id
int64 173M
173M
| flagged
bool 1
class | index
int64 1
98
| questionChoiceId
null | marksheetId
int64 6.49M
6.5M
| timeTaken
null | isAnswered
bool 1
class | striked
sequencelengths 0
0
| mark
null | questionId
int64 264
22.8k
| question
dict | __typename
stringclasses 1
value |
|---|---|---|---|---|---|---|---|---|---|---|---|
173,464,947 | false | 19 | null | 6,495,169 | null | false | [] | null | 17,210 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "A commonly experienced side effect when using antimuscarinic drugs is \"blurred vision.\" These drugs block the action of acetylcholine at muscarinic receptors, which can affect the function of the eye and lead to visual disturbances. Dry mouth, urinary retention and constipation are other common side effects with this class of drugs.",
"id": "10024060",
"label": "a",
"name": "Blurred vision",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Antimuscarinic drugs typically decrease gastrointestinal motility, leading to constipation rather than increased motility. They block muscarinic receptors in the gastrointestinal tract, inhibiting the normal contractions that move food through the digestive system.",
"id": "10024064",
"label": "e",
"name": "Increased gastrointestinal motility",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Antimuscarinic drugs are more likely to cause an increase in blood pressure (hypertension) rather than hypotension. This is due to the inhibition of muscarinic receptors, which can lead to increased sympathetic activity.",
"id": "10024061",
"label": "b",
"name": "Hypotension",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Antimuscarinic drugs often lead to dry mouth (xerostomia) rather than increased salivation. They block muscarinic receptors in salivary glands, reducing saliva production.",
"id": "10024062",
"label": "c",
"name": "Increased salivation",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Antimuscarinic drugs tend to cause tachycardia (increased heart rate) rather than bradycardia. This is due to the inhibition of the parasympathetic nervous system, which normally slows the heart rate.",
"id": "10024063",
"label": "d",
"name": "Bradycardia",
"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": "5727",
"name": "Drugs - Side Effects",
"status": null,
"topic": {
"__typename": "Topic",
"id": "195",
"name": "Pharmacology",
"typeId": 7
},
"topicId": 195,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5727,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17210",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following is a commonly experienced side effect when using anti-muscarinic drugs?",
"sbaAnswer": [
"a"
],
"totalVotes": 59,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,948 | false | 20 | null | 6,495,169 | null | false | [] | null | 17,211 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as per the formula above.",
"id": "10024067",
"label": "c",
"name": "20 mL",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as per the formula above.",
"id": "10024066",
"label": "b",
"name": "15 mL",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as per the formula above.",
"id": "10024069",
"label": "e",
"name": "30 mL",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as per the formula above. Remember the concentration mentioned in the question is per 5mL.",
"id": "10024068",
"label": "d",
"name": "2 mL",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "To calculate the required volume (in mL) of the medication to receive the prescribed dose, you can use the following formula:\nVolume (mL) = Prescribed Dose (mg)/Concentration (mg/mL)\nIn this case, the prescribed dose is 500 mg, and the concentration of the liquid medication is 250 mg/5 mL (which can be simplified to 50 mg/mL). Plugging these values into the formula:\nVolume (mL)= 500 mg/(250/5) mg/mL = 10 mL",
"id": "10024065",
"label": "a",
"name": "10 mL",
"picture": null,
"votes": 56
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5728",
"name": "Drug Calculations",
"status": null,
"topic": {
"__typename": "Topic",
"id": "195",
"name": "Pharmacology",
"typeId": 7
},
"topicId": 195,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5728,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17211",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A patient is prescribed 500 mg of a medication. The medication is available in a liquid form with a concentration of 250 mg/5 mL.\n\nHow many millilitres (mL) of the liquid medication should the patient take to receive the prescribed dose?",
"sbaAnswer": [
"a"
],
"totalVotes": 58,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,949 | false | 21 | null | 6,495,169 | null | false | [] | null | 17,212 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The GP should be careful not to prescribe propranolol for this patient with known asthma and presenting symptoms of anxiety-related palpitations and nausea. Propranolol is a non-selective beta-blocker and can potentially worsen asthma symptoms by causing bronchoconstriction due to its effects on beta-2 receptors in bronchial smooth muscle. Beta-blockers are contraindicated with salbutamol and should not be prescribed, especially in primary care.",
"id": "10024070",
"label": "a",
"name": "Propranolol",
"picture": null,
"votes": 46
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ranitidine is an H2 receptor antagonist used to reduce stomach acid production. Whilst it can be used for nausea relief, it does not have a direct effect on asthma symptoms.",
"id": "10024073",
"label": "d",
"name": "Ranitidine",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Lorazepam is a benzodiazepine medication used to treat anxiety and does not have a direct impact on respiratory function, although overdoses can cause respiratory depression. It can be prescribed for anxiety without significant risk to asthma control.",
"id": "10024071",
"label": "b",
"name": "Lorazepam",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Diphenhydramine is an antihistamine often used to relieve allergy symptoms and can cause drowsiness. It does not have a direct impact on asthma symptoms and can be used for nausea relief in some cases.",
"id": "10024074",
"label": "e",
"name": "Diphenhydramine",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Sertraline is a selective serotonin reuptake inhibitor (SSRI) used to treat anxiety and depression. It does not have direct effects on respiratory function and can be prescribed without significant concern for asthma symptoms.",
"id": "10024072",
"label": "c",
"name": "Sertraline",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5729",
"name": "Drug Interactions",
"status": null,
"topic": {
"__typename": "Topic",
"id": "287",
"name": "Asthma",
"typeId": 7
},
"topicId": 287,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5729,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17212",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 22-year-old girl is a known asthmatic. For this, she uses a salbutamol inhaler. She has presented to the GP for anxiety-related palpitations and nausea.\n\nBased on this information, which of the following drugs should the GP be careful not to prescribe?",
"sbaAnswer": [
"a"
],
"totalVotes": 58,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,950 | false | 22 | null | 6,495,169 | null | false | [] | null | 17,213 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Type I hypersensitivity reactions, also known as immediate hypersensitivity reactions, are characterised by a rapid onset of symptoms due to the release of histamine and other inflammatory mediators from mast cells and basophils. Anaphylaxis is a classic example of a Type I hypersensitivity reaction, and it can lead to severe, systemic symptoms, including difficulty breathing and hives. Type I hypersensitivity reactions are IgE-mediated; other examples include asthma and bee stings.",
"id": "10024075",
"label": "a",
"name": "Anaphylaxis",
"picture": null,
"votes": 44
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Rheumatoid arthritis is an autoimmune disease that involves immune-mediated inflammation of the joints (Type III hypersensitivity).",
"id": "10024076",
"label": "b",
"name": "Rheumatoid arthritis",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Contact dermatitis is a delayed-type hypersensitivity reaction (Type IV) involving a local skin response to allergens.",
"id": "10024077",
"label": "c",
"name": "Contact dermatitis",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The tuberculin skin test reaction is a Type IV hypersensitivity reaction, also known as delayed-type hypersensitivity, in response to exposure to the tuberculosis antigen.",
"id": "10024079",
"label": "e",
"name": "Tuberculin skin test reaction",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Systemic lupus erythematosus is an autoimmune disease characterised by immune complex deposition (Type III hypersensitivity) and the production of autoantibodies (Type II hypersensitivity).",
"id": "10024078",
"label": "d",
"name": "Systemic lupus erythematosus",
"picture": null,
"votes": 2
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5730",
"name": "Hypersensitivity Reactions",
"status": null,
"topic": {
"__typename": "Topic",
"id": "288",
"name": "Allergies",
"typeId": 7
},
"topicId": 288,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5730,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17213",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following is an example of a Type I hypersensitivity reaction?",
"sbaAnswer": [
"a"
],
"totalVotes": 59,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,951 | false | 23 | null | 6,495,169 | null | false | [] | null | 17,214 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Consolidation refers to the replacement of air in the lung's alveoli with fluid or other substances. It is not a typical finding in COPD but can be seen in conditions such as pneumonia.",
"id": "10024083",
"label": "d",
"name": "Consolidation",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The characteristic finding in COPD on a CXR is hyperinflated lungs due to the chronic airway obstruction and air trapping that are hallmarks of the disease. This results in an increased lung volume, which can be visualised on imaging. Other characteristic findings are a flattened diaphragm, narrowed heart shadow, bullae and decreased lung markings.",
"id": "10024080",
"label": "a",
"name": "Hyperinflated Lungs",
"picture": null,
"votes": 40
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pulmonary nodules are small, rounded or oval-shaped growths in the lung tissue. They are not typically associated with COPD but may be seen in conditions like lung cancer or infections.",
"id": "10024081",
"label": "b",
"name": "Pulmonary nodules",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A pleural effusion is the accumulation of excess fluid in the pleural space surrounding the lungs. Whilst pleural effusions can occur in various conditions, they are not a characteristic finding of COPD.",
"id": "10024082",
"label": "c",
"name": "Pleural effusion",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ground-glass opacities on a CXR may indicate a variety of conditions, such as interstitial lung diseases, infections, or pulmonary oedema, but they are not the primary findings associated with COPD.",
"id": "10024084",
"label": "e",
"name": "Ground-glass opacities",
"picture": null,
"votes": 2
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5731",
"name": "CXR findings in COPD",
"status": null,
"topic": {
"__typename": "Topic",
"id": "289",
"name": "COPD",
"typeId": 7
},
"topicId": 289,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5731,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17214",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 65-year-old female is suspected to have COPD. The registrar has ordered a CXR as part of his initial investigations.\n\nWhich of the following findings is he expecting to see on the CXR if the woman has COPD?",
"sbaAnswer": [
"a"
],
"totalVotes": 58,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,952 | false | 24 | null | 6,495,169 | null | false | [] | null | 17,215 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Sarcoidosis is a multisystem inflammatory disease that can affect the lungs but is distinct from COPD. It is characterised by the formation of granulomas in various organs, including the lungs.",
"id": "10024089",
"label": "e",
"name": "Sarcoidosis",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Alpha-1-antitrypsin deficiency is a known genetic cause of COPD. It is key to consider this as a cause, especially in a non-smoker and if a young patient presents with this history and results.",
"id": "10024085",
"label": "a",
"name": "Alpha-1-antitrypsin deficiency",
"picture": null,
"votes": 36
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "GORD can lead to a variety of respiratory symptoms, including cough and asthma-like symptoms, but it is not a direct cause of COPD.",
"id": "10024087",
"label": "c",
"name": "Gastroesophageal reflux disease (GORD)",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Smoking is the most common cause of COPD. This patient is young and a non-smoker making this option incorrect.",
"id": "10024088",
"label": "d",
"name": "History of smoking",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Occupational asbestos exposure is associated with a different lung condition known as asbestosis, which is characterised by the scarring of lung tissue. Whilst asbestosis can lead to respiratory symptoms, it is not typically classified as COPD.",
"id": "10024086",
"label": "b",
"name": "Occupational exposure to asbestos",
"picture": null,
"votes": 8
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5732",
"name": "Causes",
"status": null,
"topic": {
"__typename": "Topic",
"id": "289",
"name": "COPD",
"typeId": 7
},
"topicId": 289,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5732,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17215",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 30-year-old woman has presented with a productive cough, dyspnoea and a wheeze. She is a non-smoker. Her lung function tests have revealed an obstructive picture, most likely due to COPD.\n\nWhich of the following may be the cause of her COPD?",
"sbaAnswer": [
"a"
],
"totalVotes": 59,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,953 | false | 25 | null | 6,495,169 | null | false | [] | null | 17,216 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ampicillin and gentamicin may be used in hospital-acquired pneumonia and more severe cases of community-acquired pneumonia but are not typically the first-line treatment for uncomplicated community-acquired pneumonia.",
"id": "10024094",
"label": "e",
"name": "Ampicillin and gentamicin",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Azithromycin and levofloxacin are effective antibiotics for certain respiratory infections, but they are not the first-line choice for all cases of community-acquired pneumonia.",
"id": "10024093",
"label": "d",
"name": "Azithromycin and levofloxacin",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ciprofloxacin and metronidazole are antibiotics that may be used for specific types of infections, but they are not typically the first-line choice for uncomplicated community-acquired pneumonia. The amoxicillin and clarithromycin combination is often preferred.",
"id": "10024091",
"label": "b",
"name": "Ciprofloxacin and metronidazole",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Amoxicillin and clarithromycin are often chosen for the initial treatment of community-acquired pneumonia due to their efficacy against common respiratory pathogens.\n\nHowever, the specific choice of antibiotics may vary based on factors such as the patient's clinical condition, local resistance patterns, and other individual considerations. It is important for the prescribing physician to consider the most appropriate antibiotics for each patient, especially if the 1st line treatment may be ineffective.",
"id": "10024090",
"label": "a",
"name": "Amoxicillin and clarithromycin",
"picture": null,
"votes": 46
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Whilst penicillin and doxycycline may be used in some cases of pneumonia, they are not the first-line choice for many cases of community-acquired pneumonia.",
"id": "10024092",
"label": "c",
"name": "Penicillin and doxycycline",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5733",
"name": "Management",
"status": null,
"topic": {
"__typename": "Topic",
"id": "290",
"name": "Pneumonia",
"typeId": 7
},
"topicId": 290,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5733,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17216",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "When a patient is admitted to the hospital for the treatment of pneumonia, which of the following drug combinations are typically used first-line?",
"sbaAnswer": [
"a"
],
"totalVotes": 57,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,954 | false | 26 | null | 6,495,169 | null | false | [] | null | 17,217 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Whilst *Streptococcus pneumoniae* is a common cause of community-acquired pneumonia - especially in healthy individuals-, in patients with a history of alcoholism and aspiration risk, *Klebsiella pneumoniae* is the more likely cause.",
"id": "10024096",
"label": "b",
"name": "*Streptococcus pneumoniae*",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The presence of ongoing alcoholism, particularly in patients with a history of heavy drinking, can increase the risk of aspiration pneumonia caused by *Klebsiella pneumoniae* due to compromised airway defences increasing the risk of inhaling contaminated oropharyngeal contents. Klebsiella pneumonia is often associated with more severe and necrotising lung infections.",
"id": "10024095",
"label": "a",
"name": "*Klebsiella pneumoniae*",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "*Mycoplasma pneumoniae* is known for causing atypical pneumonia, which typically presents with milder symptoms. In a patient with a history of alcoholism and potentially severe pneumonia, Klebsiella is a more likely aetiology.",
"id": "10024098",
"label": "d",
"name": "*Mycoplasma pneumoniae*",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "*Haemophilus influenzae* can cause pneumonia, but it is more common in patients with compromised immune systems or chronic lung conditions. In a patient with a history of alcoholism, Klebsiella is a more likely cause of pneumonia.",
"id": "10024097",
"label": "c",
"name": "*Haemophilus influenzae*",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "*Legionella pneumophila* can cause a severe form of pneumonia known as Legionnaires' disease. Whilst it can be a cause of pneumonia, especially in certain environmental or occupational exposures, Klebsiella is a more common organism associated with alcohol-related aspiration pneumonia.",
"id": "10024099",
"label": "e",
"name": "*Legionella pneumophila*",
"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": "5734",
"name": "Causative Organisms",
"status": null,
"topic": {
"__typename": "Topic",
"id": "290",
"name": "Pneumonia",
"typeId": 7
},
"topicId": 290,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5734,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17217",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "58-year-old Mike has been recently diagnosed with community-acquired pneumonia. He is known to have a longstanding history of excessive alcohol consumption.\n\nWhich of the following organisms is the most likely cause of his pneumonia?",
"sbaAnswer": [
"a"
],
"totalVotes": 59,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,955 | false | 27 | null | 6,495,169 | null | false | [] | null | 17,218 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Amiodarone is an antiarrhythmic medication used to control atrial fibrillation rhythm, but it is not an anticoagulant. Stroke prevention in atrial fibrillation usually requires anticoagulation therapy to reduce the risk of thrombus formation.",
"id": "10024104",
"label": "e",
"name": "Amiodarone",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Diltiazem is a calcium channel blocker often used for rate control in atrial fibrillation, but it is not primarily used for stroke prevention. Stroke prevention in atrial fibrillation is achieved through anticoagulant therapy.",
"id": "10024102",
"label": "c",
"name": "Diltiazem",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Metoprolol is a beta-blocker commonly used for rate control in atrial fibrillation but does not directly address stroke prevention. Stroke prevention is a separate aspect of atrial fibrillation management that typically involves anticoagulant therapy.",
"id": "10024103",
"label": "d",
"name": "Metoprolol",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Aspirin is an antiplatelet medication and, whilst it can reduce the risk of stroke to some extent, it is generally considered less effective than anticoagulants like warfarin or direct oral anticoagulants for stroke prevention in atrial fibrillation. Anticoagulants target the formation of blood clots (thrombi) in the atria, which is a significant concern in atrial fibrillation.",
"id": "10024101",
"label": "b",
"name": "Aspirin",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Atrial fibrillation is a significant risk factor for stroke due to the potential for blood stasis and the formation of atrial thrombi. Anticoagulation therapy is crucial for stroke prevention in patients with atrial fibrillation. Warfarin is a well-established oral anticoagulant that reduces the risk of stroke by inhibiting the formation of blood clots. Other options do not provide the same level of stroke prevention in atrial fibrillation. Aspirin may be considered in some low-risk patients, but warfarin or newer oral anticoagulants (e.g. direct oral anticoagulants like rivaroxaban) are more effective choices for patients at moderate to high risk of stroke.",
"id": "10024100",
"label": "a",
"name": "Warfarin",
"picture": null,
"votes": 27
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5735",
"name": "Management & Risks",
"status": null,
"topic": {
"__typename": "Topic",
"id": "291",
"name": "Atrial Fibrillation",
"typeId": 7
},
"topicId": 291,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5735,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17218",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 65-year-old patient with atrial fibrillation is at risk of having a stroke.\n\nWhich of the following medications is the most appropriate choice for stroke prevention in this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 60,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,956 | false | 28 | null | 6,495,169 | null | false | [] | null | 17,219 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "These leads are specifically oriented to detect changes in the inferior part of the heart, making them critical for the diagnosis of an inferior STEMI.",
"id": "10024105",
"label": "a",
"name": "ST-segment elevation in leads II, III, and aVF",
"picture": null,
"votes": 41
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ST-segment elevation in leads I, aVL, and aVR can indicate high lateral involvement or possible left main coronary artery disease.",
"id": "10024108",
"label": "d",
"name": "ST-segment elevation in leads I, aVL, and aVR",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ST-segment elevation in leads I and aVL usually suggests high lateral wall involvement, while V1-V6 is associated with anterior wall involvement.",
"id": "10024107",
"label": "c",
"name": "ST-segment elevation in leads I, aVL, and V1-V6",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ST-segment elevation in the precordial (chest) leads (V1-V6) typically indicates anterior myocardial infarction, not an inferior STEMI.",
"id": "10024106",
"label": "b",
"name": "ST-segment elevation in leads V1-V6",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "T-wave inversion in the precordial leads may be seen in various conditions and could be a precursor sign for a STEMI, but is not the classic ECG change associated with an acute STEMI, especially an inferior one.",
"id": "10024109",
"label": "e",
"name": "T-wave inversion in leads V1-V6",
"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": "5736",
"name": "ECG interpretation",
"status": null,
"topic": {
"__typename": "Topic",
"id": "292",
"name": "ECG",
"typeId": 7
},
"topicId": 292,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5736,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17219",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "With regards to a standard 12-lead ECG, which of the following changes is most likely to indicate an inferior ST-elevation myocardial infarction (STEMI)?",
"sbaAnswer": [
"a"
],
"totalVotes": 57,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,957 | false | 29 | null | 6,495,169 | null | false | [] | null | 17,220 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Whilst ARBs are used in heart failure management to reduce the effects of angiotensin II and improve cardiac function, they are not primarily used for reducing fluid overload and relieving congestion.",
"id": "10024114",
"label": "e",
"name": "Angiotensin receptor blockers (ARBs)",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Beta-blockers are used in heart failure management to improve heart function and reduce the heart's workload, primarily by slowing the heart rate and decreasing myocardial oxygen demand. Whilst they have many benefits in heart failure, they do not directly target fluid overload and congestion.",
"id": "10024111",
"label": "b",
"name": "Beta-blockers",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Diuretics are medications that help reduce fluid overload in heart failure patients by increasing the excretion of excess sodium and water through the kidneys. This helps relieve symptoms of congestion, such as fluid retention and oedema, commonly seen in heart failure.",
"id": "10024110",
"label": "a",
"name": "Diuretics",
"picture": null,
"votes": 48
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ACE inhibitors are important medications in heart failure management as they help improve cardiac function and reduce afterload, but their primary role is not to reduce fluid overload and congestion. They work by inhibiting the renin-angiotensin-aldosterone system to improve cardiac remodelling.",
"id": "10024113",
"label": "d",
"name": "Angiotensin-converting enzyme (ACE) inhibitors",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Calcium channel blockers are not typically used in heart failure management as they may have negative inotropic effects. They are not the primary medications for reducing fluid overload and congestion in heart failure.",
"id": "10024112",
"label": "c",
"name": "Calcium channel blockers",
"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": "5737",
"name": "Management",
"status": null,
"topic": {
"__typename": "Topic",
"id": "293",
"name": "Heart Failure",
"typeId": 7
},
"topicId": 293,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5737,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17220",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "In the management of heart failure, which class of medications is commonly used to reduce fluid overload and relieve symptoms of congestion?",
"sbaAnswer": [
"a"
],
"totalVotes": 59,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,958 | false | 30 | null | 6,495,169 | null | false | [] | null | 17,221 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Pernicious anaemia is primarily characterised by a deficiency of vitamin B12 (cobalamin) due to impaired absorption in the gastrointestinal tract. It is typically caused by the autoimmune destruction of parietal cells in the stomach, which results in a lack of intrinsic factor. Intrinsic factor is essential for the absorption of vitamin B12 in the ileum. The deficiency of vitamin B12 results in the characteristic features of pernicious anaemia: macrocytic megaloblastic anaemia, neurological symptoms, and other systemic manifestations.",
"id": "10024115",
"label": "a",
"name": "Vitamin B12 (cobalamin)",
"picture": null,
"votes": 51
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Vitamin C deficiency leads to a condition called scurvy which is characterised by gum bleeding, skin changes, and muscle weakness. It is unrelated to the underlying mechanism of pernicious anaemia, which is specifically associated with vitamin B12 deficiency.",
"id": "10024118",
"label": "d",
"name": "Vitamin C (ascorbic acid)",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Vitamin D deficiency results in various manifestations, such as rickets in children and osteomalacia in adults. These conditions are associated with calcium and phosphate metabolism, bone health, and the musculoskeletal system. Vitamin D deficiency is not the primary cause of pernicious anaemia, which primarily involves a vitamin B12 deficiency.",
"id": "10024119",
"label": "e",
"name": "Vitamin D (cholecalciferol)",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pernicious anaemia is not related to iron deficiency. Iron deficiency anaemia is a distinct condition caused by insufficient dietary iron intake or impaired iron absorption. In pernicious anaemia, the primary issue is the inability to absorb vitamin B12 due to a lack of intrinsic factor.",
"id": "10024116",
"label": "b",
