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"__typename": "QuestionChoice",
"answer": false,
"explanation": "First-degree heart block would present on an ECG as a PR interval over 200ms. This ECG shows complete dissociation between P waves and QRS which is typical of third-degree heart block.",
"id": "10025063",
"label": "d",
"name": "First-degree heart block",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Mobitz type I heart block is a type of second-degree heart block commonly caused by a conduction system failure at the His-Purkinje system. An ECG will show increasingly prolonging PR intervals until there is a non-conducted P wave. The PR interval is longest just before the dropped beat, and then the cycle repeats again.",
"id": "10025061",
"label": "b",
"name": "Second-degree heart block Mobitz type I",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's ECG is typical of third-degree heart block, not a STEMI. A STEMI would show an elevated ST segment in a regional pattern on the ECG.",
"id": "10025064",
"label": "e",
"name": "ST-elevation myocardial infarction (STEMI)",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient's ECG describes third-degree heart block. Third degree heart block is classically described as complete dissociation between P waves and QRS complexes.",
"id": "10025060",
"label": "a",
"name": "Third-degree heart block",
"picture": null,
"votes": 147
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Mobitz type II heart block is a type of second-degree heart block where there is intermittent non-conducted P waves while the PR interval remains the same. This patient's ECG describes third-degree heart block. Third-degree heart block is classically described as complete dissociation between P waves and QRS complexes.",
"id": "10025062",
"label": "c",
"name": "Second-degree heart block Mobitz type II",
"picture": null,
"votes": 8
}
],
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"name": "Heart Block",
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"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
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"question": "A 40-year-old female presents to the emergency department with palpations for ten hours. An ECG shows complete dissociation between P waves and QRS complexes with a rate of 46.\n\nWhat is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 163,
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173,465,224 | false | 21 | null | 6,495,176 | null | false | [] | null | 17,411 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is presenting with the signs and symptoms of Cushing's syndrome. A fluid deprivation test would be the test of choice for diabetes insipidus. Diabetes insipidus would present with symptoms like excessive thirst and producing large amounts of urine.",
"id": "10025068",
"label": "d",
"name": "Fluid deprivation test",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The patient in the question is presenting with with central obesity, proximal weakness, depression and abdominal striae are typical of Cushing’s syndrome. A short synacthen test is the test of choice for adrenal sufficiency, not Cushing’s disease. Adrenal insufficiency would present with symptoms like hypotension, fatigue and weakness, gastrointestinal symptoms, and skin pigmentation.",
"id": "10025066",
"label": "b",
"name": "Short synacthen test",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a typical presentation of a patient with Cushing's syndrome: low mood, weight gain, proximal myopathy and abdominal striae. Cushing's syndrome can also cause a moon-shaped face, a \"buffalo hump\" on the back, diabetes mellitus and hypokalaemia. The diagnostic investigation of choice for Cushing’s syndrome is a dexamethasone suppression test.",
"id": "10025065",
"label": "a",
"name": "Dexamethasone suppression test",
"picture": null,
"votes": 139
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is presenting with Cushing's syndrome, and therefore a dexamethasone suppression test would be the diagnostic test of choice. You could conduct a HbA1c if you suspected diabetes mellitus, but the diagnosis of Cushing's Syndrome would be confirmed with a dexamethasone suppression test.",
"id": "10025069",
"label": "e",
"name": "HbA1c",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The patient in the question is presenting with with central obesity, proximal weakness, depression and abdominal striae are typical of Cushing’s syndrome. 24-hour plasma metanephrines would be the correct test if you suspected a pheochromocytoma. This would present with episodes of hypertension, anxiety and headaches. Therefore, the correct answer to this question is to conduct a dexamethasone suppression test.",
"id": "10025067",
"label": "c",
"name": "24-hour plasma metanephrines",
"picture": null,
"votes": 4
}
],
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"id": "3764",
"name": "Cushing's syndrome",
"status": null,
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"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
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"question": "A 19-year-old female presents to her GP with low mood. She describes experiencing weight gain, particularly around her abdomen, over the last six months despite attempts to loose weight. On examination, you notice weakness in all four proximal limbs, as well as circular hump on the back and a circular-shaped face.\n\nWhich of the following investigations would confirm the most likely diagnosis?",
"sbaAnswer": [
"a"
],
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173,465,225 | false | 22 | null | 6,495,176 | null | false | [] | null | 17,412 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Diabetic ketoacidosis requires there to be hyperglycaemia, i.e a blood glucose of 11mmol/L or above.",
"id": "10025073",
"label": "d",
"name": "Hyperglycaemia under 11mmol/L",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Diabetic ketoacidosis requires acidosis with a pH of less than 7.3, not more than 7.3. Other criteria include hyperglycaemia (a blood glucose over 11mmol/L) and ketosis (blood ketones above 3mmol/L).",
"id": "10025074",
"label": "e",
"name": "pH more than 7.3",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "To diagnose diabetic ketoacidosis, there are three criteria. First, there must be hyperglycaemia, i.e a blood glucose above 11mmol/L. Next, there must be blood ketones above 3mmol/L. Finally, there should be acidosis with a pH of less than 7.3.",
"id": "10025070",
"label": "a",
"name": "Hyperglycaemia over 11mmol/L",
"picture": null,
"votes": 136
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "To diagnose diabetic ketoacidosis, there are three criteria. First, there must be hyperglycaemia, i.e a blood glucose above 11mmolL, not under 20mmol/L. Next, there must be blood ketones above 3mmol/L and acidosis with a pH of less than 7.3.",
"id": "10025072",
"label": "c",
"name": "Hyperglycaemia under 20mmol/L",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Diabetic ketoacidosis requires the production of blood ketones to be above 3mmol/L, not below.",
"id": "10025071",
"label": "b",
"name": "Blood ketones under 3mmol/L",
"picture": null,
"votes": 4
}
],
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4005",
"name": "Diabetic ketoacidosis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
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"topicId": 133,
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"question": "An 18-year-old male is found unconscious by his parents after six hours of nausea and vomiting. His parents tell you he has been complaining of excessive thirst and passing urine more frequently for the last month. When you examine him, you notice a sweet acetone smell to his breath.\n\nWhich of the following is included in the diagnostic criteria for diabetic ketoacidosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 161,
"typeId": 1,
"userPoint": null
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173,465,226 | false | 23 | null | 6,495,176 | null | false | [] | null | 17,413 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's GCS is 7, not 4. She scores a 1 as she does not open her eyes, a 2 in verbal response (due to incomprehensible sounds) and a 4 in motor response.",
"id": "10025079",
"label": "e",
"name": "4",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient's GCS is 7. She scores a 1 for eye opening response as she does not open her eyes. She is making incomprehensible sounds, scoring a 2 for verbal response. She flexes to withdraw from pain, meaning she scores a 4 in motor response.",
"id": "10025075",
"label": "a",
"name": "7",
"picture": null,
"votes": 65
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's GCS is 7, not 6. She scores a 1 in eye opening response, a 2 in verbal response (due to incomprehensible sounds) and a 4 in motor response.",
"id": "10025077",
"label": "c",
"name": "6",
"picture": null,
"votes": 41
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's GCS is 7, not 8. She scores a 1 in eye opening response, a 2 in verbal response (due to incomprehensible sounds) and a 4 in motor response.",
"id": "10025076",
"label": "b",
"name": "8",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's GCS is 7, not 5. She scores a 1 in eye opening response, a 2 in verbal response (due to incomprehensible sounds) and a 4 in motor response.",
"id": "10025078",
"label": "d",
"name": "5",
"picture": null,
"votes": 17
}
],
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"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4108",
"name": "Glasgow Coma Scale (GCS)",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
"totalCards": null,
"typeId": null,
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"question": "A 90-year-old female is brought in to the emergency department after being found unconscious in her home. She does not open her eyes but is making incomprehensible sounds. She flexes to withdraw from pain.\n\nWhat is her Glasgow Coma Scale score?",
"sbaAnswer": [
"a"
],
"totalVotes": 160,
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173,465,227 | false | 24 | null | 6,495,176 | null | false | [] | null | 17,414 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient remains in status epilepticus despite two doses of IV lorazepam. Therefore, she requires a second-line treatment in the form of phenytoin.",
"id": "10025080",
"label": "a",
"name": "Phenytoin",
"picture": null,
"votes": 81
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is in status epilepticus and has already had two doses of lorazepam. This patient therefore requires a second-line treatment in the form of phenytoin.",
"id": "10025081",
"label": "b",
"name": "A further dose of lorazepam",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient requires a second-line drug for treatment of her status epilepticus. Sodium valproate would not be an appropriate drug to give in this scenario. This is for stabilising patients with epilepsy, not for use in the acute phase.",
"id": "10025083",
"label": "d",
"name": "Sodium valproate",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Midazolam can be given instead of lorazepam in the initial treatment of status epilepticus. It is usually given if there is no intravenous access as it can be given via the buccal route.",
"id": "10025082",
"label": "c",
"name": "Midazolam",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Diazepam can be given instead of lorazepam in the initial treatment of status epilepticus. It is usually given if there is no intravenous access as it can be given rectally.",
"id": "10025084",
"label": "e",
"name": "Diazepam",
"picture": null,
"votes": 29
}
],
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"demo": null,
"entitlement": null,
"id": "3749",
"name": "Epilepsy",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
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"question": "You are called to see a 17-year-old girl who has been having a seizure for nine minutes. She has been given two doses of IV lorazepam, but her seizures have not stopped.\n\nWhich of the following is the next best step in management?",
"sbaAnswer": [
"a"
],
"totalVotes": 160,
"typeId": 1,
"userPoint": null
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173,465,228 | false | 25 | null | 6,495,176 | null | false | [] | null | 17,415 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gastric cancer would present with symptoms such as persistent reflux, bloating and weight loss. This patient is more likely to be suffering from pancreatic cancer.",
"id": "10025088",
"label": "d",
"name": "Gastric Cancer",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Colorectal cancer would be an important diagnosis to exclude if the patient was over 60 and reported a change in bowel habit. However, this patient's symptoms are more suggestive of pancreatic cancer, so this would be the most important diagnosis to exclude.",
"id": "10025086",
"label": "b",
"name": "Colorectal Cancer",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Pancreatic cancer would be the most important diagnosis to exclude in this case. It presents with the classic symptoms of painless jaundice and a palpable gallbladder.",
"id": "10025085",
"label": "a",
"name": "Pancreatic cancer",
"picture": null,
"votes": 117
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "You would expect Gilbert’s syndrome to cause intermitted jaundice in relation to stress, infection or exercise. It would not account for the palpable gallbladder and therefore is not the most likely diagnosis in this case.",
"id": "10025089",
"label": "e",
"name": "Gilbert's syndrome",
"picture": null,
"votes": 36
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "You would expect pancreatitis to present with symptoms like epigastric pain radiating to the back, pain relived by sitting forward and associated symptoms like nausea and vomiting. Bloods may show an extremely high amylase level. This patient does not present with any pain, nausea or vomiting. Therefore, acute pancreatitis is not a likely diagnosis. This patient's symptoms are more likely to be due to pancreatic cancer.",
"id": "10025087",
"label": "c",
"name": "Acute pancreatitis",
"picture": null,
"votes": 5
}
],
"comments": [],
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"demo": null,
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"id": "3734",
"name": "Pancreatic Cancer",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
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"question": "A 40-year-old male presents to his GP with yellowing of his eyes. The GP conducts a thorough abdominal examination in which he notes a palpable gallbladder. The patient does not complain of any pain.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 161,
"typeId": 1,
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173,465,229 | false | 26 | null | 6,495,176 | null | false | [] | null | 17,416 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Omeprazole is not a cause of hypothyroidism. The most likely drug that has caused this patients symptoms is amiodarone.",
"id": "10025094",
"label": "e",
"name": "Omeprazole",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's symptoms are most likely to be caused by amiodarone. An important side effect of carbamazepine is agranulocytosis.",
"id": "10025092",
"label": "c",
"name": "Carbamazepine",
"picture": null,
"votes": 55
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Bisoprolol is not the most likely drug to have caused this patient's presentation. Amiodarone is most likely to be the cause of this patients symptoms as their symptoms are are suggestive of hypothyroidism. Bisoprolol can cause symptoms such as bradycardia, diarrhoea and erectile dysfunction.",
"id": "10025093",
"label": "d",
"name": "Bisoprolol",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Amiodarone is most likely to be the cause of this patients symptoms as they are suggestive of hypothyroidism. Amiodarone can also less commonly cause patients to present with hyperthyroidism.",
"id": "10025090",
"label": "a",
"name": "Amiodarone",
"picture": null,
"votes": 71
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Simvastatin is not the most likely cause of this patients symptoms. The most likely cause of this patients hypothyroidism is amiodarone. Simvastatin can cause symptoms such as arthralgia and muscle pain.",
"id": "10025091",
"label": "b",
"name": "Simvastatin",
"picture": null,
"votes": 5
}
],
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"id": "5821",
"name": "Metronidazole",
"status": null,
"topic": {
"__typename": "Topic",
"id": "223",
"name": "Antibiotic pharmacology",
"typeId": 7
},
"topicId": 223,
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"question": "A 55-year-old man attends his GP with constipation and tiredness. He also reports gaining some weight recently and feeling low in mood. His thyroid function tests show a high thyroid-stimulating hormone (TSH) and low T4.\n\nWhich of the following drugs is most likely to have caused this presentation?",
"sbaAnswer": [
"a"
],
"totalVotes": 157,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,230 | false | 27 | null | 6,495,176 | null | false | [] | null | 17,417 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An occlusion in the left circumflex artery would cause changes in leads I and aVL.",
"id": "10025097",
"label": "c",
"name": "Left circumflex artery",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The proximal left anterior descending artery would cause changed in leads V1-6 as well as leads I and AVL. The ECG changes in this question correlate to the right coronary artery.",
"id": "10025099",
"label": "e",
"name": "Proximal left anterior descending artery",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The ECG changes described represent an occlusion in the right coronary artery, not the right marginal artery.",
"id": "10025098",
"label": "d",
"name": "Right marginal artery",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An occlusion in the left anterior descending artery would cause changes in leads V1-V4.",
"id": "10025096",
"label": "b",
"name": "Left anterior descending artery",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "An occlusion in the right coronary artery correspond to leads II,III and aVF. These leads represent the inferior region of the heart.",
"id": "10025095",
"label": "a",
"name": "Right coronary artery",
"picture": null,
"votes": 129
}
],
"comments": [],
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"__typename": "Concept",
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"demo": null,
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"id": "4542",
"name": "Myocardial infarction and Acute Coronary Syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
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"question": "An 80-year-old male presents to the emergency department with central crushing chest pain. An ECG shows ST elevation in leads II,III and aVF.\n\nWhich coronary artery is the most likely site of occlusion?",
"sbaAnswer": [
"a"
],
"totalVotes": 152,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,231 | false | 28 | null | 6,495,176 | null | false | [] | null | 17,418 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cushing's disease would present with symptoms such as depression, proximal myopathy and central obesity. Furthermore, Cushing's disease would show a hypokalaemia, rather than hyperkalaemia. The patient in this question is more likely to have Addison's disease.",
"id": "10025101",
"label": "b",
"name": "Cushing's disease",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with the typical signs and symptoms of Addison's disease: fatigue, weakness, weight loss, bronze skin pigmentation, and low sodium and high potassium on blood results.",
"id": "10025100",
"label": "a",
"name": "Addison's disease",
"picture": null,
"votes": 121
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pheochromocytoma usually presents as episodes of hypertension, anxiety, palpitations headaches, as well as signs like tremor and hypertensive retinopathy.",
"id": "10025103",
"label": "d",
"name": "Pheochromocytoma",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Diabetes insipidus usually presents with producing large volumes of dilute urine, nocturia and excessive thirst.",
"id": "10025102",
"label": "c",
"name": "Diabetes Insipidus",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is presenting with the typical signs and symptoms of Addison's disease: fatigue, weakness, weight loss and bronze skin pigmentation. Blood tests also show a low sodium and high potassium which is typical of Addison's disease.",
"id": "10025104",
"label": "e",
"name": "Anxiety",
"picture": null,
"votes": 0
}
],
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"id": "3835",
"name": "Adrenal insufficiency and Addison's Disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
