes": 44
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4666",
"name": "Vomiting Reflex",
"status": null,
"topic": {
"__typename": "Topic",
"id": "149",
"name": "Gastro-intestinal physiology",
"typeId": 7
},
"topicId": 149,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4666,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14225",
"isLikedByMe": null,
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"likes": 0,
"multiAnswer": null,
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"question": "A 57-year-old male is reviewed following a stroke. The clinician attempts to elicit a gag reflex using a tongue depressor. There is unilateral contraction of the soft palate on the left side, with a failure to rise on the right. Sensation on both sides of the oral cavity is intact. Deviation of the uvula to the left side is observed.\n\nWhich of the following cranial nerves is damaged?",
"sbaAnswer": [
"a"
],
"totalVotes": 138,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,801 | false | 31 | null | 6,495,128 | null | false | [] | null | 14,226 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - U waves are usually the result of hypokalaemia. They are also seen in patients with ventricular hypertrophy, bradycardia, hypothyroidism, hypocalcaemia, and hypothermia.",
"id": "10008396",
"label": "b",
"name": "Visible U Waves",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - ST depression is associated cardiac ischaemia, as well as hypokalaemia. It is not associated with hyperkalaemia.",
"id": "10008398",
"label": "d",
"name": "ST Depression",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Hyperkalaemia causes small or indiscernible p waves. They presence of large p waves is a sign of right atrial enlargement.",
"id": "10008399",
"label": "e",
"name": "Increased amplitude of the P wave",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Tall, tented T waves on ECG are a common sign of hyperkalaemia. This must be treated urgently, to avoid progression into a potentially fatal arrhythmia.",
"id": "10008395",
"label": "a",
"name": "Tall, tented T waves",
"picture": null,
"votes": 132
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Hyperkalaemia causes widening of the QRS complex. A narrow QRS complex reflect rapid activation of the ventricles through a normal His-Purkinje system.",
"id": "10008397",
"label": "c",
"name": "Narrowing of the QRS complex",
"picture": null,
"votes": 7
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "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": []
},
"conceptId": 3799,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14226",
"isLikedByMe": null,
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"likes": 0,
"multiAnswer": null,
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"qaAnswer": null,
"question": "A 56-year-old women presents to the accident and emergency department with heart palpitations, shortness of breath, and chest pain. An ECG is performed.\n\nWhich of the following ECG changes is indicative of hyperkalaemia?",
"sbaAnswer": [
"a"
],
"totalVotes": 155,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,802 | false | 32 | null | 6,495,128 | null | false | [] | null | 14,227 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This patient demonstrates meralgia paresthetica, caused by irritation to the lateral femoral cutaneous nerve, which is supplied by L2 and L3. By contrast, L4 to S1 describes the supply to the superior gluteal nerve. This does not cause meralgia paresthetica.",
"id": "10008404",
"label": "e",
"name": "L4 to S1",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This patient demonstrates meralgia paresthetica, caused by irritation to the lateral femoral cutaneous nerve, which is supplied by L2 and L3. By contrast, L4 to S3 describes the supply to the sciatic nerve. This does not cause meralgia paresthetica.",
"id": "10008403",
"label": "d",
"name": "L4 to S3",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This patient demonstrates meralgia paresthetica, caused by irritation to the lateral femoral cutaneous nerve, which is supplied by L2 and L3. By contrast, L1 and L2 is the supply for the genitofemoral nerve. Damage to the genitofemoral nerve can cause symptoms such as groin pain, paraesthesia, and a burning sensation spreading from the lower abdomen to the medial aspect of the thigh. It does not cause meralgia paresthetica.",
"id": "10008401",
"label": "b",
"name": "L1 and L2",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - This patient demonstrates meralgia paresthetica, caused by irritation to the lateral femoral cutaneous nerve. It is characterised by a tingling, numbness, or burning sensation in the outer thigh. The lateral femoral cutaneous nerve is supplied by L2 and L3, making this the correct answer.",
"id": "10008400",
"label": "a",
"name": "L2 and L3",
"picture": null,
"votes": 56
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This patient demonstrates meralgia paresthetica, caused by irritation to the lateral femoral cutaneous nerve, which is supplied by L2 and L3. By contrast, S1-S3 describes the supply for the posterior femoral nerve. This does not cause meralgia paresthetica.",
"id": "10008402",
"label": "c",
"name": "S1 to S3",
"picture": null,
"votes": 24
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3780",
"name": "Dermatomes",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3780,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14227",
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"question": "A 36-year-old man attends the GP surgery with a tingling sensation on the outer aspect of his left thigh. He denies a history of trauma, although notes that he often wears underwear that is a little tight.\n\nWhich of the following spinal nerve roots are implicated in this condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 148,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,803 | false | 33 | null | 6,495,128 | null | false | [] | null | 14,228 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Methylcellulose is a bulk laxative. These work by increasing water retention in the intestinal lumen to soften & increase the bulk of stools. This drives colonic distention, which in turn stimulates intestinal motility and faecal transit.",
"id": "10008407",
"label": "c",
"name": "Methylcellulose",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Senna is a stimulant purgative. These increase intestinal motility through stimulation of the myenteric plexus. Specifically, senna decreases motility in the proximal colon and increases motility in the distal colon.",
"id": "10008405",
"label": "a",
"name": "Senna",
"picture": null,
"votes": 72
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Loperamide is used to treat diarrhoea and is not a laxative. It increases motility in the proximal colon, increasing the absorption of water, and decreases motility in the distal colon.",
"id": "10008409",
"label": "e",
"name": "Loperamide",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Arachis oil is a faecal softener. This does not affect colonic motility. It works by lowering the surface tension of the stool, softening its consistency and hence making it easier to pass.",
"id": "10008408",
"label": "d",
"name": "Arachis Oil",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Macrogol is an osmotic laxative. These work by promoting the movement of fluid across the bowel wall and into the lumen. This causes colonic distension, simulating and accelerating transit and hence defecation.",
"id": "10008406",
"label": "b",
"name": "Macrogol",
"picture": null,
"votes": 20
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4667",
"name": "Laxatives",
"status": null,
"topic": {
"__typename": "Topic",
"id": "229",
"name": "Pharmacology of the gastro-intestinal system",
"typeId": 7
},
"topicId": 229,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4667,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14228",
"isLikedByMe": null,
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"likes": 0,
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"psaSectionId": null,