"name": "Iron",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Whilst a deficiency of folate can also lead to a macrocytic megaloblastic anaemia, it is not the primary nutrient deficiency associated with pernicious anaemia. Pernicious anaemia specifically involves vitamin B12 deficiency due to impaired absorption.",
"id": "10024117",
"label": "c",
"name": "Folate (vitamin B9)",
"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": "5738",
"name": "Pernicious Anaemia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "294",
"name": "Anaemia",
"typeId": 7
},
"topicId": 294,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5738,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17221",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Pernicious anaemia is characterised by a deficiency of which essential nutrient due to impaired absorption?",
"sbaAnswer": [
"a"
],
"totalVotes": 58,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,959 | false | 31 | null | 6,495,169 | null | false | [] | null | 17,222 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Beta-blockers, such as labetalol, are considered safe and are often used for the management of hypertension during pregnancy. They can help reduce blood pressure without posing significant risks to the developing foetus. However, this woman is asthmatic, thus beta-blockers are contraindicated.",
"id": "10024122",
"label": "c",
"name": "Labetalol",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The first line treatment for hypertension in pregnant women is labetalol. However, since this woman is asthmatic, beta-blockers are contraindicated. Calcium channel blockers, such as nifedipine, are generally considered safe and effective for managing hypertension during pregnancy. They relax blood vessels and lower blood pressure without significant adverse effects on the foetus.",
"id": "10024120",
"label": "a",
"name": "Nifedipine",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ACE inhibitors are contraindicated during pregnancy as they have been associated with foetal abnormalities; they particularly affect the development of the foetal kidneys and lungs. They can lead to a condition known as foetal ACE inhibitor syndrome.",
"id": "10024121",
"label": "b",
"name": "Ramipril",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Drugs like losartan and valsartan, which are similar to ACE inhibitors in their mechanism of action, are contraindicated in pregnancy due to the risk of foetal harm.",
"id": "10024123",
"label": "d",
"name": "Losartan",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Medications like spironolactone are typically not recommended during pregnancy because they can affect foetal development, particularly the development of male reproductive organs.",
"id": "10024124",
"label": "e",
"name": "Spironolactone",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5739",
"name": "Hypertension in Pregnancy",
"status": null,
"topic": {
"__typename": "Topic",
"id": "295",
"name": "Hypertension",
"typeId": 7
},
"topicId": 295,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5739,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17222",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 32-year-old pregnant woman in her second trimester presents with hypertension. She is also asthmatic.\n\nWhich of the following drugs is considered safe for the management of hypertension during pregnancy?",
"sbaAnswer": [
"a"
],
"totalVotes": 57,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,960 | false | 32 | null | 6,495,169 | null | false | [] | null | 17,223 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Constipation is not a common side effect of ACE inhibitors.",
"id": "10024128",
"label": "d",
"name": "Constipation",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ACE inhibitors are not typically associated with hypoglycemia. In fact, they may slightly increase blood glucose levels and are sometimes used to manage blood pressure in individuals with diabetes.",
"id": "10024126",
"label": "b",
"name": "Hypoglycemia",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Weight gain is not a common side effect of ACE inhibitors. In fact, these medications are more likely to have a neutral or even a mild weight-reducing effect.",
"id": "10024129",
"label": "e",
"name": "Weight gain",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ACE inhibitors are not known to cause bradycardia (slow heart rate). They can affect blood pressure but usually do not have a significant impact on heart rate.",
"id": "10024127",
"label": "c",
"name": "Bradycardia",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "ACE inhibitors can lead to hyperkalemia, an elevated level of potassium in the blood. They reduce aldosterone secretion, which normally helps regulate potassium levels, leading to an increased risk of hyperkalemia.",
"id": "10024125",
"label": "a",
"name": "Hyperkalemia",
"picture": null,
"votes": 35
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5740",
"name": "Side Effects of Medications",
"status": null,
"topic": {
"__typename": "Topic",
"id": "295",
"name": "Hypertension",
"typeId": 7
},
"topicId": 295,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5740,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17223",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 55-year-old patient with hypertension has been prescribed an ACE inhibitor for blood pressure management.\n\nWhich of the following side effects is commonly associated with ACE inhibitors?",
"sbaAnswer": [
"a"
],
"totalVotes": 58,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,961 | false | 33 | null | 6,495,169 | null | false | [] | null | 17,224 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Squamous cell carcinoma is another type of lung cancer, but it is not the most common. It tends to arise in the central airways and is often associated with a history of smoking.",
"id": "10024131",
"label": "b",
"name": "Squamous cell carcinoma",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Large cell carcinoma is a less common type of lung cancer. It is characterised by large, abnormal-looking cells and can occur in any part of the lung.",
"id": "10024133",
"label": "d",
"name": "Large cell carcinoma",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Carcinoid tumours are relatively rare in the lung and are usually slow-growing. They are not the most common type of lung cancer.",
"id": "10024134",
"label": "e",
"name": "Carcinoid tumours",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Small cell lung cancer is a type of lung cancer, but it is not the most common. It accounts for a smaller percentage of lung cancer cases and is often associated with a more aggressive clinical course.",
"id": "10024132",
"label": "c",
"name": "Small cell lung cancer",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Adenocarcinoma is the most common type of lung cancer among adults. It typically originates in the peripheral (outer) areas of the lung and is often seen in non-smokers and ex-smokers.",
"id": "10024130",
"label": "a",
"name": "Adenocarcinoma",
"picture": null,
"votes": 28
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5741",
"name": "Types of Lung Cancer",
"status": null,
"topic": {
"__typename": "Topic",
"id": "296",
"name": "Lung Cancer",
"typeId": 7
},
"topicId": 296,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5741,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17224",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following is the most common type of lung cancer among adults?",
"sbaAnswer": [
"a"
],
"totalVotes": 57,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,962 | false | 34 | null | 6,495,169 | null | false | [] | null | 17,225 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The inferior border of the mandible is the correct answer. It forms the superior border of the anterior triangle of the neck, which extends from the mandible down to the clavicle.",
"id": "10024135",
"label": "a",
"name": "Inferior border of the mandible",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The hyoid bone is located in the neck and serves as a reference point for various structures, but it is not part of the superior border of the anterior triangle.",
"id": "10024138",
"label": "d",
"name": "Hyoid bone",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The thyroid cartilage is a structure in the neck but does not contribute to the formation of the superior border of the anterior triangle.",
"id": "10024139",
"label": "e",
"name": "Thyroid cartilage",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The anterior belly of the digastric muscle is an important landmark, but it is not part of the superior border of the anterior triangle. It helps define the submandibular triangle.",
"id": "10024136",
"label": "b",
"name": "Anterior belly of the digastric muscle",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The sternocleidomastoid muscle is a prominent muscle located in the neck, but it does not form the superior border of the anterior triangle of the neck. It actually divides the neck into anterior and posterior triangles.",
"id": "10024137",
"label": "c",
"name": "Sternocleidomastoid muscle",
"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": "5742",
"name": "Triangles of the Neck",
"status": null,
"topic": {
"__typename": "Topic",
"id": "297",
"name": "Anatomy of the Neck",
"typeId": 7
},
"topicId": 297,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5742,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17225",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "When considering the borders of the anterior triangle of the neck, which of the following structures forms its superior border?",
"sbaAnswer": [
"a"
],
"totalVotes": 54,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,963 | false | 35 | null | 6,495,169 | null | false | [] | null | 17,226 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "KRAS mutations are more commonly associated with colorectal cancer and certain other cancers. They are not a primary genetic factor in hereditary breast cancer.",
"id": "10024144",
"label": "e",
"name": "KRAS",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Mutations in the BRCA1 gene are strongly associated with an increased risk of hereditary breast cancer. Individuals with BRCA1 mutations have a significantly higher lifetime risk of developing breast cancer, as well as ovarian cancer.",
"id": "10024140",
"label": "a",
"name": "BRCA1",
"picture": null,
"votes": 50
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "BCR-ABL gene fusions are characteristic of chronic myeloid leukaemia (CML) and are not directly related to breast cancer.",
"id": "10024143",
"label": "d",
"name": "BCR-ABL",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The EGFR (Epidermal Growth Factor Receptor) gene is not typically associated with hereditary breast cancer. EGFR mutations are more commonly linked to certain types of lung cancer and other malignancies.",
"id": "10024142",
"label": "c",
"name": "EGFR",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Mutations in the TP53 gene are associated with Li-Fraumeni syndrome, which increases the risk of various cancers, including breast cancer. However, BRCA1/BRCA2 mutations are more strongly associated with hereditary breast cancer.",
"id": "10024141",
"label": "b",
"name": "TP53",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5743",
"name": "Genetics",
"status": null,
"topic": {
"__typename": "Topic",
"id": "298",
"name": "Breast Cancer",
"typeId": 7
},
"topicId": 298,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5743,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17226",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following genetic mutations is most strongly associated with an increased risk of hereditary breast cancer?",
"sbaAnswer": [
"a"
],
"totalVotes": 55,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,964 | false | 36 | null | 6,495,169 | null | false | [] | null | 17,227 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The daily consumption of organic foods has not been established as a risk factor for breast cancer. The relationship between diet and breast cancer risk is complex and multifactorial.",
"id": "10024146",
"label": "b",
"name": "Daily consumption of organic foods",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Living at higher altitudes is not a well-established risk factor for breast cancer. Breast cancer risk is influenced by a range of factors: altitude is not one of the major determinants.",
"id": "10024149",
"label": "e",
"name": "Living at higher altitudes",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "A family history of breast cancer, especially in first-degree relatives (e.g. mother, sister), is a well-established risk factor for the development of breast cancer. Individuals with affected family members may have an increased risk due to genetic and environmental factors.",
"id": "10024145",
"label": "a",
"name": "Having a first-degree relative with breast cancer",
"picture": null,
"votes": 56
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "High consumption of vitamin C is not a well-established risk factor for breast cancer. Whilst a healthy diet is important, the impact of specific nutrients like vitamin C on breast cancer risk is not fully understood.",
"id": "10024148",
"label": "d",
"name": "High consumption of vitamin C",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There is no scientific evidence to support the claim that frequent use of underwire bras is a risk factor for breast cancer. This is a common misconception.",
"id": "10024147",
"label": "c",
"name": "Frequent use of underwire bras",
"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": "5744",
"name": "Risk Factors",
"status": null,
"topic": {
"__typename": "Topic",
"id": "298",
"name": "Breast Cancer",
"typeId": 7
},
"topicId": 298,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5744,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17227",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following is considered a major risk factor for the development of breast cancer?",
"sbaAnswer": [
"a"
],
"totalVotes": 56,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,965 | false | 37 | null | 6,495,169 | null | false | [] | null | 17,228 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Whilst this can result in wrist injuries, including scaphoid fractures, it is not the most common mechanism of injury for scaphoid fractures.",
"id": "10024151",
"label": "b",
"name": "Direct blow to the dorsal surface of the wrist",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Compression injuries can affect the wrist, but they are not the most common cause of scaphoid fractures.",
"id": "10024154",
"label": "e",
"name": "Compression of the wrist from a heavy load",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Repetitive stress on the wrist can lead to overuse injuries, but it is not the primary mechanism for acute scaphoid fractures.",
"id": "10024153",
"label": "d",
"name": "Repetitive stress from gripping objects",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hyperextension of the wrist can lead to various wrist injuries, but it is not the primary mechanism for scaphoid fractures.",
"id": "10024152",
"label": "c",
"name": "Hyperextension of the wrist",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Falling on an outstretched hand with the wrist in dorsiflexion is the most common mechanism of injury for scaphoid fractures. This position places stress on the scaphoid bone and can lead to a fracture.",
"id": "10024150",
"label": "a",
"name": "Falling on an outstretched hand with the wrist in dorsiflexion",
"picture": null,
"votes": 46
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5745",
"name": "Scaphoid Fracture",
"status": null,
"topic": {
"__typename": "Topic",
"id": "299",
"name": "Fractures",
"typeId": 7
},
"topicId": 299,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5745,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17228",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "What is the most common mechanism of injury for scaphoid fractures in the wrist?",
"sbaAnswer": [
"a"
],
"totalVotes": 53,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,966 | false | 38 | null | 6,495,169 | null | false | [] | null | 17,229 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Osteoblasts are responsible for the production of new bone. They lay down the matrix for bone formation and initiate the mineralisation process during bone healing.",
"id": "10024155",
"label": "a",
"name": "Osteoblasts",
"picture": null,
"votes": 45
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Osteoclasts are responsible for the resorption of old or damaged bone tissue, not the production of new bone. They break down bone as part of the bone remodelling process.",
"id": "10024156",
"label": "b",
"name": "Osteoclasts",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Chondrocytes are specialised cells responsible for cartilage formation and maintenance. They are not directly involved in the production of new bone.",
"id": "10024158",
"label": "d",
"name": "Chondrocytes",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Macrophages play a role in the immune response and can be involved in clearing cellular debris at a fracture site, but they are not the primary cells responsible for new bone production.",
"id": "10024159",
"label": "e",
"name": "Macrophages",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Fibroblasts are involved in the production of collagen and other connective tissue components, such as scar tissue, but they are not primarily responsible for the production of new bone.",
"id": "10024157",
"label": "c",
"name": "Fibroblasts",
"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": "5746",
"name": "Fracture Healing",
"status": null,
"topic": {
"__typename": "Topic",
"id": "299",
"name": "Fractures",
"typeId": 7
},
"topicId": 299,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5746,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17229",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "With reference to the process of healing after a fracture, which of the following cells are responsible for the production of new bone?",
"sbaAnswer": [
"a"
],
"totalVotes": 56,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,967 | false | 39 | null | 6,495,169 | null | false | [] | null | 17,230 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The brachial plexus is a complex network of nerves that serves the upper extremity. It is not involved in carpal tunnel syndrome or its surgical management.",
"id": "10024164",
"label": "e",
"name": "Brachial plexus",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The median nerve is the structure affected by carpal tunnel syndrome, and the goal of surgical intervention is to relieve pressure on this nerve. The median nerve is not divided during the procedure.",
"id": "10024161",
"label": "b",
"name": "Median nerve",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "During carpal tunnel release surgery, the flexor retinaculum (transverse carpal ligament) is divided. This surgical procedure involves cutting the ligament to relieve pressure on the median nerve and alleviate symptoms.",
"id": "10024160",
"label": "a",
"name": "Flexor retinaculum",
"picture": null,
"votes": 33
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The ulnar nerve is not typically involved in carpal tunnel syndrome, and it is not divided during carpal tunnel release surgery.",
"id": "10024162",
"label": "c",
"name": "Ulnar nerve",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The radial artery is not divided during carpal tunnel release surgery. The surgical focus is on releasing the pressure on the median nerve.",
"id": "10024163",
"label": "d",
"name": "Radial artery",
"picture": null,
"votes": 2
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5747",
"name": "Carpal Tunnel Syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "300",
"name": "Syndromes",
"typeId": 7
},
"topicId": 300,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5747,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17230",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "With reference to the surgical management of carpal tunnel syndrome, which of the following structures is divided?",
"sbaAnswer": [
"a"
],
"totalVotes": 52,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,968 | false | 40 | null | 6,495,169 | null | false | [] | null | 17,231 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The ATFL is primarily associated with lateral ankle sprains and is not involved in high ankle sprains. High ankle sprains involve the ligaments higher up in the leg, closer to the tibia and fibula.",
"id": "10024166",
"label": "b",
"name": "Anterior talofibular ligament (ATFL)",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The CFL is also associated with lateral ankle sprains and is not a part of the high ankle sprain mechanism.",
"id": "10024167",
"label": "c",
"name": "Calcaneofibular ligament (CFL)",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "High ankle sprains involve the disruption of the anterior inferior tibiofibular ligament (AITFL), which connects the tibia and fibula just above the ankle joint. This ligament plays a key role in maintaining the stability of the ankle joint.",
"id": "10024165",
"label": "a",
"name": "Anterior inferior tibiofibular ligament (AITFL)",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The deltoid ligament is a strong, broad ligament on the medial (inner) side of the ankle. It is not the primary structure involved in high ankle sprains.",
"id": "10024168",
"label": "d",
"name": "Deltoid ligament",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The PTFL is primarily involved in lateral ankle sprains, not high ankle sprains.",
"id": "10024169",
"label": "e",
"name": "Posterior talofibular ligament (PTFL)",
"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": "5748",
"name": "Ankle Sprain",
"status": null,
"topic": {
"__typename": "Topic",
"id": "301",
"name": "Sports Injuries",
"typeId": 7
},
"topicId": 301,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5748,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17231",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "High ankle sprains, also known as syndesmotic ankle injuries, primarily involve which ligamentous structure in the ankle joint?",
"sbaAnswer": [
"a"
],
"totalVotes": 49,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,969 | false | 41 | null | 6,495,169 | null | false | [] | null | 17,232 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Varicose veins result from venous insufficiency rather than arterial insufficiency. They occur in the superficial venous system, not the arterial system.",
"id": "10024171",
"label": "b",
"name": "Arterial insufficiency leading to vein dilation",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Whilst lymphatic system disorders can lead to various medical conditions, they are not a primary cause of varicose veins. Varicose veins are primarily a result of venous insufficiency.",
"id": "10024174",
"label": "e",
"name": "Deficiency of the lymphatic system",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Excessive exercise and muscle hypertrophy do not directly cause varicose veins. In fact, regular exercise can help improve venous circulation and reduce the risk of varicose veins.",
"id": "10024172",
"label": "c",
"name": "Excessive exercise and muscle hypertrophy",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cold temperatures are not a known cause of varicose veins. Varicose veins are more influenced by factors related to vein function and genetics.",
"id": "10024173",
"label": "d",
"name": "Chronic exposure to cold temperatures",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Varicose veins are primarily caused by impaired venous valves and increased venous pressure. When these valves fail to function properly, blood flows backward and pools in the veins, causing them to dilate and become varicose.",
"id": "10024170",
"label": "a",
"name": "Impaired venous valves and increased venous pressure",
"picture": null,
"votes": 49
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5749",
"name": "Varicose Veins",
"status": null,
"topic": {
"__typename": "Topic",
"id": "302",
"name": "Leg Pain",
"typeId": 7
},
"topicId": 302,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5749,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17232",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following best describes the cause of varicose veins?",
"sbaAnswer": [
"a"
],
"totalVotes": 57,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,970 | false | 42 | null | 6,495,169 | null | false | [] | null | 17,233 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Whilst MRI can be used for diagnosing DVT in specific situations, the most commonly employed diagnostic tool is Doppler ultrasound which is easier and cheaper to carry out.",
"id": "10024178",
"label": "d",
"name": "Magnetic resonance imaging",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Chest X-rays are not typically used for diagnosing DVT. They are more commonly employed to evaluate conditions of the chest and lungs, such as pneumonia or pneumothorax.",
"id": "10024176",
"label": "b",
"name": "Chest X-ray",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Electrocardiograms are used to assess the electrical activity of the heart and are not a primary diagnostic tool for DVT. However, they may be performed to rule out other cardiac conditions if there are associated symptoms.",
"id": "10024177",
"label": "c",
"name": "Electrocardiogram",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ABG analysis assesses oxygen and carbon dioxide levels in the blood and is not used for diagnosing DVT. It is primarily used in the evaluation of respiratory and metabolic disorders.",
"id": "10024179",
"label": "e",
"name": "Arterial blood gas (ABG) analysis",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Doppler ultrasound is the most commonly used diagnostic test for confirming DVT. It is a non-invasive and highly sensitive method for visualising blood flow in deep veins and identifying the presence of blood clots.",
"id": "10024175",
"label": "a",
"name": "Doppler ultrasound",
"picture": null,
"votes": 49
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5750",
"name": "DVT",
"status": null,
"topic": {
"__typename": "Topic",
"id": "302",
"name": "Leg Pain",
"typeId": 7
},
"topicId": 302,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5750,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17233",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 52-year-old male patient presents with unilateral lower extremity pain, swelling, and redness.\n\nBased on the clinical presentation and initial evaluation, which of the following diagnostic tests is most commonly used for confirming the diagnosis of deep vein thrombosis (DVT)?",
"sbaAnswer": [
"a"
],
"totalVotes": 58,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,971 | false | 43 | null | 6,495,169 | null | false | [] | null | 17,234 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The patient's presentation, with dorsal displacement of the distal radius following a fall onto an outstretched hand, is indicative of a Colles fracture. Colles fractures are common wrist fractures, often resulting from a fall onto an outstretched hand with the wrist extended.",
"id": "10024180",
"label": "a",
"name": "Colles fracture",
"picture": null,
"votes": 36
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A Smith fracture, also known as a reverse Colles fracture, is characterised by volar (palmar) displacement of the distal radius, rather than dorsal displacement.",
"id": "10024184",
"label": "e",
"name": "Smith fracture",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Scaphoid fractures typically present with pain in the anatomical snuffbox and are less likely to cause dorsal displacement of the distal radius. The anatomical snuffbox is a depression on the thumb side of the wrist.",
"id": "10024181",
"label": "b",
"name": "Scaphoid fractures",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Monteggia fractures involve a fracture of the proximal ulna and dislocation of the radial head. They occur at the elbow, not the wrist, and are not consistent with the presentation described.",
"id": "10024182",
"label": "c",
"name": "Monteggia fracture",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Galeazzi fractures involve a fracture of the distal radius and dislocation of the distal ulna. Whilst it includes a distal radius fracture, the displacement pattern and location described in this question are not consistent with a Galeazzi fracture.",
"id": "10024183",
"label": "d",
"name": "Galeazzi fracture",
"picture": null,
"votes": 2
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5751",
"name": "Fractures",
"status": null,
"topic": {
"__typename": "Topic",
"id": "303",
"name": "Falls",
"typeId": 7
},
"topicId": 303,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5751,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17234",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 45-year-old patient presents with a history of a fall onto an outstretched hand and presents with a characteristic deformity of the wrist. On physical examination, there is dorsal displacement of the distal radius.\n\nBased on these findings, which of the following is the most likely diagnosis for this wrist injury?",
"sbaAnswer": [
"a"
],