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"question": "A 23-year-old female presents to her GP with a one-month history of tiredness and weight loss. On closer inspection, you notice her skin looks bronze in colour. Her blood tests results show low sodium and high potassium levels.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 158,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,232 | false | 29 | null | 6,495,176 | null | false | [] | null | 17,419 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Yellow fever usually presents with a sudden onset fever, followed by a headache, muscle aches, vomiting and tiredness. This patient's symptoms fit more with a diagnosis of hepatitis.",
"id": "10025109",
"label": "e",
"name": "Yellow fever",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Infective endocarditis usually presents with a new heart murmur, fever, tachycardia and specific nail signs like splinter haemorrhages. This patient is more likely to have hepatitis given the position of his abdominal pain, his jaundice, and pale stools and dark urine.",
"id": "10025108",
"label": "d",
"name": "Infective endocarditis",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with classic symptoms of hepatitis: right upper quadrant pain, jaundice, dark urine and pale stools. Hepatitis A is the most common type of hepatitis in the world, but is quite rare in the UK.",
"id": "10025105",
"label": "a",
"name": "Hepatitis A",
"picture": null,
"votes": 136
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Malaria would be accompanied with symptoms such as fevers, headache, muscle aches and tiredness. This patient has more specific symptoms of right upper quadrant pain and jaundice which fits better with a diagnosis of hepatitis.",
"id": "10025107",
"label": "c",
"name": "Malaria",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Coeliac Disease is a possible differential for a presentation of abdominal pain and weight loss. However, this patient has a typical presentation of hepatitis with right upper quadrant pain, jaundice, pale stools and dark urine.",
"id": "10025106",
"label": "b",
"name": "Coeliac Disease",
"picture": null,
"votes": 8
}
],
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},
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"demo": null,
"entitlement": null,
"id": "4039",
"name": "Hepatitis viruses",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
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},
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"question": "A 25-year-old male presents to the emergency department with right upper quadrant pain for the last six hours. On further questioning, he tells you his urine has looked quite dark and his stools are pale. You notice yellowing of the eyes. On examination, he looks jaundice and has a temperature of 37.4 degree Celsius.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 155,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,233 | false | 30 | null | 6,495,176 | null | false | [] | null | 17,420 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "For a male with a suspected urinary tract infection, the correct treatment would be treatment with nitrofurantoin for seven days. A single dose of Nitrofurantoin is not enough.",
"id": "10025114",
"label": "e",
"name": "Single dose of nitrofurantoin",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This medication would not be an appopiate first-line choice for a urinary tract infection. Pivmecillinam may be an option there is no improvement with a first choice antimicrobial or if a first choice is not suitable.",
"id": "10025112",
"label": "c",
"name": "Pivmecillinam for three days",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with a suspected urinary tract infection. The correct treatment for a male with a suspected lower urinary tract infection is nitrofurantoin for seven days.",
"id": "10025110",
"label": "a",
"name": "Nitrofurantoin for seven days",
"picture": null,
"votes": 103
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The correct treatment for a male with a suspected lower urinary tract infection is nitrofurantoin for seven days, not five days.",
"id": "10025111",
"label": "b",
"name": "Nitrofurantoin for five days",
"picture": null,
"votes": 42
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is presenting with symptoms of a urinary tract infection. IV cephalosporin would be the appropriate management if the patient was presenting with symptoms of pyelonephritis, such as pyrexia and loin or flank tenderness.",
"id": "10025113",
"label": "d",
"name": "IV cephalosporin for five days",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
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"typeId": 7
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"demo": null,
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"id": "4613",
"name": "Urinary tract infection",
"status": null,
"topic": {
"__typename": "Topic",
"id": "162",
"name": "General practice",
"typeId": 5
},
"topicId": 162,
"totalCards": null,
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},
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"id": "17420",
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"question": "A 21-year-old male attends his GP with dysuria that began eight days ago. He also reports some increased urinary frequency and foul smelling urine. A urine dipstick is positive for nitrites and leucocytes. All other observations are within the normal range.\n\nWhich of the following is the most appropriate management?",
"sbaAnswer": [
"a"
],
"totalVotes": 155,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,234 | false | 31 | null | 6,495,176 | null | false | [] | null | 17,421 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gliclazide is an option in the management of diabetes. However, in order to be diagnosed with diabetes and to commence treatment, patients with no symptoms need to have to at least two separate HbA1c readings above 48mmol/mol a week apart. This patient therefore requires a second HbA1c in one weeks time to confirm a diagnosis.",
"id": "10025118",
"label": "d",
"name": "Commence gliclazide",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an asymptomatic patient with a HbA1c above diagnostic level. In order to be diagnosed with diabetes, this patient requires a second HbA1c reading above 48mmol/mol in one weeks time.",
"id": "10025117",
"label": "c",
"name": "Commence pioglitazone",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Diabetes can be diagnosed with a HbA1c greater than or equal to 48mmol/mol as long as the patient has symptoms of diabetes alongside this. However, this patient does not have any symptoms of diabetes and this reading was found incidentally. Therefore, this patient requires a repeat HbA1c in one weeks time in order to confirm a diagnosis of diabetes.",
"id": "10025115",
"label": "a",
"name": "Repeat HbA1c in 1 week",
"picture": null,
"votes": 132
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Diabetes can be diagnosed with a HbA1c greater than or equal to 48mmol/mol as long as the patient has symptoms of diabetes alongside this. However, this patient does not have any symptoms of diabetes. Therefore, this patient cannot be diagnosed based on this HbA1c reading. The HbA1c needs to be repeated in one weeks time to confirm diagnosis.",
"id": "10025119",
"label": "e",
"name": "Commence Insulin",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Diabetes can be diagnosed with a HbA1c greater than or equal to 48mmol/mol as long as the patient has symptoms of diabetes alongside this. However, this patient does not have any symptoms of diabetes and therefore cannot be diagnosed based on this one HbA1c reading.",
"id": "10025116",
"label": "b",
"name": "Commence metformin",
"picture": null,
"votes": 19
}
],
"comments": [
{
"__typename": "QuestionComment",
"comment": "Not sure if this is right but what different is it gonig to make to retake the HbA1c after 1 weeks when this value only really changes every 3 months due to the RBC turnover? If someone could clarify, that's be great :)",
"createdAt": 1703986813,
"dislikes": 0,
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"questionId": 17421,
"replies": [
{
"__typename": "QuestionComment",
"comment": "Completely agree",
"createdAt": 1708346033,
"dislikes": 0,
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"chapterId": 2693,
"demo": null,
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"id": "4058",
"name": "Diabetes Mellitus",
"status": null,
"topic": {
"__typename": "Topic",
"id": "167",
"name": "Endocrine physiology",
"typeId": 7
},
"topicId": 167,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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"dislikes": 0,
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"question": "A 30-year-old female is incidentally found to have an HbA1c of 58mmol/mol. She has no previous diagnosis of Type 2 diabetes. She does not report experiencing any polyuria or polydipsia.\n\nWhich of the following is the most appropriate next step?",
"sbaAnswer": [
"a"
],
"totalVotes": 156,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,235 | false | 32 | null | 6,495,176 | null | false | [] | null | 17,422 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Seizures that originate in the temporal lobe are associated with emotional disturbances such as sudden terror or déjà vu. Temporal lobe seizures can also involve auditory or olfactory hallucinations.",
"id": "10025124",
"label": "e",
"name": "Temporal lobe",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The seizure in this question is most likely to originate in the parietal lobe as this is most associated with sensory symptoms like numbness and weakness.",
"id": "10025123",
"label": "d",
"name": "Cerebellum",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Seizures that affect the occipital lobe of the brain are often associated with visual symptoms. This can include seeing flashes of colour or shapes before a seizure occurs.",
"id": "10025122",
"label": "c",
"name": "Occipital lobe",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The frontal lobe is associated with motor symptoms, including a type of seizure called a Jacksonian march. This is a seizure where shaking or tingling begins in one area of the body and gradually spreads its way to another area.",
"id": "10025121",
"label": "b",
"name": "Frontal Lobe",
"picture": null,
"votes": 48
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Seizures that originate in the Parietal Lobe can cause sensory symptoms such as numbness and weakness.",
"id": "10025120",
"label": "a",
"name": "Parietal lobe",
"picture": null,
"votes": 59
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"typeId": 7
},
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"demo": null,
"entitlement": null,
"id": "3749",
"name": "Epilepsy",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
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"question": "You are called to the neurology ward to review a 60-year-old male who has had a seizure. Before his seizure began, he complained of numbness and weakness in the right side of his body.\n\nIn which of the following brain regions did his seizure most likely originate?",
"sbaAnswer": [
"a"
],
"totalVotes": 154,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,236 | false | 33 | null | 6,495,176 | null | false | [] | null | 17,423 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Polymyalgia rheumatica would typically present with shoulder and hip girdle stiffness. It can also be associated with more systemic symptoms such as fever, anorexia, muscle pains and tiredness.",
"id": "10025129",
"label": "e",
"name": "Polymyalgia rheumatica",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cauda equina syndrome can cause bilateral sciatica symptoms, as well as other symptoms like perianal anaesthesia, urinary incontinence or sexual dysfunction. This would be an important differential to rule out in all patients with back pain. However, this is not the most likely diagnosis in this patient's case.",
"id": "10025126",
"label": "b",
"name": "Cauda equina syndrome",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Myeloma can present with back pain, but the patient describes the pain going down the back of his leg. This is more typical of sciatica.",
"id": "10025127",
"label": "c",
"name": "Multiple myeloma",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This clinical picture makes sciatica the most likely diagnosis in this patient. The unilateral shooting pain down the leg associated with tingling and weakness is typical of sciatica. Patients can often have back pain alongside this, but it is not typically as bad as the pain in their legs or feet.",
"id": "10025125",
"label": "a",
"name": "Sciatica",
"picture": null,
"votes": 143
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This option would be more likely with a history of trauma, such as involvement in a road traffic collision. This patient is more likely to be experiencing symptoms of sciatica.",
"id": "10025128",
"label": "d",
"name": "Vertebral fracture",
"picture": null,
"votes": 0
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"id": "2693",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4247",
"name": "Back Pain",
"status": null,
"topic": {
"__typename": "Topic",
"id": "146",
"name": "Rheumatology",
"typeId": 7
},
"topicId": 146,
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},
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"question": "A 25-year-old builder presents to the GP with leg pain for the last two months. He describes a unilateral shooting pain that travels down the back of his left leg below the knee. He also has pins and needles in this area.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 157,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,237 | false | 34 | null | 6,495,176 | null | false | [] | null | 17,424 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gout would also present with a single red, hot swollen joint. However, on joint fluid analysis gout would show negatively birefringent crystals that are needle-shaped, rather than rhomboid-shaped.",
"id": "10025131",
"label": "b",
"name": "Gout",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Rheumatoid arthritis can produce an inflammatory joint effusion that gives patients warm, swollen joints. These effusions would consist of mainly neutrophils and the gram-stain would be negative.",
"id": "10025134",
"label": "e",
"name": "Rheumatoid arthritis",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a typical presentation of pseudogout: a single red, hot swollen joint, most commonly affecting the wrist or the shoulder. Pseudogout causes rhomboid-shaped crystals that are positively birefringent to be seen on aspiration.",
"id": "10025130",
"label": "a",
"name": "Pseudogout",
"picture": null,
"votes": 125
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Paget's disease of the bone would usually present as an isolated rise in alkaline phosphatase (ALP) levels alongside bone pain. This description of a single hot and swollen joint with rhomboid-shaped crystals on joint fluid analysis is more typical of pseudogout.",
"id": "10025133",
"label": "d",
"name": "Paget's disease of the bone",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Septic arthritis will produce similar symptoms to the ones described: joint pain, swelling, redness and warmth. However, individuals with septic arthritis will be be systemically unwell and have a fever, tachycardic or be hypotensive. Additionally, the joint fluid analysis results are more suggestive of pseudogout.",
"id": "10025132",
"label": "c",
"name": "Septic arthritis",
"picture": null,
"votes": 5
}
],
"comments": [],
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"__typename": "Concept",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3905",
"name": "pseudogout",
"status": null,
"topic": {
"__typename": "Topic",
"id": "146",
"name": "Rheumatology",
"typeId": 7
},
"topicId": 146,
"totalCards": null,
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"question": "A 66-year-old male presents to his GP with a painful, swollen left knee. On examination, it feels hot to touch. Joint fluid analysis shows rhomboid-shaped crystals that are positively birefringent.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 155,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,238 | false | 35 | null | 6,495,176 | null | false | [] | null | 17,425 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Paget's disease of the bone would present as an isolated rise in ALP levels. It would not explain the low calcium or phosphate, or the rise in PTH levels. Therefore, it is not the most likely diagnosis in this case.",
"id": "10025136",
"label": "b",
"name": "Paget's disease of the bone",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Osteoporosis would produce normal bone profile results. It would not explain the low calcium or phosphate levels or the rise in PTH.",
"id": "10025138",
"label": "d",
"name": "Osteoporosis",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Osteomalacia is caused by low vitamin D levels and results in bone softening. Osteomalacia can cause normal or low levels of calcium or phosphate. It will cause a rise in the levels of alkaline phosphatase (ALP). It can cause normal or high levels of PTH.",
"id": "10025135",
"label": "a",
"name": "Osteomalacia",
"picture": null,
"votes": 53
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "If this patient was presenting with bony metastases, the bone profile would look slightly different. Bony metastases would cause high levels of calcium and ALP, and low levels of PTH. The phosphate levels would remain in range. The biochemical results in this question suggest a diagnosis of osteomalacia.",
"id": "10025137",
"label": "c",
"name": "Bony metastases",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Primary hyperparathyroidism will cause high levels of calcium, ALP and PTH. It will cause low phosphate levels. The biochemical results in this question suggest a diagnosis of osteomalacia.",
"id": "10025139",
"label": "e",
"name": "Primary hyperparathyroidism",
"picture": null,
"votes": 66
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"typeId": 7
},
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"demo": null,
"entitlement": null,
"id": "4117",
"name": "Osteomalacia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
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},
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"question": "A 20-year-old male comes into the GP for a routine blood test. He is found to have low calcium, low phosphate, low viatmin D levels, and high levels of parathyroid hormone (PTH).\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 155,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,239 | false | 36 | null | 6,495,176 | null | false | [] | null | 17,426 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Alendronic acid is an example of a bisphosphonate. Bisphosphonates can cause oesophagitis, oesophageal ulcers, dysphagia and dyspepsia. To reduce the risk of these side effects, there are guidelines surrounding these medications, including taking the tablets on an empty stomach and sitting upright for 30 minutes after taking these medications.",
"id": "10025140",
"label": "a",
"name": "Alendronic acid",
"picture": null,
"votes": 115
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Phenytoin would not cause the symptoms this patient is experiencing. The dyspepsia and dysphagia described is more likely to be a consequence of alendronic acid, a bisphosphonate.",
"id": "10025142",
"label": "c",
"name": "Phenytoin",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Amiodarone is a medication that can be used to treat atrial fibrillation. It would not cause the symptoms this patient is experiencing. However, amiodarone can cause hypothyroidism or hyperthyroidism, as well as corneal deposits and liver failure.",
"id": "10025141",
"label": "b",
"name": "Amiodarone",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The symptoms this patient is describing is not likely to be a result of ramipril. The dyspepsia and dysphagia described is more likely to be a consequence of alendronic acid, a bisphosphonate.",
"id": "10025143",
"label": "d",
"name": "Ramipril",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The symptoms this patient is describing is not likely to be a result of hydroxychloroquine. The dyspepsia and dysphagia described is more likely to be down to alendronic acid. Hydroxychloroquine can cause retinopathy or rashes, but dysphagia is not a known side effect of this medication.",
"id": "10025144",
"label": "e",
"name": "Hydroxychloroquine",
"picture": null,
"votes": 14
}
],
"comments": [],
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"__typename": "Concept",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5822",
"name": "Side effect of bisphosphonates",
"status": null,
"topic": {
"__typename": "Topic",
"id": "146",
"name": "Rheumatology",
"typeId": 7
},
"topicId": 146,
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},