"qaAnswer": null,
"question": "A 26-year-old woman visits the GP surgery for support managing her constipation. She is advised to increase the amount of fluid and fibre in her diet. She is also prescribed a laxative.\n\nWhich of the following laxatives decreases motility in the proximal colon and increases motility in the distal colon?",
"sbaAnswer": [
"a"
],
"totalVotes": 132,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,804 | false | 34 | null | 6,495,128 | null | false | [] | null | 14,229 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The urorectal septum divides the cloaca into the urogenital sinus and the rectum. Adult kidneys develop from the metanephros and the ureteric bud.",
"id": "10008413",
"label": "d",
"name": "Urorectal Septum",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The early stage embryological kidney develops from the mesonephros but is ultimately resorbed. Adult kidneys develop from the metanephros and the ureteric bud.",
"id": "10008411",
"label": "b",
"name": "Mesonephros",
"picture": null,
"votes": 73
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - The adult kidneys develop from the metanephros and the ureteric bud.",
"id": "10008410",
"label": "a",
"name": "Metanephros",
"picture": null,
"votes": 47
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The bladder develops from the cloaca, and the perineal body is formed at the point where the urorectal septum meets the cloacal membrane. Adult kidneys develop from the metanephros and the ureteric bud.",
"id": "10008412",
"label": "c",
"name": "Cloaca",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The urachus ultimately becomes the allantois, a fibrous cord, that passes from the bladder to the umbilicus. Adult kidneys develop from the metanephros and the ureteric bud.",
"id": "10008414",
"label": "e",
"name": "Urachus",
"picture": null,
"votes": 4
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "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,
"userNote": null,
"videos": []
},
"conceptId": 4466,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14229",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
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"psaSectionId": null,
"qaAnswer": null,
"question": "A 6-month-old baby has recently been diagnosed with horseshoe kidney disease. His parents are confused as during the pregnancy they were informed that their child was healthy and developing well.\n\nWhich of the following embryological structures does the adult kidney develop from?",
"sbaAnswer": [
"a"
],
"totalVotes": 133,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,805 | false | 35 | null | 6,495,128 | null | false | [] | null | 14,230 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Desogestrel is a progestin medication that is used as a form of contraception and in treating menopausal symptoms. It is not an oestrogen analogue.",
"id": "10008418",
"label": "d",
"name": "Desogestrel",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Medroxyprogesterone is a combination of oestrogen and progesterone that is used to treat the symptoms of menopause. It can also be used as a contraceptive.",
"id": "10008416",
"label": "b",
"name": "Medroxyprogesterone",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Norethisterone is a combination of oestrogen and progesterone that is used to treat the symptoms of menopause. It can also be used as a means of contraception, or to prevent uterine bleeding.",
"id": "10008417",
"label": "c",
"name": "Norethisterone",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Estradiol is a natural oestrogen. Topical estradiol creams are often used to treat urogenital symptoms of menopause such as vaginal atrophy and dyspareunia.",
"id": "10008415",
"label": "a",
"name": "Estradiol",
"picture": null,
"votes": 83
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The copper coil does not contain any hormones. It is primarily used as a method of contraception. It is not commonly used in the management of menopausal symptoms, as it tends to make uterine bleeding somewhat heavier. It is not an oestrogen analogue.",
"id": "10008419",
"label": "e",
"name": "The copper coil",
"picture": null,
"votes": 4
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4668",
"name": "Hormone Replacement Therapy",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4668,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14230",
"isLikedByMe": null,
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"likes": 0,
"multiAnswer": null,
"pictures": [],
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"psaSectionId": null,
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"question": "A 53-year-old woman attends her GP surgery for support in managing her symptoms of menopause. She is particularly troubled by vaginal dryness, which has been interfering with her sex life significantly.\n\nWhich of the following oestrogen analogues is most commonly used to relieve menopausal symptoms?",
"sbaAnswer": [
"a"
],
"totalVotes": 131,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,806 | false | 36 | null | 6,495,128 | null | false | [] | null | 14,231 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Simple squamous epithelium is ideal for exchange functions, including the exchange of gases or chemicals. It is found in the alveoli of the lings, glomerulus of the kidneys, and in capillaries. It is not found in the bladder.",
"id": "10008421",
"label": "b",
"name": "Simple squamous",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Stratified squamous epithelium is designed for protection. It is the epithelium found at many of the body openings, such as the vagina, anal canal, and mouth. It is not seen in a healthy bladder.",
"id": "10008423",
"label": "d",
"name": "Stratified Squamous",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Simple columnar epithelium is designed to facilitated motility, absorption, and processing. It has a high organelle density. It does not make up the bladder.",
"id": "10008422",
"label": "c",
"name": "Columnar",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Pseudostratified columnar is found in areas where secretion and protection are the primary functions. For example, the respiratory tract. It is not seen in a healthy bladder.",
"id": "10008424",
"label": "e",
"name": "Pseudostratified Columnar",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - transitional epithelium lines the bladder. This allows the bladder to stretch as it fills with urine. Stratified squamous cell cancer is the most common form of bladder cancer.",
"id": "10008420",
"label": "a",
"name": "Transitional cell",
"picture": null,
"votes": 111
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4615",
"name": "Bladder cancer",
"status": null,
"topic": {
"__typename": "Topic",
"id": "143",
"name": "Urology",
"typeId": 7
},
"topicId": 143,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"difficulty": 1,
"dislikes": 0,
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"highlights": [],
"id": "14231",
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"question": "A 68-year-old man suffered a spinal cord injury as a teenager in a road traffic accident. He has a long term indwelling catheter and has noticed blood in his urine. At cystoscopy the bladder is inflamed and there are patches of metaplastic white mucosa.\n\nWhich of the following types of epithelium would you normally expect to see in the bladder?",
"sbaAnswer": [
"a"
],
"totalVotes": 150,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,807 | false | 37 | null | 6,495,128 | null | false | [] | null | 14,232 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This patient is presenting with osteomalacia, which involves a softening of the bones and hence susceptibility to recurrent fractures. Vitamin C deficiency is the main risk factor for the development of scurvy. Individuals with scurvy will suffer from fatigue, irritability, severe joint and leg pain, swollen and bleeding gums, and will bruise easily. It is not implicated in the development of osteomalacia.",