"totalVotes": 53,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,972 | false | 44 | null | 6,495,169 | null | false | [] | null | 17,235 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Whilst hyperthyroidism can have a range of effects on an individual's health, including changes to metabolism and heart rate, it is not the most common underlying reason for falls in older adults.",
"id": "10024189",
"label": "e",
"name": "Hyperthyroidism",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Osteoarthritis can lead to joint pain and decreased mobility, but it is not generally the primary reason for falls in older adults. Falls in this population are often due to other factors.",
"id": "10024188",
"label": "d",
"name": "Osteoarthritis",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypertension can increase the risk of cardiovascular events such as strokes but is not the most common reason for falls in older adults.",
"id": "10024187",
"label": "c",
"name": "Hypertension",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Peripheral neuropathy, a condition that affects the nerves in the extremities, can contribute to balance and gait issues, but it is not the leading reason for falls in older adults.",
"id": "10024186",
"label": "b",
"name": "Peripheral neuropathy",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Urinary tract infections (UTIs) are a common underlying reason for falls in older adults. UTIs can lead to altered mental status, confusion, and gait disturbances, which increase the risk of falls.",
"id": "10024185",
"label": "a",
"name": "Urinary tract infection (UTI)",
"picture": null,
"votes": 27
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5752",
"name": "Common Causes",
"status": null,
"topic": {
"__typename": "Topic",
"id": "303",
"name": "Falls",
"typeId": 7
},
"topicId": 303,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5752,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17235",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "In older adults, which of the following conditions is the most common underlying reason for falls, often due to factors such as altered mental status and gait disturbances?",
"sbaAnswer": [
"a"
],
"totalVotes": 57,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,973 | false | 45 | null | 6,495,169 | null | false | [] | null | 17,236 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "In OA, the hips and knees are frequently affected, whereas RA predominantly affects the small joints of the hands and wrists, such as the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints.",
"id": "10024190",
"label": "a",
"name": "OA primarily affects the hips and knees, whilst RA primarily affects the small joints of the hands and wrists",
"picture": null,
"votes": 46
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This option is not accurate. Whilst there can be some overlap in joint involvement, OA and RA typically affect different joints.",
"id": "10024194",
"label": "e",
"name": "OA and RA both primarily affect the same joints, such as the wrists and ankles",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In OA, the weight-bearing joints like the hips and knees are more affected. In contrast, RA commonly involves the small joints of the hands and wrists.",
"id": "10024191",
"label": "b",
"name": "OA primarily affects the small joints of the hands and wrists, whilst RA primarily affects the hips and knees",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This option incorrectly attributes shoulder and ankle joint involvement to RA, which is not the most common pattern of joint involvement in this condition.",
"id": "10024193",
"label": "d",
"name": "OA primarily affects the large weight-bearing joints like the knees and hips, whilst RA primarily affects the shoulders and ankle joints",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This option does not accurately describe the most common patterns of joint involvement in OA and RA.",
"id": "10024192",
"label": "c",
"name": "OA primarily affects the spine and the sacroiliac joints, whilst RA primarily affects the shoulder and elbow joints",
"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": "5753",
"name": "Joints Affected",
"status": null,
"topic": {
"__typename": "Topic",
"id": "304",
"name": "Osteoarthritis",
"typeId": 7
},
"topicId": 304,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5753,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17236",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "When comparing osteoarthritis (OA) and rheumatoid arthritis (RA), which of the following correctly identifies the joints most commonly affected in each condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 55,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,974 | false | 46 | null | 6,495,169 | null | false | [] | null | 17,237 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Soft tissue calcifications and joint subluxation are not common X-ray findings in OA. They may be seen in other musculoskeletal conditions but are not specific to OA.",
"id": "10024199",
"label": "e",
"name": "Soft tissue calcifications and joint subluxation",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pannus formation and joint ankylosis are associated with inflammatory arthritis, particularly rheumatoid arthritis, and are not typical X-ray findings in OA.",
"id": "10024198",
"label": "d",
"name": "Pannus formation and joint ankylosis",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Narrowed joint space and osteophyte formation are common X-ray findings in osteoarthritis. These changes result from the gradual loss of cartilage in the affected joint and the body's attempt to repair the damage by forming bony outgrowths (osteophytes).",
"id": "10024195",
"label": "a",
"name": "Narrowed joint space and osteophyte formation",
"picture": null,
"votes": 38
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Joint effusion and synovial hypertrophy are more commonly associated with inflammatory arthritis, such as rheumatoid arthritis, and are not typical X-ray findings in OA.",
"id": "10024196",
"label": "b",
"name": "Joint effusion and synovial hypertrophy",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Periarticular erosions and subchondral cysts are typically seen in inflammatory arthropathies like rheumatoid arthritis. They are not common X-ray findings in OA.",
"id": "10024197",
"label": "c",
"name": "Periarticular erosions and subchondral cysts",
"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": "5754",
"name": "X-Ray Findings",
"status": null,
"topic": {
"__typename": "Topic",
"id": "304",
"name": "Osteoarthritis",
"typeId": 7
},
"topicId": 304,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5754,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17237",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "On radiographic imaging of osteoarthritis (OA), which of the following are common X-ray findings that may suggest the presence of this degenerative joint condition?",
"sbaAnswer": [
"a"
],
"totalVotes": 53,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,975 | false | 47 | null | 6,495,169 | null | false | [] | null | 17,238 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Methotrexate can cause gastrointestinal side effects, including nausea and ulcerative mucositis, but gastrointestinal bleeding is not primarily attributed to its immunosuppressive properties.",
"id": "10024201",
"label": "b",
"name": "Gastrointestinal bleeding",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Methotrexate is an immunosuppressive medication and can weaken the immune system. This is an important aspect of its use in RA, as it helps to reduce the autoimmune inflammatory response associated with the disease.",
"id": "10024200",
"label": "a",
"name": "Immunosuppression",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Haemolytic anaemia is not a typical side effect of methotrexate's immunosuppressive action. Anaemia can occur due to other mechanisms but is not directly related to immunosuppression.",
"id": "10024203",
"label": "d",
"name": "Haemolytic anaemia",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Whilst methotrexate is primarily metabolised by the kidneys, nephrotoxicity is not a common side effect related to its immunosuppressive action.",
"id": "10024202",
"label": "c",
"name": "Nephrotoxicity",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Osteoporosis can be a concern with long-term methotrexate use, but it is not primarily attributed to its immunosuppressive properties.",
"id": "10024204",
"label": "e",
"name": "Osteoporosis",
"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": "5755",
"name": "Drug Side Effects",
"status": null,
"topic": {
"__typename": "Topic",
"id": "305",
"name": "Rheumatoid Arthritis",
"typeId": 7
},
"topicId": 305,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5755,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17238",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Methotrexate is commonly used in the management of rheumatoid arthritis (RA).\n\nWhich of the following side effects is associated with methotrexate and is attributed to its immunosuppressive properties?",
"sbaAnswer": [
"a"
],
"totalVotes": 55,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,976 | false | 48 | null | 6,495,169 | null | false | [] | null | 17,239 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Lumbar spinal nerve roots L2 and L3 are associated with lower limb functions and are not involved in shoulder abduction.",
"id": "10024209",
"label": "e",
"name": "L2 and L3",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "C7 and T1 contribute to functions of the lower brachial plexus and upper thoracic regions and are not primarily responsible for shoulder abduction.",
"id": "10024208",
"label": "d",
"name": "C7 and T1",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "C6 and C7 are both part of the brachial plexus and contribute to shoulder abduction. However, they are not the primary spinal nerve roots responsible for this specific movement.",
"id": "10024207",
"label": "c",
"name": "C6 and C7",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The spinal nerve roots C5 and C6 play a significant role in shoulder abduction, particularly in the context of the brachial plexus. The axillary nerve, a branch of the brachial plexus, innervates the deltoid muscle, which is a key muscle responsible for shoulder abduction.",
"id": "10024205",
"label": "a",
"name": "C5 and C6",
"picture": null,
"votes": 45
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "C7 and C8 are not primarily responsible for shoulder abduction. They are associated with different upper limb functions and regions.",
"id": "10024206",
"label": "b",
"name": "C7 and C8",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5756",
"name": "Myotomes",
"status": null,
"topic": {
"__typename": "Topic",
"id": "306",
"name": "Joint Movements",
"typeId": 7
},
"topicId": 306,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5756,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17239",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "In the context of myotomes and their corresponding spinal nerve roots, which spinal nerve roots are primarily responsible for the abduction of the shoulder, a movement commonly associated with the function of the brachial plexus?",
"sbaAnswer": [
"a"
],
"totalVotes": 56,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,977 | false | 49 | null | 6,495,169 | null | false | [] | null | 17,240 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The oesophageal hiatus allows the oesophagus to pass through the diaphragm but is not the opening through which the inferior vena cava traverses.",
"id": "10024211",
"label": "b",
"name": "Oesophageal hiatus",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The caval opening, also known as the caval foramen, is the diaphragmatic opening through which the inferior vena cava passes from the abdomen to the thoracic cavity.",
"id": "10024210",
"label": "a",
"name": "Caval opening",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The phrenic foramen is not a recognised diaphragmatic opening for major blood vessels. Instead, it is related to the passage of the phrenic nerve through the diaphragm.",
"id": "10024214",
"label": "e",
"name": "Phrenic foramen",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The aortic hiatus permits the aorta to pass through the diaphragm, but it is not the correct opening for the inferior vena cava.",
"id": "10024212",
"label": "c",
"name": "Aortic hiatus",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The sternal foramen is not associated with the diaphragm but is related to the sternum (breastbone).",
"id": "10024213",
"label": "d",
"name": "Sternal foramen",
"picture": null,
"votes": 2
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5757",
"name": "Diaphragmatic Openings",
"status": null,
"topic": {
"__typename": "Topic",
"id": "307",
"name": "General Anatomy",
"typeId": 7
},
"topicId": 307,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5757,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17240",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "The diaphragm, a critical respiratory muscle, contains several openings or passages through which structures pass.\n\nWhich of the following diaphragmatic openings allows the inferior vena cava to traverse from the abdomen to the thoracic cavity?",
"sbaAnswer": [
"a"
],
"totalVotes": 55,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,464,978 | false | 50 | null | 6,495,169 | null | false | [] | null | 17,241 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The sciatic nerve primarily innervates the posterior thigh and lower leg muscles. It is not responsible for knee extension or the sensory loss described in this question.",
"id": "10024216",
"label": "b",
"name": "Sciatic nerve",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The genitofemoral nerve primarily provides sensory innervation to the genital region and the upper thigh. It is not responsible for knee extension.",
"id": "10024219",
"label": "e",
"name": "Genitofemoral nerve",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The obturator nerve innervates the medial thigh and is not responsible for knee extension. It does not match the pattern of symptoms described in this question.",
"id": "10024217",
"label": "c",
"name": "Obturator nerve",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The lateral femoral cutaneous nerve is responsible for providing sensation to the lateral thigh but does not control knee extension or innervate the areas described in this question.",
"id": "10024218",
"label": "d",
"name": "Lateral femoral cutaneous nerve",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The femoral nerve innervates the anterior thigh muscles, including the quadriceps, which are essential for knee extension. Damage to the femoral nerve can result in the loss of knee extension and sensory deficits in the anterior and medial thigh.",
"id": "10024215",
"label": "a",
"name": "Femoral nerve",
"picture": null,
"votes": 36
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5758",
"name": "Femoral Nerve",
"status": null,
"topic": {
"__typename": "Topic",
"id": "307",
"name": "General Anatomy",
"typeId": 7
},
"topicId": 307,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5758,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17241",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A patient presents with a loss of knee extension and sensory loss to the anterior and medial thigh after a stab injury to the upper thigh.\n\nWhich anatomical structure is most likely to be damaged in this case?",
"sbaAnswer": [
"a"
],
"totalVotes": 55,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,129 | false | 1 | null | 6,495,173 | null | false | [] | null | 17,242 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is defined as a suppressed TSH with normal fT4 and fT3 in a patient with no symptoms. As the fT3 and fT4 levels in this case are high, this is not the correct answer.",
"id": "10024223",
"label": "d",
"name": "Subclinical hyperthyroidism",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not correct as the fT4 levels are also raised. In T3 toxicosis, only fT3 levels are raised. This is usually seen in multinodular goitres.",
"id": "10024222",
"label": "c",
"name": "T3 toxicosis",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypothyroidism, i.e. low thyroid hormone levels, increases thyroid-releasing hormone secretion from the hypothalamus and thyroid-stimulating hormone (TSH) secretion from the anterior pituitary via the hypothalamic-pituitary-thyroid axis. This results in a high TSH level with suppressed fT3 and fT4.",
"id": "10024221",
"label": "b",
"name": "Hypothyroidism",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is defined as a high TSH with normal fT4 and fT3 in a patient with no symptoms. As the TSH is suppressed and fT3 and fT4 levels are high, this is not the correct answer.",
"id": "10024224",
"label": "e",
"name": "Subclinical hypothyroidism",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Hyperthyroidism is the presence of excess thyroid hormones (fT3 and fT4). These increased hormones act on the hypothalamic-pituitary-thyroid axis and activate a negative feedback loop. This decreases thyroid-releasing hormone (TRH) production from the hypothalamus as well as thyroid-stimulating hormone (TSH) from the anterior pituitary.",
"id": "10024220",
"label": "a",
"name": "Hyperthyroidism",
"picture": null,
"votes": 224
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3959",
"name": "Hyperthyroidism",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3959,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17242",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 37-year-old female presents to her general practitioner with irregular periods and weight loss. A series of blood tests are performed which show a suppressed TSH and high fT3 and fT4.\n\nWhat is the likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 269,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,130 | false | 2 | null | 6,495,173 | null | false | [] | null | 17,243 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pseudo-Cushing's syndrome is thought to be caused by decreased clearance of cortisol by the liver leading to excess serum cortisol. In Pseudo-Cushing's syndrome, high-dose dexamethasone acts on the intact hypothalamus-pituitary-adrenal axis to reduce both ACTH and cortisol.",
"id": "10024229",
"label": "e",
"name": "Pseudo-Cushing's Syndrome due to alcohol",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Exogenous corticosteroid use results in a raised cortisol which is completely independent from the hypothalamus-pituitary-adrenal axis. Therefore dexamethasone, which acts on this axis, does not affect cortisol levels.",
"id": "10024228",
"label": "d",
"name": "Exogenous corticosteroid use",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as ectopic sources of ACTH, such as lung cancers, are independent of BOTH the hypothalamus and pituitary. These sources will produce excess ACTH which will act on the adrenals resulting in excess cortisol production. As dexamethasone only acts centrally on the hypothalamus and not on the ectopic source of ACTH, it will not suppress serum ACTH or cortisol levels.",
"id": "10024227",
"label": "c",
"name": "Ectopic ACTH production",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as dexamethasone will act on the pituitary to suppress ACTH production. This will, by extension, suppress cortisol production from the adrenals.",
"id": "10024226",
"label": "b",
"name": "Pituitary adenoma",
"picture": null,
"votes": 65
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "In patients with adrenal adenomas, cortisol production is independent from the pituitary as the excess production is derived from the adrenals. Therefore, even though dexamethasone will suppress the pituitary (resulting in low ACTH), cortisol levels will remain high due to the ectopic production from the adrenals.",
"id": "10024225",
"label": "a",
"name": "Adrenal adenoma",
"picture": null,
"votes": 134
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3764",
"name": "Cushing's syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3764,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17243",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 50-year-old female experiencing weight gain, excessive hair growth and proximal muscle wasting is referred to an endocrinologist for suspected Cushing’s syndrome. A high-dose dexamethasone test is performed which reveals a suppressed ACTH and a high cortisol level.\n\nWhich of the following is the most likely cause of this patient's Cushing’s syndrome?",
"sbaAnswer": [
"a"
],
"totalVotes": 245,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,131 | false | 3 | null | 6,495,173 | null | false | [] | null | 17,244 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the first-line test used in the diagnosis of hyperaldosteronism. Although Conn’s syndrome and hyperaldosteronism can present with headaches and hypertension, the excess aldosterone will also cause increased urination and thirst as well as cramps due to hyperkalaemia.",
"id": "10024232",
"label": "c",
"name": "Aldosterone:Renin ratio",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This test is used in the workup of Cushing’s syndrome. Cushing's syndrome can present with central obesity, buffalo hump, moon face, proximal myopathy and hirsutism.",
"id": "10024231",
"label": "b",
"name": "24-hour urinary cortisol",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The most likely diagnosis is phaeochromocytoma, a catecholamine-secreting tumour associated with MEN2. Adrenaline and noradrenaline secretion from the phaeochromocytoma stimulates the sympathetic nervous system which leads to excess sweating, palpitations, headaches and increased blood pressure through arterial vasoconstriction. The gold-standard investigation is the measurement of plasma and urinary metanephrines, which are metabolites of adrenaline.",
"id": "10024230",
"label": "a",
"name": "Plasma and urinary metanephrines",
"picture": null,
"votes": 69
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This test is used to diagnose Addison’s disease. Addison's typically presents with **hypotension**, weakness, hyperpigmentation and GI symptoms such as nausea, vomiting and abdominal pain. There is no formal link between MEN2 and Addison's disease.",
"id": "10024233",
"label": "d",
"name": "Short Synacthen test",
"picture": null,
"votes": 51
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Aldosterone concentration may be helpful in the diagnosis of hyperaldosteronism and adrenal insufficiency. However, it alone cannot confirm either diagnosis and is not indicated in this case.",
"id": "10024234",
"label": "e",
"name": "Plasma aldosterone concentration",
"picture": null,
"votes": 31
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5759",
"name": "Phaechromocytoma",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5759,
"conditions": [],
"difficulty": 1,
"dislikes": 1,
"explanation": null,
"highlights": [],
"id": "17244",
"isLikedByMe": 0,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 30-year-old male presents to his GP with headache, sweating and abdominal pain. His father was previously diagnosed with multiple endocrine neoplasia 2 (MEN2). The GP measures his blood pressure and finds it to be 160/83.\n\nWhich of the following tests will confirm the diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 223,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,132 | false | 4 | null | 6,495,173 | null | false | [] | null | 17,245 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of action of biguanides such as metformin. As well as reducing the hepatic production of glucose, metformin also increases insulin sensitivity and decreases glucose absorption in the intestines.",
"id": "10024236",
"label": "b",
"name": "Decreases gluconeogenesis",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This refers to the mechanism of action of DPP4 inhibitors, also known as dipeptidyl peptidase-4 inhibitors. DPP4 breaks down incretin hormones such as GLP-1 and GIP. By inhibiting this enzyme, the levels of incretins increase which inhibit glucagon and stimulate insulin secretion thereby decreasing blood sugar levels.",
"id": "10024239",
"label": "e",
"name": "Inhibits the enzyme DPP4 which breaks down incretin hormones",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Pioglitazone, alongside other thiazolidinediones, are agonists at the peroxisome proliferator-activated receptor-gamma (PPARγ) receptor. Through activation of this receptor, thiazolidinediones enhance tissue sensitivity to insulin and reduce gluconeogenesis.",
"id": "10024235",
"label": "a",
"name": "They activate PPARγ receptors which increase peripheral insulin sensitivity",
"picture": null,
"votes": 124
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of action of sulfonylurea medication. An example of this class of medication is gliclazide.",
"id": "10024237",
"label": "c",
"name": "Bind and close the potassium ATP channels causing depolarisation of beta cells and the release of insulin",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of action of sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors). These co-transporters are found in the proximal tubule of the nephron and are responsible for glucose re-absorption. By inhibiting this protein, SGLT2 inhibitors promote glucosuria. An example of this class of medication is dapagliflozin.",
"id": "10024238",
"label": "d",
"name": "Promotes glucose excretion through the kidney",
"picture": null,
"votes": 35
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5760",
"name": "Diabetes",
"status": null,
"topic": {
"__typename": "Topic",
"id": "220",
"name": "Endocrine Pharmacology",
"typeId": 7
},
"topicId": 220,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5760,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17245",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 50-year-old female was recently diagnosed with type 2 diabetes and given pioglitazone.\n\nWhich of the following is the mechanism of action of thiazolidinediones?",
"sbaAnswer": [
"a"
],
"totalVotes": 219,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,133 | false | 5 | null | 6,495,173 | null | false | [] | null | 17,246 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypoglycaemia stimulates the hypothalamus to increase growth hormone-releasing hormone (GHRH) and decrease somatostatin production. This increases the pituitary release of growth hormone.",
"id": "10024242",
"label": "c",
"name": "Hypoglycaemia",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Growth hormone acts on adipose tissue to increase lipolysis: the breakdown of lipids into fatty acids. Decreased fatty acids will exert negative feedback on the hypothalamus and pituitary gland to increase growth hormone production and secretion.",
"id": "10024243",
"label": "d",
"name": "Decreased fatty acids",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ghrelin acts on and stimulates both the hypothalamus and pituitary gland to increase growth hormone concentration.",
"id": "10024241",
"label": "b",
"name": "Ghrelin",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Growth hormone-releasing hormone (GHRH) is released from the hypothalamus and acts on the pituitary gland to increase growth hormone secretion.",
"id": "10024244",
"label": "e",
"name": "Growth hormone-releasing hormone (GHRH)",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Somatostatin is also known as growth hormone inhibiting hormone (GHIH). Somatostatin is released by the hypothalamus and acts on the pituitary gland to reduce GH secretion.",
"id": "10024240",
"label": "a",
"name": "Somatostatin",
"picture": null,
"votes": 161
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5761",
"name": "Growth hormone",
"status": null,
"topic": {
"__typename": "Topic",
"id": "167",
"name": "Endocrine physiology",
"typeId": 7
},
"topicId": 167,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5761,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17246",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 30-year-old male complains of his jaw and tongue getting larger and his shoes no longer fitting him properly. His IGF1 levels are raised.\n\nWhich of the following factors inhibit growth hormone secretion?",
"sbaAnswer": [
"a"
],
"totalVotes": 227,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,134 | false | 6 | null | 6,495,173 | null | false | [] | null | 17,247 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Addison's disease involves low cortisol levels due to adrenal insufficiency. Cortisol increases blood glucose by decreasing glucose intake into muscles and adipose tissue and increasing lipolysis. Therefore, hypocortisolism, as is the case in Addison's, leads to **hypoglycaemia**.",
"id": "10024248",
"label": "d",
"name": "Hyperglycaemia",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Addison's disease is a primary adrenal insufficiency leading to inadequate production of the steroid hormones aldosterone and cortisol. Aldosterone acts on Na+-K+ pumps to increase urinary potassium secretion and sodium reabsorption. Deficit of this hormone therefore leads to a high potassium (hyperkalaemia) and a low sodium (hyponatremia).",
"id": "10024245",
"label": "a",
"name": "Hyponatremia",
"picture": null,
"votes": 127
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Patients with Addison's disease may develop **hypercalcaemia** due to reduced calcium removal by the kidneys.",
"id": "10024246",
"label": "b",