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"question": "A 30-year-old female attends the GP with a 11-day history of dysphagia. On further questioning, she also describes having a burning sensation in her chest.\n\nWhich of the following medications is the most likely cause of her symptoms?",
"sbaAnswer": [
"a"
],
"totalVotes": 152,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,240 | false | 37 | null | 6,495,176 | null | false | [] | null | 17,427 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Wilson's disease would show a low serum ceruloplasmin and copper levels. Wilsons disease would not account for the high ALT.",
"id": "10025147",
"label": "c",
"name": "Wilson’s disease",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Alpha-1 antitrypsin deficiency is an inherited condition that causes lung emphysema and liver cirrhosis. You would expect patients to present with shortness of breath and a raised ALP on blood results.",
"id": "10025148",
"label": "d",
"name": "Alpha-1 antitrypsin deficiency",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is presenting with intermittent jaundice and a high bilirubin which makes a diagnosis of Gilbert's syndrome the most likely diagnosis.",
"id": "10025149",
"label": "e",
"name": "Hepatitis E",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Haemochromatosis is a disorder of iron metabolism where excessive iron builds up in the body and accumulates in the body. It is deposited in a number of sites including the liver, heart, joints, pancreas and skin. You would expect haemochromatosis to show deranged LFTs as well as a raised serum ferritin and raised transferrin saturation.",
"id": "10025146",
"label": "b",
"name": "Haemochromatosis",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with the signs and symptoms of Gilbert's syndrome. This condition causes intermitted episodes of jaundice which often occur due to stress, infection, fasting or exercise. Gilbert's syndrome will cause a raised bilirubin level in an otherwise normal set of bloods.",
"id": "10025145",
"label": "a",
"name": "Gilbert's syndrome",
"picture": null,
"votes": 124
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5823",
"name": "Gilbert's syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "136",
"name": "Gastroenterology",
"typeId": 7
},
"topicId": 136,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5823,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17427",
"isLikedByMe": null,
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"question": "A 17-year-old university student presents to the GP as he has noticed yellowing of the skin. On further questioning, he tells you this skin yellowing comes and goes. He undergoes blood tests which show a raised bilirubin. Alkaline phosphatase (ALP), alanine transaminase (ALT) and albumin are all within the normal range. He drinks two to three units of alcohol per week and his BMI is 21.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 154,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,241 | false | 38 | null | 6,495,176 | null | false | [] | null | 17,428 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A presentation of ankylosing spondylitis would normally describe back pain that gets better with exercise. It would not account for the rise in ALP levels, and therefore Paget's disease is a more likely diagnosis in this case.",
"id": "10025153",
"label": "d",
"name": "Ankylosing spondylitis",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with bone pain and an isolated rise in their ALP levels which is typical of a diagnosis of Paget's disease. Paget’s disease may also be diagnosed on X-ray where you may find osteolysis or an increase in bone size.",
"id": "10025150",
"label": "a",
"name": "Paget’s disease of the bone",
"picture": null,
"votes": 95
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "If the patient had osteoporosis, this would produce a normal bone profile and would not account for the raised ALP. Paget's disease is more likely to account for the biochemical findings in this patient.",
"id": "10025154",
"label": "e",
"name": "Osteoporosis",
"picture": null,
"votes": 42
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gout would normally present with a single red, hot and swollen joint. Gout would not account for a raise in ALP, so is not the most likely diagnosis in this case.",
"id": "10025152",
"label": "c",
"name": "Gout",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pseudogout would present as a single inflamed joint, and it usually affects the wrist or shoulder joints. It would not account for this patient’s high ALP, so is not the most likely diagnosis in this case.",
"id": "10025151",
"label": "b",
"name": "Pseudogout",
"picture": null,
"votes": 3
}
],
"comments": [],
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4617",
"name": "Paget's Disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "170",
"name": "Clinical Chemistry",
"typeId": 7
},
"topicId": 170,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17428",
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"question": "A 65-year-old female presents to the GP with bone pain that began eight months ago. A blood test reveals no abnormalities except for a raised alkaline phosphatase (ALP) level.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 154,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,242 | false | 39 | null | 6,495,176 | null | false | [] | null | 17,429 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with the typical symptoms of ankylosing spondylitis: back pain and stiffness worse in the morning that gets better with movement. This condition is also associated with anterior uveitis, which this patient experienced one month ago.",
"id": "10025155",
"label": "a",
"name": "Ankylosing Spondylitis",
"picture": null,
"votes": 97
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cauda equina syndrome would present with symptoms such as saddle anaesthesia, serve sudden onset back pain and urinary incontinence. This patient is more likely to have ankylosing spondylitis.",
"id": "10025156",
"label": "b",
"name": "Cauda equina syndrome",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Polymyalgia rheumatica would typically cause shoulder and hip girdle stiffness alongside some systemic symptoms such as fever, anorexia, weight loss and malaise. Normally, there would be raised inflammatory markers.",
"id": "10025157",
"label": "c",
"name": "Polymyalgia Rheumatica",
"picture": null,
"votes": 41
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's presentation is more typical of ankylosing spondylitis. The age and gender of this patient (a young man) also points towards this diagnosis.",
"id": "10025159",
"label": "e",
"name": "Mechanical back pain",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Paget's disease would present with bone pain and an isolated rise in alkaline phosphatase (ALP). It could also be picked up on X-ray where you may find osteolysis, increased bone size and sclerosis or pathological fractures.",
"id": "10025158",
"label": "d",
"name": "Paget’s disease of the bone",
"picture": null,
"votes": 3
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3911",
"name": "ankylosing spondylitis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "146",
"name": "Rheumatology",
"typeId": 7
},
"topicId": 146,
"totalCards": null,
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},
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"question": "A 20-year-old male presents to the GP with worsening back pain for the past ten months. He tells you the pain is worse in the morning, but gets better on exercise. You note he had an episode of anterior uveitis a month ago.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 153,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,243 | false | 40 | null | 6,495,176 | null | false | [] | null | 17,430 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "You would expect a tension headache to present as a bilateral, non-pulsatile headache. They can feel tight, like around the head. They are not associated with aura’s or photophobia, and therefore do not fit this woman’s symptoms.",
"id": "10025161",
"label": "b",
"name": "Tension headache",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cluster headaches present as unilateral headaches that are worse around the eye. They occur in attacks, or clusters over time. Patients would typically describe associated symptoms such as a bloodshot eye, rhinorrhea, lid swelling and facial flushing. The length of attacks is a lot shorter than migraines, typically lasting between 15 minutes and three hours.",
"id": "10025162",
"label": "c",
"name": "Cluster headache",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This classically presents as a temporal headache alongside jaw claudication (pain on chewing food) and scalp tenderness. It can also lead to blindness if not treated promptly. The patient may also describe a thickened tender temporal artery on examination. You should also look out for a patient with symmetrical proximal muscle weakness and oligoarthritis as giant cell arteritis is often associated with polymyalgia rheumatica.",
"id": "10025164",
"label": "e",
"name": "Giant cell arteritis",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a typical presentation of a migraine. The question describes a unilateral headache associated with photophobia and phonophobia. Migraines can last anything from four to 72 hours at a time. Episodes of migraine can be preceded by an aura, such as a visual aura, like in this patient, or can present with sensory symptoms like paraesthesia. Migraines can have various triggers, which include medications such as aspirin and naproxen and certain foods like cheese or chocolate.",
"id": "10025160",
"label": "a",
"name": "Migraine",
"picture": null,
"votes": 110
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This presents as short episodes of stabbing pain, affecting one side of the face, in the trigeminal nerve distribution. They are triggered by talking, eating or touching the face. The headache in this patient is not described as following the trigeminal nerve distribution, and no triggers are given that would indicate trigeminal neuralgia being the most likely diagnosis.",
"id": "10025163",
"label": "d",
"name": "Trigeminal Neuralgia",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5824",
"name": "Headache",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5824,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17430",
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"question": "A 37-year-old female attends the GP practice complaining of episodes of throbbing pain on the left side of her head. Before these episodes, her vision can go funny. The episodes can last from 10- 24 hours at a time. She has a past medical history of osteoarthritis and is currently taking naproxen.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 158,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,244 | false | 41 | null | 6,495,176 | null | false | [] | null | 17,431 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Schizotypal personality disorder is a personality disorder is characterized by bizarre or magical thinking. It causes individuals to have difficulty with social interactions.",
"id": "10025169",
"label": "e",
"name": "Schizotypal personality disorder",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is experiencing symptoms of acute stress reaction, which is a mental health condition that can occur up to a month after someone goes through a traumatic event.",
"id": "10025165",
"label": "a",
"name": "Acute stress reaction",
"picture": null,
"votes": 63
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "EUPD is characterized by individuals having sudden mood swings, unstable relationships, and an unstable sense of self and self-image. The patient in this question is experiencing symptoms of acute stress reaction after experiencing a traumatic event.",
"id": "10025168",
"label": "d",
"name": "Emotionally unstable personality disorder (EUPD)",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Post traumatic stress disorder can only be diagnosed when a person has symptoms for more than one month. Therefore, the correct answer to this question is acute stress reaction.",
"id": "10025166",
"label": "b",
"name": "Post-traumatic stress disorder",
"picture": null,
"votes": 88
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Bipolar disorder is diagnosed when someone has both a major depressive episode and an episode of mania or hypomania. Manic episodes involve elated mood or irritability, often involving people making dangerous decisions with little thought for consequences. The patient in this question is experiencing symptoms of acute stress reaction after experiencing a traumatic event.",
"id": "10025167",
"label": "c",
"name": "Bipolar Disorder",
"picture": null,
"votes": 0
}
],
"comments": [],
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},
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"demo": null,
"entitlement": null,
"id": "4067",
"name": "Anxiety, Obsessions and Stress Reactions (including OCD)",
"status": null,
"topic": {
"__typename": "Topic",
"id": "173",
"name": "Psychiatry",
"typeId": 5
},
"topicId": 173,
"totalCards": null,
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"userNote": null,
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"question": "A 25-year-old female presents to the GP with palpations and shortness of breath for the last two weeks. She describes several episodes of feeling hot and breathless before seeing vivid images. She says these episodes began after she was involved in a car crash two weeks ago.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 153,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,245 | false | 42 | null | 6,495,176 | null | false | [] | null | 17,432 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hyperosmolar hyperglycaemic state is a complication of untreated type 2 diabetes. Like DKA, it often presents with polyuria and polydipsia. It does not produce ketones, making it different to diabetic ketoacidosis.",
"id": "10025174",
"label": "e",
"name": "Hyperosmolar hyperglycaemic state (HHS)",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Thyrotoxicosis occurs when there is excess thyroid hormone action at the level of the tissues. The most common cause of this is Grave's disease. This patient is presenting with lots of the typical symptoms of thyrotoxicosis: weight loss, heat intolerance, tremor, palpitations, irritability and muscle weakness.",
"id": "10025170",
"label": "a",
"name": "Thyrotoxicosis",
"picture": null,
"votes": 101
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An Addisonian crisis is a severe presentation of Addison's disease when it is left untreated. It can present with symptoms such as dizziness, fainting, abdominal pain, depression and muscle weakness. Patients will often describe a bronze hyperpigmentation to the skin. The key biochemical finding of hyponatremia.",
"id": "10025172",
"label": "c",
"name": "Addisonian crisis",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypothyroidism would present with weight gain, rather than weight loss. It would also cause symptoms like lethargy, anhydrosis, constipation and in some patients menorrhagia.",
"id": "10025171",
"label": "b",
"name": "Hypothyroidism",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Diabetic ketoacidosis will often present with polyuria and polydipsia preceding unconsciousness. This patient is presenting with lots of the typical symptoms of thyrotoxicosis.",
"id": "10025173",
"label": "d",
"name": "Diabetic ketoacidosis (DKA)",
"picture": null,
"votes": 0
}
],
"comments": [],
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5825",
"name": "Hyperthyroidism",
"status": null,
"topic": {
"__typename": "Topic",
"id": "161",
"name": "Emergency Medicine",
"typeId": 5
},
"topicId": 161,
"totalCards": null,
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},
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"question": "A 50-year-old female is found collapsed in her home. She is found to have thin hair, and is hot and clammy to touch. Her wife tells you that she has lost some weight in the last month. On examination, you notice brisk reflexes and a heartrate of 144. A thyroid function test shows a low thyroid-stimulating hormone (TSH) and high T4.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 157,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,246 | false | 43 | null | 6,495,176 | null | false | [] | null | 17,433 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient has taken a staggered overdose, and therefore requires treatment with N-acetylcysteine.",
"id": "10025178",
"label": "d",
"name": "Take paracetamol levels at one hour after the second dose",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient has taken a staggered overdose, and therefore requires treatment with N-acetylcysteine.",
"id": "10025177",
"label": "c",
"name": "Take paracetamol levels at four hours after the second dose",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient has taken a staggered overdose, taking two doses over an hour apart. This means the patient should be treated with N-acetylcysteine. Other indications for N-acetylcysteine treatment include uncertainty over the timing of the overdose and the patient being unconscious.",
"id": "10025175",
"label": "a",
"name": "Give N-acetylcysteine",
"picture": null,
"votes": 116
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "IV fluids are not the most appropriate treatment for this patient. This patient has taken a staggered overdose, and therefore they require management with N-acetylcysteine.",
"id": "10025179",
"label": "e",
"name": "Give IV fluids",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Activated charcoal should only be given to patients who are less than an hour post-overdose and have taken more than 75mg/kg. This patient has taken a staggered overdose, and therefore requires treatment with N-acetylcysteine.",
"id": "10025176",
"label": "b",
"name": "Give activated charcoal",
"picture": null,
"votes": 14
}
],
"comments": [],
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"__typename": "Chapter",
"explanation": null,
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4620",
"name": "Paracetamol Overdose",
"status": null,
"topic": {
"__typename": "Topic",
"id": "161",
"name": "Emergency Medicine",
"typeId": 5
},
"topicId": 161,
"totalCards": null,
"typeId": null,
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"dislikes": 1,
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"question": "A 19-year-old male is brought into the emergency department by his flatmates after taking an overdose of paracetamol. He states that he took a total of 8g of paracetamol at around 6pm and another 6g of paracetamol an hour and a half later. It is now 9pm.\n\nWhich of the following is the most appropriate management of this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 158,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,247 | false | 44 | null | 6,495,176 | null | false | [] | null | 17,434 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A consequence of anorexia nervosa is hypercholesterolaemia, which is thought to be due to changes to metabolic pathways as a consequence of the conditon.",
"id": "10025182",
"label": "c",
"name": "Low cholesterol levels",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Anorexia nervosa causes the levels of sex hormones to decrease, so it would be typical to find low levels of testosterone, rather than high.",
"id": "10025184",
"label": "e",
"name": "High testosterone levels",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Anorexia nervosa causes the levels of growth hormone to increase, rather than decrease.",
"id": "10025183",
"label": "d",
"name": "Low growth hormone (GH) levels",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Anorexia nervosa causes low potassium levels, not high.",
"id": "10025181",
"label": "b",
"name": "Hyperkalaemia",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "A consequence of anorexia nervosa is low levels of lutenising hormone (LH) and FSH. It also causes lower levels of other sex hormones, including low oestrogen and testosterone levels.",
"id": "10025180",
"label": "a",
"name": "Low follicle stimulating hormone (FSH)",
"picture": null,
"votes": 84
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4469",
"name": "Anorexia nervosa",
"status": null,
"topic": {
"__typename": "Topic",
"id": "173",
"name": "Psychiatry",
"typeId": 5
},
"topicId": 173,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4469,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17434",
"isLikedByMe": null,
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"question": "A 17-year-old female patient is currently detained under the Mental Health Act with anorexia nervosa.\n\nWhich of the following is a consequence of anorexia nervosa?",
"sbaAnswer": [
"a"
],