"id": "10008427",
"label": "c",
"name": "Vitamin C",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This patient is presenting with osteomalacia, which involves a softening of the bones and hence susceptibility to recurrent fractures. Vitamin B12 deficiency can cause a range of neuropsychiatric symptoms including numbness, muscle weakness, and fatigue. It is not implicated in the development of osteomalacia.",
"id": "10008426",
"label": "b",
"name": "Vitamin B12",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This patient is presenting with osteomalacia, which involves a softening of the bones and hence susceptibility to recurrent fractures. Vitamin E deficiency is extremely rare. An individual suffering from vitamin E deficiency will have nerve and muscle damage, resulting in loss of sensation in the limbs, loss of body movement control, muscle weakness, and vision problems. However, it is not implicated in the development of osteomalacia.",
"id": "10008429",
"label": "e",
"name": "Vitamin E",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - This patient is presenting with osteomalacia, which involves a softening of the bones and hence susceptibility to recurrent fractures. Vitamin A deficiency can cause blindness and increased morbidity and mortality from infection. However, it is not implicated in the development of osteomalacia.",
"id": "10008428",
"label": "d",
"name": "Vitamin A",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - This patient is presenting with osteomalacia, which involves a softening of the bones and hence susceptibility to recurrent fractures. Vitamin D deficiency is the main risk factor for the development of osteomalacia in adults, and rickets in children. Calcium and phosphate deficiencies are also risk factors for developing osteomalacia.",
"id": "10008425",
"label": "a",
"name": "Vitamin D",
"picture": null,
"votes": 143
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4669",
"name": "Osteogenesis Imperfecta",
"status": null,
"topic": {
"__typename": "Topic",
"id": "154",
"name": "Musculoskeletal physiology and disease",
"typeId": 7
},
"topicId": 154,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4669,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14232",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
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"qaAnswer": null,
"question": "A 27-year-old man attends A&E after fracturing his humerus. This is his fifth fracture in the past six months, and each has occurred at a different site. He complains of a constant \"ache\" in his bones.\n\nOn examination, he is neurologically intact aside from some mild proximal muscle weakness in his lower limbs. A DEXA scan reveals low bone mineral density.\n\nWhich of the following vitamins is most likely to be deficient?",
"sbaAnswer": [
"a"
],
"totalVotes": 153,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,808 | false | 38 | null | 6,495,128 | null | false | [] | null | 14,233 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The inferior gluteal artery supplies blood to gluteus maximus. It does not contribute to supplying blood to the femoral head.",
"id": "10008433",
"label": "d",
"name": "Inferior Gluteal Artery",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The superior gluteal artery supplies blood to gluteus medius and minimus. It does not contribute to supplying blood to the femoral head.",
"id": "10008432",
"label": "c",
"name": "Superior Gluteal Artery",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The pudendal artery supplies pelvic viscera, including the bulb of the penis in males, and the blub of the vestibule in females. It does not contribute to supplying blood to the femoral head",
"id": "10008434",
"label": "e",
"name": "Pudendal Artery",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - The femoral circumflex arteries supply blood to the head of the femur. In intracapsular fractures their ability to supply blood becomes compromised and the patient is at risk of avascular necrosis of the head of the femur.",
"id": "10008430",
"label": "a",
"name": "Femoral Circumflex Arteries",
"picture": null,
"votes": 105
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The superficial femoral artery passes down the medial aspect of the thigh, eventually passing deep through the adductor hiatus. It does not contribute to supplying blood to the femoral head.",
"id": "10008431",
"label": "b",
"name": "Superficial femoral Artery",
"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": "4574",
"name": "Avascular necrosis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "154",
"name": "Musculoskeletal physiology and disease",
"typeId": 7
},
"topicId": 154,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4574,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14233",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
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"question": "An 87-year-old woman is brought into the accident and emergency department by paramedics after falling in the street. She complains of severe pain on the left side of her pelvis.\n\nAn X-ray reveals a left-sided intracapsular fracture. Surgeons are concerned about her developing avascular necrosis.\n\nWhich of the following arteries supply blood to the femoral head?",
"sbaAnswer": [
"a"
],
"totalVotes": 142,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,809 | false | 39 | null | 6,495,128 | null | false | [] | null | 14,234 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Disagreeing with a management plan is not a sign of diminished capacity. If the patient cannot clearly articulate why they disagree with the management plan, or cannot remember the plan, then their capacity may be reduced. However, disagreeing is not evidence of diminished capacity in itself.",
"id": "10008437",
"label": "c",
"name": "The patient disagrees with the proposed management plan",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Disagreeing with the proposed course of action, or stating a preference for a different investigation, is not a sign of diminished capacity in itself. As long as patients can retain, understand and weigh information, as well as communicate their decision, they are entitled to refuse (but not demand) treatment.",
"id": "10008438",
"label": "d",
"name": "The patient would rather have an MRI as they have heard it is more accurate",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The ability to communicate a decision is a key component of a capacity assessment. However, writing is a form of communication. Provided the patient fulfils other components of the capacity assessment, this is not a sign of diminished capacity.",
"id": "10008439",
"label": "e",
"name": "The patient writes out their decision rather than saying it",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - An individual making a decision which is not in their best interests is not a sign of diminished capacity, provided they can retain, understand and weigh information, as well as communicate their decision.",
"id": "10008436",
"label": "b",
"name": "The patient makes a decision that is not in their best interest",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - A key feature of capacity is the ability of the patients to understand and weigh the information presented to them. If a patient is disorientated to place and cannot appreciate the importance of having such an investigation, they are unlikely to have capacity to refuse treatment.",
"id": "10008435",
"label": "a",
"name": "The patient appears confused",
"picture": null,
"votes": 144
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4670",
"name": "Key Principles of the Mental Capacity Act",
"status": null,
"topic": {
"__typename": "Topic",
"id": "184",
"name": "Ethics and Law",
"typeId": 7
},
"topicId": 184,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4670,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14234",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