"name": "Hypocalcaemia",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The adrenal glands produce androgens such as oestrogen and testosterone in the zona reticularis. Adrenal impairment means there will be low production and secretion of androgens.",
"id": "10024249",
"label": "e",
"name": "Hyperandrogenism",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Addison's disease is a primary adrenal insufficiency leading to inadequate production of the steroid hormones aldosterone and cortisol. Aldosterone acts on Na+-K+ pumps to increase urinary potassium secretion and sodium reabsorption. Deficit of this hormone therefore leads to a high potassium **(hyperkalaemia)** and a low sodium (hyponatremia).",
"id": "10024247",
"label": "c",
"name": "Hypokalaemia",
"picture": null,
"votes": 49
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3835",
"name": "Adrenal insufficiency and Addison's Disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3835,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17247",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following is a feature of Addison’s disease?",
"sbaAnswer": [
"a"
],
"totalVotes": 229,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,135 | false | 7 | null | 6,495,173 | null | false | [] | null | 17,248 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The pancreas contains GLUT2 transporters. This transporter has a low affinity for glucose and therefore allows glucose to equilibrate across membranes.",
"id": "10024253",
"label": "d",
"name": "Pancreas",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The kidneys contain GLUT2 transporters. This transporter has a low affinity for glucose and therefore allows glucose to equilibrate across membranes.",
"id": "10024252",
"label": "c",
"name": "Kidneys",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The liver contains GLUT2 transporters. This transporter has a low affinity for glucose and therefore allows glucose to equilibrate across membranes.",
"id": "10024251",
"label": "b",
"name": "Liver",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Muscle and adipose tissue contain GLUT4 transporters. This transporter has a medium affinity for glucose and allows insulin-dependent uptake of glucose into cells.",
"id": "10024254",
"label": "e",
"name": "Muscle and adipose tissue",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "These transporters are found in the blood-brain barrier. They are also found in erythrocytes. This transporter has a high affinity for glucose and therefore allows a constant uptake of glucose into the brain.",
"id": "10024250",
"label": "a",
"name": "Brain",
"picture": null,
"votes": 141
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4024",
"name": "Hormonal control of glucose metabolism",
"status": null,
"topic": {
"__typename": "Topic",
"id": "167",
"name": "Endocrine physiology",
"typeId": 7
},
"topicId": 167,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4024,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17248",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Glucose is uptaken into organs by a family of glucose transporters known as GLUT.\n\nWhich of the following organs contains the highest expression of GLUT1 transporters?",
"sbaAnswer": [
"a"
],
"totalVotes": 230,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,136 | false | 8 | null | 6,495,173 | null | false | [] | null | 17,249 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "CCK is a satiety factor, which means it inhibits further food intake. Injection of CCK into the hypothalamus would reduce appetite.",
"id": "10024255",
"label": "a",
"name": "It slows down gastric emptying and inhibits appetite if injected into the hypothalamus",
"picture": null,
"votes": 149
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Fat ingestion causes the release of CCK which slows gastric emptying and induces a state of satiety. CCK then decreases gastric emptying to promote gastric distension and further increase satiety.",
"id": "10024258",
"label": "d",
"name": "Fat ingestion inhibits CCK release and increases gastric emptying",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as CCK acts centrally in the hypothalamus to reduce appetite.",
"id": "10024259",
"label": "e",
"name": "It does not have any central effects, but it suppresses a sense of fullness by stimulating the fundus",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "CCK is a satiety factor, which means it inhibits further food intake. Injection of CCK into the hypothalamus would reduce appetite.",
"id": "10024257",
"label": "c",
"name": "It increases one’s sense of fullness and improves appetite if injected into the hypothalamus",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although CCK does promote gastric emptying, it decreases appetite as a result of its central effects on the hypothalamus.",
"id": "10024256",
"label": "b",
"name": "It slows down gastric emptying and increases appetite",
"picture": null,
"votes": 22
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5762",
"name": "Cholecystokinin",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5762,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17249",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Cholecystokinin (CCK) has several important functions in the body, including secretion of bile from the gallbladder, inhibition of gastric acid secretion, and control of food intake.\n\nWhich of the following best describes the central and peripheral effects of CCK?",
"sbaAnswer": [
"a"
],
"totalVotes": 217,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,137 | false | 9 | null | 6,495,173 | null | false | [] | null | 17,250 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Lansoprazole is a proton pump inhibitor which acts on the H+/K+ ATPase enzyme system at the secretory surface of gastric parietal cells.",
"id": "10024261",
"label": "b",
"name": "Lansoprazole",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Omeprazole is a proton pump inhibitor which acts on the H+/K+ ATPase enzyme system at the secretory surface of gastric parietal cells.",
"id": "10024263",
"label": "d",
"name": "Omeprazole",
"picture": null,
"votes": 43
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Latanoprost is a prostaglandin F2-alpha analogue. It is not used to decrease gastric acid secretion as the stomach does not contain F2-alpha receptors. Its main indication is in glaucoma to reduce intraocular pressure.",
"id": "10024264",
"label": "e",
"name": "Latanoprost",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Cimetidine binds to H2-receptors located on the basolateral membrane of gastric parietal cells to block the effects of histamine. This results in decreased gastric acid secretion. Other H2 receptor antagonists include ranitidine and lafutidine.",
"id": "10024260",
"label": "a",
"name": "Cimetidine",
"picture": null,
"votes": 155
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Misoprostol is a prostaglandin E1 analogue which stimulates E1 receptors on the parietal cells in the stomach to reduce gastric acid secretion.",
"id": "10024262",
"label": "c",
"name": "Misoprostol",
"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": "4051",
"name": "Gastro-oesophageal reflux disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4051,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17250",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 47-year-old male presents to his GP with a burning sensation in his throat and chest, and difficulty swallowing solid foods. He is prescribed an H2-receptor antagonist for the treatment of gastro-oesophageal reflux disease.\n\nWhich of the following is an H2-receptor antagonist?",
"sbaAnswer": [
"a"
],
"totalVotes": 225,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,138 | false | 10 | null | 6,495,173 | null | false | [] | null | 17,251 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Metoclopramide stimulates inhibitory nitrergic neurons which results in coordinated gastric motility.",
"id": "10024268",
"label": "d",
"name": "Metoclopramide inhibits inhibitory nitrergic neurons",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Metoclopramide increases lower oesophageal sphincter and gastric tone to increase intragastric pressure. This helps to stimulate gastric motility and accelerate gastric emptying.",
"id": "10024267",
"label": "c",
"name": "It decreases intragastric pressure",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Metoclopramide **inhibits** D2 receptors. This increases the release of acetylcholine which increases lower oesophageal sphincter tone and gastric contractions.",
"id": "10024266",
"label": "b",
"name": "It stimulates presynaptic and postsynaptic D2 receptors which promotes the release of acetylcholine from intrinsic myenteric cholinergic neurons",
"picture": null,
"votes": 58
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Metoclopramide inhibits 5-HT3 receptors.",
"id": "10024269",
"label": "e",
"name": "It stimulates 5-HT3 receptors",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Inhibition of D2 receptors by metoclopramide increases the release of acetylcholine. Acetylcholine acts on the parasympathetic nervous system to increase digestion and excretion.",
"id": "10024265",
"label": "a",
"name": "It stimulates the release of acetylcholine which increases peristalsis of the small intestine",
"picture": null,
"votes": 115
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5763",
"name": "Gastroparesis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5763,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17251",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 55-year-old male presents with abdominal pain and bloating. After several tests are conducted, he is diagnosed with gastroparesis and given metoclopramide for symptomatic relief.\n\nHow does metoclopramide promote gastric motility and emptying?",
"sbaAnswer": [
"a"
],
"totalVotes": 212,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,139 | false | 11 | null | 6,495,173 | null | false | [] | null | 17,252 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Chronic kidney disease decreases glomerular filtration (GFR) which decreases phosphate excretion. This stimulates the production of FGF-23 which inhibits 1-alpha hydroxylase. This decreases the level of calcitriol and hence reduces intestinal calcium absorption. As a result, the parathyroid gland is stimulated to release more parathyroid hormone. Therefore chronic kidney disease causes secondary **hyperparathyroidism**.",
"id": "10024272",
"label": "c",
"name": "Secondary hypoparathyroidism",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Due to kidney damage in CKD, there is reduced production of erythropoietin and hence reduced production of red blood cells.",
"id": "10024270",
"label": "a",
"name": "Anaemia",
"picture": null,
"votes": 100
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Chronic kidney disease results in the reduced conversion of calcidiol to calcitriol. This leads to decreased calcium absorption from the small intestine and subsequent **hypocalcaemia**.",
"id": "10024274",
"label": "e",
"name": "Hypercalcaemia",
"picture": null,
"votes": 41
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Chronic kidney disease causes sodium and fluid retention. This stimulates the renin-angiotensin-aldosterone system which increases sympathetic nervous system activity and vasoconstriction, and results in **hypertension**.",
"id": "10024273",
"label": "d",
"name": "Hypotension",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as chronic kidney disease decreases glomerular filtration (GFR) therefore decreasing potassium excretion. This leads to a high serum potassium level, i.e. **hyperkalaemia**.",
"id": "10024271",
"label": "b",
"name": "Hypokalaemia",
"picture": null,
"votes": 50
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4243",
"name": "Chronic Kidney Disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "168",
"name": "Renal Physiology",
"typeId": 7
},
"topicId": 168,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4243,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17252",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 70-year-old male with a background of type 1 diabetes, hypertension and hypertriglyceridaemia attends his GP for a check-up appointment for his chronic kidney disease (CKD).\n\nWhich of the following is a consequence of chronic kidney disease?",
"sbaAnswer": [
"a"
],
"totalVotes": 212,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,140 | false | 12 | null | 6,495,173 | null | false | [] | null | 17,253 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Amiloride and Triamterene bind to epithelial sodium channels, known as ENaC, to inhibit sodium reabsorption and potassium loss.",
"id": "10024278",
"label": "d",
"name": "Epithelial sodium channels in the collecting duct",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the site where carbonic anhydrase works. This reduces the availability of hydrogen ions in the lumen and increases the excretion of sodium, bicarbonate and water.",
"id": "10024276",
"label": "b",
"name": "Na-H channels in the proximal convoluted tubule",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The thick ascending loop of Henle is where loop diuretics, such as furosemide, exert their effects.",
"id": "10024279",
"label": "e",
"name": "Na-K-Cl channels in the loop of Henle",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Aldosterone receptor antagonists competitively bind to receptors on sodium-potassium channels in the distal convoluted tubule. This causes the excretion of sodium and water and the retention of potassium. They are therefore also known as potassium-sparing diuretics.",
"id": "10024277",
"label": "c",
"name": "Na-K channels in the distal convoluted tubule",
"picture": null,
"votes": 54
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Thiazide diuretics inhibit Na and Cl uptake via a co-transporter in the distal convoluted tubule.",
"id": "10024275",
"label": "a",
"name": "Na-Cl channels in the distal convoluted tubule",
"picture": null,
"votes": 119
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5764",
"name": "Thiazide diuretics",
"status": null,
"topic": {
"__typename": "Topic",
"id": "188",
"name": "Renal Pharmacology",
"typeId": 7
},
"topicId": 188,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5764,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17253",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 40-year-old patient taking thiazide diuretics presents with nausea, muscle cramps and palpitations. His ABG shows a potassium level of 2.5mmol/L (3.5-5.3 mmol/L).\n\n\nWhere in the nephrons do thiazide diuretics act?",
"sbaAnswer": [
"a"
],
"totalVotes": 212,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,141 | false | 13 | null | 6,495,173 | null | false | [] | null | 17,254 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Thiazides act on the Na-Cl co-transporter in the distal convoluted tubule. They inhibit chloride reabsorption, causing the excretion of chloride, sodium and water. This leads to hyponatremia.",
"id": "10024284",
"label": "e",
"name": "Thiazide diuretic use",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Excessive antidiuretic hormone (ADH) results in increased water reabsorption in the collecting ducts, diluting the blood. This excess water reduces the sodium concentration, causing hyponatraemia.",
"id": "10024281",
"label": "b",
"name": "Syndrome of inappropriate ADH (SIADH)",
"picture": null,
"votes": 40
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Adrenal insufficiency refers to an inadequate production of the steroid hormones, aldosterone and cortisol. Aldosterone acts on Na+-K+ pumps to increase urinary potassium secretion and increase sodium reabsorption. A deficit of this hormone therefore leads to a high potassium (hyperkalaemia) and a low sodium (hyponatremia).",
"id": "10024283",
"label": "d",
"name": "Adrenal insufficiency",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Diabetes insipidus is the lack of production or response to anti-diuretic hormone (ADH). This causes decreased water reabsorption from the collecting duct into the vasculature which decreases blood volume and increases sodium concentration (hypernatremia).",
"id": "10024280",
"label": "a",
"name": "Diabetes insipidus",
"picture": null,
"votes": 102
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Nephrotic syndrome causes loss of albumin in the glomerulus which decreases the plasma oncotic pressure, inducing hyponatremia.",
"id": "10024282",
"label": "c",
"name": "Nephrotic syndrome",
"picture": null,
"votes": 22
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5765",
"name": "Hypernatremia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "170",
"name": "Clinical Chemistry",
"typeId": 7
},
"topicId": 170,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5765,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17254",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 50-year-old patient is brought to the hospital by their daughter due to increasing confusion and agitation. Blood tests reveal a sodium level of 149 mmol/L (normal range 135-145 mmol/L).\n\n\nWhich of the following is a possible cause of this patient’s hypernatremia?",
"sbaAnswer": [
"a"
],
"totalVotes": 206,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,142 | false | 14 | null | 6,495,173 | null | false | [] | null | 17,255 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although the high pH and low CO2 point to a respiratory alkalosis, there are no signs of compensation (i.e. a low bicarbonate level).",
"id": "10024288",
"label": "d",
"name": "Respiratory alkalosis with metabolic compensation",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as the bicarbonate in this case is normal. Therefore the acid-base balance cannot be metabolic in nature.",
"id": "10024289",
"label": "e",
"name": "Metabolic alkalosis",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "To determine whether this is an acidosis or an alkalosis, look at the pH value. A value less than 7.35 is an acidosis and a value above 7.45 is an alkalosis. As the pH is above the normal range, this is an alkalosis. Next, to determine whether this is due to the kidneys or lungs, we look at the concentration of carbon dioxide (indicative of a respiratory cause) and bicarbonate (indicative of a metabolic cause). A low CO2 will cause an alkalosis and a high CO2 will cause an acidosis. The opposite applies to bicarbonate, in other words, a low bicarbonate will cause an acidosis. Therefore this is a respiratory alkalosis.",
"id": "10024285",
"label": "a",
"name": "Respiratory alkalosis",
"picture": null,
"votes": 188
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as the pH is above the normal range, making it an alkalosis.",
"id": "10024287",
"label": "c",
"name": "Respiratory acidosis",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as the pH is above the normal range, making it an alkalosis.",
"id": "10024286",
"label": "b",
"name": "Metabolic acidosis",
"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": "5766",
"name": "Acid-base balance and Arterial blood gas",
"status": null,
"topic": {
"__typename": "Topic",
"id": "150",
"name": "Respiratory physiology",
"typeId": 7
},
"topicId": 150,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5766,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17255",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 22-year-old female presents to hospital with chest tightness and shortness of breath. The patient tells you that she thinks she is having a panic attack. On examination, she is distressed and tachypnoeic at a respiratory rate of 30. Her ABG is as follows:\n\n\n||||\n|--------------|:-------:|------------------|\n|pH|7.49|7.35 - 7.45|\n|PaCO₂|3.1 kPa|4.6 - 6.4|\n|Bicarbonate|24 mmol/L|22 - 30|\n\nWhich acid-base imbalance does this patient have?",
"sbaAnswer": [
"a"
],
"totalVotes": 210,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,143 | false | 15 | null | 6,495,173 | null | false | [] | null | 17,256 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as a pneumothorax will increase the pleural cavity space and pressure due to air entering the pleural space.",
"id": "10024291",
"label": "b",
"name": "Decreased lung volume, decreased pleural cavity volume, decreased intrapleural pressure",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as a pneumothorax will increase the pleural cavity space due to air entering the pleural space.",
"id": "10024292",
"label": "c",
"name": "Decreased lung volume, decreased pleural cavity volume, increased intrapleural pressure",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Intrapleural pressure is naturally subatmospheric (negative) due to the opposing recoil of the lungs and chest wall. A pneumothorax refers to air entering the pleural space due to a rupture of the pleura. This increases the pleural cavity volume. As the pressure of the cavity is naturally negative, the addition of more gas molecules will increase the intrapleural pressure. As a result, the lung and chest wall will no longer be attached and will start to recoil in different directions causing the lung to collapse (decreased lung volume).",
"id": "10024290",
"label": "a",
"name": "Decreased lung volume, increased pleural cavity volume, increased intrapleural pressure",
"picture": null,
"votes": 117
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as a pneumothorax will increase the pleural cavity pressure due to air entering the pleural space.",
"id": "10024293",
"label": "d",
"name": "Decreased lung volume, increased pleural cavity volume, decreased intrapleural pressure",
"picture": null,
"votes": 44
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as a pneumothorax will cause the collapse of the lung, reducing lung volume.",
"id": "10024294",
"label": "e",
"name": "Increased lung volume, increased pleural cavity, increased intrapleural pressure",
"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": "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": []
},
"conceptId": 4212,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17256",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 27-year-old slim male is brought to A&E after being stabbed in the chest. He is diagnosed with a traumatic pneumothorax.\n\nWhich changes would you expect to see in the lung volume, pleural cavity volume and intrapleural pressure in the affected lung?",
"sbaAnswer": [
"a"
],
"totalVotes": 208,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,144 | false | 16 | null | 6,495,173 | null | false | [] | null | 17,257 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a secondary bile acid. In the large intestine, bacterial 7α-dehydroxylase removes a hydroxyl from cholic acid (a primary bile acid) to form deoxycholic acid (a secondary bile acid).",
"id": "10024296",
"label": "b",
"name": "Deoxycholic acid",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a bile acid.",
"id": "10024299",
"label": "e",
"name": "Lactic acid",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a primary bile acid and is produced in the liver.",
"id": "10024295",
"label": "a",
"name": "Cholic acid",
"picture": null,
"votes": 150
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a secondary bile acid. In the large intestine, bacterial 7α-dehydroxylase removes a hydroxyl from chenodeoxycholic acid (a primary acid) to form lithocholic acid (a secondary bile acid).",
"id": "10024297",
"label": "c",
"name": "Lithocholic acid",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a secondary bile acid. In the large intestine, bacterial 7α-dehydroxylase removes a hydroxyl from chenodeoxycholic acid (a primary bile acid) to form ursodeoxycholic acid (a secondary bile acid).",
"id": "10024298",
"label": "d",
"name": "Ursodeoxycholic acid",
"picture": null,
"votes": 12
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4571",
"name": "Formation of bile acids and bile salts",
"status": null,
"topic": {
"__typename": "Topic",
"id": "180",
"name": "Biochemistry",
"typeId": 7
},
"topicId": 180,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4571,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17257",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Bile acids may be primary or secondary depending on their metabolism.\n\nWhich of the following is a primary acid?",
"sbaAnswer": [
"a"
],
"totalVotes": 208,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,145 | false | 17 | null | 6,495,173 | null | false | [] | null | 17,258 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This enzyme converts glucose-6-phosphate into glucose. This reaction is involved in gluconeogenesis, the formation of glucose from non-carbohydrate substrates.",
"id": "10024304",
"label": "e",
"name": "Glucose-6-phosphatase",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This enzyme converts oxaloacetic acid into phosphoenol pyruvate. This reaction is involved in gluconeogenesis, the formation of glucose from non-carbohydrate substrates.",
"id": "10024302",
"label": "c",
"name": "Phosphoenolpyruvate carboxykinase",
"picture": null,
"votes": 38
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This enzyme converts glucose into glucose-6-phosphate. This step is involved in glycolysis however it occurs before phosphoenol pyruvate is converted to pyruvate.",
"id": "10024303",
"label": "d",
"name": "Hexokinase",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This enzyme converts phosphoenol pyruvate into pyruvate. Pyruvate kinase can be inhibited by glucagon.",
"id": "10024300",
"label": "a",
"name": "Pyruvate kinase",
"picture": null,
"votes": 127
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This enzyme converts pyruvate into oxaloacetic acid. This step is involved in gluconeogenesis, the formation of glucose from non-carbohydrate substrates.",
"id": "10024301",
"label": "b",
"name": "Pyruvate carboxylase",
"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": "3941",
"name": "Glycolysis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "180",
"name": "Biochemistry",
"typeId": 7
},
"topicId": 180,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3941,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17258",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Glycolysis is the breakdown of glucose to pyruvate to produce ATP which serves as a source of energy for aerobic respiration.\n\nWhich enzyme in the pathway converts phosphoenol pyruvate into pyruvate?",
"sbaAnswer": [
"a"
],
"totalVotes": 205,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,146 | false | 18 | null | 6,495,173 | null | false | [] | null | 17,259 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Transforming growth factor β (TGF-β) receptors contain a serine-threonine receptor kinase. Binding causes dimerisation of the receptors, thus activating the receptor. This allows for the phosphorylation of the Smad protein. The complex then translocates to the nucleus where it regulates gene expression.",
"id": "10024307",
"label": "c",
"name": "Transforming growth factor β (TGF-β)",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Thyroid hormone binds to nuclear receptors, which are types of intracellular receptors. Thyroid hormone is bound to a binding globulin and transported through the plasma membrane. It then diffuses across the nucleus to bind to the thyroid hormone receptor (THR), causing gene transcription.",
"id": "10024309",
"label": "e",
"name": "Thyroid hormone",
"picture": null,
"votes": 38
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Epidermal growth factor binds to tyrosine kinase receptors causing dimerisation and autophosphorylation. This activates other proteins in the signalling cascade.",
"id": "10024305",
"label": "a",
"name": "Epidermal growth factor",
"picture": null,
"votes": 55
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Glucocorticoids bind to nuclear receptors, which are types of intracellular receptors. The glucocorticoid receptor (GR) is bound to a heat shock protein. Glucocorticoids cause dissociation of the heat shock protein and dimerisation of glucocorticoid receptors. This complex diffuses across the nuclear membrane to bind to the glucocorticoid response element which leads to gene transcription.",
"id": "10024308",
"label": "d",
"name": "Glucocorticoids",
"picture": null,
"votes": 40
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Growth hormone acts on the JakSTAT signalling pathway. The binding of growth hormone causes the dimerisation of receptors containing Jak proteins. Jak proteins contain kinase activity and cause autophosphorylation and subsequent phosphorylation of the receptors. This dimer is able to dissociate and migrate to the nucleus where it regulates gene expression.",
"id": "10024306",
"label": "b",
"name": "Growth hormone",
"picture": null,
"votes": 34
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4365",
"name": "Types of cell signalling",
"status": null,
"topic": {
"__typename": "Topic",
"id": "166",
"name": "General pharmacological concepts",
"typeId": 7
},
"topicId": 166,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4365,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17259",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Cell signalling is important in metabolic regulation.\n\nWhich of the following substrates bind to tyrosine kinase receptors?",
"sbaAnswer": [
"a"
],
"totalVotes": 204,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,147 | false | 19 | null | 6,495,173 | null | false | [] | null | 17,260 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "LDL contains B100 only.",