"totalVotes": 152,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,248 | false | 45 | null | 6,495,176 | null | false | [] | null | 17,435 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would cause a viral meningitis, meaning the cerebral fluid analysis would show a high glucose and low protein content. This patient has a bacterial meningitis, and the most likely causative organism is *Neisseria meningitidis*.",
"id": "10025189",
"label": "e",
"name": "Coxsackie Virus A",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "*Listeria monocytogenes* causes infections in immunosuppressed patients and can be found in patients at the extremes of age. The patient in question is more likely to be caused by *Neisseria meningitidis*.",
"id": "10025187",
"label": "c",
"name": "*Listeria monocytogenes*",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with meningococcal disease. *Neisseria meningitidis* is the most likely causative organism. Typical features include fever, headache, neck stiffness and photophobia. The presence of a non-blanching rash indicates the infection has spread into the bloodstream.",
"id": "10025185",
"label": "a",
"name": "*Neisseria meningitidis*",
"picture": null,
"votes": 142
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Herpes simplex virus 2 would cause a viral meningitis, meaning the cerebral spinal fluid would show a high glucose and low protein. This patient has a bacterial meningitis, and the most likely causative organism is *Neisseria meningitidis*.",
"id": "10025188",
"label": "d",
"name": "Herpes simplex virus 2",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the most common cause of meningococcal sepsis in neonates, so is unlikely to be the cause of this patient's meningitis. The rash described in the question is more typical of *Neisseria meningitidis*, rather than Group B Streptococcus.",
"id": "10025186",
"label": "b",
"name": "Group B Streptococcus",
"picture": null,
"votes": 3
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3751",
"name": "Meningitis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
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},
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"question": "An 18-year-old female student presents to the GP with a fever. She also reports a headache and neck stiffness. On examination, she has a temperature of 39 degree Celsius and you notice a purpuric rash on her abdomen. Cerebral spinal fluid analysis shows low glucose levels, high protein levels and an increased white cell count.\n\nWhich of the following is the most likely causative organism?",
"sbaAnswer": [
"a"
],
"totalVotes": 155,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,249 | false | 46 | null | 6,495,176 | null | false | [] | null | 17,436 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "*Streptococcus viridans* is found in dental plaque and is a common cause of endocarditis in patients with poor dental hygiene. However, this patient is most likely to be colonised with *staph. epidermis* as he has had a prosthetic valve replacement a month ago.",
"id": "10025193",
"label": "d",
"name": "*Streptococcus viridans*",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The most common causative organism of infective endocarditis overall is *Staph. aureus*. However, this patient has had a prosthetic valve replacement a month ago and therefore is at risk of colonisation with *staph. epidermis*.",
"id": "10025191",
"label": "b",
"name": "*Staphylococcus aureus*",
"picture": null,
"votes": 79
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient has the typical findings of infective endocarditis: fevers (most common), weight loss, and chest pain. You may also find night sweats, muscle pains and lethargy as well as typical nail signs like splinter haemorrhages. The first two months after prosthetic valve surgery would put a patient at risk of infective endocarditis with *staph. epidermis*. Therefore, the most likely causative organism in this case is *staph. epidermis*.",
"id": "10025190",
"label": "a",
"name": "*Staphlococcus epidermis*",
"picture": null,
"votes": 50
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an uncommon cause of infective endocarditis and therefore is not the most likely causative organism of this patient’s infective endocarditis.",
"id": "10025194",
"label": "e",
"name": "*Coxiella burnetii*",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This organism is associated with colorectal cancer. The question gives us no indications the patient has colorectal cancer. Therefore, *strep. bovis* is not a likely cause of this patient's infective endocarditis.",
"id": "10025192",
"label": "c",
"name": "*Streptococcus bovis*",
"picture": null,
"votes": 6
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"id": "2693",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3710",
"name": "Infective Endocarditis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
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"userNote": null,
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},
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"question": "A 55-year-old male presents to the emergency department with a three-week history of fevers, weight loss and chest pain. On examination, there are splinter haemorrhages on his nails and macules on his palms consistent with janeway lesions. He had a prosthetic valve replacement one month ago.\n\nGiven the most likely diagnosis, which of the following is the most likely causative organism?",
"sbaAnswer": [
"a"
],
"totalVotes": 153,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,250 | false | 47 | null | 6,495,176 | null | false | [] | null | 17,437 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an excitatory neurotransmitter that interacts with nuclei in the midbrain during sleep. It does not control paralysis during sleep.",
"id": "10025198",
"label": "d",
"name": "Hypocretin",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This structure stabilizes the sleep-wake switch. It does not control paralysis during sleep.",
"id": "10025199",
"label": "e",
"name": "Hypothalamic orexin",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The suprachiasmatic nucleus controls the circadian rhythm, meaning it controls the regulation of sleep across 24 hours. Circadian rhythm is affected by both light and melatonin. It does not control paralysis during sleep.",
"id": "10025196",
"label": "b",
"name": "Suprachiasmatic nucleus",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This structure is located in the brainstem and is silenced during REM (rapid eye movement) atonia. The ventrolateral preorbital nucleus controls paralysis during sleep.",
"id": "10025197",
"label": "c",
"name": "Locus coeruleus",
"picture": null,
"votes": 56
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The ventrolateral preorbital nucleus is the structure in the brain responsible for paralysis during sleep.",
"id": "10025195",
"label": "a",
"name": "Ventrolateral preorbital nucleus",
"picture": null,
"votes": 44
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4310",
"name": "Phases of sleep",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
"totalCards": null,
"typeId": null,
"userChapter": null,
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},
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"difficulty": 1,
"dislikes": 0,
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"highlights": [],
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"question": "Which structure control paralysis during sleep?",
"sbaAnswer": [
"a"
],
"totalVotes": 148,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,251 | false | 48 | null | 6,495,176 | null | false | [] | null | 17,438 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Haloperidol is associated with a reduced seizure threshold, rather than an increased seizure threshold.",
"id": "10025203",
"label": "d",
"name": "Increased seizure threshold",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Haloperidol is a first-generation antipsychotic. Dystonia is a type of extra-pyramidal side effect that can occur with use of these medications. Other extra-pyramidal side effects include akathisia, parkinsonism and tardive dyskinesia.",
"id": "10025200",
"label": "a",
"name": "Dystonia",
"picture": null,
"votes": 53
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Agranulocytosis is more likely to occur with second-generation antipsychotics like clozapine. Haloperidol is more likely to cause side effects like dystonia and akathisia.",
"id": "10025201",
"label": "b",
"name": "Agranulocytosis",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Dyslipidaemia is a side effect more likely to occur with the use of second-generation antipsychotics like clozapine and olanzapine, not first-generation antipsychotics like haloperidol.",
"id": "10025204",
"label": "e",
"name": "Dyslipidaemia",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Weight gain is more likely to occur with second-generation antipsychotics like olanzapine, rather than first-generation antipsychotics like haloperidol.",
"id": "10025202",
"label": "c",
"name": "Weight gain",
"picture": null,
"votes": 45
}
],
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"question": "A 50-year-old female attends the GP for a medication review. She has recently been started on haloperidol by her psychiatrist.\n\nWhich of the following side effects is most likely to occur with this medication?",
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"a"
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173,465,252 | false | 49 | null | 6,495,176 | null | false | [] | null | 17,439 | {
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Generalised anxiety disorder would not normally present in this manner. It can cause symptoms such as feeling restless or worried a lot of the time, having trouble concentrating or physical symptoms like palpations and shortness of breath.",
"id": "10025206",
"label": "b",
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},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the most likely diagnosis in this patient. Although this condition is more common in women, it should not be ignored in the male population. Individuals often have unstable moods and difficulty in relationships.",
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"label": "a",
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "This often presents as intense fears of abandonment, excess reliance on caregivers and low self-esteem. They would find it difficult to make decisions or complete tasks without caregiver support.",
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"label": "d",
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"__typename": "QuestionChoice",
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"explanation": "Individuals with histrionic personality disorder often engage in attention-seeking behaviour, and can be flirtatious. The individual in this question is described as having a low self-esteem and unstable moods which fits in better with a diagnosis of emotionally unstable personality disorder. It is not common for these individuals to display self-harm or suicidal behaviours.",
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"label": "e",
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"__typename": "QuestionChoice",
"answer": false,
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"label": "c",
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"question": "A 24-year-old male presents to A+E after a paracetamol overdose. He reports a history of unstable relationships, and often alternates between isolating partners to believing 'they are the best thing to have ever happened to him'. He finds he can have difficulty controlling anger and acts impulsively.\n\nWhich of the following is the most likely diagnosis?",
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"a"
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173,465,253 | false | 50 | null | 6,495,176 | null | false | [] | null | 17,440 | {
"__typename": "QuestionSBA",
"choices": [
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "This section can be used by police to enter private premises and remove a person to a place of safety. This can last up to 24 hours. Because this patient is in A+E, the police can use a section 136 to detain this patient.",
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"label": "e",
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"votes": 28
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "A section 136 can be used by police to bring someone in from a public place if the police believe they are mentally unwell. This section can last up to 24hours, after which they should have a mental health act assessment. Because this patient is in A+E, this counts as a public place.",
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"label": "a",
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "A section 5(4) can be used by nurses and means they can detain an individual for six hours if they believe this individual is suffering from a mental disorder. However, this patient is in a public place (A+E), and therefore require a Section 136 by the police to be detained.",
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"label": "b",
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"__typename": "QuestionChoice",
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"explanation": "A Section 5(2) is used by doctors to detain a person for up to 72 hours. However, this patient is in a public place (A+E), and therefore require a Section 136 by the police to be detained.",
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"label": "c",
"name": "Section 5(2)",
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"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is in the emergency department which is classed as a public place, and therefore require a section 136 instead of a Section 5(3).",
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"label": "d",
"name": "Section 5(3)",
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}
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"a"
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173,465,395 | false | 1 | null | 6,495,183 | null | false | [] | null | 17,291 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
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},
{
"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
"answer": false,
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"id": "10024469",
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"name": "Site of transcription",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
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"label": "b",
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"votes": 2
}
],
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"question": "Which of the following describes a role of the golgi apparatus?",
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"a"
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"totalVotes": 42,
"typeId": 1,
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173,465,396 | false | 2 | null | 6,495,183 | null | false | [] | null | 17,292 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the quaternary structure of a protein.",
"id": "10024471",
"label": "b",
"name": "The three dimensional structure involving at least two polypeptides",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the primary structure of a protein.",
"id": "10024473",
"label": "d",
"name": "Specific sequence of amino acids",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This does not describe any stage of protein structure",
"id": "10024474",
"label": "e",
"name": "The R group of the amino acid is swapped for another",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The secondary structure of a protein involves formation of α-helixes and β-sheets using hydrogen bonds.",
"id": "10024470",
"label": "a",
"name": "Polypeptide chains forming α-helixes and β-sheets",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the tertiary structure of a protein.",
"id": "10024472",
"label": "c",
"name": "Specific hydrophobic interactions form a larger globular strcucture",
"picture": null,
"votes": 3
}
],
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"question": "Which of the following describes the secondary structure of a protein?",
"sbaAnswer": [
"a"
],
"totalVotes": 41,
"typeId": 1,
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} | MarksheetMark |
173,465,397 | false | 3 | null | 6,495,183 | null | false | [] | null | 17,293 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Transcription is catalysed by RNA polymerase, not translation.",
"id": "10024479",
"label": "e",
"name": "Translation is catalysed by RNA polymerase",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The tRNA anticodon is compelentary to the mRNA codon.",
"id": "10024477",
"label": "c",
"name": "The tRNA anticodon is identical to the mRNA codon",
"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Each tRNA molecule contains an amino acid. They join together in the correct order to form a polypeptide.",
"id": "10024475",
"label": "a",
"name": "tRNA molecules carry an amino acid",
"picture": null,
"votes": 33
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The AUG codon is the start codon.",
"id": "10024478",
"label": "d",
"name": "The AUG codon is the stop codon in translation",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "They are read as codons of three bases.",
"id": "10024476",
"label": "b",
"name": "The mRNA nucleotide bases are read as codons of four bases",
"picture": null,
"votes": 0
}
],
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"name": "Translation",
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"question": "Which of the following statements is true regarding translation?",
"sbaAnswer": [
"a"
],
"totalVotes": 39,
"typeId": 1,
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} | MarksheetMark |
173,465,398 | false | 4 | null | 6,495,183 | null | false | [] | null | 17,294 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The posterolateral fissure separates the posterior and flocculonodular lobes",
"id": "10024483",
"label": "d",
"name": "Posterolateral fissure separates the anterior and posterior lobes",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "It lies in the posterior cranial fossa of the skull.",
"id": "10024484",
"label": "e",
"name": "The cerebellum lies anatomically in the anterior cranial fossa of the skull",
"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The vermis is acutally in the midline of the cerebellum.",
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"label": "b",
"name": "The vermis describes the lateral aspect of the cerebellum",
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},
{
"__typename": "QuestionChoice",
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"explanation": "This is correct.",
"id": "10024480",
"label": "a",
"name": "Three paired peduncles connect the cerebellum to the brainstem",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The cerebellum is involved in coordinating smooth motor activities. Personality is predominantly controlled by the frontal lobe.",
"id": "10024482",
"label": "c",
"name": "The cerebellum is involved in determining personality",
"picture": null,
"votes": 3
}
],
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"question": "Which of the following statements is true regarding the cerebellum?",
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"a"
],
"totalVotes": 38,
"typeId": 1,
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} | MarksheetMark |
173,465,399 | false | 5 | null | 6,495,183 | null | false | [] | null | 17,295 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This hormone is produced by the pancreas, not the adrenal gland.",
"id": "10024488",
"label": "d",
"name": "Insulin",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This hormone is produced by the posterior pituitary gland, not the adrenal gland.",
"id": "10024486",
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"name": "Oxytocin",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This hormone is produced by the anterior pituitary gland, not the adrenal gland.",
"id": "10024487",
"label": "c",
"name": "Growth hormone",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The adrenal glands produce cortisol, aldosterone and androgens. Cortisol is the most commonly affected hormone in CAH.",
"id": "10024485",
"label": "a",
"name": "Cortisol",
"picture": null,
"votes": 33
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This hormone is produced by the thyroid gland, not the adrenal gland.",
"id": "10024489",
"label": "e",
"name": "Thyroxine",
"picture": null,
"votes": 0
}
],
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},
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"question": "A six-month-old baby boy has recently been diagnosed with congenital adrenal hyperplasia (CAH).\n\nWhich hormone is most likely to be deficient in this patient?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