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"question": "A 19-year-old man is brought to Accident and Emergency by his friends after falling over and hitting his head on a night out. On assessment he seems confused and not entirely sure of where he is. His friends confirm that this is highly unusual for him.\n\nIt is decided that he will need a CT head to rule out an intracranial bleed. Upon hearing this, the patient becomes agitated and threatens to leave the hospital. He doesn't appear to understand attempts to explain why the scan is necessary.\n\nWhich of these is a sign the patient lacks capacity?",
"sbaAnswer": [
"a"
],
"totalVotes": 151,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,810 | false | 40 | null | 6,495,128 | null | false | [] | null | 14,235 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The ovarian artery, sometimes referred to as the gonadal artery, arises from the abdominal aorta. It branches off at the level of L2, below the superior mesenteric artery. It does not arise from the pudendal artery.",
"id": "10008444",
"label": "e",
"name": "Pudendal Artery",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The ovarian artery, sometimes referred to as the gonadal artery, arises from the abdominal aorta. It branches off at the level of L2, below the superior mesenteric artery. It does not arise from the external iliac artery.",
"id": "10008443",
"label": "d",
"name": "The external iliac artery",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The ovarian artery, sometimes referred to as the gonadal artery, arises from the abdominal aorta. It branches off at the level of L2, below the superior mesenteric artery. It does not arise from the internal iliac artery.",
"id": "10008442",
"label": "c",
"name": "The internal iliac artery",
"picture": null,
"votes": 52
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - The ovarian artery, sometimes referred to as the gonadal artery, arises from the abdominal aorta. It branches off at the level of L2, below the superior mesenteric artery.",
"id": "10008440",
"label": "a",
"name": "The aorta",
"picture": null,
"votes": 67
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The ovarian artery, sometimes referred to as the gonadal artery, arises from the abdominal aorta. It branches off at the level of L2, below the superior mesenteric artery. It does not arise from the common iliac artery.",
"id": "10008441",
"label": "b",
"name": "The common iliac artery",
"picture": null,
"votes": 11
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4649",
"name": "Ovaries",
"status": null,
"topic": {
"__typename": "Topic",
"id": "175",
"name": "Reproductive Physiology",
"typeId": 7
},
"topicId": 175,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4649,
"conditions": [],
"difficulty": 1,
"dislikes": 1,
"explanation": null,
"highlights": [],
"id": "14235",
"isLikedByMe": 0,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
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"psaSectionId": null,
"qaAnswer": null,
"question": "A 23-year-old woman has just given birth when the midwife notices a large amount of vaginal bleeding. The patient appears pale and sweaty. On examination, she has an increased pulse and respiratory rate. An urgent CT angiogram reveals damage to the ovarian artery.\n\nWhich of the following arteries does the ovarian artery originate from?",
"sbaAnswer": [
"a"
],
"totalVotes": 142,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,811 | false | 41 | null | 6,495,128 | null | false | [] | null | 14,236 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - All patients aged 75 years or over should have an annual review of their repeat medication. Those taking 4 or more medicines should be reviewed every 6 months. As this patient is taking 6 daily medications, he should be reviewed every 6 months.",
"id": "10008446",
"label": "b",
"name": "Every 4 months",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - If the patient were taking 3 or fewer medications then in accordance with the national service framework for older people, he should be reviewed every 12 months. However, as this patient is taking 6 daily medications, he should be reviewed every 6 months.",
"id": "10008447",
"label": "c",
"name": "Every 12 months",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - All patients aged 75 years or over should have an annual review of their repeat medication. Those taking 4 or more medicines should be reviewed every 6 months. As this patient is taking 6 daily medications, he should be reviewed every 6 months.",
"id": "10008445",
"label": "a",
"name": "Every 6 months",
"picture": null,
"votes": 56
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - All patients aged 75 years or over should have an annual review of their repeat medication. Those taking 4 or more medicines should be reviewed every 6 months. As this patient is taking 6 daily medications, he should be reviewed every 6 months.",
"id": "10008448",
"label": "d",
"name": "Every 3 months",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - All patients aged 75 years or over should have an annual review of their repeat medication. Those taking 4 or more medicines should be reviewed every 6 months. As this patient is taking 6 daily medications, he should be reviewed every 6 months.",
"id": "10008449",
"label": "e",
"name": "Every month",
"picture": null,
"votes": 6
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4671",
"name": "End of Life Care",
"status": null,
"topic": {
"__typename": "Topic",
"id": "191",
"name": "Geriatrics",
"typeId": 7
},
"topicId": 191,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4671,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14236",
"isLikedByMe": null,
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"question": "A 79-year-old man attends his GP surgery for a medication review. He is currently taking six daily medications.\n\nAccording to the national service framework for older people, how frequently should the patient have a medication review?",
"sbaAnswer": [
"a"
],
"totalVotes": 140,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,812 | false | 42 | null | 6,495,128 | null | false | [] | null | 14,237 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The urachus ultimately becomes the allantois, a fibrous cord, that passes from the bladder to the umbilicus. It is not associated with the development of the penis or reproductive system.",
"id": "10008454",
"label": "e",
"name": "Urachus",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - the genital swellings form the scrotum in males and the labia in females.",
"id": "10008451",
"label": "b",
"name": "Genital Swellings",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The inguinal ligament is not associated with the development of the penis or reproductive system.",
"id": "10008453",
"label": "d",
"name": "Inguinal Ligament",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The genital tubercle forms the glans of the penis and erectile tissue in males and the clitoris in females.",
"id": "10008452",
"label": "c",
"name": "Genital tubercle",
"picture": null,
"votes": 57
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - The shaft of the penis originates from the urethral folds. Failure of their fusion can result in epispadias (where the urethral opening arises from the dorsal aspect of the penis) or hypospadias (where the urethral opening arises from the ventral aspect of the penis).",
"id": "10008450",
"label": "a",
"name": "Urethral Folds",
"picture": null,
"votes": 37
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3871",
"name": "Development of the male reproductive system",
"status": null,
"topic": {
"__typename": "Topic",
"id": "171",
"name": "Embryology",
"typeId": 7
},
"topicId": 171,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3871,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14237",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
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"question": "A 6-month-old baby boy is brought to the GP surgery by his mother. When changing the baby's nappy she has noticed that he does not seem to urinate out of the end of his penis. On examination, the GP identifies hypospadias.\n\nWhich of the following embryological tissue does the shaft of the penis originate from?",