"id": "10024314",
"label": "e",
"name": "Low-density lipoproteins (LDL)",
"picture": null,
"votes": 42
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "IDL contains B100 and Apo E",
"id": "10024312",
"label": "c",
"name": "Intermediate-density lipoproteins (IDL)",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Chylomicrons contain B48, Apo C2 and Apo E.",
"id": "10024310",
"label": "a",
"name": "Chylomicrons",
"picture": null,
"votes": 78
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "HDL contains Apo A1, Apo A2, Apo C2, Apo C3, Apo D, Apo E.",
"id": "10024313",
"label": "d",
"name": "High-density lipoproteins (HDL)",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "VLDL contains B100, Apo C1, Apo C2, Apo C3 and Apo E.",
"id": "10024311",
"label": "b",
"name": "Very low-density lipoproteins (VLDL)",
"picture": null,
"votes": 42
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5767",
"name": "Digestion and absorption of fat",
"status": null,
"topic": {
"__typename": "Topic",
"id": "180",
"name": "Biochemistry",
"typeId": 7
},
"topicId": 180,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5767,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17260",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following lipoproteins has the B48 apoprotein?",
"sbaAnswer": [
"a"
],
"totalVotes": 194,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,148 | false | 20 | null | 6,495,173 | null | false | [] | null | 17,261 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Insulin suppresses lipolysis in adipocytes. This increases free fatty acids which stimulate the assembling and secretion of VLDL. Growth hormone increases adipose lipolysis which suppresses VLDL formation.",
"id": "10024317",
"label": "c",
"name": "Stimulated by growth hormone, inhibited by insulin",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Insulin suppresses lipolysis in adipocytes. This increases free fatty acids which stimulate the assembling and secretion of VLDL. Thyroid hormone decreases the secretion of VLDL, and VLDL levels are usually high in those with hypothyroidism (low thyroid hormones).",
"id": "10024318",
"label": "d",
"name": "Stimulated by thyroid hormone, inhibited by insulin",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Insulin suppresses lipolysis in adipocytes. This increases free fatty acids which stimulate the assembling and secretion of VLDL. Oestrogen increases VLDL levels due to the enhanced production of apolipoprotein B and triglycerides.",
"id": "10024319",
"label": "e",
"name": "Stimulated by insulin, inhibited by oestrogen",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Insulin suppresses lipolysis in adipocytes. This increases free fatty acids which stimulate the assembling and secretion of VLDL. High glucagon levels reduce VLDL production.",
"id": "10024315",
"label": "a",
"name": "Stimulated by insulin, inhibited by glucagon",
"picture": null,
"votes": 110
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Insulin suppresses lipolysis in adipocytes. This increases free fatty acids which stimulate the assembling and secretion of VLDL. High glucagon levels reduce VLDL production.",
"id": "10024316",
"label": "b",
"name": "Stimulated by glucagon, inhibited by insulin",
"picture": null,
"votes": 58
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5768",
"name": "VLDL",
"status": null,
"topic": {
"__typename": "Topic",
"id": "180",
"name": "Biochemistry",
"typeId": 7
},
"topicId": 180,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5768,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17261",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following hormones stimulate and inhibit very low-density lipoprotein (VLDL) formation?",
"sbaAnswer": [
"a"
],
"totalVotes": 196,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,149 | false | 21 | null | 6,495,173 | null | false | [] | null | 17,262 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This enzyme mediates the first step of fatty acid synthesis to form malonyl-CoA from acetyl-CoA.",
"id": "10024322",
"label": "c",
"name": "Acetyl-CoA carboxylase",
"picture": null,
"votes": 39
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a molecule formed by 2 acetyl-CoA molecules. It is not an enzyme.",
"id": "10024323",
"label": "d",
"name": "Acetoacetyl-CoA",
"picture": null,
"votes": 33
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This enzyme is responsible for the conversion of 3-hydroxy-3-methylglutaryl-CoA to mevalonate. This reaction is part of the cholesterol synthesis pathway.",
"id": "10024321",
"label": "b",
"name": "3-hydroxyl-3-methylglutaryl CoA (HMG-CoA) reductase",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This enzyme catalyses the reaction between acetoacetyl-CoA and acetyl-CoA to form 3-hydroxyl-3-methylglutaryl CoA (HMG-CoA).",
"id": "10024324",
"label": "e",
"name": "3-hydroxyl-3-methylglutaryl CoA (HMG-CoA) synthase",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Fatty acids are transported to the liver and activated by acyl-CoA synthase in the cytoplasm to form fatty acyl-CoA. Activation of the fatty acyl-CoA traps the fatty acid in the cell. In order for it to cross the mitochondrial membrane, it reacts with carnitine to form acyl-carnitine which passes into the mitochondria.",
"id": "10024320",
"label": "a",
"name": "Acyl-CoA synthase",
"picture": null,
"votes": 67
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3879",
"name": "Beta oxidation of fatty acids",
"status": null,
"topic": {
"__typename": "Topic",
"id": "180",
"name": "Biochemistry",
"typeId": 7
},
"topicId": 180,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3879,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17262",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Fatty acids are broken down to release energy from reserves stored in adipose tissue. This involves mobilisation, activation and degradation.\n\nWhich of the following activates fatty acids in the liver?",
"sbaAnswer": [
"a"
],
"totalVotes": 192,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,150 | false | 22 | null | 6,495,173 | null | false | [] | null | 17,263 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is also known as scurvy. It may present with tiredness, irritability, muscle pain and easy bruising.",
"id": "10024328",
"label": "d",
"name": "Vitamin C",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a deficiency of folate. It may present with fatigue, dizziness, pallor, and headache. Folate deficiency is a cause of macrocytic anaemia.",
"id": "10024329",
"label": "e",
"name": "Vitamin B9",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a cause of rickets in children and osteomalacia in adults. It is often asymptomatic but may present with bowing of the legs, proximal muscle weakness and gait abnormalities in children.",
"id": "10024327",
"label": "c",
"name": "Vitamin D",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a deficiency of cobalamin. This may present with shortness of breath, headaches, fatigue, paraesthesia and ataxia (problems with balance and coordination). B12 deficiency is a cause of macrocytic anaemia.",
"id": "10024326",
"label": "b",
"name": "Vitamin B12",
"picture": null,
"votes": 43
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a deficiency of thiamine. An acute severe deficiency of vitamin B1 may lead to Wernicke's encephalopathy. This is characterised by the classic triad of acute confusion, ataxia, and ocular abnormalities such as nystagmus.",
"id": "10024325",
"label": "a",
"name": "Vitamin B1",
"picture": null,
"votes": 121
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4061",
"name": "Vitamin deficiency syndromes",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4061,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17263",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 58-year-old male presents to the hospital with confusion, ataxia and ocular abnormalities. He is subsequently diagnosed with beriberi.\n\nBeriberi is a deficiency of which vitamin?",
"sbaAnswer": [
"a"
],
"totalVotes": 194,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,151 | false | 23 | null | 6,495,173 | null | false | [] | null | 17,264 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Activation of beta-2 receptors on airway smooth muscle by glucocorticoids stimulates the Gs pathway. This increases the concentration of cAMP which stimulates protein kinase A to decrease calcium mobilisation and sensitivity. This causes muscle relaxation and therefore relieves the bronchoconstriction associated with asthma.",
"id": "10024330",
"label": "a",
"name": "Increases beta-2 receptor activation",
"picture": null,
"votes": 126
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Glucocorticoids decrease the number of mast cells. As mast cells are immune cells, this reduces the inflammatory response produced by the immune system.",
"id": "10024333",
"label": "d",
"name": "Increases number of mast cells",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Glucocorticoids reduce endothelial cell leakage. As cell leakage is part of the inflammatory response, glucocorticoids can reduce inflammation by decreasing leakage.",
"id": "10024332",
"label": "c",
"name": "Increases endothelial cell leakage",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Glucocorticoids reduce the number of dendritic cells. As dendritic cells are immune cells, this reduces the inflammatory response produced by the immune system.",
"id": "10024331",
"label": "b",
"name": "Increases the number of dendritic cells",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Glucocorticoids reduce cytokine release from T cells. Asthma is associated with the cytokines interleukin 4, 5 and 13 (IL-4, IL-5, IL-13) which promote airway eosinophilia and mucus overproduction. Therefore glucocorticoids can reduce inflammation by decreasing cytokine mediators.",
"id": "10024334",
"label": "e",
"name": "Increases cytokine mediators of inflammation",
"picture": null,
"votes": 49
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4228",
"name": "Treatment options in Asthma",
"status": null,
"topic": {
"__typename": "Topic",
"id": "189",
"name": "Respiratory Pharmacology",
"typeId": 7
},
"topicId": 189,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4228,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17264",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following is the mechanism of action by which glucocorticoids reduce asthmatic inflammation?",
"sbaAnswer": [
"a"
],
"totalVotes": 195,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,152 | false | 24 | null | 6,495,173 | null | false | [] | null | 17,265 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes \"respiratory reserve volume\".",
"id": "10024338",
"label": "d",
"name": "The additional volume of gas that can be expired below tidal volume on maximal expiration",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes \"residual volume\".",
"id": "10024337",
"label": "c",
"name": "The volume of gas that remains in the lungs following maximal expiration",
"picture": null,
"votes": 38
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This describes \"functional residual capacity\".",
"id": "10024335",
"label": "a",
"name": "The volume of gas that remains in the lungs following normal quiet expiration",
"picture": null,
"votes": 104
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes \"vital capacity\".",
"id": "10024339",
"label": "e",
"name": "The volume of gas that can be expired following maximal inspiration",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes \"tidal volume\".",
"id": "10024336",
"label": "b",
"name": "The volume of air moved into or out of the lungs during quiet breathing",
"picture": null,
"votes": 8
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3893",
"name": "Volume, pressure and compliance",
"status": null,
"topic": {
"__typename": "Topic",
"id": "150",
"name": "Respiratory physiology",
"typeId": 7
},
"topicId": 150,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3893,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17265",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following describes the term \"function residual capacity\"?",
"sbaAnswer": [
"a"
],
"totalVotes": 191,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,153 | false | 25 | null | 6,495,173 | null | false | [] | null | 17,266 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Increased temperature **decreases** Hb-O2 binding affinity, decreasing oxygen saturation at a given partial pressure of oxygen and effectively releasing oxygen from haemoglobin.",
"id": "10024344",
"label": "e",
"name": "High temperature increases haemoglobin-oxygen (Hb-O2) affinity and decreases O2 unloading from haemoglobin",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A high pH (alkalosis) **increases** haemoglobin-oxygen binding as it decreases the rate of ligand dissociation. This allows for a higher rate of oxygen binding in the lungs where there is a lower pCO2 and the environment is more alkalotic.",
"id": "10024341",
"label": "b",
"name": "High pH decreases haemoglobin-oxygen (Hb-O2) affinity and increases O2 unloading from haemoglobin",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Increased 2,3-diphosphoglycerate (2,3-DPG) **decreases** Hb-O2 binding affinity, decreasing oxygen saturation at a given partial pressure of oxygen and effectively releasing oxygen from haemoglobin.",
"id": "10024343",
"label": "d",
"name": "High 2,3-diphosphoglycerate (2,3-DPG) increases haemoglobin-oxygen (Hb-O2) affinity and decreases O2 unloading from haemoglobin",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "At the site of respiration, there is a high pCO2 due to the production of waste products. Carbon dioxide increases hydrogen ion concentration which causes acidosis (low pH). This increases ligand dissociation and promotes the release of oxygen from haemoglobin.",
"id": "10024340",
"label": "a",
"name": "High pCO2 decreases haemoglobin-oxygen (Hb-O2) affinity and increases oxygen unloading from haemoglobin",
"picture": null,
"votes": 137
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Increased temperature decreases Hb-O2 binding affinity, decreasing oxygen saturation at a given partial pressure of oxygen and effectively releasing oxygen from haemoglobin.",
"id": "10024342",
"label": "c",
"name": "High temperature increases haemoglobin-oxygen (Hb-O2) affinity and increases O2 unloading from haemoglobin",
"picture": null,
"votes": 9
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5769",
"name": "Gaseous exchange and transportation",
"status": null,
"topic": {
"__typename": "Topic",
"id": "150",
"name": "Respiratory physiology",
"typeId": 7
},
"topicId": 150,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5769,
"conditions": [],
"difficulty": 1,
"dislikes": 1,
"explanation": null,
"highlights": [],
"id": "17266",
"isLikedByMe": 0,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Oxygen-haemoglobin binding is affected by several factors.\n\nWhich of the following statements is correct?",
"sbaAnswer": [
"a"
],
"totalVotes": 189,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,154 | false | 26 | null | 6,495,173 | null | false | [] | null | 17,267 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "In anaemia, haemoglobin affinity is unchanged i.e. the percentage of haemoglobin binding sites that are occupied with oxygen remains the same. Therefore, despite there being less haemoglobin overall, the oxygen saturation of haemoglobin remains unchanged. In carbon monoxide poisoning, the number of haemoglobin is unchanged but carbon monoxide displaces oxygen that would normally bind to haemoglobin and causes a low haemoglobin oxygen saturation.",
"id": "10024345",
"label": "a",
"name": "Haemoglobin saturation (Hb SaO2) is normal in anaemia and reduced in carbon monoxide poisoning",
"picture": null,
"votes": 127
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "CaO2 is reduced in **both** carbon monoxide poisoning and anaemia. The total arterial oxygen concentration includes the oxygen bound to haemoglobin as well as the oxygen concentration in the plasma. As both anaemia and carbon monoxide affect haemoglobin, the oxygen-carrying capacity is reduced (the plasma oxygen concentration is unaffected however). This reduces the overall arterial oxygen concentration.",
"id": "10024346",
"label": "b",
"name": "CaO2 (total arterial oxygen concentration) is reduced in carbon monoxide poisoning and normal in anaemia",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Haemoglobin concentration is reduced in anaemia and **normal** in carbon monoxide poisoning. This is because, in carbon monoxide poisoning, carbon monoxide displaces oxygen at haemoglobin binding sites as it has a higher affinity than oxygen. This reduces the oxygen-carrying capacity, however the number of haemoglobin molecules remains unaffected.",
"id": "10024349",
"label": "e",
"name": "Haemoglobin concentration is reduced in both anaemia and carbon monoxide poisoning",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Haemoglobin-oxygen concentration is reduced in **both** anaemia and carbon monoxide poisoning. Carbon monoxide displaces oxygen at haemoglobin binding sites as it has a higher affinity than oxygen. This reduces the oxygen-carrying capacity and hence the haemoglobin-oxygen concentration.",
"id": "10024348",
"label": "d",
"name": "Haemoglobin-oxygen concentration is reduced in anaemia and normal in carbon monoxide poisoning",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "PaO2 is normal in both anaemia and carbon monoxide poisoning. The partial pressure of oxygen refers to the pressure of oxygen in the plasma, not the overall concentration of oxygen in the blood i.e. it does not include oxygen bound to haemoglobin. As it is only the oxygen bound to haemoglobin (the oxygen-carrying capacity) that is affected in anaemia and carbon monoxide poisoning, the PaO2 is unaffected.",
"id": "10024347",
"label": "c",
"name": "PaO2 is reduced in anaemia and normal in carbon monoxide poisoning",
"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": "5769",
"name": "Gaseous exchange and transportation",
"status": null,
"topic": {
"__typename": "Topic",
"id": "150",
"name": "Respiratory physiology",
"typeId": 7
},
"topicId": 150,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5769,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17267",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "What impact do anaemia and carbon monoxide poisoning have on blood oxygen transportation?",
"sbaAnswer": [
"a"
],
"totalVotes": 190,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,155 | false | 27 | null | 6,495,173 | null | false | [] | null | 17,268 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Carbon monoxide poisoning is a type of insufficient oxygen-carrying capacity that presents with a low oxygen saturation and a normal PaO2 (it only affects the oxygen that is normally bound to haemoglobin).",
"id": "10024354",
"label": "e",
"name": "Carbon monoxide poisoning",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Insufficient ventilation means that carbon dioxide can not be exhaled: this increases PaCO2. As carbon dioxide is acidic, this will cause the arterial pH to decrease. As inhalation is also affected, there is less oxygen in the blood leading to a low PaO2. A lower total arterial oxygen content (CaO2) means that oxygen saturation is also low as there are fewer oxygen molecules to bind to haemoglobin. As the problem is not with oxygen diffusion, the Alveolar-arterial gradient is normal.",
"id": "10024351",
"label": "b",
"name": "Insufficient ventilation e.g. COPD",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "In the presence of insufficient oxygen, hypoxaemia triggers hyperventilation which normalises carbon dioxide levels (which may have increased due to ventilation or perfusion abnormalities). This also normalises the pH. PaO2 is low as oxygen is unable to diffuse into the circulation, which also causes a low oxygen saturation. A high Alveolar-arterial gradient indicates that the partial pressure of oxygen in the alveoli is higher than in arterial blood as there is an issue with the oxygenation of the blood.",
"id": "10024350",
"label": "a",
"name": "Insufficient oxygenation e.g. VQ mismatch",
"picture": null,
"votes": 111
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Insufficient oxygen-carrying capacity does not affect carbon dioxide levels, therefore PaCO2 is unaffected. PaO2 is also unaffected as this refers to the partial pressure of oxygen in the plasma rather than bound to haemoglobin. In anaemia, haemoglobin affinity is unchanged i.e. the percentage of haemoglobin binding sites that are occupied with oxygen remains the same. Therefore the oxygen saturation of haemoglobin remains unchanged. As oxygenation is not affected in anaemia, the Alveolar-arterial gradient is normal.",
"id": "10024352",
"label": "c",
"name": "Insufficient oxygen-carrying capacity e.g. anaemia",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Insufficient oxygen in the atmosphere triggers hyperventilation which decreases PaCO2. As carbon dioxide can release hydrogen ions and cause an acidic environment, the lack of CO2 causes pH to increase (becomes more alkaline). The PaO2 decreases due to a lack of available oxygen which therefore causes a low oxygen saturation. As the problem is not with oxygen diffusion, the Alveolar-arterial gradient is normal.",
"id": "10024353",
"label": "d",
"name": "Insufficient oxygen in the atmosphere e.g. altitude",
"picture": null,
"votes": 25
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5770",
"name": "Respiratory failure",
"status": null,
"topic": {
"__typename": "Topic",
"id": "150",
"name": "Respiratory physiology",
"typeId": 7
},
"topicId": 150,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5770,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17268",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which mechanism of respiratory failure correlates to this clinical pattern with the presence of compensatory hyperventilation?\n\nPaCO2 – normal\n\nPaO2 – decreased\n\nArterial Ph – normal\n\n%SaO2 – decreased\n\nA-a gradient – high",
"sbaAnswer": [
"a"
],
"totalVotes": 191,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,156 | false | 28 | null | 6,495,173 | null | false | [] | null | 17,269 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Renin is not released by hepatocytes in the liver. Renin is released from juxtaglomerular cells in the kidneys. This converts angiotensinogen (which is produced by the liver) into angiotensin I.",
"id": "10024357",
"label": "c",
"name": "Hepatocytes",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These cells cleave angiotensin 1 into angiotensin 2 through the action of angiotensin converting enzyme ACE).",
"id": "10024358",
"label": "d",
"name": "Lung endothelial cells",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The macula densa is a collection of cells which sense the concentration of sodium in the distal convoluted tubule and signal to the juxtaglomerular cells to release renin.",
"id": "10024359",
"label": "e",
"name": "Macula densa",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Peritubular cells are the site of erythropoietin (EPO) synthesis which stimulates red blood cell production. It does not release renin.",
"id": "10024356",
"label": "b",
"name": "Peritubular cells",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The juxtaglomerular cells are derived from smooth muscle cells in the afferent arteriole and contain granules with the enzyme renin. In response to low sodium, renin indirectly increases vascular tone and sodium reabsorption to increase blood pressure.",
"id": "10024355",
"label": "a",
"name": "Juxtaglomerular cells",
"picture": null,
"votes": 162
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5771",
"name": "Tubuloglomerular feedback",
"status": null,
"topic": {
"__typename": "Topic",
"id": "168",
"name": "Renal Physiology",
"typeId": 7
},
"topicId": 168,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5771,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17269",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following cells is renin released from?",
"sbaAnswer": [
"a"
],
"totalVotes": 190,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,157 | false | 29 | null | 6,495,173 | null | false | [] | null | 17,270 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is carried out by the process of exfoliation, which is undertaken by uroepithelial cells in response to infection.",
"id": "10024364",
"label": "e",
"name": "Removal of infected cells from the urinary tract",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the result of unidirectional urine flow.",
"id": "10024361",
"label": "b",
"name": "Physical removal of bacteria from the urinary tract",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the action of lysozymes.",
"id": "10024363",
"label": "d",
"name": "Cleaves cell wall component, killing bacteria",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Tamm Horsfall protein possesses a mannose-containing side chain which can trap the mannose-sensitive pili or fimbriae of organisms such as *Escherichia coli*.",
"id": "10024360",
"label": "a",
"name": "Competitive inhibition of bacterial binding",
"picture": null,
"votes": 66
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of action of mucous and mucin within the urinary tract.",
"id": "10024362",
"label": "c",
"name": "Traps and prevents bacterial adherence to the epithelium",
"picture": null,
"votes": 67
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5772",
"name": "Urinary tract infections",
"status": null,
"topic": {
"__typename": "Topic",
"id": "162",
"name": "General practice",
"typeId": 5
},
"topicId": 162,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5772,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17270",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "By what mechanism does Tamm Horsfall protein act to prevent urinary tract infections?",
"sbaAnswer": [
"a"
],
"totalVotes": 172,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,158 | false | 30 | null | 6,495,173 | null | false | [] | null | 17,271 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Achalasia is the inability of the lower oesophageal sphincter to relax and the loss of oesophageal peristalsis due to a loss of inhibitory nitrinergic neurons. As a result, patients may experience difficulty swallowing and regurgitation. The history of episodic coughs, purulent sputum, fever, dyspnoea and chest pain is suggestive of an aspiration pneumonia which has occurred secondary to regurgitation.",
"id": "10024365",
"label": "a",
"name": "Achalasia",
"picture": null,
"votes": 107
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gastro-oesophageal reflux disease may present with regurgitation, chest pain and dysphagia (difficulty swallowing), however this would typically present with heartburn that occurs after having larger meals and is aggravated by lying down or bending forward. GORD is unlikely to cause an aspiration pneumonia or infective symptoms.",
"id": "10024366",
"label": "b",
"name": "Gastro-oesophageal reflux disease (GORD)",
"picture": null,
"votes": 39
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Peptic ulcer disease may present with epigastric pain, nausea, vomiting and dyspepsia. It does not present with dysphagia.",
"id": "10024367",
"label": "c",
"name": "Peptic ulcer disease",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Dyspepsia describes multiple upper gastrointestinal symptoms which persist for 4 or more weeks. This includes heartburn, burping, bloating, nausea, vomiting and early satiety. It is also known as indigestion. Causes of dyspepsia include GORD, peptic ulcer disease and Barrett's oesophagus.",
"id": "10024369",
"label": "e",
"name": "Dyspepsia",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "*Helicobacter pylori* is a gram-negative infection which causes peptic ulcers. It may present with abdominal pain, nausea, bloating and loss of appetite.",
"id": "10024368",
"label": "d",
"name": "*Helicobacter pylori* infection",
"picture": null,
"votes": 27
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4006",
"name": "Achalasia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4006,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17271",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 36-year-old female presents with a history of episodic coughing with purulent sputum, fever, dyspnoea, and chest pain over the last six days. She gives a history of vomiting and hiccups on and off for 7 years. She says that she has difficulty swallowing her food and sometimes regurgitates it.\n\nWhat is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 188,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,159 | false | 31 | null | 6,495,173 | null | false | [] | null | 17,272 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This enzyme is inhibited by malate and oxaloacetate.",
"id": "10024371",
"label": "b",
"name": "Succinate dehydrogenase",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This enzyme is inhibited by ATP and NADH.",
"id": "10024372",
"label": "c",
"name": "Isocitrate dehydrogenase",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This enzyme is inhibited by NADH, ATP and succinyl CoA.",
"id": "10024373",
"label": "d",
"name": "Alpha-ketoglutarate dehydrogenase",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This enzyme is inhibited by citrate and glutamate.",
"id": "10024374",
"label": "e",
"name": "Malate dehydrogenase",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This enzyme is inhibited by NADH, ATP, and acetyl CoA.",