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173,465,400 | false | 6 | null | 6,495,183 | null | false | [] | null | 17,296 | {
"__typename": "QuestionSBA",
"choices": [
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "The first stain is purple (the cyrstal violet stain). This is washed away, and then the sample is stained pink (the safranin or Carbol fuchsin stain).",
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"label": "c",
"name": "The bacteria is stained pink and then purple",
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},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gram-negative bacteria appear pink with gram-staining as the crystal violet-iodine purple stain is washed away from their cell wall, and they then turn pink with the counterstain.",
"id": "10024494",
"label": "e",
"name": "Gram-negative bacteria appear purple",
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},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "It is actually the cell wall that determines the staining of bacteria, and hence the colour of the bacteria.",
"id": "10024491",
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"name": "It is the cell membrane which determines the colour of the bacteria",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The first stain added in a gram stain is crystal violet stain, which will stain all of the bacteria present purple. Next, an iodine stain is added. The iodine forms a complex with the crystal violet stain to stabilise it. Thirdly, alcohol or acetone is added which will wash the crystal violet-iodine complex away from the gram-negative bacteria. Lastly, a safranin or Carbol fuchsin stain is added to stain the gram-negative bacteria pink.",
"id": "10024490",
"label": "a",
"name": "Iodine binds the crystal violet stain within the cell wall",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "It is actually either ethanol or acetone is used for decolourisation.",
"id": "10024493",
"label": "d",
"name": "Nitrofurantoin is used to decolourise the sample before the final stain is added",
"picture": null,
"votes": 5
}
],
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"id": "5780",
"name": "Gram-positive and Gram-negative bacteria classification",
"status": null,
"topic": {
"__typename": "Topic",
"id": "148",
"name": "Microbiology",
"typeId": 7
},
"topicId": 148,
"totalCards": null,
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"question": "Which of the following is true regarding the process of gram staining bacteria?",
"sbaAnswer": [
"a"
],
"totalVotes": 37,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,401 | false | 7 | null | 6,495,183 | null | false | [] | null | 17,297 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an example of a calcium channel blocker. The patient should be started on an ACE inhibitor or ARB as they have a diagnosis of diabetes.",
"id": "10024496",
"label": "b",
"name": "Amlodipine",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an example of a thiazide-like diuretic, which can be used as a second-line drug.",
"id": "10024497",
"label": "c",
"name": "Indapamide",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Whilst this may be appropriate to manage their diabetes, the question asks for a drug to manage their hypertension.",
"id": "10024498",
"label": "d",
"name": "Metformin",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is an example of an angiotensin-converting enzyme (ACE) inhibitor and this patient is a diabetic with stage 1 hypertension. NICE guidelines state that under 80s with diabetes and stage 1 hypertension should be considered for drug treatment, and an ACE inhibitor or angiotensin-receptor blocker (ARB) is first-line for this due to the presence of type 2 diabetes.",
"id": "10024495",
"label": "a",
"name": "Lisinopril",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This can be used as a further management option if the patient also has low blood potassium level.",
"id": "10024499",
"label": "e",
"name": "Spironolactone",
"picture": null,
"votes": 1
}
],
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"name": "Hypertension",
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"id": "134",
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"typeId": 7
},
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"question": "A 57-year-old white male comes to the GP for a health check. Their blood pressure is measured at 150/95, and this is confirmed with ambulatory blood pressure monitoring. The patient has a past medical history of type 2 diabetes and eczema.\n\nWhat drug would be a suitable first-line option for his hypertension?",
"sbaAnswer": [
"a"
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"totalVotes": 38,
"typeId": 1,
"userPoint": null
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173,465,402 | false | 8 | null | 6,495,183 | null | false | [] | null | 17,298 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a calcium-channel blocker. Common side effects include angioedema, dizziness and a dry mouth.",
"id": "10024501",
"label": "b",
"name": "Amlodipine",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a thiazide diuretic. Common side effects include constipation and hyperglycaemia.",
"id": "10024502",
"label": "c",
"name": "Bendroflumethiazide",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is an angiotensin-receptor blocker. They can cause an increased risk of infection.",
"id": "10024503",
"label": "d",
"name": "Candesartan",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Angiotensin-converting enzyme (ACE) inhibitors cause a dry cough in 10% of patients, and is a common reason for drug discontinuation.",
"id": "10024500",
"label": "a",
"name": "Ramipril",
"picture": null,
"votes": 33
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A side effect of this drug to be aware of is acute kidney injury.",
"id": "10024504",
"label": "e",
"name": "Spironolactone",
"picture": null,
"votes": 0
}
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"name": "ACE inhibitors",
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"question": "A patient has a review of a newly prescribed anti-hypertensive. Since beginning to take it they have developed a persistent dry cough and they would like to change medication.\n\nWhich anti-hypertensive is most likely to cause a dry cough?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
"userPoint": null
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173,465,403 | false | 9 | null | 6,495,183 | null | false | [] | null | 17,299 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Whilst hyperlipidaemia can contribute to atheroma formation, HDL cholesterol removes cholesterol from the blood and takes it back to the liver so is considered the 'good' cholesterol. Therefore, it is not as likely to contribute to atheroma formation.",
"id": "10024505",
"label": "a",
"name": "High levels of high-density lipoprotein (HDL) cholesterol",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypertension is a risk factor for atheroma formation due to physical stress on the arterial wall.",
"id": "10024508",
"label": "d",
"name": "Hypertension",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "People with diabetes are more likely to develop atherosclerosis for multiple reasons - one of which includes high blood glucose levels and the macrovascular complications of this.",
"id": "10024507",
"label": "c",
"name": "Diabetes mellitus",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The chance of atheroma formation increases as people get older.",
"id": "10024506",
"label": "b",
"name": "Increasing age",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a risk factor for atheroma formation for multiple reasons including hypertension and hyperglycaemia.",
"id": "10024509",
"label": "e",
"name": "Obesity",
"picture": null,
"votes": 4
}
],
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"name": "Atherosclerosis",
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"question": "During a clinic session, you are talking to a 23-year-old woman about her lifestyle and risk factors for health problems later in life. She mentions that she is particularly concerned about having a heart attack as her father has just had one.\n\nWhich of the following factors is least likely to contribute to atheroma formation?",
"sbaAnswer": [
"a"
],
"totalVotes": 37,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,404 | false | 10 | null | 6,495,183 | null | false | [] | null | 17,300 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In children, the thymus could be seen here. However, it regresses during puberty.",
"id": "10024512",
"label": "c",
"name": "Anterior mediastinum",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This contains the oesophagus and thoracic aorta.",
"id": "10024514",
"label": "e",
"name": "Posterior mediastinum",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This contains the heart and great vessels, and is the biggest part of the mediastinum.",
"id": "10024513",
"label": "d",
"name": "Middle mediastinum",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the region where gas exchange occurs within the lung.",
"id": "10024511",
"label": "b",
"name": "Lung parenchyma",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "At this age, the thymus gland will have reduced in size from childhood and so will only be found in the superior mediastinum.",
"id": "10024510",
"label": "a",
"name": "Superior mediastinum",
"picture": null,
"votes": 18
}
],
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"name": "Superior mediastinum",
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"question": "A 65-year-old male has a CT scan as it is suspected he has interstitial lung disease. The radiographer is testing your knowledge of thoracic anatomy and asks you the following question.\n\nIn which part of the thorax will the thymus be found in this man?",
"sbaAnswer": [
"a"
],
"totalVotes": 37,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,405 | false | 11 | null | 6,495,183 | null | false | [] | null | 17,301 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Baroreceptors respond to changes in blood pressure to ensure it remains at adequate levels. They do this by detecting stretch on the arterial wall.",
"id": "10024515",
"label": "a",
"name": "Blood pressure regulation",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is managed by chemoreceptors in the brain and blood vessels which measure the carbon dioxide levels in the blood.",
"id": "10024518",
"label": "d",
"name": "Controling rate of respiration",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is mainly regulated by the kidneys through the renin-angiotensin-aldosterone system.",
"id": "10024517",
"label": "c",
"name": "Sodium regulation",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is regulated in a feedback loop with Vitamin D and parathyroid hormone.",
"id": "10024516",
"label": "b",
"name": "Calcium regulation",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is regulated by vasopressin secretion from the posterior pituitary gland.",
"id": "10024519",
"label": "e",
"name": "Retention of water",
"picture": null,
"votes": 0
}
],
"comments": [],
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"id": "4219",
"name": "Baroreceptor reflex",
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"name": "Cardiovascular physiology",
"typeId": 7
},
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"question": "What is the role of the baroreceptor reflex?",
"sbaAnswer": [
"a"
],
"totalVotes": 37,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,406 | false | 12 | null | 6,495,183 | null | false | [] | null | 17,302 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes a class II anti-arrythmic such as bisoprolol.",
"id": "10024522",
"label": "c",
"name": "Competitive antagonist that blocks adrenaline and noradrenaline at beta receptors",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes a class I anti-arrythmic such as flecainide.",
"id": "10024521",
"label": "b",
"name": "Blocks sodium channels in cardiomyocytes to reduce velocity of action potentials",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes a class V anti-arrythmic.",
"id": "10024523",
"label": "d",
"name": "Unknown mechanism",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Amiodarone is a class III anti-arrythmic and this is the mechanism of action.",
"id": "10024520",
"label": "a",
"name": "Blocks potassium channels in atrioventricular cardiomyocytes",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes a class IV anti-arrythmic such as verapamil. Amiodarone has some of these effects, but it is not the primary action.",
"id": "10024524",
"label": "e",
"name": "Disrupts the movement of calcium through calcium channels",
"picture": null,
"votes": 7
}
],
"comments": [],
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"id": "5781",
"name": "Class III anti-arrythmics: Potassium-channel blockers",
"status": null,
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"name": "Cardiovascular pharmacology",
"typeId": 7
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"question": "What is the primary mechanism of amiodarone?",
"sbaAnswer": [
"a"
],
"totalVotes": 37,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,407 | false | 13 | null | 6,495,183 | null | false | [] | null | 17,303 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the PR interval.",
"id": "10024528",
"label": "d",
"name": "Time taken for conduction to pass through the AV node",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the T wave.",
"id": "10024529",
"label": "e",
"name": "Ventricular repolarisation",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the QRS complex.",
"id": "10024526",
"label": "b",
"name": "Ventricular depolarisation",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the QT interval.",
"id": "10024527",
"label": "c",
"name": "Time between ventricular depolarisation and repolarisation",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "On an ECG, the p wave is representative of the electrical signal caused by depolarisation of the atria.",
"id": "10024525",
"label": "a",
"name": "Atrial depolarisation",
"picture": null,
"votes": 36
}
],
"comments": [],
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"name": "ECG",
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"typeId": 7
},
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},
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"question": "Describe the physiological basis of P wave on an ECG",
"sbaAnswer": [
"a"
],
"totalVotes": 37,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,408 | false | 14 | null | 6,495,183 | null | false | [] | null | 17,304 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the normal physiological movement of blood in an adult so does not require a duct in foetal life.",
"id": "10024532",
"label": "c",
"name": "Move blood right atrium to right ventricle",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the role of the foramen ovale.",
"id": "10024531",
"label": "b",
"name": "Move blood from the right to left atrium",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the role of the ductus arteriosus. It should close functionally in the first 12-24 hours of life, and anatomically by the first two to three weeks of life.",
"id": "10024530",
"label": "a",
"name": "Moves blood from the pulmonary artery to the aorta",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This should not occur and, if seen, it is usually due to a ventricular-septal defect.",
"id": "10024534",
"label": "e",
"name": "Move blood from right ventricle to left ventricle",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the role of the ductus venosus.",
"id": "10024533",
"label": "d",
"name": "Allows blood in the umbilical vein to bypass the liver",
"picture": null,
"votes": 2
}
],
"comments": [],
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"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4579",
"name": "Patent Ductus arteriosus",
"status": null,
"topic": {
"__typename": "Topic",
"id": "153",
"name": "Paediatrics",
"typeId": 7
},
"topicId": 153,
"totalCards": null,
"typeId": null,
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"question": "During the six to eight week newborn check, a baby is found to have a continuous murmur and is diagnosed with patent ductus arteriosus.\n\nWhat is the role of the ductus arteriosus in foetal circulation?",
"sbaAnswer": [
"a"
],
"totalVotes": 37,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,409 | false | 15 | null | 6,495,183 | null | false | [] | null | 17,305 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This contributes to the yolk sac, amnion and chorion.",
"id": "10024537",
"label": "c",
"name": "Extra-embryonic mesoderm",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Along with the heart, the mesoderm also forms the bones and limbs.",
"id": "10024535",
"label": "a",
"name": "Mesoderm",
"picture": null,
"votes": 31
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This forms the nervous system and sensory organs.",
"id": "10024536",
"label": "b",
"name": "Neural ectoderm",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This contributes to the epidermis.",
"id": "10024538",
"label": "d",
"name": "Surface ectoderm",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This forms the abdominal organs and lungs.",
"id": "10024539",
"label": "e",
"name": "Endoderm",
"picture": null,
"votes": 4
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3818",
"name": "Primitive development of the heart",
"status": null,
"topic": {
"__typename": "Topic",
"id": "171",
"name": "Embryology",
"typeId": 7
},
"topicId": 171,
"totalCards": null,
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"qaAnswer": null,
"question": "Which embryological tissue forms the heart?",
"sbaAnswer": [
"a"
],
"totalVotes": 37,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,410 | false | 16 | null | 6,495,183 | null | false | [] | null | 17,306 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This supplies the inferior region of the heart.",
"id": "10024541",
"label": "b",
"name": "Right coronary artery",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This artery also supplies the septal region of the heart.",
"id": "10024540",
"label": "a",
"name": "Left anterior descending artery",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a branch of the left coronary artery.",
"id": "10024544",
"label": "e",
"name": "Left marginal artery",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This supplies the lateral region of the heart.",
"id": "10024542",
"label": "c",
"name": "Left circumflex artery",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a branch of the right coronary artery,, which supplies the inferior region of the heart.",
"id": "10024543",
"label": "d",
"name": "Posterior interventricular artery",
"picture": null,
"votes": 0
}
],
"comments": [],
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"__typename": "Concept",
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"demo": null,
"entitlement": null,
"id": "3792",
"name": "Coronary blood flow",
"status": null,
"topic": {
"__typename": "Topic",
"id": "159",
"name": "Cardiovascular physiology",
"typeId": 7
},
"topicId": 159,
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"question": "Which artery mainly supplies the anterior region of the heart?",
"sbaAnswer": [
"a"
],
"totalVotes": 37,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,411 | false | 17 | null | 6,495,183 | null | false | [] | null | 17,307 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is one of the four main types of cardiomyopathy.",
"id": "10024547",
"label": "c",
"name": "Hypertrophic",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is not a type of cardiomyopathy, but in tako-tsubo cardiomyopathy, apical ballooning can be seen.",
"id": "10024545",
"label": "a",
"name": "Apical",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is one of the four main types of cardiomyopathy.",
"id": "10024548",
"label": "d",
"name": "Arrhythmogenic right ventricular cardiomyopathy",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is one of the four main types of cardiomyopathy.",
"id": "10024549",
"label": "e",
"name": "Dilated",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is one of the four main types of cardiomyopathy.",
"id": "10024546",
"label": "b",
"name": "Restrictive",
"picture": null,
"votes": 0
}
],
"comments": [],
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"__typename": "Concept",
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5782",
"name": "Cardiomyopathies",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
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},
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"question": "Which of the following is NOT a type of cardiomyopathy>",
"sbaAnswer": [
"a"
],
"totalVotes": 37,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,412 | false | 18 | null | 6,495,183 | null | false | [] | null | 17,308 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "They have a reduced eGFR and evidence this has been ongoing for over three months.",