"sbaAnswer": [
"a"
],
"totalVotes": 132,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,813 | false | 43 | null | 6,495,128 | null | false | [] | null | 14,238 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - V5 and V6 provide a lateral view of the heart. ST elevation would not be seen in these leads if the infarction was isolated to the anterior aspect of the heart",
"id": "10008456",
"label": "b",
"name": "V5 and V6",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Leads V1 and V2 provide an septal view of the heart, and ST elevation would not be seen in these leads if the infarction was isolated to the anterior aspect of the heart.",
"id": "10008459",
"label": "e",
"name": "V1 and V2",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Leads V3 and V4 provide an anterior view of the heart. In the case of an anterior ST elevation myocardial infarction, ST elevation would be seen in these leads.",
"id": "10008455",
"label": "a",
"name": "V3 and V4",
"picture": null,
"votes": 69
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Leads I and aVL provide a lateral view of the heart. ST elevation would not be seen in these leads if the infarction was isolated to the anterior aspect of the heart.",
"id": "10008458",
"label": "d",
"name": "Leads I and aVL",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Leads II and III provide an inferior view of the heart. ST elevation would not be seen in these leads if the infarction was isolated to the anterior aspect of the heart.",
"id": "10008457",
"label": "c",
"name": "Leads II and III",
"picture": null,
"votes": 13
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "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": []
},
"conceptId": 3799,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14238",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
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"psaSectionId": null,
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"question": "A 67-year-old man presents to Accident and Emergency with severe chest pain that is radiating down his left arm and up to his jaw. He is sweaty and nauseous. His pain is not alleviated by GTN spray, and it is suspected he is having a myocardial infarction. An ECG is performed.\n\nWhich of the following ECG leads would demonstrate an anterior ST elevation infarction?",
"sbaAnswer": [
"a"
],
"totalVotes": 145,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,814 | false | 44 | null | 6,495,128 | null | false | [] | null | 14,239 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - The APGAR score is a rapid assessment of a baby's health immediately after birth, and is a useful method of risk stratification. It is made up of five components: activity, pulse, reflex irritability, appearance (level of perfusion), and respiration. The infant scored 2 points on all aspects of the APGAR assessment except appearance as she has cyanosis in her hands and feet.",
"id": "10008460",
"label": "a",
"name": "9",
"picture": null,
"votes": 52
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The infant scored 2 points on all aspects of the APGAR score except appearance as she has cyanosis in her hands and feet. Her total score is calculated as 9.",
"id": "10008462",
"label": "c",
"name": "8",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The infant scored 2 points on all aspects of the APGAR score except appearance as she has cyanosis in her hands and feet. Her total score is calculated as 9.",
"id": "10008463",
"label": "d",
"name": "7",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - As the infant has cyanosis in her hands and feet she cannot score 10 on an APGAR assessment. She does, however, score 2 points for all of the other criteria. Her total score is calculated as 9.",
"id": "10008461",
"label": "b",
"name": "10",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The infant scored 2 points on all aspects of the APGAR score except appearance as she has cyanosis in her hands and feet. Her total score is calculated as 9.",
"id": "10008464",
"label": "e",
"name": "5",
"picture": null,
"votes": 15
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4672",
"name": "APGAR Scores",
"status": null,
"topic": {
"__typename": "Topic",
"id": "153",
"name": "Paediatrics",
"typeId": 7
},
"topicId": 153,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4672,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14239",
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"likes": 0,
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"question": "A newborn baby girl is reviewed by the midwife one minute after birth. She appears pink in colour, aside from her hands and feet which are still a little blue, and is flexing her arms and legs. She has a strong cry in response to stimulation. Her heart rate is 125.\n\nWhich of the following best describes the infant's APGAR score?",
"sbaAnswer": [
"a"
],
"totalVotes": 124,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,815 | false | 45 | null | 6,495,128 | null | false | [] | null | 14,240 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Fibroblasts migrate to and proliferate at the site of an injury and deposit extracellular matrix. They are not responsible for bone resorption.",
"id": "10008469",
"label": "e",
"name": "Fibroblasts",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Osteocytes were once osteoblasts which have become trapped within the matrix they secreted. They are not involved in bone resorption.",
"id": "10008467",
"label": "c",
"name": "Osteocytes",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Osteoclasts secrete enzymes and acid to break down extracellular matrix and mineralised bone to facilitate resorption. They are the primary cell type driving bone destruction, as is necessary for remodelling and repair. An imbalance of osteoclasts and osteoblasts, which are responsible for bone production, can lead to bone disorders such as osteoporosis.",
"id": "10008465",
"label": "a",
"name": "Osteoclasts",
"picture": null,
"votes": 126
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Osteoblasts are responsible for bone production. They secrete osteoid (the organic bone matrix containing type 1 collagen) which is then mineralised to form bone. They are not involved in bone resorption.",
"id": "10008466",
"label": "b",
"name": "Osteoblasts",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Basophils are a type of granulocyte. They are involved in immune response and the immune system. They are not involved in bone resorption.",
"id": "10008468",
"label": "d",
"name": "Basophils",
"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": "4673",
"name": "Osteoclasts",
"status": null,
"topic": {
"__typename": "Topic",
"id": "154",
"name": "Musculoskeletal physiology and disease",
"typeId": 7
},
"topicId": 154,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
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"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14240",
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"likes": 0,
"multiAnswer": null,
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"psaSectionId": null,
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"question": "A 54-year-old woman visits her GP as she is concerned that she might have osteoporosis. She asks the doctor if there are any tests that can be done to make sure her bones are healthy.\n\nWhich of the following is the main cell involved in bone resorption?",
"sbaAnswer": [
"a"
],
"totalVotes": 150,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,816 | false | 46 | null | 6,495,128 | null | false | [] | null | 14,241 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - In a Bennett's fracture the proximal 1st metacarpal is damaged, usually by forced abduction of the thumb. It is associated with skiing and boxing, or falling on an outstretched hand. The patient will often present with swelling at the base of the thumb and on the thenar eminence, and will have difficulty grasping objects.",