"id": "10024370",
"label": "a",
"name": "Pyruvate dehydrogenase",
"picture": null,
"votes": 123
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4527",
"name": "Krebs cycle",
"status": null,
"topic": {
"__typename": "Topic",
"id": "180",
"name": "Biochemistry",
"typeId": 7
},
"topicId": 180,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4527,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17272",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "The tricarboxylic acid cycle (TCA cycle), also known as the Krebs cycle, is the first step of aerobic respiration in an eukaryotic cell. The TSA cycle is regulated by several enzymes.\n\nWhich of the following enzymes is inhibited by acetyl-CoA?",
"sbaAnswer": [
"a"
],
"totalVotes": 189,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,160 | false | 32 | null | 6,495,173 | null | false | [] | null | 17,273 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Around 65% of potassium is re-absorbed in the proximal tubule, and 20-150% is secreted by the distal tubule and principal cells in the collecting duct.",
"id": "10024375",
"label": "a",
"name": "Highest re-absorption in the proximal tubule, highest secretion in the distal tubule and principal cells in the collecting duct",
"picture": null,
"votes": 112
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Re-absorption of potassium in the proximal tubule is around 65%. However, the thick ascending limb of the loop of Henle is responsible for the absorption of potassium, not secretion.",
"id": "10024379",
"label": "e",
"name": "Highest re-absorption in the proximal tubule, highest secretion in the thick ascending limb of the loop of Henle",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The thick ascending limb of the loop of Henle only re-absorbs 25% of potassium. Intercalated cells in the collecting duct secrete 0-5% of potassium.",
"id": "10024376",
"label": "b",
"name": "Highest re-absorption in the thick ascending limb of the loop of Henle, highest secretion in the intercalated cells of the collecting duct",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The thick ascending limb only absorbs 25% of potassium in comparison to 65% by the proximal tubule. The highest secretion of potassium is in the distal tubule and principal cells (20-150%).",
"id": "10024378",
"label": "d",
"name": "Highest re-absorption in the thick ascending limb of the loop of Henle, highest secretion in the distal tubule and principal cells of the collecting duct",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The re-absorption of potassium in the proximal tubule is around 65% but intercalated cells in the collecting duct only secrete 0-5% of potassium in comparison to the distal tubule and principal cells which secrete >20%.",
"id": "10024377",
"label": "c",
"name": "Highest re-absorption in the proximal tubule, highest secretion in the intercalated cells of the collecting duct",
"picture": null,
"votes": 20
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5773",
"name": "Potassium excretion",
"status": null,
"topic": {
"__typename": "Topic",
"id": "168",
"name": "Renal Physiology",
"typeId": 7
},
"topicId": 168,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5773,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17273",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "In which parts of the nephron are potassium re-absorption and secretion the highest?",
"sbaAnswer": [
"a"
],
"totalVotes": 185,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,161 | false | 33 | null | 6,495,173 | null | false | [] | null | 17,274 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Membranous nephropathy is one of the most common causes of **nephrotic syndrome** in adults. Nephrotic syndrome is characterised by proteinuria, hypoalbuminaemia and oedema. It does not present with haematuria.",
"id": "10024382",
"label": "c",
"name": "Membranous nephropathy",
"picture": null,
"votes": 52
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Focal segmental glomerulosclerosis is a cause of **nephrotic syndrome** and describes scarring of the glomeruli. Nephrotic syndrome is characterised by proteinuria, hypoalbuminaemia and oedema. It does not present with haematuria.",
"id": "10024383",
"label": "d",
"name": "Focal segmental glomerulosclerosis",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Whilst a recent group A Streptococcus infection can cause **nephritic syndrome**, this is very uncommon in adults. Poststreptococcal glomerulonephritis is the most common cause of glomerulonephritis in children.",
"id": "10024384",
"label": "e",
"name": "Post-streptococcal glomerulonephritis",
"picture": null,
"votes": 66
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Minimal change disease is one of the most common causes of **nephrotic** syndrome. Nephrotic syndrome is characterised by proteinuria, hypoalbuminaemia and oedema. It does not present with haematuria.",
"id": "10024381",
"label": "b",
"name": "Minimal change disease",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "ANCA-associated vasculitis is a broad umbrella term for 3 types of vasculitis which affect the glomeruli. They are causes of **nephritic syndrome** which is characterised by haematuria, proteinuria and renal impairment.",
"id": "10024380",
"label": "a",
"name": "ANCA-associated vasculitis",
"picture": null,
"votes": 43
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5774",
"name": "Nephritic syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "263",
"name": "Renal",
"typeId": 7
},
"topicId": 263,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5774,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17274",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 73-year-old male attends his GP as he was alarmed when he found blood in his urine this morning. The urine sample provided by the patient shows macroscopic haematuria and a urine dipstick reveals 2+ protein.\n\nWhich of the following is the most likely cause of these findings?",
"sbaAnswer": [
"a"
],
"totalVotes": 180,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,162 | false | 34 | null | 6,495,173 | null | false | [] | null | 17,275 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would effectively cause a low eGFR and therefore lead to an acute kidney injury (AKI).",
"id": "10024389",
"label": "e",
"name": "Angiotensin II acts on afferent arterioles to cause vasoconstriction and prostaglandins act on efferent arterioles to cause vasodilation",
"picture": null,
"votes": 33
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Angiotensin II causes arterial vasoconstriction.",
"id": "10024388",
"label": "d",
"name": "Angiotensin II acts on afferent and efferent arterioles to cause vasodilation",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Angiotensin II is a vasoconstrictor whereas prostaglandins are vasodilators.",
"id": "10024386",
"label": "b",
"name": "Angiotensin II acts on afferent arterioles to cause vasodilation and prostaglandins act on efferent arterioles to cause vasoconstriction",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Prostaglandins are vasodilators.",
"id": "10024387",
"label": "c",
"name": "Prostaglandins act on afferent and efferent arterioles to cause vasoconstriction",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Prostaglandins are produced in response to stimulation of the sympathetic nervous system and cause smooth muscle relaxation, preferentially of the afferent arteriole wall. This causes vasodilation. Angiotensin acts on AT1 receptors to cause vasoconstriction. Both of these actions increase eGFR.",
"id": "10024385",
"label": "a",
"name": "Prostaglandins act on afferent arterioles to cause vasodilation and angiotensin II acts on efferent arterioles to cause vasoconstriction",
"picture": null,
"votes": 114
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4496",
"name": "Renal autoregulation",
"status": null,
"topic": {
"__typename": "Topic",
"id": "168",
"name": "Renal Physiology",
"typeId": 7
},
"topicId": 168,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4496,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17275",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "An 84-year-old male with diabetes and heart failure has his blood pressure checked by his GP. His BP is found to be 92/70.\n\nWhich of the following statements is correct in describing how renal autoregulation corrects hypotension?",
"sbaAnswer": [
"a"
],
"totalVotes": 185,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,163 | false | 35 | null | 6,495,173 | null | false | [] | null | 17,276 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Plasmin is an enzyme which breaks down fibrin mesh into fibrin fragments such as D-dimer.",
"id": "10024391",
"label": "b",
"name": "Plasmin",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Thrombin is a factor in the clotting cascade. It activates receptors on platelets to increase platelet aggregation and the release of von Willebrand factor from endothelial cells. It also converts fibrinogen into fibrin.",
"id": "10024393",
"label": "d",
"name": "Thrombin",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Thromboxane A2 (TXA2) is released by activated platelets to cause platelet aggregation and vasoconstriction through TXA2 receptors.",
"id": "10024390",
"label": "a",
"name": "Thromboxane A2",
"picture": null,
"votes": 150
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Tissue plasminogen activator is an enzyme released from endothelial cells which converts the inactive soluble circulating protein plasminogen into a potent proteolytic enzyme called plasmin.",
"id": "10024394",
"label": "e",
"name": "Tissue plasminogen activator (tPA)",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Fibrinogen is a plasma protein which is converted to fibrin (by thrombin) to stabilise blood clots.",
"id": "10024392",
"label": "c",
"name": "Fibrinogen",
"picture": null,
"votes": 2
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5775",
"name": "Structure and physiology of blood vessels",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5775,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17276",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 37-year-old male presents to the emergency department after a motorcycle accident which has caused the rupture of his spleen.\n\nDuring a tissue bleed, the clotting cascade is initiated. This also involves local vasoconstriction to prevent blood loss.\n\nWhich of the following molecules is involved in this vasoconstriction?",
"sbaAnswer": [
"a"
],
"totalVotes": 187,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,164 | false | 36 | null | 6,495,173 | null | false | [] | null | 17,277 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Action potentials from the sinoatrial node coordinate synchronous atrial contraction. This increases the pressure in the atria above that in the ventricles, causing the tricuspid and mitral valves to open and the active filling of the ventricles. An **S4** heart sound may be heard here if the atria are contracting against a stiff or hypertrophic ventricle. This is a pathological heart sound.",
"id": "10024397",
"label": "c",
"name": "Atrial contraction",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ventricular filling occurs just after ventricular relaxation. Relaxation of the ventricular walls increases the internal volume of the ventricle which decreases the pressure. Due to passive filling and atrial contraction, the pressure in the atria increases and blood flows down the pressure gradient, filling the ventricles with blood. At this stage, the aortic and pulmonary valves are already closed. The **S3** heart sound may be heard here which indicates vigorous refilling of the ventricles. This may be heard in younger individuals and may not be pathological.",
"id": "10024399",
"label": "e",
"name": "Ventricular filling",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ventricular ejection refers to the flow of blood from the ventricles into the aorta and pulmonary artery. During this stage, the aortic and pulmonary valves are **open**. No heart sounds are heard during this stage.",
"id": "10024398",
"label": "d",
"name": "Ventricular ejection",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Once blood has been ejected from the ventricles into the aorta and pulmonary artery, the pressure in these vessels becomes higher than the pressure in the ventricles. This causes the aortic and pulmonary valves to close to prevent backflow of blood into the heart. The S2 heart sound indicates the **closure** of the aortic and pulmonary valves.",
"id": "10024395",
"label": "a",
"name": "Ventricular relaxation",
"picture": null,
"votes": 102
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "During ventricular contraction, there is a higher pressure in the ventricles compared to the atria. To prevent backflow of blood into the atria, the mitral and tricuspid valves close. This is indicated by the **S1** heart sound.",
"id": "10024396",
"label": "b",
"name": "Ventricular contraction",
"picture": null,
"votes": 23
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4231",
"name": "Blood flow through the heart",
"status": null,
"topic": {
"__typename": "Topic",
"id": "159",
"name": "Cardiovascular physiology",
"typeId": 7
},
"topicId": 159,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4231,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17277",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "The cardiac cycle describes the flow of blood through the heart.\n\nWhat best describes the stage in the cardiac cycle that begins with the S2 heart sound?",
"sbaAnswer": [
"a"
],
"totalVotes": 189,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,165 | false | 37 | null | 6,495,173 | null | false | [] | null | 17,278 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Protein C and Protein S inhibit factor Va but do not inhibit factor IIa (this is inhibited by antithrombin).",
"id": "10024404",
"label": "e",
"name": "Factors IIa and Va",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Antithrombin acts to inhibit factors Xa and IIa (thrombin). It can also inhibit factors VIIa, IXa, XIa and XIIa.",
"id": "10024402",
"label": "c",
"name": "Factors Xa and IIa",
"picture": null,
"votes": 38
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Protein C and Protein S inhibit factor Va but do not inhibit factor X directly.",
"id": "10024403",
"label": "d",
"name": "Factors Va and X",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Protein C & Protein S inhibit factor Va, but do not inhibit factor Xa (this is inhibited by antithrombin).",
"id": "10024401",
"label": "b",
"name": "Factors Va and Xa",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Activated protein C triggers protein S to inhibit factors VIIIa and Va.",
"id": "10024400",
"label": "a",
"name": "Factors VIIIa and Va",
"picture": null,
"votes": 92
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5776",
"name": "Clotting cascade",
"status": null,
"topic": {
"__typename": "Topic",
"id": "157",
"name": "Haematology",
"typeId": 7
},
"topicId": 157,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5776,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17278",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 43-year-old female presents to her GP with unilateral leg pain and swelling. The overlying skin is red and warmer compared to the other limb. A Doppler ultrasound confirms a DVT and further testing shows she has a protein C deficiency.\n\nActivated protein C acts on which factors in the clotting cascade pathway?",
"sbaAnswer": [
"a"
],
"totalVotes": 181,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,166 | false | 38 | null | 6,495,173 | null | false | [] | null | 17,279 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Sinoatrial and atrioventricular nodes do not depend on sodium channels for depolarisation. Therefore blocking sodium channels has no effect.",
"id": "10024406",
"label": "b",
"name": "Sodium channel blockers",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The irregularly irregular rhythm coupled with the lightheadedness and chest pain points to the diagnosis of atrial fibrillation. As the onset of symptoms started more than 48 hours ago, rate control is the recommended treatment option. Examples of rate control agents include beta-blockers such as bisoprolol and calcium channel blockers such as verapamil.",
"id": "10024405",
"label": "a",
"name": "Beta-blocker",
"picture": null,
"votes": 90
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Potassium channel blockers such as amiodarone are used for rhythm control. As the onset of symptoms started more than 48 hours ago, rate control is the recommended treatment option.",
"id": "10024408",
"label": "d",
"name": "Potassium channel blockers",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is used in patients who are haemodynamically unstable, including if they are in shock.",
"id": "10024409",
"label": "e",
"name": "Synchronised DC cardioversion",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This medication is only used in sedentary patients.",
"id": "10024407",
"label": "c",
"name": "Digoxin",
"picture": null,
"votes": 40
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3714",
"name": "Atrial fibrillation",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3714,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17279",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 37-year-old female presents to the emergency department with increased episodes of lightheadedness and a few episodes of fainting. She has also experienced chest pain for 3 days now.\n\nHer heart rate is measured as 140 beats per minute. An ECG is performed and shows an irregularly irregular rhythm with no discrete p waves. She is currently haemodynamically stable.\n\nWhat should be used to treat her?",
"sbaAnswer": [
"a"
],
"totalVotes": 185,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,167 | false | 39 | null | 6,495,173 | null | false | [] | null | 17,280 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ryanodine receptors are found in myocytes, particularly on the membrane of the sarcoplasmic reticulum. They increase intracellular calcium levels which activates the troponin-tropomyosin system to cause heart muscle contraction. They are not involved in pacemaker potentials.",
"id": "10024413",
"label": "d",
"name": "Ryanodine receptors",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Potassium efflux through voltage-gated potassium channels causes repolarisation of the sino-atrial node, terminating the pacemaker potential before the next potential starts.",
"id": "10024412",
"label": "c",
"name": "K+ channels",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Voltage-gated calcium channels are activated once the membrane potential reaches the threshold. The firing of the action potential is due to the influx of calcium which causes a faster depolarisation.",
"id": "10024411",
"label": "b",
"name": "Calcium channels",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "IP3 receptors mediate calcium release from the endoplasmic reticulum. They are not involved in pacemaker potentials.",
"id": "10024414",
"label": "e",
"name": "IP3 receptors",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Pacemaker potentials start with the slow depolarisation of pacemaker cells in the sino-atrial node towards the membrane potential threshold. If (funny current) channels allow sodium influx into cardiomyocytes resulting in this slow depolarisation. Once the membrane reaches the membrane potential threshold, it can fire an action potential.",
"id": "10024410",
"label": "a",
"name": "If channels",
"picture": null,
"votes": 132
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3962",
"name": "Cardiac Action Potential Generation and Conduction",
"status": null,
"topic": {
"__typename": "Topic",
"id": "159",
"name": "Cardiovascular physiology",
"typeId": 7
},
"topicId": 159,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3962,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17280",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "The heart can generate electrical activity and contraction without external input.\n\nWhich of the following best describes the molecules involved in generating an unstable resting potential in the sino-atrial node which leads to the initiation of pacemaker potentials and determines heart rate?",
"sbaAnswer": [
"a"
],
"totalVotes": 187,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,168 | false | 40 | null | 6,495,173 | null | false | [] | null | 17,281 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Troponin is raised in both STEMI and NSTEMI as there is myocardial necrosis (death of the tissue) in both. Death of the myocardium causes the release of troponin into the blood.",
"id": "10024416",
"label": "b",
"name": "Troponin is raised in STEMI and normal in NSTEMI",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "In a STEMI, there is total occlusion of a coronary artery. This causes full-thickness (transmural) infarction in the muscular territory of the affected coronary artery. In NSTEMI, there is partial occlusion of a coronary artery which only affects the areas furthest away from the coronary artery (i.e. the innermost part of the myocardium, known as the subendocardium).",
"id": "10024415",
"label": "a",
"name": "STEMI refers to a transmural infarction whereas NSTEMI refers to a subendocardial infarction",
"picture": null,
"votes": 100
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cardiac enzymes are raised in both STEMI and NSTEMI as myocardial necrosis causes the release of these enzymes into the blood. The degree of necrosis varies in NSTEMI and STEMI, but there is still a rise in cardiac enzymes in both.",
"id": "10024417",
"label": "c",
"name": "Cardiac enzymes are elevated in STEMI but normal in NSTEMI",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pain at rest occurs in NSTEMI, STEMI and **unstable angina**. Stable angina is characterised by exertional pain which is relieved by rest and glyceryl trinitrate (GTN).",
"id": "10024418",
"label": "d",
"name": "Pain at rest occurs in NSTEMI, STEMI and stable angina",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ST depression may occur in NSTEMI, unstable and stable angina (on exertion). It can also be seen in leads V1 - V3 in posterior STEMI. ST segment changes can be a sign of myocardial ischaemia.",
"id": "10024419",
"label": "e",
"name": "ST segment depression only occurs in NSTEMI",
"picture": null,
"votes": 40
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4542",
"name": "Myocardial infarction and Acute Coronary Syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4542,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17281",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 69-year-old gentleman presents to A&E with central crushing chest pain which radiates to his jaw. The man appears to be breathless and sweating profusely. Blood tests reveal a troponin of 150 ng/litre (normal <14 ng/L) and ECG shows ST elevation in leads V1-V4.\n\n\nWhich of the following statements is correct?",
"sbaAnswer": [
"a"
],
"totalVotes": 183,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,169 | false | 41 | null | 6,495,173 | null | false | [] | null | 17,282 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The inhibition of β3-adrenoreceptors causes contraction of the detrusor muscle. These would not help alleviate urinary symptoms.",
"id": "10024423",
"label": "d",
"name": "β3 adrenergic receptor antagonist",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Activation of M3 receptors causes smooth muscle contraction in the bladder through the Gq receptor pathway. This would not alleviate urinary symptoms.",
"id": "10024422",
"label": "c",
"name": "M3 muscarinic receptor agonist",
"picture": null,
"votes": 72
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The stimulation of β3-adrenoreceptors causes relaxation of the detrusor muscle. An example of a β3 receptor agonist is mirabegron which is used to treat overactive bladder syndrome.",
"id": "10024424",
"label": "e",
"name": "β3 adrenergic receptor agonist",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Tamsulosin is an alpha-1 adrenoceptor blocker. Blocking α1 receptors in the bladder causes detrusor muscle relaxation which improves urinary storage symptoms. This is used in conditions such as benign prostatic hyperplasia, which is what this gentleman is likely presenting with.",
"id": "10024420",
"label": "a",
"name": "α1 receptor antagonist",
"picture": null,
"votes": 50
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This induces contraction of the internal urethral sphincter which prevents the flow of urine.",
"id": "10024421",
"label": "b",
"name": "α1 receptor agonist",
"picture": null,
"votes": 18
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4538",
"name": "Micturition reflex",
"status": null,
"topic": {
"__typename": "Topic",
"id": "168",
"name": "Renal Physiology",
"typeId": 7
},
"topicId": 168,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4538,
"conditions": [],
"difficulty": 1,
"dislikes": 1,
"explanation": null,
"highlights": [],
"id": "17282",
"isLikedByMe": 0,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 69-year-old male presents to his general practitioner due to difficulty in emptying his bladder and waking in the middle of the night to urinate. The GP prescribes him tamsulosin.\n\nWhat is the mechanism of action of tamsulosin?",
"sbaAnswer": [
"a"
],
"totalVotes": 179,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,170 | false | 42 | null | 6,495,173 | null | false | [] | null | 17,283 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ARB competitively bind to AT1 receptors on vascular smooth muscle preventing angiotensin II from binding and causing vasoconstriction. They have a mortality benefit in patients with heart failure.",
"id": "10024429",
"label": "e",
"name": "Angiotensin receptor blockers (ARB)",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Beta-blockers work by decreasing preload and afterload and improving left ventricular function. They have a mortality benefit in patients with heart failure.",
"id": "10024427",
"label": "c",
"name": "Beta-blocker",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ACE inhibitors decrease preload and afterload which increases cardiac output. ACE inhibitors do have a mortality benefit in heart failure and are strongly recommended as a first-line treatment.",
"id": "10024426",
"label": "b",
"name": "ACE inhibitor",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are potassium-sparing diuretics which promote sodium and water excretion. They also have a mortality benefit in patients with heart failure.",
"id": "10024428",
"label": "d",
"name": "Aldosterone antagonists",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Loop diuretics, e.g. furosemide, are used for symptom management in heart failure. Loop diuretics promote diuresis by blocking sodium and chloride reabsorption. The overall effect of this is reduced shortness of breath and peripheral oedema. There is not enough evidence to suggest that this improves survival.",
"id": "10024425",
"label": "a",
"name": "Loop diuretics",
"picture": null,
"votes": 129
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3798",
"name": "Heart Failure",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3798,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17283",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 73-year-old male presents to his GP with a 3-month history of shortness of breath which is worse on exertion and moderate leg swelling at the ankles. When asked, he admits he has been finding it difficult to sleep flat and has to use a few pillows. He has a background history of aortic stenosis and hypertension and has a 30-pack-year history.\n\nWhich of the following heart failure medications only provide symptomatic relief?",
"sbaAnswer": [
"a"
],
"totalVotes": 188,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,171 | false | 43 | null | 6,495,173 | null | false | [] | null | 17,284 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Nucleating factors such as mucin promote the crystallisation of cholesterol, which increases the risk of stones.",
"id": "10024434",
"label": "e",
"name": "Low levels of nucleation",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Bacteria help in the formation of pigment stones by releasing lytic enzymes which can hydrolyse lecithin into fatty acids. This can bind to calcium to form brown mixed stones.",
"id": "10024430",
"label": "a",
"name": "Chronic infection",
"picture": null,
"votes": 70
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Low levels of bile acids contribute to gallstone formation, for example, due to an ileal resection or malabsorptive conditions. A lower concentration of bile compared to cholesterol causes saturation of the bile and the formation of stones.",
"id": "10024431",
"label": "b",
"name": "Increased amount of bile acids",
"picture": null,
"votes": 99
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gallbladder stasis promotes gallstone formation as impaired emptying results in a build-up of bile and an increased predisposition for stone formation. Gallbladder stasis may occur in pregnancy and diabetes.",
"id": "10024433",
"label": "d",
"name": "Gallbladder hypermotility",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "High cholesterol levels exceed the solubilising capacity of bile, causing the precipitation of bile into stones.",
"id": "10024432",