"id": "10024551",
"label": "b",
"name": "This patient does not have chronic kidney disease",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In Stage 2, the eGFR would be between 60 and 89.",
"id": "10024552",
"label": "c",
"name": "Stage 2",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In stage 3a, the eGFR would be between between 45 and 59.",
"id": "10024554",
"label": "e",
"name": "Stage 3a",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In stage 4, the eGFR would be between between 15 and 29.",
"id": "10024553",
"label": "d",
"name": "Stage 4",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct. The eGFR of this stage is between 30 and 44.",
"id": "10024550",
"label": "a",
"name": "Stage 3b",
"picture": null,
"votes": 18
}
],
"comments": [],
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"demo": null,
"entitlement": null,
"id": "3753",
"name": "Chronic kidney disease",
"status": null,
"topic": {
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"id": "142",
"name": "Nephrology",
"typeId": 7
},
"topicId": 142,
"totalCards": null,
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"question": "A 74-year-old patient presents to hospital with tibial fracture and is found to have anaemia and an eGFR of 43. You look back on their records and find they had another reduced eGFR four months ago.\n\nWhat stage of chronic kidney disease does this patient have?",
"sbaAnswer": [
"a"
],
"totalVotes": 36,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,413 | false | 19 | null | 6,495,183 | null | false | [] | null | 17,309 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes an organ which was originally intraperitoneal but become retroperitoneal as the foetus develops.",
"id": "10024556",
"label": "b",
"name": "Secondary retroperitoneal",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the area below the peritoneum, and includes the bladder and final part of the rectum.",
"id": "10024558",
"label": "d",
"name": "Subperitoneal",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This can be used to describe a full bladder when it extends between the abdominal wall and peritoneum.",
"id": "10024559",
"label": "e",
"name": "Preperitoneal",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes organs which are completely wrapped in visceral peritoneum.",
"id": "10024557",
"label": "c",
"name": "Intraperitoneal",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This means the organ developed and remained outside the parietal peritoneum.",
"id": "10024555",
"label": "a",
"name": "Primary retroperitoneal",
"picture": null,
"votes": 29
}
],
"comments": [],
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"demo": null,
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"id": "4082",
"name": "Intraperitoneal and retroperitoneal organs",
"status": null,
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"id": "197",
"name": "Abdominal anatomy",
"typeId": 7
},
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},
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"question": "Which of the following anatomical terms is the kidney classified as?",
"sbaAnswer": [
"a"
],
"totalVotes": 36,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,414 | false | 20 | null | 6,495,183 | null | false | [] | null | 17,310 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This connects the spleen to the left kidney.",
"id": "10024564",
"label": "e",
"name": "Splenorenal ligament",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the ligament connecting the bladder and pelvic floor in men, not women.",
"id": "10024561",
"label": "b",
"name": "Puboprostatic ligament",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This ligaments connects the bony pelvis and vertebral column.",
"id": "10024562",
"label": "c",
"name": "Sacrotuberous ligament",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The pubovesical ligament is a continuation of the detrusor muscle and adventitia which anchors the bladder to the pelvic floor.",
"id": "10024560",
"label": "a",
"name": "Pubovesical ligament",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This connects the liver and stomach.",
"id": "10024563",
"label": "d",
"name": "Gastrohepatic ligament",
"picture": null,
"votes": 0
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5783",
"name": "Urinary bladder",
"status": null,
"topic": {
"__typename": "Topic",
"id": "308",
"name": "Pelvic anatomy",
"typeId": 7
},
"topicId": 308,
"totalCards": null,
"typeId": null,
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"userNote": null,
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},
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"question": "Which ligament anchors the neck of the bladder to the pelvic floor in females?",
"sbaAnswer": [
"a"
],
"totalVotes": 36,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,415 | false | 21 | null | 6,495,183 | null | false | [] | null | 17,441 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a collection of fat in the posterior aspect of the kidney.",
"id": "10025217",
"label": "c",
"name": "Paranephric fat",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a layer of extraperitoneal fat immediately surrounding the renal capsule.",
"id": "10025215",
"label": "a",
"name": "Perinephric fat",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This layer covers the perinephric fat and fuses with layers of the abdominal wall.",
"id": "10025216",
"label": "b",
"name": "Renal fascia",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a structure found inside the kidney.",
"id": "10025219",
"label": "e",
"name": "Renal papilla",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This covers the anterior and posterior surfaces of the kidney.",
"id": "10025218",
"label": "d",
"name": "Fibrous capsule",
"picture": null,
"votes": 11
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5332",
"name": "Kidneys",
"status": null,
"topic": {
"__typename": "Topic",
"id": "197",
"name": "Abdominal anatomy",
"typeId": 7
},
"topicId": 197,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17441",
"isLikedByMe": null,
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"likes": 0,
"multiAnswer": null,
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"psaSectionId": null,
"qaAnswer": null,
"question": "What is the layer found immediately outside the renal capsule?",
"sbaAnswer": [
"a"
],
"totalVotes": 36,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,416 | false | 22 | null | 6,495,183 | null | false | [] | null | 17,442 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a function of the kidney. The functions can be remembered by the mnemonic A WET BED.\n\nAcid-base balance\nWater balance\nElectrolyte balance\nToxin removal\nBlood pressure control\nErythropoiesis\nD- Vitamin D metabolism",
"id": "10025222",
"label": "c",
"name": "Digestion of macromolecules",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a function of the kidney. The functions can be remembered by the mnemonic A WET BED.\n\nAcid-base balance\nWater balance\nElectrolyte balance\nToxin removal\nBlood pressure control\nErythropoiesis\nD- Vitamin D metabolism",
"id": "10025224",
"label": "e",
"name": "Production of sex hormones",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a function of the kidney. The functions can be remembered by the mnemonic A WET BED.\n\nAcid-base balance\nWater balance\nElectrolyte balance\nToxin removal\nBlood pressure control\nErythropoiesis\nD- Vitamin D metabolism",
"id": "10025223",
"label": "d",
"name": "Produce and store bile",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a function of the kidney. Clotting factors are produced by the liver. The functions can be remembered by the mnemonic A WET BED.\n\nAcid-base balance\nWater balance\nElectrolyte balance\nToxin removal\nBlood pressure control\nErythropoiesis\nD- Vitamin D metabolism",
"id": "10025221",
"label": "b",
"name": "Regulate blood clotting",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Correct. This is a function of the kidney. The functions can be remembered by the mnemonic A WET BED.\n\nAcid-base balance\nWater balance\nElectrolyte balance\nToxin removal\nBlood pressure control\nErythropoiesis\nD- Vitamin D metabolism",
"id": "10025220",
"label": "a",
"name": "Blood pressure control",
"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": "5332",
"name": "Kidneys",
"status": null,
"topic": {
"__typename": "Topic",
"id": "197",
"name": "Abdominal anatomy",
"typeId": 7
},
"topicId": 197,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
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"question": "Which of the following is a function of the kidney?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
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} | MarksheetMark |
173,465,417 | false | 23 | null | 6,495,183 | null | false | [] | null | 17,443 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Capillaries in this area come together to form the efferent arteriole and is where the filtrate is formed.",
"id": "10025227",
"label": "c",
"name": "Glomerulus",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the outer layer enclosing the kidney.",
"id": "10025229",
"label": "e",
"name": "Renal fascia",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
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"id": "10025225",
"label": "a",
"name": "Inner 1/3 of cortex and medulla",
"picture": null,
"votes": 28
},
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"__typename": "QuestionChoice",
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"explanation": "This is supplied by interlobar arteries.",
"id": "10025228",
"label": "d",
"name": "Renal capsule",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is supplied by interlobular/peritubular capillaries.",
"id": "10025226",
"label": "b",
"name": "Outer 2/3 of renal cortex",
"picture": null,
"votes": 5
}
],
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"name": "Kidneys",
"status": null,
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"typeId": 7
},
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"question": "Which part of the microanatomy of the kidney does the vasa recta supply?",
"sbaAnswer": [
"a"
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"totalVotes": 36,
"typeId": 1,
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} | MarksheetMark |
173,465,418 | false | 24 | null | 6,495,183 | null | false | [] | null | 17,314 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "It causes dilation of afferent arterioles and constriction of efferent arterioles.",
"id": "10024583",
"label": "d",
"name": "It causes dilation of efferent arterioles within the kidney",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "ANP is released from atrial cells in response to stretching of the right atrium.",
"id": "10024580",
"label": "a",
"name": "ANP is released in response to an increased venous pressure",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ANP increases glomerular filtration rate by dilating the afferent arterioles and constricting the efferent arterioles.",
"id": "10024581",
"label": "b",
"name": "ANP decreases glomerular filtration rate within the kidney",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Increased ANP leads to decreased renin.",
"id": "10024584",
"label": "e",
"name": "Increased ANP leads to increased renin",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "ANP is released from heart muscle cells in response to stretching of the right atrium.",
"id": "10024582",
"label": "c",
"name": "Cells in the adrenal medulla release ANP",
"picture": null,
"votes": 0
}
],
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"id": "5785",
"name": "Effect of ANP on the kidney",
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"name": "Renal Physiology",
"typeId": 7
},
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"question": "Which of the following is true regarding atrial natriuretic peptide (ANP)?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,419 | false | 25 | null | 6,495,183 | null | false | [] | null | 17,315 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the first-line treatment for a non-pregnant woman over the age of 16.",
"id": "10024585",
"label": "a",
"name": "Nitrofurantoin for three days",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the correct first-line drug, but the length of use would apply to pregnant women or males. Non-pregnant women can have a shorter course of three days.",
"id": "10024586",
"label": "b",
"name": "Nitrofurantoin for seven days",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be suitable for a lower UTI in children.",
"id": "10024589",
"label": "e",
"name": "Cefalexin for three days",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be suitable for a catheter-associated UTI.",
"id": "10024588",
"label": "d",
"name": "Amoxicillin for seven days",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a second-line option if the first line treatment does not show improvement in symptoms",
"id": "10024587",
"label": "c",
"name": "Fosfomycin 3g single dose sachet",
"picture": null,
"votes": 0
}
],
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"id": "4613",
"name": "Urinary tract infection",
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"typeId": 5
},
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"question": "A 19-year-old non-pregnant woman presents to the GP with dysuria. After further history taking, they are diagnosed with a lower urinary tract infection (UTI).\n\nWhat would be the most appropriate antibiotic regime to give to this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 36,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,420 | false | 26 | null | 6,495,183 | null | false | [] | null | 17,316 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a symptom you would expect to see in an uncomplicated lower urinary tract infection.",
"id": "10024593",
"label": "d",
"name": "Foul smelling urine",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a symptom you would expect to see in an uncomplicated lower urinary tract infection.",
"id": "10024591",
"label": "b",
"name": "Increased urinary frequency",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Whilst this is seen in pyelonephritis, it is also seen in uncomplicated lower urinary tract infection.",
"id": "10024592",
"label": "c",
"name": "Urine dipstick is positive for leucocytes and nitrites",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is suggestive of pyelonephritis as a lower urinary tract infection is more likely to cause just suprapubic pain.",
"id": "10024590",
"label": "a",
"name": "Loin pain",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a symptom you would expect to see in an uncomplicated lower urinary tract infection.",
"id": "10024594",
"label": "e",
"name": "Suprapubic tenderness",
"picture": null,
"votes": 4
}
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"question": "A 250-year-old pregnant woman presents to the GP with fever, urgency and dysuria. It is suspected that they have pyelonephritis and they are admitted to hospital.\n\nWhich of the following would make you most suspicious of pyelonephritis instead of a lower urinary tract infection?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,421 | false | 27 | null | 6,495,183 | null | false | [] | null | 17,317 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes what occurs during S phase.",
"id": "10024599",
"label": "e",
"name": "DNA duplicates for 4 to 6 hours",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes what happens during prophase.",
"id": "10024598",
"label": "d",
"name": "The chromosomes within the cell condense",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This describes what occurs during anaphase.",
"id": "10024595",
"label": "a",
"name": "Contraction of spindle fibres pull chromatids to opposite poles",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes what occurs during prometaphase.",
"id": "10024597",
"label": "c",
"name": "Nuclear membrane breaks down",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes what occurs during telophase.",
"id": "10024596",
"label": "b",
"name": "A membrane forms around the chromosomes",
"picture": null,
"votes": 0
}
],
"comments": [],
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"id": "5786",
"name": "Cell cycle",
"status": null,
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"typeId": 7
},
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"question": "Which of these best describes anaphase?",
"sbaAnswer": [
"a"
],
"totalVotes": 37,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,422 | false | 28 | null | 6,495,183 | null | false | [] | null | 17,318 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the correct frequency, but incorrect age group for routine screening in the UK.",
"id": "10024603",
"label": "d",
"name": "Women aged between 30 and 70 every 3 years",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the correct age group, but incorrect frequency of routine screening in the UK. Screening should occur every three years.",
"id": "10024602",
"label": "c",
"name": "Women aged between 50 and 70 years, every 5 years",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Women in this group can request screening but it will not be routinely offered.",
"id": "10024601",
"label": "b",
"name": "Women over 70, every 3 years",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not correct. Routine screening is offered to women aged 50-70 years every three years.",
"id": "10024604",
"label": "e",
"name": "No screening is offered routinely in the UK",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the age group and frequency women are offered routine breast screening in the UK. Women will be invited to have a mammogram of their breasts.",
"id": "10024600",
"label": "a",
"name": "Women aged between 50 and 70 years, every 3 years",
"picture": null,
"votes": 26
}
],
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"demo": null,
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"id": "3779",
"name": "Breast Cancer",
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"__typename": "Topic",
"id": "151",
"name": "Breast Disease",
"typeId": 7
},
"topicId": 151,
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"question": "In the UK, at what age is breast cancer screening routinely offered?",
"sbaAnswer": [
"a"
],
"totalVotes": 36,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,423 | false | 29 | null | 6,495,183 | null | false | [] | null | 17,319 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a common side effect of ferrous sulphate.",
"id": "10024606",
"label": "b",
"name": "Headache",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a common side effect of ferrous sulphate. Patients may also report that their stools look black.",
"id": "10024605",
"label": "a",
"name": "Constipation",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a common side effect of ferrous sulphate.",
"id": "10024609",
"label": "e",
"name": "Palpitations",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a common side effect of ferrous sulphate.",
"id": "10024607",
"label": "c",
"name": "Postural hypotension",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not a common side effect of ferrous sulphate.",
"id": "10024608",
"label": "d",
"name": "Hyperglycaemia",
"picture": null,
"votes": 3
}
],
"comments": [],
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"id": "3794",
"name": "Iron deficiency anaemia",
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"name": "Haematology",
"typeId": 7
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"question": "A 25-year-old female patient presents with tiredness. Following blood tests, she is diagnosed with iron deficiency anaemia. She is prescribed ferrous sulphate as treatment for this.\n\nWhich of the following is the most likely side effect of ferrous sulphate?",
"sbaAnswer": [
"a"
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"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,424 | false | 30 | null | 6,495,183 | null | false | [] | null | 17,320 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "M0 indicates they have no distant metastasis.",
"id": "10024614",
"label": "e",
"name": "They may have a lung metastasis",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "T1 is the smallest size and T4 is significantly bigger. Hence, T1 has a better prognosis than T4.",
"id": "10024612",
"label": "c",
"name": "T4 has a better prognosis than T1",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is indicated by T3. The T refers to the size and extent of the tumour.",
"id": "10024610",
"label": "a",
"name": "The tumour has extended into subserosa of colon",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "It indicates the size of the tumour and how far it has invaded the bowel wall. N represents nodes whilst M represents metastases.",
"id": "10024611",
"label": "b",