"id": "10008470",
"label": "a",
"name": "First Proximal Metacarpal",
"picture": null,
"votes": 67
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - In a Bennett's fracture the proximal, not the distal, 1st metacarpal is damaged. This is usually by forced abduction of the thumb. It is associated with skiing and boxing, or falling on an outstretched hand. The patient will often present with swelling at the base of the thumb and on the thenar eminence, and will have difficulty grasping objects.",
"id": "10008471",
"label": "b",
"name": "First Distal Metacarpal",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Fractures of the neck of the 5th metacarpal are often called Boxer's fractures. By contrast, in a Bennett's fracture the proximal 1st metacarpal is damaged, usually by forced abduction of the thumb. It is associated with skiing and boxing, or falling on an outstretched hand. The patient will often present with swelling at the base of the thumb and on the thenar eminence and will have difficulty grasping objects.",
"id": "10008473",
"label": "d",
"name": "Fifth Distal Metacarpal",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Fractures of the neck of the 5th metacarpal are often called Boxer's fractures. By contrast, in a Bennett's fracture the proximal 1st metacarpal is damaged, usually by forced abduction of the thumb. It is associated with skiing and boxing, or falling on an outstretched hand. The patient will often present with swelling at the base of the thumb and on the thenar eminence and will have difficulty grasping objects.",
"id": "10008472",
"label": "c",
"name": "Fifth Proximal Metacarpal",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - In a Bennett's fracture the proximal 1st, rather than 2nd metacarpal is damaged, usually by forced abduction of the thumb. It is associated with skiing and boxing, or falling on an outstretched hand. The patient will often present with swelling at the base of the thumb and on the thenar eminence and will have difficulty grasping objects.",
"id": "10008474",
"label": "e",
"name": "Second Proximal Metacarpal",
"picture": null,
"votes": 4
}
],
"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": "4674",
"name": "Bennett Fracture",
"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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},
"conceptId": 4674,
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"difficulty": 1,
"dislikes": 0,
"explanation": null,
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"question": "An 38-year-old man attends the minor injuries unit complaining of pain and swelling in his hand. He has recently returned from a skiing holiday, and began to notice the pain on his final day.\n\nWhich of the following bones is damaged in a Bennett's fracture?",
"sbaAnswer": [
"a"
],
"totalVotes": 129,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,817 | false | 47 | null | 6,495,128 | null | false | [] | null | 14,242 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Macrophages play a role in the inflammatory response of wound healing. They do not deposit extracellular matrix to form scars.",
"id": "10008478",
"label": "d",
"name": "Macrophages",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Collagen does not deposit extracellular matrix. Fibroblasts produce collagen and ground substance (extracellular matrix) to facilitate wound healing.",
"id": "10008479",
"label": "e",
"name": "Collagen",
"picture": null,
"votes": 36
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Fibroblasts migrate to the site of an injury. Here they proliferate and deposit an extracellular matrix that facilitates scar formation.",
"id": "10008475",
"label": "a",
"name": "Fibroblasts",
"picture": null,
"votes": 102
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Parenchymal cells are the cells that carry out the specific function of the organ or stroma, which in this case has become damaged. Scar formation is the replacement of parenchymal cells with stromal cells and a fibrotic extracellular matrix.",
"id": "10008477",
"label": "c",
"name": "Parenchymal Cells",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Neutrophils will infiltrate a wound within 24 hours but do not release extracellular matrix.",
"id": "10008476",
"label": "b",
"name": "Neutrophils",
"picture": null,
"votes": 1
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4675",
"name": "Keloid Scar",
"status": null,
"topic": {
"__typename": "Topic",
"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4675,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14242",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
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"psaSectionId": null,
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"question": "A 13-year-old girl presents to Accident and Emergency after accidentally cutting her arm with a kitchen knife. She is concerned about the possibility of developing a permanent scar.\n\nWhich of the following cell types are responsible for the elaboration of extracellular matrix during scar formation?",
"sbaAnswer": [
"a"
],
"totalVotes": 149,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,818 | false | 48 | null | 6,495,128 | null | false | [] | null | 14,243 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The ovarian ligament runs from the ovary to the uterus. It does not travel to the labia majora.",
"id": "10008481",
"label": "b",
"name": "Ovarian Ligament",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - the broad ligament is a double layer of peritoneum that hangs from the fallopian tubes on either side of the pelvis. It supports the uterus, uterine tubes, and ovaries, and helps anchor the uterus to the pelvis. It has 3 main parts; the mesometrium, mesosalpinx, and mesovarium. It does not travel to the labia majora.",
"id": "10008482",
"label": "c",
"name": "Broad Ligament",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - The round ligament of the uterus travels from the uterus to the labia major and through the inguinal canal (in addition to lymphatics from the uterus, the ilioinguinal nerve, and the genital branch of the genitofemoral nerve).",
"id": "10008480",
"label": "a",
"name": "Round ligament of the uterus",
"picture": null,
"votes": 62
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - the cardinal ligament does not travel from the uterus to the labia majora. It is one of the key parametrial ligaments that form the tendinous arch to support the uterus, in addition to the utero-sacral ligament and pubocervical ligament. It is found lateral to the uterus.",
"id": "10008484",
"label": "e",
"name": "Cardinal Ligament",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - the uterosacral ligament does not travel from the uterus to the labia majora. It is one of the key parametrial ligaments that form the tendinous arch to support the uterus, in addition to the cardinal ligament and pubocervical ligament.",
"id": "10008483",
"label": "d",
"name": "Utero-sacral ligament",
"picture": null,
"votes": 16
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4676",
"name": "Inversion of the uterus",
"status": null,
"topic": {
"__typename": "Topic",
"id": "174",
"name": "Obstetrics",
"typeId": 7
},
"topicId": 174,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4676,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14243",
"isLikedByMe": null,
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"likes": 0,
"multiAnswer": null,
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"question": "A 56-year-old woman presents to her GP after finding a small lump on her labia majora. She is known to have uterine cancer, and is very worried that this new lump means her disease has spread.\n\nWhich of the following ligaments runs from the uterus to the labia majora?",
"sbaAnswer": [
"a"
],