"label": "c",
"name": "Low cholesterol",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4571",
"name": "Formation of bile acids and bile salts",
"status": null,
"topic": {
"__typename": "Topic",
"id": "180",
"name": "Biochemistry",
"typeId": 7
},
"topicId": 180,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4571,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17284",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 40-year-old female presents to A&E with right upper quadrant pain, fever and vomiting. An ultrasound of the abdomen reveals an impacted stone in the neck of the gallbladder.\n\nWhich of the following is a factor involved in gallstone formation?",
"sbaAnswer": [
"a"
],
"totalVotes": 188,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,172 | false | 44 | null | 6,495,173 | null | false | [] | null | 17,285 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is an exotoxin which is secreted by *H pylori* that causes gastric mucosal injury.",
"id": "10024435",
"label": "a",
"name": "Vacuolating toxin A (VacA)",
"picture": null,
"votes": 112
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This virulence factor is found in *Staphylococcus aureus* and *Clostridium perfringens*. It disrupts cell membranes.",
"id": "10024439",
"label": "e",
"name": "Alpha toxin",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a virulence factor of influenza. It allows influenza to bind to host cell membranes to aid with infectivity.",
"id": "10024436",
"label": "b",
"name": "Neuraminidase",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a virulence factor of *Staphylococcus aureus* and degrades hyaluronic acid between adjacent cells.",
"id": "10024438",
"label": "d",
"name": "Hyaluronidase",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a virulence factor of influenza. It also allows influenza to bind to host cell membranes to aid with infectivity.",
"id": "10024437",
"label": "c",
"name": "Haemagglutinin",
"picture": null,
"votes": 9
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4019",
"name": "H. Pylori",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4019,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17285",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 62-year-old male attends his GP due to severe heartburn and epigastric pain. His symptoms are not relieved by ranitidine. Following a urea breath test, he is diagnosed as having *Helicobacter pylori*.\n\nWhich of the following is a virulence factor of *H pylori*?",
"sbaAnswer": [
"a"
],
"totalVotes": 184,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,173 | false | 45 | null | 6,495,173 | null | false | [] | null | 17,286 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is used in long-term management if beta blockers are contraindicated (for example, in patients with asthma).",
"id": "10024442",
"label": "c",
"name": "Calcium channel blockers",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is used in long-term management. It is offered first-line alongside beta-blockers in patients with left ventricular dysfunction.",
"id": "10024443",
"label": "d",
"name": "ACE inhibitors",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is used in long-term management. They are offered first-line for at least 12 months after an MI.",
"id": "10024441",
"label": "b",
"name": "Beta-blockers",
"picture": null,
"votes": 41
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Streptokinase is a thrombolytic agent used to break down clots in myocardial infarction. It is offered to those who present within 12 hours of symptoms but are unable to undergo primary percutaneous coronary intervention (PCI).",
"id": "10024440",
"label": "a",
"name": "Streptokinase",
"picture": null,
"votes": 101
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is used in long-term management. This is a secondary prevention drug which reduces the risk of another MI occurring in the future by lowering cholesterol levels.",
"id": "10024444",
"label": "e",
"name": "Statins",
"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": "4542",
"name": "Myocardial infarction and Acute Coronary Syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4542,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17286",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 63-year-old male with a background history of diabetes and hypertension presents to Accident and Emergency with clamminess and palpitations. His ECG shows ST elevation in the lateral leads.\n\nWhich of the following is used in the immediate treatment of an ST elevated myocardial infarction?",
"sbaAnswer": [
"a"
],
"totalVotes": 185,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,174 | false | 46 | null | 6,495,173 | null | false | [] | null | 17,287 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Alanine does not react with oxaloacetate. Instead, the reaction between alanine and α-ketoglutarate forms glutamate which transfers its amino group to oxaloacetate.",
"id": "10024448",
"label": "d",
"name": "Alanine + oxaloacetate ↔ pyruvate + aspartate",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Aspartate is not formed in the reaction between alanine and α-ketoglutarate.",
"id": "10024447",
"label": "c",
"name": "Alanine + α-ketoglutarate ↔ pyruvate + aspartate",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oxaloacetate is not formed in the reaction between alanine and α-ketoglutarate.",
"id": "10024449",
"label": "e",
"name": "Alanine + α-ketoglutarate ↔ oxaloacetate + glutamate",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is incorrect as glutamate transfers an amino group to oxaloacetate in the second transamination reaction. The reaction is as follows: Glutamate + oxaloacetate ↔ α-ketoglutarate + aspartate",
"id": "10024446",
"label": "b",
"name": "Alanine + oxaloacetate ↔ pyruvate + glutamate",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The transamination of alanine (an amino acid) results in the transfer of an amino group to α-ketoglutarate, which is an amino-group acceptor, to produce glutamate, a new amino acid.",
"id": "10024445",
"label": "a",
"name": "Alanine + α-ketoglutarate ↔ pyruvate + glutamate",
"picture": null,
"votes": 92
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4206",
"name": "Amino acids",
"status": null,
"topic": {
"__typename": "Topic",
"id": "180",
"name": "Biochemistry",
"typeId": 7
},
"topicId": 180,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4206,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17287",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Amino acids are broken down by transaminases into non-essential amino acids.\n\nWhich of the following is the correct reaction for the transamination of alanine?",
"sbaAnswer": [
"a"
],
"totalVotes": 183,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,175 | false | 47 | null | 6,495,173 | null | false | [] | null | 17,288 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Lactulose works by increasing the volume of fluid in the lumen of the bowel via osmosis and causes peristalsis.",
"id": "10024454",
"label": "e",
"name": "Lactulose",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is used for treating infections,e.g. *Campylobacter jejuni*, that cause **diarrhoea**.",
"id": "10024453",
"label": "d",
"name": "Erythromycin",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a stimulant laxative which stimulates peristalsis and therefore increases the motility of the large bowel.",
"id": "10024451",
"label": "b",
"name": "Senna",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Loperamide is an opioid which can decrease intestinal motility and hence decrease the passage of faeces. This induces constipation.",
"id": "10024450",
"label": "a",
"name": "Loperamide",
"picture": null,
"votes": 131
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a type of bulk-forming laxative. It contains fibre which uses water in the intestines to bulk the stool and improve its movement within the bowel. It does not affect intestinal motility.",
"id": "10024452",
"label": "c",
"name": "Methylcellulose",
"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": "5777",
"name": "Anti-diarrhoeals",
"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": 5777,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17288",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following drugs is useful for decreasing colonic mass movement?",
"sbaAnswer": [
"a"
],
"totalVotes": 183,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,176 | false | 48 | null | 6,495,173 | null | false | [] | null | 17,289 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Excess growth hormone causes excess insulin secretion.",
"id": "10024458",
"label": "d",
"name": "Normal insulin levels",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Growth hormone excess increases gluconeogenesis which raises glucose levels.",
"id": "10024457",
"label": "c",
"name": "Low glucose levels",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Growth hormone excess increases lipolysis raising free fatty acid levels.",
"id": "10024456",
"label": "b",
"name": "Low free fatty acids",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Excess growth hormone causes excess insulin secretion. This decreases the number of insulin receptors and decreases their affinity for insulin which causes impaired glucose tolerance.",
"id": "10024455",
"label": "a",
"name": "Impaired glucose tolerance",
"picture": null,
"votes": 121
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Excess growth hormone causes local insulin-like growth factor (IGF-1) overproduction. This acts on connective tissues and causes overgrowth. This causes hyperhidrosis (excess sweating).",
"id": "10024459",
"label": "e",
"name": "Decreased sweating",
"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": "5761",
"name": "Growth hormone",
"status": null,
"topic": {
"__typename": "Topic",
"id": "167",
"name": "Endocrine physiology",
"typeId": 7
},
"topicId": 167,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5761,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17289",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following is a feature of growth hormone excess?",
"sbaAnswer": [
"a"
],
"totalVotes": 184,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,177 | false | 49 | null | 6,495,173 | null | false | [] | null | 17,290 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Acute liver failure is characterised by coagulopathy (INR> 1.5) and altered levels of consciousness due to hepatic encephalopathy. Acute liver injury is the initial trigger due to a primary liver aetiology and therefore does not present with encephalopathy.",
"id": "10024460",
"label": "a",
"name": "Acute liver failure results in hepatic encephalopathy whilst acute liver injury does not",
"picture": null,
"votes": 86
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The most common cause of drug-induced liver injury and failure is paracetamol.",
"id": "10024463",
"label": "d",
"name": "The most common cause of drug-induced acute liver injury and failure is amiodarone",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Acute liver injury and acute liver failure **both** cause an increase in hepatocellular (AST, ALT) and cholestatic (ALP, GGT) enzymes.",
"id": "10024461",
"label": "b",
"name": "Acute liver injury results in increased ALT and AST but normal ALP whilst acute liver failure has raised AST, ALT and ALP",
"picture": null,
"votes": 77
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Coagulopathy indicated by an INR >1.5 is a characteristic feature of acute liver failure and can also occur in acute liver injury.",
"id": "10024462",
"label": "c",
"name": "Coagulopathy does not occur in acute liver failure but occurs in acute liver injury",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Patients should be treated with N-acetyl cysteine if ingestion of paracetamol is over 8 hours.",
"id": "10024464",
"label": "e",
"name": "Patients should be treated with activated charcoal if ingestion of paracetamol is over 8 hours",
"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": "3986",
"name": "Liver Failure",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3986,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17290",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following statements on acute liver failure and acute liver injury is correct?",
"sbaAnswer": [
"a"
],
"totalVotes": 185,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,204 | false | 1 | null | 6,495,176 | null | false | [] | null | 17,391 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are premalignant skins lesions that often precede the development of squamous cell carcinomas. Actinic keratosis present as lesions with surrounding erythema and a rough or warty surface. They are often described as incredibly itchy lesions on sun exposed areas of skin.",
"id": "10024966",
"label": "b",
"name": "Actinic Keratosis",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These often appear as irregular red nodules with a scaly or crusty surface and irregular and raised margins. Unlike basal cell carcinomas, they can cause pain and bleeding and grow more quickly, over weeks to months.",
"id": "10024969",
"label": "e",
"name": "Squamous cell carcinoma",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These often have a ‘stuck on’ appearance. They can range in colour from light to black. The lesion described in this question is more likely to be a basal cell carcinoma.",
"id": "10024968",
"label": "d",
"name": "Seborrheic Keratosis",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a typical description of a basal cell carcinoma. Basal cell carcinomas usually present with the following three features: a pearly rolled edge, central ulceration and fine telangiectasias. They do not commonly present with any pain or bleeding. They are slow-growing and are more likely to appear on sun exposed areas of skin.",
"id": "10024965",
"label": "a",
"name": "Basal cell carcinoma",
"picture": null,
"votes": 151
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Features of melanomas can be recognised using the ABCDE approach, which stands for: Asymmetrical lesion, Border irregularity, Colour variation, Diameter more than 6mm and Evolution over time. Melanomas can also be itchy or bleed and often grow more quickly than basal cell carcinomas.",
"id": "10024967",
"label": "c",
"name": "Malignant melanoma",
"picture": null,
"votes": 9
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3760",
"name": "Basal cell carcinoma",
"status": null,
"topic": {
"__typename": "Topic",
"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3760,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17391",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 60-year-old male presents to his GP after noticing a new lesion on his cheek. On closer inspection, you notice a raised, flesh-coloured nodule approximately 4mm in diameter. You notice a pearly rolled edge and an ulceration in the centre of the lesion, with multiple small telangiectasia on the surface of the nodule.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 187,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,205 | false | 2 | null | 6,495,176 | null | false | [] | null | 17,392 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ehlers-Danlos syndrome occurs due to a genetic mutation in collagen, not fibrin. Different types of mutations in fibrin can cause bleeding disorders such as hypofibrinogenemia.",
"id": "10024972",
"label": "c",
"name": "Fibrin",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ehlers-Danlos syndrome occurs due to a genetic mutation in collagen, not elastin. Loss of function mutations in the elastin gene can cause the heart defect supravalvular aortic stenosis.",
"id": "10024973",
"label": "d",
"name": "Elastin",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A mutation of the CFTR gene, otherwise known as the cystic fibrosis transmembrane conductance regulator gene, causes cystic fibrosis. Ehlers-Danlos syndrome is caused by a genetic mutation of collagen.",
"id": "10024971",
"label": "b",
"name": "Cystic fibrosis transmembrane conductance regulator (CFTR)",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Keratin is the building block of hair and nails. Mutations in keratin does not cause the development of Ehlers-Danlos syndrome.",
"id": "10024974",
"label": "e",
"name": "Keratin",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Enlers-Danlos syndrome is a group of inherited conditions that cause hypermobile joints, hyperelastic skin and fragile blood vessels. This occurs due to a genetic mutation of collagen.",
"id": "10024970",
"label": "a",
"name": "Collagen",
"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": "5814",
"name": "Ehlers-Danlos syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "156",
"name": "Medical Genetics",
"typeId": 7
},
"topicId": 156,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5814,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17392",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 20-year-old female presents to the emergency department as she has dislocated her shoulder. She has a past medical history of Ehlers-Danlos syndrome.\n\nEhlers-Danlos syndrome is caused by a genetic mutation of which structure?",
"sbaAnswer": [
"a"
],
"totalVotes": 180,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,206 | false | 3 | null | 6,495,176 | null | false | [] | null | 17,393 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hodgkin's lymphoma is not a known complication of glandular fever. However, having glandular fever can be assoictaed with a higher risk of developing non-Hodgkin's lymphoma.",
"id": "10024978",
"label": "d",
"name": "Hodgkin's lymphoma",
"picture": null,
"votes": 52
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a typical description of glandular fever. An important complication of this condition includes splenic rupture, so individuals are advised to avoid contact sports for a month after diagnosis. Signs of splenic rupture include: abdominal pain, referred shoulder tip pain and tachycardia.",
"id": "10024975",
"label": "a",
"name": "Splenic rupture",
"picture": null,
"votes": 58
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This question describes a patient with glandular fever. An important complication of glandular fever is splenic rupture. ST-elevation myocardial infarction is not a complication of this condition.",
"id": "10024979",
"label": "e",
"name": "ST-elevation myocardial infarction (STEMI)",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ramsey-Hunt syndrome occurs when a herpes zoster infection affects the facial nerve. It is not a complication of glandular fever.",
"id": "10024976",
"label": "b",
"name": "Ramsey-Hunt syndrome",
"picture": null,
"votes": 50
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hepatitis A is not a complication of glandular fever. Glandular fever can, however, lead to development of autoimmune hepatitis which is an important complication to monitor for.",
"id": "10024977",
"label": "c",
"name": "Hepatitis A",
"picture": null,
"votes": 14
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5815",
"name": "Glandular fever",
"status": null,
"topic": {
"__typename": "Topic",
"id": "161",
"name": "Emergency Medicine",
"typeId": 5
},
"topicId": 161,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5815,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17393",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "An 18-year-old university student presents to her GP with a sore throat and fatigue for the past three weeks. She was prescribed a course of amoxicillin a week ago which she stopped taking as she developed a widespread macular rash. On examination, she is noted to have cervical lymphadenopathy.\n\nWhich of the following is a possible complication of the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 177,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,207 | false | 4 | null | 6,495,176 | null | false | [] | null | 17,394 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Graves' Disease is a type 5 hypersensitivity reaction. These reactions occur when antibodies bind to cell surface receptors. A further example of a type 5 hypersensitivity reaction is myasthenia gravis. Type 5 reactions are relatively new within the medical literature, and previously Graves' would have been considered a Type 2 reaction, which your university may still be teaching. If this is the case, we would advise clarifying with your university.",
"id": "10024980",
"label": "a",
"name": "Type 5",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Type 2 hypersensitivity reactions include rheumatic fever and autoimmune haemolytic anaemia. These reactions take place when either IgG or IgM bind to a cell surface antigen, so are known as cell bound reactions. The patient in this question has Graves' disease, which is a type 5 hypersensitivity reaction.",
"id": "10024983",
"label": "d",
"name": "Type 2",
"picture": null,
"votes": 76
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Type 1 hypersensitivity reactions occur when antigens bind and react to IgE immunoglobulins. Common examples of type 1 hypersensitivity reactions include anaphylaxis, asthma, eczema and hay fever.",
"id": "10024982",
"label": "c",
"name": "Type 1",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Type 4 hypersensitivity reactions are known as delayed-type hypersensitivity reactions. They involve T lymphocytes and reactions often occur 24 to 72 hours after exposure to an antigen. Examples of type 4 hypersensitivity reactions include contact dermatitis and transplant rejections.",
"id": "10024984",
"label": "e",
"name": "Type 4",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Examples of type 3 hypersensitivity reactions include systemic lupus erythematosus, and less commonly post-streptococcal glomerulonephritis. These reactions are mediated by immune complexes.",
"id": "10024981",
"label": "b",
"name": "Type 3",
"picture": null,
"votes": 33
}
],
"comments": [
{
"__typename": "QuestionComment",
"comment": "bristol teaches graves disease as a type IIb hypersensitivity reaction",
"createdAt": 1716670683,
"dislikes": 0,
"id": "50727",
"isLikedByMe": 0,
"likes": 8,
"parentId": null,
"questionId": 17394,
"replies": [],
"user": {
"__typename": "User",
"accessLevel": "subscriber",
"displayName": "zuzu0103",
"id": 60202
}
}
],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4091",
"name": "Hypersensitivity reactions",
"status": null,
"topic": {
"__typename": "Topic",
"id": "158",
"name": "Immunology",
"typeId": 7
},
"topicId": 158,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4091,
"conditions": [],
"difficulty": 1,
"dislikes": 3,
"explanation": null,
"highlights": [],
"id": "17394",
"isLikedByMe": 0,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 15-year-old male attends his GP with a six-month history of weight loss and diarrhoea. On further questioning, he is found to be sweaty and restless, and has had trouble sleeping. On examination, he has diplopia and you notice the upper eyelid is slow to descend on downgaze. The GP suspects a diagnosis of Graves' disease.\n\nWhich type of hypersensitivity reaction is Graves' disease?",
"sbaAnswer": [
"a"
],
"totalVotes": 180,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,208 | false | 5 | null | 6,495,176 | null | false | [] | null | 17,395 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pitted scars are often seen in individuals with acne. The description of the skin lesion in this question is more typical of a keloid scar.",
"id": "10024988",
"label": "d",
"name": "Pitted scar",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypertrophic scars are usually hard and raised. They do not exceed past the borders of the original wound- which makes them different to keloid scars.",
"id": "10024989",
"label": "e",
"name": "Hypertrophic scar",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a typical presentation of a keloid scar. The description of a smooth, hard growth at the site of trauma is typical of this type of scar. Keloids are most commonly found after injury to the upper chest, sternum, shoulder, face, earlobes and lower legs.",
"id": "10024985",
"label": "a",
"name": "Keloid Scar",
"picture": null,
"votes": 142
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The patient in this question is most likely to have a keloid scar. A pickaxe scar is a type of scar that is often seen if an individual has severe acne.",
"id": "10024987",
"label": "c",
"name": "Pickaxe scar",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Actinic keratosis are premalignant lesions that often appear before the development of squamous cell carcinoma. They look like thickened papule or plaques and often have surrounding erythematous skin. They have a rough warty surface and can cause pruritis. The patient in this question is likely to have a keloid scar at the site of injury.",
"id": "10024986",
"label": "b",
"name": "Actinic keratosis",
"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": "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": "17395",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 30-year-old male has a new skin lesion. He has a smooth, hard growth on the left side of his nose where he has recently has his nose pierced. The lesion extends beyond the margin of the initial piercing.\n\nWhat is the name given to this skin leison?",
"sbaAnswer": [
"a"
],
"totalVotes": 174,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,209 | false | 6 | null | 6,495,176 | null | false | [] | null | 17,396 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Mast cells are responsible for triggering the inflammatory response. They are present in tissues and are the cells responsible for releasing histamine during allergic reactions.",
"id": "10024990",
"label": "a",
"name": "Mast cells",
"picture": null,
"votes": 155
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Neutrophils play an important role in fighting early stages of bacterial infections as they destroy rapidly dividing bacteria. They are not the cells responsible for producing histamine in allergic reactions.",
"id": "10024994",
"label": "e",
"name": "Neutrophils",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Dendritic cells are antigen-presenting cells that help to trigger the adaptive immune response to an infectious agent. They are not responsible for releasing histamine in allergic reactions.",
"id": "10024992",
"label": "c",
"name": "Dendritic cells",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Eosinophils defend against protozoan and parasitic infections. They would not be responsible for releasing histamine in allergic reactions.",
"id": "10024991",
"label": "b",
"name": "Eosinophils",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Macrophages act to increase body temperature when individuals have a fever. They also act as antigen-presenting cells and are involved in phagocytosis of pathogens. Mast cells are the cells responsible for releasing histamine during allergic reactions.",
"id": "10024993",
"label": "d",
"name": "Macrophages",
"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": "5816",
"name": "Mast Cells",
"status": null,
"topic": {
"__typename": "Topic",
"id": "158",
"name": "Immunology",
"typeId": 7
},
"topicId": 158,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5816,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17396",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 10-year-old female presents to the emergency department with shortness of breath and facial swelling after eating peanuts.\n\nWhich of the following cell types are responsible for releasing histamine in allergic reactions?",
"sbaAnswer": [
"a"
],
"totalVotes": 176,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,210 | false | 7 | null | 6,495,176 | null | false | [] | null | 17,397 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Antibiotics like rifampicin work by inhibiting the synthesis of RNA. Trimethoprim acts by inhibiting folic acid synthesis.",
"id": "10024998",
"label": "d",
"name": "Inhibits RNA synthesis",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Antibiotics like macrolides and aminoglycosides act by inhibiting protein synthesis. Trimethoprim instead acts by inhibiting folic acid formation.",
"id": "10024996",
"label": "b",
"name": "Inhibits protein synthesis",
"picture": null,
"votes": 31
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Trimethoprim acts by inhibiting folic acid formation, not by inhibiting the formation of cell walls. Cell wall inhibitors include antibiotics like penicillin, glycopeptides and cephalosporins.",
"id": "10024997",
"label": "c",
"name": "Inhibits cell wall formation",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Trimethoprim acts by inhibiting folic acid formation. It does not damage DNA, unlike antibiotics such as metronidazole.",
"id": "10024999",
"label": "e",
"name": "Damages DNA",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Trimethoprim is an antibiotic that acts by inhibiting folic acid formation.",
"id": "10024995",
"label": "a",
"name": "Inhibits folic acid formation",
"picture": null,
"votes": 90
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3887",
"name": "Antibiotics",
"status": null,
"topic": {
"__typename": "Topic",
"id": "148",
"name": "Microbiology",
"typeId": 7
},
"topicId": 148,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3887,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17397",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following options best describes the mechanism of action of trimethoprim?",
"sbaAnswer": [