"name": "T describes the shape of the tumour",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "N1 indicates they have at four or more regional lymph nodes affected.",
"id": "10024613",
"label": "d",
"name": "At least six region lymph nodes have evidence of spread",
"picture": null,
"votes": 1
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"entitlement": null,
"id": "4239",
"name": "Colorectal Cancer",
"status": null,
"topic": {
"__typename": "Topic",
"id": "135",
"name": "General surgery",
"typeId": 7
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"topicId": 135,
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"question": "A 56-year-old male is diagnosed colon cancer and TNM staging is used for classification. It is found that they have T3, N1, M0 colon cancer.\n\nWhich of the following is true?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
"userPoint": null
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173,465,425 | false | 31 | null | 6,495,183 | null | false | [] | null | 17,321 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the definition of a sarcoma.",
"id": "10024615",
"label": "a",
"name": "Malignant tumour arising in connective or other non-epithelial tumour",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes an adenocarcinoma.",
"id": "10024616",
"label": "b",
"name": "Malignant tumour arising in glandular tissue",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the process of dysplasia.",
"id": "10024617",
"label": "c",
"name": "Pre-cancerous area with abnormal cells and increased cell division",
"picture": null,
"votes": 2
},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes a papilloma.",
"id": "10024619",
"label": "e",
"name": "Benign epithelial tumour growing exophytically",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes an adenoma.",
"id": "10024618",
"label": "d",
"name": "Benign tumour arising in glandular tissue",
"picture": null,
"votes": 2
}
],
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"id": "5787",
"name": "Benign and malignant tumours",
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"id": "182",
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"question": "Which of the following describes a sarcoma?",
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173,465,426 | false | 32 | null | 6,495,183 | null | false | [] | null | 17,322 | {
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{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Three copies of the defective gene leads to symptomatic haemoglobin H disease.",
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"label": "a",
"name": "Microcytic anaemia, haemolysis and splenomegaly",
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"__typename": "QuestionChoice",
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"label": "c",
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},
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"__typename": "QuestionChoice",
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"explanation": "This describe what happens in sickle cell disease.",
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"label": "e",
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"explanation": "This would be more likely with four copies of the gene, as this is the most serious phenotype.",
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"label": "b",
"name": "Hydrops fetalis",
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},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Thalassaemia causes microcytic anaemia, not macrocytic anaemia.",
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"label": "d",
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"a"
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173,465,427 | false | 33 | null | 6,495,183 | null | false | [] | null | 17,323 | {
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"__typename": "QuestionChoice",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The O group undergoes autosomal recessive inheritance.",
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"label": "b",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There are actually over 400 blood groups.",
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"label": "c",
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"explanation": "They are expressed on the surface of red blood cells.",
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"label": "d",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "They can recieve blood from A and O.",
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"label": "e",
"name": "People with blood group A can recieve blood from A and AB",
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"question": "Which of the following is true?",
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"a"
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173,465,428 | false | 34 | null | 6,495,183 | null | false | [] | null | 17,324 | {
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{
"__typename": "QuestionChoice",
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"explanation": "This ligament connects the left colic flexure to the diaphragm and supports the spleen.",
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"label": "c",
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{
"__typename": "QuestionChoice",
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"explanation": "This contains the short gastric and gastro-omental vessels.",
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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173,465,429 | false | 35 | null | 6,495,183 | null | false | [] | null | 17,325 | {
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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173,465,430 | false | 36 | null | 6,495,183 | null | false | [] | null | 17,326 | {
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"__typename": "QuestionChoice",
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{
"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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173,465,431 | false | 37 | null | 6,495,183 | null | false | [] | null | 17,327 | {
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"__typename": "QuestionChoice",
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},
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"__typename": "QuestionChoice",
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"explanation": "Of the 20 standard amino acids, nine are referred to as the \"essential\" amino acids. This means that they must be obtained through the diet.",
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}
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173,465,432 | false | 38 | null | 6,495,183 | null | false | [] | null | 17,328 | {
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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},
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"__typename": "QuestionChoice",
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"explanation": "This is the role of a chylomicron. They are large triglyceride-rich lipoproteins with a central lipid core.",
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"name": "Transports cholesterol from the small intestine to the liver and adipose tissue",
"picture": null,
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},
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"__typename": "QuestionChoice",
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"explanation": "This explains what can happen to intermediate-density lipoproteins (IDLs).",
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"votes": 1
}
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173,465,433 | false | 39 | null | 6,495,183 | null | false | [] | null | 17,329 | {
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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"label": "d",
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"__typename": "QuestionChoice",
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"explanation": "The costotransverse joint is the joint between the facet of the tubercle of the rib and the adjacent transverse process of a thoracic vertebra. It is a plane joint that allows gliding movements.",
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"label": "a",
"name": "Tubercle of the rib and the transverse process of the corresponding vertebra",
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"explanation": "This describes the costovertebral joint.",
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"label": "b",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the costotransverse ligament.",
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"label": "e",
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173,465,435 | false | 41 | null | 6,495,183 | null | false | [] | null | 17,331 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the partial pressure of oxygen in inspired air.",
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"label": "b",
"name": "21.2",
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"votes": 6
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the partial pressure of carbon dioxide in expired air.",
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"label": "c",
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{
"__typename": "QuestionChoice",
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"explanation": "This is the partial pressure of oxygen in the arteries.",
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"label": "e",
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"__typename": "QuestionChoice",
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"explanation": "The partial pressure of oygen in the air that is inspired is about 21.2. The alveoli subtract oxygen to use in respiration, but they do not use all of it. When air is expired, the partial pressure is now about 15.5.",
"id": "10024665",
"label": "a",
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{
"__typename": "QuestionChoice",
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"explanation": "This is the partial pressure of carbon dioxide in inspired air.",
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173,465,436 | false | 42 | null | 6,495,183 | null | false | [] | null | 17,332 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This supplies all of the intrinsic muscles of the larynx, except the cricothyroid muscles. It also supplies sensation to the larynx below the level of the vocal cords.",
"id": "10024672",
"label": "c",
"name": "Recurrent laryngeal nerve",
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"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This supplies the infrahyoid muscles.",
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"label": "e",
"name": "Ansa Cervicalis",
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"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This innervates the diaphragm.",
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"label": "d",
"name": "Phrenic nerve",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "It is supplied by the external branch of the superior laryngeal nerve.",
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"label": "b",
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"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The cricothyroid muscle is supplied by the external branch of the superior laryngeal nerve.",
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"label": "a",
"name": "External branch of the superior laryngeal nerve",
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"votes": 15
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"a"
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are the other type of cells within the alveolus, but they do not produce surfactant. They are the site of gas exchange in the lungs.",
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"label": "b",
"name": "Type I pneumocytes",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a type of white blood cell responsible for mediating the immune response.",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The salivary glands produce saliva, as well as secreting lipases and amylases.",
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"label": "c",
"name": "Salivary glands",
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"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These secrete oil in the skin.",
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"label": "d",
"name": "Sebaceous gland",
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"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Surfactant is produced by type II pneumocytes. Surfactant is important for reducing the surface tension of the lungs and preventing collapse of the airways.",
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"label": "a",
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"a"
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173,465,438 | false | 44 | null | 6,495,183 | null | false | [] | null | 17,334 | {
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"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This supplies the transverse colon.",
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"label": "b",
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This supplies the sigmoid colon.",
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"label": "d",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This supplies the descending colon.",
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"label": "c",
"name": "Left colic artery",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This supplies the middle portion of the rectum.",
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"label": "e",
"name": "Middle rectal artery",
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},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The ascending colon is supplied by the right colic artery, which is a branch of the superior mesenteric artery.",
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"label": "a",
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],
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Some types of diarrhoea may be due to bacteria, but loperamide is not an antibiotic.",
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"label": "d",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of racecadotril and it decreases excessive secretion of water. It has been found to be better tolerated than loperamide as it causes less flatulence and constipation, especially in children.",
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{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "It does this by acting on opioid receptors.",
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Many people with diarrhoea require oral rehydration therapy but this is not the role of loperamide.",
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"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of stimulant laxatives such as senna.",
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"label": "e",
"name": "Increase intestinal motility",
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}
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173,465,440 | false | 46 | null | 6,495,183 | null | false | [] | null | 17,336 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Blood sugar control is largerly mediated by the pancreas releasing glucagon and insulin.",
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"label": "b",
"name": "Blood sugar control",
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{
"__typename": "QuestionChoice",
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"explanation": "C cells in the thyroid gland releases calcitonin which lowers serum calcium.",
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{
"__typename": "QuestionChoice",
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"explanation": "The thyroid gland does not have a dominant role in blood pressure control.",
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"__typename": "QuestionChoice",
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"explanation": "This is mainly managed by the kidneys through the renin-angiotensin-aldosterone system (RAAS).",
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is mainly carried out by enzymes produced by the pancreas.",
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"question": "Which of the following is a function of the thyroid gland?",
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"a"
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173,465,441 | false | 47 | null | 6,495,183 | null | false | [] | null | 17,337 | {
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{
"__typename": "QuestionChoice",
"answer": false,
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},
{
"__typename": "QuestionChoice",
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},
{
"__typename": "QuestionChoice",
"answer": false,
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"__typename": "QuestionChoice",
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"explanation": "This describes a neutrophil.",
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},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This describes the role of basophils and mast cells.",
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}
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173,465,442 | false | 48 | null | 6,495,183 | null | false | [] | null | 17,338 | {
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"choices": [
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"__typename": "QuestionChoice",
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"__typename": "QuestionChoice",
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"explanation": "Alpha 1 antitrypsin decreases excessive activity of neutrophil elastase.",
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is true for emphysema, not chronic bronchitis.",
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"__typename": "QuestionChoice",
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cigarrette smoke has a role in both chronic bronchitis and emphysema.",
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"label": "d",
"name": "Cigarette smoke only contributes to chronic bronchitis types of COPD",
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}
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"id": "3902",
"name": "COPD",
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"topic": {
"__typename": "Topic",
"id": "132",
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"typeId": 7
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"question": "Which of the following is true regarding chronic obstructive pulmonary disorder (COPD) pathophysiology?",
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"a"
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173,465,443 | false | 49 | null | 6,495,183 | null | false | [] | null | 17,339 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Oxybutynin is an antimuscarinic which is not associated with hypotension.",
"id": "10024705",
"label": "a",
"name": "Hypotension",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oxybutynin is an antimuscarinic which are known to cause a dry mouth.",
"id": "10024708",
"label": "d",
"name": "Dry mouth",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oxybutynin is an antimuscarinic which is known to cause diarrhoea.",
"id": "10024706",
"label": "b",
"name": "Diarrhoea",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oxybutynin is an antimuscarinic which are known to cause dizziness.",
"id": "10024709",
"label": "e",
"name": "Dizziness",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oxybutynin is an antimuscarinic which are known to cause headaches.",
"id": "10024707",
"label": "c",
"name": "Headache",
"picture": null,
"votes": 3
}
],
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"name": "Antimuscarinic agents",
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"question": "Oxybutynin (an anti-muscarinic) is given to a 75-year-old male patient to improve symptoms of urinary incontinence.\n\nWhat side effect is this medication LEAST likely to cause?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
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173,465,444 | false | 50 | null | 6,495,183 | null | false | [] | null | 17,340 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is why pain occurs in inflammation.",
"id": "10024713",
"label": "d",
"name": "Stimulation of nerve endings",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Inflamamtion leads to vasodilation as this allows immune cells to leave the vessels to enter tissues. This leads to increased blood flow, which causes redness.",
"id": "10024710",
"label": "a",
"name": "Inflammation leads to vasodilation",
"picture": null,
"votes": 33
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In inflammation, there is increased blood flow, not decreased.",