"totalVotes": 131,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,819 | false | 49 | null | 6,495,128 | null | false | [] | null | 14,244 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Trust vs mistrust is the first stage of psychosocial development and lasts from birth to around 18 months. During this stage, infants develop the ability to trust those around them and feel safe and secure in the world. This child has progressed past this stage.",
"id": "10008487",
"label": "c",
"name": "Trust vs Mistrust",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct - Autonomy vs Shame and Doubt usually occurs between the ages of 18 months to approximately 3 years. This child is demonstrating many of the traits associated with this stage such as a desire to choose and being toilet trained.",
"id": "10008485",
"label": "a",
"name": "Autonomy vs Shame and Doubt",
"picture": null,
"votes": 51
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Initiative vs Guilt is the third stage of psychosocial development and usually begins in children around the age of 3 to the age of 5. At this point in development, children begin to assert power and control over their surroundings, usually through directing play and other social interactions.",
"id": "10008486",
"label": "b",
"name": "Initiative vs Guilt",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Industry vs Inferiority is the fourth stage in psychosocial development and typically takes place in the early school year, between the ages of 5 to 11. During this stage children begin to develop a sense of pride in their accomplishments and abilities and begin to cope with new social and academic demands.",
"id": "10008488",
"label": "d",
"name": "Industry vs Inferiority",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - Identity vs Role confusion is usually experienced by teenagers and is centred around the development of social relationships.",
"id": "10008489",
"label": "e",
"name": "Identity vs Role Confusion",
"picture": null,
"votes": 30
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3782",
"name": "Developmental milestones",
"status": null,
"topic": {
"__typename": "Topic",
"id": "153",
"name": "Paediatrics",
"typeId": 7
},
"topicId": 153,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3782,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14244",
"isLikedByMe": null,
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"multiAnswer": null,
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"question": "A 2-year-old boy attends his GP surgery for a review. His mum reports that he has recently begun to choose which toys he would like to play with and what clothes he would like to wear. He engages well in games directed by his older brother. He has also become fully toilet trained.\n\nWhich of the following stages of Erickson's stages of psychosocial development would this represent?",
"sbaAnswer": [
"a"
],
"totalVotes": 127,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,463,820 | false | 50 | null | 6,495,128 | null | false | [] | null | 14,245 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - It is the absence of anti-Mullerian hormone and testosterone that triggers the degeneration of the mesonephric duct within the female foetus. The presence of anti-Mullerian hormone, combined with testosterone, supports the persistence of the mesonephric duct in males.",
"id": "10008491",
"label": "b",
"name": "Presence of Anti-Mullerian hormones",
"picture": null,
"votes": 39
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - It is the absence of anti-Mullerian hormone and testosterone that triggers the degeneration of the mesonephric duct within the female foetus. The presence of high testosterone levels, combined with anti-Mullerian hormone, supports the persistence of the mesonephric duct in males.",
"id": "10008492",
"label": "c",
"name": "Presence of Testosterone",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The absence of oestrogen does not influence the persistence or degeneration of the mesonephric duct.",
"id": "10008494",
"label": "e",
"name": "Absence of Oestrogen",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct. It is the absence of anti-Mullerian hormone and testosterone that triggers the degeneration of the mesonephric duct and supports the persistence of the paramesonephric ducts. This ultimately forms the uterine tubes, uterus, and upper vagina.",
"id": "10008490",
"label": "a",
"name": "Absence of anti-Mullerian hormone",
"picture": null,
"votes": 54
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Incorrect - The presence of oestrogen does not influence the persistence or degeneration of the mesonephric duct.",
"id": "10008493",
"label": "d",
"name": "Presence of Oestrogen",
"picture": null,
"votes": 16
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4517",
"name": "Development of the female reproductive system",
"status": null,
"topic": {
"__typename": "Topic",
"id": "171",
"name": "Embryology",
"typeId": 7
},
"topicId": 171,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4517,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "14245",
"isLikedByMe": null,
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"likes": 0,
"multiAnswer": null,
"pictures": [],
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"psaSectionId": null,
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"question": "A 31-year-old pregnant woman attends the antenatal clinic for an ultrasound scan. She is keen to learn more about her baby's development.\n\nWhich of the following triggers the degeneration of the mesonephric duct in females?",
"sbaAnswer": [
"a"
],
"totalVotes": 132,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,009 | false | 1 | null | 6,495,135 | null | false | [] | null | 14,246 | {
"__typename": "QuestionSBA",
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"explanation": "This region is bounded by the pectoralis major, deltoid and clavicle. It is an opening in the anterior wall of the axilla.",
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"explanation": "The synovial sheath is located deep to the flexor retinaculum. The tendons that lie deep to the flexor retinaculum, run in three synovial sheaths.",
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"explanation": "The flexor retinaculum is a fibrous connective tissue band that is located on the roof of the carpal tunnel. It extends between the hook of hamate and pisiform medially to the scaphoid and trapezium laterally.",
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"explanation": "The median nerve is located medial to the brachial artery at this level and it passes between the two heads of the pronator teres muscle to leave the cubital fossa.",
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"label": "b",
"name": "Median nerve",
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"explanation": "The profunda brachii artery is the first and largest branch of the brachial. It runs on the posterior surface of the humerus with the radial nerve and passes between the medial and long heads of the triceps brachii muscle. It then travels in the spiral groove of the humerus. The image is showing the cubital fossa, which is located at the anterior aspect of the elbow joint, between the arm and forearm. This fossa does not contain the profunda brachii artery.",
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"label": "d",
"name": "Profunda brachii artery",
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"explanation": "The image shows the cubital fossa of the right arm and the brachial artery is located lateral to the median nerve at this level. It bifurcates into the radial and ulnar arteries at the apex of the cubital fossa. The structures lateral to medial in the cubital fossa can be remembered with the mnemonic \"TAN\" - **t**endon (biceps tendon), **a**rtery (brachial artery) and **n**erve (median nerve).\n\n*[N.B. the median nerve originally travels lateral to the brachial artery, before crossing anteriorly, to lie medial to the brachial artery]*",
"id": "10008525",
"label": "a",
"name": "Brachial artery",