"a"
],
"totalVotes": 173,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,211 | false | 8 | null | 6,495,176 | null | false | [] | null | 17,398 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of action of sulphonamides and trimethoprim. Statins do not work in this way, but instead by inhibiting HMG-CoA reductase.",
"id": "10025002",
"label": "c",
"name": "Inhibit folic acid formation",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of action of warfarin, not statins. Statins inhibit HMG-CoA reductase, which reduces the amount of cholesterol in the blood.",
"id": "10025001",
"label": "b",
"name": "Inhibit vitamin K epoxide reductase complex 1",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Antibiotics like macrolides and tetracycline work to inhibit protein synthesis. Statins instead work by inhibiting HMG-CoA reductase.",
"id": "10025003",
"label": "d",
"name": "Inhibit protein synthesis",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Antibiotics like metronidazole work by damaging DNA. Statins do not work in this way, but instead by inhibiting HMG-CoA reductase.",
"id": "10025004",
"label": "e",
"name": "Damage DNA",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. Statins inhibit HMG-CoA reductase which, in turn, reduces the amount of cholesterol made by the liver (and also helps the liver remove cholesterol that has already been formed and deposited in the blood).",
"id": "10025000",
"label": "a",
"name": "Inhibit HMG-CoA reductase",
"picture": null,
"votes": 163
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5817",
"name": "Statins",
"status": null,
"topic": {
"__typename": "Topic",
"id": "166",
"name": "General pharmacological concepts",
"typeId": 7
},
"topicId": 166,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5817,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17398",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 45-year-old male found to have a QRESEARCH cardiovasclar risk algorithm (QRISK) score that is over 10%. His GP recommends he begins a medication called atorvastatin.\n\nWhich of the following correctly descibes the mechanism of action of statins?",
"sbaAnswer": [
"a"
],
"totalVotes": 171,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,212 | false | 9 | null | 6,495,176 | null | false | [] | null | 17,399 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "IgE is associated with Type 1 Hypersensitivity reactions. It is synthesized by plasma cells and provides immunity to parasites such as helminths. It is not the first immunoglobulin to be secreted in infection, this is IgM.",
"id": "10025008",
"label": "d",
"name": "IgE",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The role of IgD is less clear than that of the other antibodies. It is possible that it enhances the response of the other classes of antibodies, or helps to block viral replication. It is not the first immunoglobulin to be secreted in infection, this is IgM.",
"id": "10025009",
"label": "e",
"name": "IgD",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "IgA is the most predominant immunoglobulin found in breast milk. It can also be found in secretions of the digestive, respiratory and urogenital systems. The other main role of IgA is to provided protection on cell mucus membranes. It is not the first immunoglobulin to be secreted in infection, this is IgM.",
"id": "10025007",
"label": "c",
"name": "IgA",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This immunoglobin is the only type that is able to pass into the foetal circulation. IgG is also involved in phagocytosis of bacteria and viruses, and is the most abundant type of immunoglobulin found in the blood serum. However, the first immunoglobulin to be secreted in infection is IgM.",
"id": "10025006",
"label": "b",
"name": "IgG",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The defining feature of IgM is that it is the first immunoglobulin to be secreted in response to infection. It is secreted as a pentamer.",
"id": "10025005",
"label": "a",
"name": "IgM",
"picture": null,
"votes": 123
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3854",
"name": "Antibodies",
"status": null,
"topic": {
"__typename": "Topic",
"id": "158",
"name": "Immunology",
"typeId": 7
},
"topicId": 158,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3854,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17399",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "Which is the first immunoglobulin to be secreted in repsonse to infection?",
"sbaAnswer": [
"a"
],
"totalVotes": 173,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,213 | false | 10 | null | 6,495,176 | null | false | [] | null | 17,400 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Ramipril can cause high potassium levels as it blocks the aldosterone pathway, and therefore leads to more potassium being retained in the body. Hyperkalaemia is defined as a serum potassium of higher than 5.5mmol/L.",
"id": "10025010",
"label": "a",
"name": "Ramipril",
"picture": null,
"votes": 124
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Furosemide is a loop diuretic that works by inhibiting the Na-K-Cl co-transporter in the loop of Henle- in the kidney. This means that furosemide causes hypokalaemia, rather than hyperkalaemia.",
"id": "10025011",
"label": "b",
"name": "Furosemide",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Beta blockers can cause a number of side effects including bronchospasm, insomnia and erectile dysfunction. They do not, however, cause hyperkalemia.",
"id": "10025014",
"label": "e",
"name": "Propranolol",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Nicorandil is a vasodilatory drug used used in the treatment of angina. It does not cause hyperkalemia but can, however, have a range of other side effects including headaches, flushing and skin ulceration.",
"id": "10025013",
"label": "d",
"name": "Nicorandil",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Metformin is not a direct cause of hyperkalaemia. Instead, this high potassium level is more likely to be caused by use of an angiotensin-converting enzyme (ACE) inhibitor.",
"id": "10025012",
"label": "c",
"name": "Metformin",
"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": "3934",
"name": "hyperkalaemia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "170",
"name": "Clinical Chemistry",
"typeId": 7
},
"topicId": 170,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3934,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17400",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 71-year-old male attends his GP to receive the results for his routine blood test. His medications include furosemide, metformin, propranolol, ramipril and nicorandil. His potassium levels are found to be 6.0mmol/L (normal range 3.5-5.3 mmol/L).\n\nWhich of the following medications is likely to be the biggest contributor to his hyperkalaemia?",
"sbaAnswer": [
"a"
],
"totalVotes": 173,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,214 | false | 11 | null | 6,495,176 | null | false | [] | null | 17,401 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a typical description of a patient with haemophilia A. Haemophilia A can vary in severity, but typically presents with bleeding into soft tissues, muscles and joints. It is diagnosed with a factor VIII assay and genetic testing. It is caused by deficiency of clotting factor VIII, an important part of the intrinsic component of the coagulation cascade.",
"id": "10025015",
"label": "a",
"name": "Haemophilia A",
"picture": null,
"votes": 153
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Alexander's disease is a rare genetic bleeding disorder, which would show a deficiency in factor VII, not factor VIII. Alexander's disease presents with easy bruising, frequent nosebleeds and prolonged bleeding after physical injury. It does not commonly present with haemarthroses.",
"id": "10025017",
"label": "c",
"name": "Alexander's disease",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Acute myeloid leukaemia would present with symptoms such as weight loss, frequent infections, tiredness and shortness of breath. This question is more typical of a presentation of haemophilia.",
"id": "10025019",
"label": "e",
"name": "Acute myeloid leukaemia",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Acute lymphoid leukaemia does occur in children, and can present with increased bleeding. It is an important diagnosis to rule out. However, it would not explain the low levels of Factor VIII. It would also be likely to present with other symptoms such as pallor, frequent infections, weight loss and fatigue.",
"id": "10025018",
"label": "d",
"name": "Acute lymphoid leukaemia",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Haemophilia B would show a deficiency in clotting factor IX, not clotting factor VIII.",
"id": "10025016",
"label": "b",
"name": "Haemophilia B",
"picture": null,
"votes": 12
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3925",
"name": "haemophilia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "157",
"name": "Haematology",
"typeId": 7
},
"topicId": 157,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3925,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17401",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A nine-year-old male attends his GP with recurrent haemarthroses. He undergoes multiple blood tests, which reveal low levels of factor VIII.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 168,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,215 | false | 12 | null | 6,495,176 | null | false | [] | null | 17,402 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient's dry cough is most likely to have been caused by starting an angiotensin-converting enzyme (ACE) inhibitor such as Ramipril. When an ACE inhibitor is not tolerated in the treatment of hypertension, patients are offers an angiotensin II receptor blocker (ARB) instead.",
"id": "10025020",
"label": "a",
"name": "Ramipril",
"picture": null,
"votes": 148
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's dry cough is most likely to be caused by starting an ACE inhibitor, not a calcium channel blocker like amlodipine. Calcium channel blockers can have a range of side effects, including abdominal pain, peripheral oedema or gingival hyperplasia.",
"id": "10025023",
"label": "d",
"name": "Amlodipine",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's dry cough is most likely to be caused by starting an ACE inhibitor such as ramipril, rather than spironolactone.",
"id": "10025021",
"label": "b",
"name": "Spironolactone",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's dry cough is most likely to be caused by starting an ACE inhibitor, rather than beginning Indapamide. Indapamide can cause patients to become constipated, cause hyperuricaemia or, in rare cases, agranulocytosis.",
"id": "10025022",
"label": "c",
"name": "Indapamide",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's dry cough is most likely to be caused by starting an ACE inhibitor, rather than an angiotensin II receptor antagonist (ARB) such as losartan.",
"id": "10025024",
"label": "e",
"name": "Losartan",
"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": "4215",
"name": "ACE inhibitors",
"status": null,
"topic": {
"__typename": "Topic",
"id": "169",
"name": "Cardiovascular pharmacology",
"typeId": 7
},
"topicId": 169,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4215,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17402",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 58-year-old man is started on a new medication for hypertension by his GP. Eight days later, he returns to his GP complaining of a dry cough.\n\nWhich of the following medications is the patient most likely to have been started on?",
"sbaAnswer": [
"a"
],
"totalVotes": 167,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,216 | false | 13 | null | 6,495,176 | null | false | [] | null | 17,403 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An echocardiogram can be a useful investigation if you want to check for signs of right heart strain or hypotension in patients with high-risk pulmonary embolisms. However, the best initial investigation in this woman’s case would be to conduct a CT pulmonary angiogram.",
"id": "10025028",
"label": "d",
"name": "Echocardiogram",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be the best initial investigation for a pulmonary embolism if the patient had renal impairment, a contrast allergy or was pregnant. The question mentions none of these criteria, so the best initial investigation for this woman would be a CT pulmonary angiogram.",
"id": "10025027",
"label": "c",
"name": "V/Q scan",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The most likely diagnosis in this woman in pulmonary embolism. The best initial investigation for this woman would be a CT pulmonary angiogram.",
"id": "10025026",
"label": "b",
"name": "Doppler ultrasound",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is presenting with a pulmonary embolism after a long flight (one of the risk factors for a pulmonary embolism). The best initial investigation for this woman would be a CT pulmonary angiogram.",
"id": "10025029",
"label": "e",
"name": "Blood pressure",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The most likely diagnosis in this woman is pulmonary embolism. This is due to the classic triad of symptoms: sudden onset shortness of breath, pleuritic chest pain and haemoptysis. Her observations of tachycardia and tachypnoea further confirm this diagnosis. The best initial investigation for this woman would be a CT pulmonary angiogram, which would likely show a filling defect in the pulmonary vasculature.",
"id": "10025025",
"label": "a",
"name": "CT pulmonary angiogram",
"picture": null,
"votes": 131
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3724",
"name": "Pulmonary Embolism",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3724,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17403",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 33-year-old female presents to A+E with shortness of breath that began four hours ago. She also reports having chest pain that is worse breathing in and has brought up some small flecks of bright red blood when coughing. She has recently returned from a two-week holiday in Australia. On examination, she has a heart rate of 120 and respiratory rate of 18. Her oxygen saturations are 90%. She has a temperature of 38.0.\n\nWhich of the following is the most appropriate initial investigation?",
"sbaAnswer": [
"a"
],
"totalVotes": 165,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,217 | false | 14 | null | 6,495,176 | null | false | [] | null | 17,404 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "*Mycoplasma pneumoniae* would typically appear present with flu-like symptoms and a possible rash. It also has the potential to cause autoimmune haemolytic anaemia. This patient is most likely to have an infection caused by *legionella pneumoniae* given their blood results.",
"id": "10025031",
"label": "b",
"name": "*Mycoplasma pneumoniae*",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "*Streptococcus pneumoniae* is one of the most common causes of community-acquired pneumonia so is a good differential. However, the low sodium and deranged LFTs here are indicative of a legionella pneumonia.",
"id": "10025034",
"label": "e",
"name": "*Streptococcus pneumoniae*",
"picture": null,
"votes": 52
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "*Klebsiella pneumoniae* usually affects patients with weakened immune systems, which includes elderly patients and those with diabetes. It is also a common cause of aspiration pneumonia so may be seen in patients with risk factors for aspiration, such as alcoholics. The patient would usually describe having ‘’red currant’’ sputum.",
"id": "10025032",
"label": "c",
"name": "*Klebsiella pneumoniae*",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "*Pneumocystis jirovecii* usually presents as a lower respiratory tract infection in patients who are immunosuppressed e.g. those who are HIV-positive and have a CD4 count is under 200 cells/uL. This patient is most likely to have an infection caused by *legionella pneumoniae* given their blood results.",
"id": "10025033",
"label": "d",
"name": "*Pneumocystis jirovecii*",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "*Legionella pneumoniae* presents with fevers, muscle pain, shortness of breath, and a dry cough. It causes low sodium levels and deranged LFTs on blood results.",
"id": "10025030",
"label": "a",
"name": "*Legionella pneumoniae*",
"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": "5818",
"name": "Pneumonia (Infectious Diseases)",
"status": null,
"topic": {
"__typename": "Topic",
"id": "194",
"name": "Infectious Diseases",
"typeId": 7
},
"topicId": 194,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5818,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17404",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 23-year-old female presents to A&E with a non-productive cough and fever for five days. She is diagnosed with a lower respiratory tract infection. Blood results show low sodium levels and deranged liver function tests (LFTs).\n\nGiven the likely diagnosis, which of the following is the most likely causative organism?",
"sbaAnswer": [
"a"
],
"totalVotes": 166,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,218 | false | 15 | null | 6,495,176 | null | false | [] | null | 17,405 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is currently experiencing an epiosde of supraventricular tachycardia (SVT). The first-line treatment for SVT is to conduct vagal manoeuvres, such as the valsalva manoeuvre where a patient can close their mouth, clamp their nose shut and exhale. Another example of a vagal manoeuvre in this stage would be carotid artery massage.",
"id": "10025035",
"label": "a",
"name": "Valsalva manoeuvre",
"picture": null,
"votes": 105
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Adenosine is a treatment option used to terminate episodes of SVT. However, vagal manoeuvres such as the valsalva manoeuvre should be attempted before adenosine is given.",
"id": "10025036",
"label": "b",
"name": "Adenosine",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Verapamil is a treatment option used to terminate episodes of SVT. However, vagal manoeuvres such as the valsalva manoeuvre should be attempted before adenosine is given.",
"id": "10025037",
"label": "c",
"name": "Verapamil",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Catheter ablation of an accessory pathway is a treatment option to terminate episodes of SVT. However, vagal manoeuvres such as the valsalva manoeuvre should be attempted before adenosine is given.",
"id": "10025038",
"label": "d",
"name": "Catheter ablation of an accessory pathway",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In rare cases, a pacemaker can be inserted to prevent recurrent episodes of SVT. However, in this case it would first be appropriate to attempt vagal manoeuvres to try to terminate this patients SVT.",
"id": "10025039",
"label": "e",
"name": "Pacemaker",
"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": "5819",
"name": "Emergency Management of Supraventricular tachycardia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5819,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17405",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 23-year-old female attends the emergency department complaining of palpations for the last 15 minutes. She describes feeling dizzy and lightheaded. An ECG is conducted which shows a narrow complex tachycardia with a rate of 150bpm.\n\nWhich of the following is the most appropriate initial management for this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 163,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,219 | false | 16 | null | 6,495,176 | null | false | [] | null | 17,406 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is currently taking the maximum dose of amlodipine and therefore you cannot increase the dose further. This patient therefore requires the addition of another agent to control their blood pressure. In this case, NICE guidelines suggest the addition of an ARB such as losartan.",
"id": "10025041",
"label": "b",
"name": "Increase dose of amlodipine",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Spironolactone is a potassium-sparing diuretic that can be used in management of hypertension through its effects on the renin-angiotensin-aldosterone system (RAAS). However, it is not used before a calcium channel blocker and an ACE inhibitor or ARB have been tried together.",
"id": "10025042",
"label": "c",
"name": "Spironolactone",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Lifestyle modifications always play a part in the management of hypertension. However, this patient has consistently high blood pressure despite taking amlodipine so lifestyle modifications alone would not be enough. This patient requires the addition of another treatment to control their blood pressure.",
"id": "10025043",
"label": "d",
"name": "Advise lifestyle modifications",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient requires a second-line treatment to control their blood pressure. As she is already taking a calcium channel blocker (amlodipine), she should be given an angiotensin receptor blocker (ARB). ARBs are the preferred choice over angiotensin-converting enzyme (ACE) inhibitors for patients of African-Caribbean origin.",
"id": "10025040",
"label": "a",
"name": "Add in losartan",
"picture": null,
"votes": 125
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's blood pressure has remained above 140/90 despite treatment with amlodipine. Therefore, she requires the addition of a second medication to control her blood pressure.",
"id": "10025044",
"label": "e",
"name": "Continue with current regime",
"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": "3701",
"name": "Hypertension",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3701,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17406",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 64-year-old female presents to the GP for a blood pressure review. She is currently taking amlodipine 10mg once a day. She is of African-Caribbean origin. Her blood pressure reading comes back as 151/96.\n\nWhat is the most appropriate next step in management?",
"sbaAnswer": [
"a"
],
"totalVotes": 165,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,220 | false | 17 | null | 6,495,176 | null | false | [] | null | 17,407 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is most likely to be having an aortic dissection. The definitive diagnostic investigation for an aortic dissection is a CT angiogram.",
"id": "10025049",
"label": "e",
"name": "CT head",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is most likely to be having an aortic dissection. A chest X-ray can be useful in ruling out other causes of his chest pain, but the definitive diagnostic investigation is a CT angiogram.",
"id": "10025047",
"label": "c",
"name": "Chest X-ray",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with symptoms of an aortic dissection- chest pain described as 'tearing' radiating to the back. He also has a background of hypertension and Marfan's syndrome (two important risk factors). Therefore, this patient requires a CT angiogram to confirm this diagnosis.",
"id": "10025045",
"label": "a",
"name": "CT angiogram",
"picture": null,
"votes": 142
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is most likely to be having an aortic dissection. The definitive diagnostic investigation for an aortic dissection is a CT angiogram.",
"id": "10025048",
"label": "d",
"name": "Blood pressure",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is most likely to be having an aortic dissection. An ECG can be useful in ruling out other causes of his chest pain, but the definitive diagnostic investigation is a CT angiogram.",
"id": "10025046",
"label": "b",
"name": "ECG",
"picture": null,
"votes": 9
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3707",
"name": "Aortic Dissection",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3707,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17407",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 60-year-old male presents to the emergency department with chest pain. He describes the pain as 'tearing' and radiating to his back. He has a past medical history of hypertension and Marfan's syndrome. On observation, his heart rate is 89, blood pressure 116/79 and oxygen saturations 93%.\n\nWhich investigation will confirm the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 166,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,221 | false | 18 | null | 6,495,176 | null | false | [] | null | 17,408 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Aortic stenosis is an ejection systolic murmur, rather than a pan-systolic murmur. It is heard best in the second intercostal space at the right sternal border. The patient in this question is therefore most likely to have mitral regurgitation.",
"id": "10025052",
"label": "c",
"name": "Aortic stenosis",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypertrophic obstructive cardiomyopathy would produce an ejection-systolic murmur, rather than a pan-systolic murmur. It would be heard best at the fourth intercostal space on the left sternal border.",
"id": "10025054",
"label": "e",
"name": "Hypertrophic obstructive cardiomyopathy",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Mitral Regurgitation is a pan-systolic murmur heard best in the fifth intercostal space at the mid-clavicular line.",
"id": "10025050",
"label": "a",
"name": "Mitral Regurgitation",
"picture": null,
"votes": 129
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Tricuspid regurgitation would also present as a pan-systolic murmur. However, this type of murmur would be found at the left sternal border of the fifth intercostal space, rather than in the mid-clavicular line. Therefore, the murmur in this question is most likely to be mitral regurgitation.",
"id": "10025051",
"label": "b",
"name": "Tricuspid regurgitation",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pulmonary stenosis is an ejection systolic murmur that is heard at the left sternal border of the second intercostal space. This is a pan-systolic murmur heard best in the fifth intercostal space at the mid-clavicular line, and is therefore more likely to be mitral regurgitation.",
"id": "10025053",
"label": "d",
"name": "Pulmonary stenosis",
"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": "5820",
"name": "Differentials of Pan-systolic murmur",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5820,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17408",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "You are called to conduct a cardiology examination on an 89-year-old female on the cardiology ward. On examination, you hear a pansystolic murmur at the fifth intercostal space in the mid -clavicular line.\n\nWhich of the following is the most likely cause of her murmur?",
"sbaAnswer": [
"a"
],
"totalVotes": 162,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,222 | false | 19 | null | 6,495,176 | null | false | [] | null | 17,409 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient describes episodes of cardiac-type chest pain that begins on exertion and is always relieved by rest. This is a description of stable angina.",
"id": "10025055",
"label": "a",
"name": "Stable Angina",
"picture": null,
"votes": 152
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Patients with unstable angina would experience symptoms when at rest. Symptoms of this would not be relieved by rest and occur at random. Therefore, this presentation is most likely to be caused by stable angina.",
"id": "10025056",
"label": "b",
"name": "Unstable angina",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient describes episodes of chest pain that begins on exertion and is always relieved by rest. This is most likely a presentation of stable angina. STEMI's would present with additional symptoms like pain radiating to the jaw, nausea and vomiting and shortness of breath.",
"id": "10025057",
"label": "c",
"name": "ST elevation myocardial infarction (STEMI)",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient describes episodes of chest pain that begins on exertion and is always relieved by rest. This is most likely a presentation of stable angina. NSTEMIs would present with additional symptoms like pain radiating to the jaw, nausea and vomiting and shortness of breath.",
"id": "10025059",
"label": "e",
"name": "Non-ST-elevation myocardial infarction (NSTEMI)",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient describes episodes of chest pain that begins on exertion and is always relieved by rest. This is most likely a presentation of stable angina.",
"id": "10025058",
"label": "d",
"name": "Anxiety",
"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": "3721",
"name": "Stable angina",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3721,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17409",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
"presentations": [],
"psaSectionId": null,
"qaAnswer": null,
"question": "A 70-year-old male presents to his GP complaining of episodes of central crushing chest pain. On further questioning, you find that he has had five episodes similar to this in the past last week, and the pain begins on exertion and is always relieved by rest.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 165,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.