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"explanation": "The brachial artery divides into the radial and ulnar arteries at the inferior aspect of the cubital fossa, at the level of the radial head. The radial artery then travels along the radial aspect of the anterior compartment of the forearm. It lies beneath the brachioradialis.",
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"explanation": "The long head of the biceps brachii attaches to the supraglenoid tubercle of the scapula.",
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"explanation": "The short head of the biceps brachii attaches to the coracoid process of the scapula, along with coracobrachialis.",
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"explanation": "The radial tuberosity is a bony landmark on the radius. It provides an insertion site for the biceps brachii muscle.",
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"explanation": "The trochlear notch is an articular surface that is formed by the olecrannon and coronoid process. It articulates with the trochlea of the humerus to form the elbow joint. It is also known as the semilunar notch due to its crescent shape.",
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"explanation": "The olecrannon process is a larger superior projection on the proximal end of the shaft of the ulna. It ends proximally to form part of the trochlear notch.",
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"explanation": "The arrow is labelling the coronoid process of the ulna. This is a bony projection on the proximal end of the ulna just inferior to the olecrannon process.",
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"explanation": "The arrow is pointing to the proximal aspect of the radius where the head of radius is located. The head is a disc shaped structure that articulates with the capitulum of the humerus at the elbow joint.",
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"explanation": "The radial tuberosity is a bony projection found just inferior to the neck of the radius. It is located at the anteromedial aspect of the radius and provides an insertion site for the biceps brachii muscle.",
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"explanation": "The styloid process is formed as the lateral surface of the radius extends distally. It is found at the most distal aspect of the radius.",
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"explanation": "The olecranon process is the large superior projection located at the proximal end of the radius. It ends proximally to form part of the trochlear notch. It also provides the site of attachment for the triceps muscle.",
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"explanation": "The subclavius muscle pulls the clavicle medially to stabilise the sternoclavicular joint and depresses the tip of the shoulder",
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"name": "Abduction of the arm beyond the initial 15<sup>o</sup>",
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"explanation": "The trapezius, levator scapulae, rhomboid minor and rhomboid major are involved in the elevation of the scapula.",
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"explanation": "This image shows the posterior compartment of the arm. The short head of biceps brachii is located in the anterior compartment. It arises from the coracoid process of the scapula.",
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"label": "e",
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"explanation": "This image shows the posterior compartment of the arm. The long head of biceps brachii is located in the anterior compartment. It arises from the supraglenoid tubercle of the scapula.",
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173,464,023 | false | 15 | null | 6,495,135 | null | false | [] | null | 14,260 | {
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"explanation": "The extensor carpi radialis brevis attaches to the dorsal surface of the base of metacarpal II and III.",
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173,464,024 | false | 16 | null | 6,495,135 | null | false | [] | null | 14,261 | {
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"explanation": "The arrow is highlighting the flexor carpi ulnaris muscle which is the most medial muscle in the superficial layer of the anterior compartment of the forearm. It is involved in the flexion and adduction of the wrist joint.",
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"explanation": "Extensor digitorum can extend the wrist, however it plays no role in abduction of the wrist. This is mediated by the extensor carpi radialis longus and brevis.",
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"explanation": "The arrow is highlighting one of the muscles of the thenar eminence. It is pointing to the abductor pollicis brevis which lies superficial to the opponens pollicis and flexor pollicis brevis. The main function of this muscle is to abduct the thumb at the metacarpophalangeal joint.",
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173,464,027 | false | 19 | null | 6,495,135 | null | false | [] | null | 14,264 | {
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"explanation": "The cords of the brachial plexus are named according to their relation to the second part of the axillary artery, which in turn is located deep to pectoralis minor. The lateral cord of the brachial plexus is located lateral to the axillary artery. The lateral cord is formed from the union of the anterior divisions of the upper and middle trunks.",
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173,464,044 | false | 36 | null | 6,495,135 | null | false | [] | null | 14,281 | {
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173,464,045 | false | 37 | null | 6,495,135 | null | false | [] | null | 14,282 | {
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"explanation": "A number of structures pass posterior to the medial malleolus, under the flexor retinaculum. Their order (from anterior to posterior) can be remembered using the mnemonic \"Tom Dick And Very Nervous Harry\":\n\n- **T**ibialis posterior\n- Flexor **D**igitorum longus\n- Posterior tibial **A**rtery\n- Posterior tibial **V**ein\n- Tibial **N**erve\n- Flexor **H**allucis longus",
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"label": "d",
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"explanation": "The popliteal vein is located more medial to the tibial and common fibular nerves and it found superficial to the popliteal artery.",
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"explanation": "This image shows the popliteal fossa. The arrow indicates the common fibular nerve. The common fibular nerve and the tibial nerve originate from the sciatic nerve which splits into the two branches. The common fibular nerve exits the popliteal fossa by passing with the biceps femoris tendon over the lower lateral margin of this region to continue to the lateral side of the leg.",
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"explanation": "The sural nerve is a purely sensory nerve that innervates the posterolateral aspect of the distal leg, ankle, foot and heel.",
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"explanation": "The arrow points to tibialis anterior muscle which is the most medial and anterior muscle in the anterior compartment of the leg. It is innervated by the deep peroneal nerve.",
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"explanation": "The medial malleolus is located on the medial aspect of the ankle joint and formed by the distal end of the tibia.",
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"label": "b",
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},
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"explanation": "The medial malleolus is located on the lateral aspect of the ankle joint and formed by the distal end of the fibula.",
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"name": "Lateral malleolus",
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173,464,074 | false | 1 | null | 6,495,138 | null | false | [] | null | 14,296 | {
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