"id": "10024714",
"label": "e",
"name": "Decreased blood flow",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is one of the hallmarks of inflammation, but does not cause the redness.",
"id": "10024711",
"label": "b",
"name": "Increase in temperature",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is why swelling occurs in inflammation.",
"id": "10024712",
"label": "c",
"name": "Increased vessel permeability",
"picture": null,
"votes": 1
}
],
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"name": "Hallmarks of inflammation",
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"question": "Which of the following statements best explains why redness occurs in inflammation?",
"sbaAnswer": [
"a"
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173,465,445 | false | 1 | null | 6,495,184 | null | false | [] | null | 17,444 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes a focal seizure involving the left temporal lobe. Common signs of a frontal lobe seizure include contralateral motor symptoms, post-ictal weakness and Jacksonian march (clonic movements travelling proximally). By contrast, lip-smacking, language deficits and unusual epigastric sensations are more suggestive of a temporal lobe seizure.",
"id": "10025231",
"label": "b",
"name": "Left frontal lobe",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes a focal seizure involving the left temporal lobe. As this woman is right-handed, the most likely localisation would be in the left hemisphere of the brain. In right-handed individuals, language and speech centres are typically located in the left hemisphere. The lip-smacking, language deficits and unusual epigastric sensation are consistent with a temporal lobe seizure localisation. The temporal lobe is often associated with processing visceral and emotional experiences, and orofacial automatisms. By contrast, symptoms of occipital lobe seizures include visual hallucinations, uncontrolled eye movements and flashes, as the primary visual cortex is located in the occipital lobe.",
"id": "10025234",
"label": "e",
"name": "Right occipital lobe",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes a focal seizure involving the left temporal lobe. As the primary visual cortex is located in the occipital lobe, symptoms of occipital lobe seizures include visual hallucinations, uncontrolled eye movements and flashes. By contrast, lip-smacking, language deficits and unusual epigastric sensations are more suggestive of a temporal lobe seizure.",
"id": "10025232",
"label": "c",
"name": "Left occipital lobe",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. This vignette describes a focal seizure involving the left temporal lobe. In right-handed individuals, language and speech centres are typically located in the left hemisphere. This suggests a left-sided seizure location in this patient. The lip-smacking, language deficits and unusual epigastric sensation are consistent with a temporal lobe seizure localisation: this region is associated with processing visceral and emotional experiences, as well as orofacial automatisms.",
"id": "10025230",
"label": "a",
"name": "Left temporal lobe",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes a focal seizure involving the left temporal lobe. Common signs of a frontal lobe seizure include contralateral motor symptoms, post-ictal weakness and Jacksonian march (clonic movements travelling proximally). By contrast, lip-smacking, language deficits and unusual epigastric sensations are more suggestive of a temporal lobe seizure.",
"id": "10025233",
"label": "d",
"name": "Right temporal lobe",
"picture": null,
"votes": 10
}
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"id": "3749",
"name": "Epilepsy",
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"name": "Neurology",
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"question": "A 60 year old woman is reviewed in a neurology clinic after experiencing three 'funny turns' in the last month. She describes a rising feeling in her stomach, after which she goes 'blank' for around one minute. She does not fall to the floor, and has had no incontinence or tongue biting (her daughter reports vigorous lip movements during the episodes.) The patient does not recall what has happened and remains confused for a few minutes. \n\nShe is usually fit and well, takes no regular medications, and does not smoke or drink alcohol. She is right-handed.\n\n\nNeurological examination is normal, and all observations are within normal limits.\n\n\nWhich of the following brain regions is most likely implicated in this patient's presentation?",
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"a"
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173,465,446 | false | 2 | null | 6,495,184 | null | false | [] | null | 17,445 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Myasthenia gravis is also an autoimmune condition characterised by muscle weakness. However, in myasthenia gravis the muscle weakness is classically fatigable, and facial muscle and extraocular muscle involvement is common. Furthermore, it is not typically proceeded by an infectious illness. Deep tendon reflexes are typically normal or even increased in myasthenia gravis. Guillain-Barré Syndrome is therefore a more likely diagnosis.",
"id": "10025238",
"label": "d",
"name": "Spinal cord injury",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "LEMS is primarily an autoimmune disorder that affects neuromuscular junctions by inhibiting the release of acetylcholine. It is often associated with an underlying malignancy; most commonly small-cell lung cancer. The absence of red-flag symptoms such as weight loss, and no reference to respiratory symptoms, makes malignancy less likely in this case. Deep tendon reflexes are typically normal or even increased in LEMS. Guillain-Barré Syndrome is therefore a more likely diagnosis.",
"id": "10025237",
"label": "c",
"name": "Lambert-Eaton Myasthenic Syndrome (LEMS)",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Viral myositis is inflammation of the muscles caused by a viral infection. It is often associated with significant muscle pain, tenderness and swelling, which the patient did not mention. In contrast, the primary symptom described in this case is acute muscle weakness. Hyporeflexia is also not characteristic of viral myositis. Guillain-Barré Syndrome is therefore a more likely diagnosis.",
"id": "10025239",
"label": "e",
"name": "Viral myositis",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. GBS is an autoimmune disorder characterised by demyelinating polyneuropathy, often occurring after an infection. Campylobacter is a common precipitating infection, as indicated by the diarrhoeal illness in this case. In GBS, muscle weakness typically starts in the lower limbs and may ascend to involve the upper limbs and even the respiratory muscles in severe cases. It is typically symmetrical, and weakness ascends rapidly over days to weeks. Deep tendon reflexes are often decreased or absent (areflexia or hyporeflexia), due to damage of the myelin sheath.",
"id": "10025235",
"label": "a",
"name": "Guillain-Barré Syndrome (GBS)",
"picture": null,
"votes": 58
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Myasthenia gravis is also an autoimmune condition characterised by muscle weakness. However, in myasthenia gravis the muscle weakness is classically fatigable, and facial muscle and extraocular muscle involvement is common. Furthermore, it is not typically proceeded by an infectious illness. Deep tendon reflexes are typically normal or even increased in myasthenia gravis. Guillain-Barré Syndrome is therefore a more likely diagnosis.",
"id": "10025236",
"label": "b",
"name": "Myasthenia gravis",
"picture": null,
"votes": 1
}
],
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},
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"demo": null,
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"id": "4388",
"name": "Guillain-Barré Syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
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"explanation": "Guillain-Barré Syndrome (GBS)",
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"question": "A 46-year-old man presents to his GP with progressive muscle weakness, starting in his feet and moving up his legs to mid-thigh, with tingling in both legs and weakness now also in his arms. The weakness is constant and does not vary throughout the day.\n\nHe is usually healthy, on no regular medications, with no unintentional weight change or smoking history. However the patient notes he did experience a diarrhoeal illness around a week before the weakness first began.\n\n\nUpon examination, power is reduced bilaterally in the upper and lower limbs. Deep tendon reflexes of the lower limbs are also reduced bilaterally. Cranial nerve exam is unremarkable.\n\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
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"totalVotes": 65,
"typeId": 1,
"userPoint": null
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173,465,447 | false | 3 | null | 6,495,184 | null | false | [] | null | 17,446 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This advice violates the DVLA regulations. Once diagnosed with epilepsy, one is legally required to inform the DVLA and stop driving immediately. Driving normally must cease for 12 months from the date of the most recent seizure.",
"id": "10025243",
"label": "d",
"name": "Advise the teenager to inform the DVLA only if they experience a seizure while driving",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. In the UK, it is a legal requirement to inform the DVLA about a diagnosis of epilepsy. This is because epilepsy can impact a person's ability to drive safely and may pose a risk to both the individual and other road users. Upon an epilepsy diagnosis, one must not drive and must notify the DVLA. Driving normally must cease for 12 months from the date of the most recent seizure.",
"id": "10025240",
"label": "a",
"name": "Advise the teenager to immediately inform the DVLA about the epilepsy diagnosis",
"picture": null,
"votes": 64
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "While this is practical advice, it does not address the legal requirement to inform the DVLA about the epilepsy diagnosis. Individuals with epilepsy need to comply with legal regulations regarding driving and take appropriate measures to ensure their road safety.",
"id": "10025242",
"label": "c",
"name": "Advise the teenager to explore alternative transportation options, such as public transit or carpooling",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although this teenager has been seizure-free for 2 months, DVLA specifies that a person with epilepsy may qualify for a driving licence only if they have been free from any seizure for 1 year. This needs to include being free of minor seizures, including those that do not involve a loss of consciousness and epilepsy signs such as limb jerking and auras.",
"id": "10025241",
"label": "b",
"name": "Advise the teenager to continue taking sodium valproate and hold off informing the DVLA",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "While the doctor may make changes to the drug dosage according to the frequency and severity of seizures, it does not change the fact that a person with epilepsy must inform the DVLA about a diagnosis of epilepsy and stop driving immediately.",
"id": "10025244",
"label": "e",
"name": "Advise the teenager to gradually stop taking sodium valproate and take no further action",
"picture": null,
"votes": 0
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"id": "5826",
"name": "Epilepsy and Driving",
"status": null,
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"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
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"question": "A 19 year old teenager attends a medication review with his GP, after being diagnosed with epilepsy last year. He takes daily sodium valproate, and on this has remained seizure-free for 2 months.\n\nThe patient holds a current driving licence, but only occasionally drives. He reports that he has not informed any authority including the Driver and Vehicle Licensing Agency (DVLA) about his diagnosis.\n\nWhich of the following actions should be taken next?",
"sbaAnswer": [
"a"
],
"totalVotes": 66,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,448 | false | 4 | null | 6,495,184 | null | false | [] | null | 17,447 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The lateral femoral cutaneous nerve provides sensory innervation to the skin of the lateral thigh. It does not control motor function. Injury to this nerve could cause sensory disturbances such as such as numbness and tingling. 'Cutaneous' in the name of a nerve suggests that it provides nerve supply to the skin and has sensory functions only.",
"id": "10025249",
"label": "e",
"name": "Lateral femoral cutaneous nerve injury",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. This vignette describes an isolated right foot drop. The common fibular nerve, a branch of the sciatic nerve, is particularly susceptible to injury at the fibular head and is more commonly associated with isolated foot drop due to its role in dorsiflexion of the foot. Causes of common fibular nerve damage include fractures of the fibula and the use of a tight plaster cast.",
"id": "10025245",
"label": "a",
"name": "Common fibular nerve injury",
"picture": null,
"votes": 45
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The femoral nerve primarily innervates the muscles of the anterior thigh, such as the quadriceps muscles, and is not directly responsible for dorsiflexion of the foot. As all other lower limb examinations are normal, it is unlikely femoral nerve. Injury to the femoral nerve would lead to other motor deficits such as weakness in knee extension (due to innervation of quadriceps), but not isolated foot drop.",
"id": "10025247",
"label": "c",
"name": "Femoral nerve injury",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The sciatic nerve is a major nerve that provides both sensory and motor innervation to the lower limbs, including the muscles responsible for leg and foot movement. A proximal lesion of the sciatic nerve could potentially affect the common fibular nerve and lead to foot drop, however, a direct injury to the sciatic nerve itself is less common and typically causes more widespread neurological deficits than just an isolated foot drop.",
"id": "10025246",
"label": "b",
"name": "Sciatic nerve injury",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The tibial nerve primarily innervates the posterior leg muscles and is responsible for plantarflexion of the foot, not dorsiflexion. The tibial nerve also supplies the muscles involved in flexing the toes, such as the flexor digitorum longus and the flexor hallucis longus. Injury to the tibial nerve could affect toe flexion.",
"id": "10025248",
"label": "d",
"name": "Tibial nerve injury",
"picture": null,
"votes": 8
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"pictures": [],
"typeId": 7
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"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3856",
"name": "Foot drop",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
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"topicId": 141,
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"question": "A 24 year old man attends his GP surgery with difficulty walking. He broke his left leg in a skiing accident several months ago. Although the fracture has healed well, he has noted ongoing difficulty in lifting his left foot from the floor.\n\nOn examination, he is unable to dorsiflex the right foot and therefore has difficulty in lifting the toes while walking. Sensation is reduced on the dorsum of the left foot and lateral aspect of the left leg. Both feet are peripherally warm and well perfused. All other lower limb examinations are normal.\n\nWhich of the following is the most likely underlying diagnosis?",
"sbaAnswer": [
"a"
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"totalVotes": 64,
"typeId": 1,
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173,465,449 | false | 5 | null | 6,495,184 | null | false | [] | null | 17,448 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes a sudden onset of isolated non-fluent (expressive) aphasia, representative of partial anterior circulatory syndrome (PACS). Lacunar stroke is characterised by small subcortical infarctions in the deep structures of the brain. It usually manifests with pure motor or pure sensory deficits, ataxic hemiparesis, dysarthria-clumsy hand syndrome, or other focal neurological signs without significant language or cognitive impairment. This patient's symptoms are not consistent with a lacunar stroke, as they involve language and communication difficulties.",
"id": "10025251",
"label": "b",
"name": "Lacunar syndrome",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes a sudden onset of isolated non-fluent (expressive) aphasia, representative of partial anterior circulatory syndrome (PACS). Lacunar stroke is characterised by small subcortical infarctions in the deep structures of the brain. It usually manifests with pure motor or pure sensory deficits, ataxic hemiparesis, dysarthria-clumsy hand syndrome, or other focal neurological signs without significant language or cognitive impairment. This patient's symptoms are not consistent with a lacunar stroke, as they involve language and communication difficulties.",
"id": "10025253",
"label": "d",
"name": "Posterior circulatory syndrome",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes a sudden onset of isolated non-fluent (expressive) aphasia, representative of PACS. A diagnosis of TACS needs to fulfil **all** of the following:\n \n\n * Unilateral motor and/or sensory deficit of the face, arm and leg\n * Homonymous hemianopia\n * Higher cerebral dysfunction\n \n\n In this case, only higher cerebral dysfunction (aphasia) is fulfilled.",
"id": "10025252",
"label": "c",
"name": "Total anterior circulatory syndrome",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. This vignette describes a sudden onset of isolated non-fluent (expressive) aphasia. Higher cerebral dysfunction such as visuospatial disorder or aphasia (in this case) in the absence of hemiplegia/hemiparesis, and homonymous hemianopia, is classified as PACS.",
"id": "10025250",
"label": "a",
"name": "Partial anterior circulatory syndrome (PACS)",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Basilar artery thrombosis is a type of ischaemic stroke that occurs when there is a blockage in the basilar artery, a major blood vessel at the base of the brain. Common symptoms of basilar artery thrombosis include impaired consciousness, paralysis of the face and limbs, difficulty speaking, and vision problems. It can also result in the dysfunction of cranial nerves, which may cause facial weakness and impaired eye movements. It typically does not present with isolated language and communication deficits.",
"id": "10025254",
"label": "e",
"name": "Basilar artery thrombosis",
"picture": null,
"votes": 1
}
],
"comments": [],
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"demo": null,
"entitlement": null,
"id": "3743",
"name": "Ischaemic Stroke",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
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"topicId": 141,
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"dislikes": 0,
"explanation": "Partial anterior circulatory syndrome (PACS)",
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"question": "A 64-year-old man is brought to the emergency department after suddenly struggling to communicate earlier that day, substituting words with unrelated ones and speaking in fragmented, incoherent sentences during a conversation with his wife.\n\nOn examination, the patient is alert and appears aware of his surroundings. He understands spoken language and is able to follow simple commands, but is unable to articulate his thoughts coherently. Power, tone and sensation of the upper and lower limbs are intact. Cranial nerve examination is unremarkable.\n\n\nWhich of the following is the most likely diagnosis based on the Bamford classification system?",
"sbaAnswer": [
"a"
],
"totalVotes": 62,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,450 | false | 6 | null | 6,495,184 | null | false | [] | null | 17,449 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes peripheral vision loss, essentially a bitemporal hemianopia. If the right optic nerve is damaged, the patient will experience complete right vision loss. This is because the right optic nerve fibres transmit visual signals from the whole of the right eye to the optic tract.",
"id": "10025256",
"label": "b",
"name": "Right optic nerve",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes peripheral vision loss, essentially a bitemporal hemianopia. If the right optic tract is damaged, the patient would experience left (contralateral) homonymous hemianopia, meaning the loss of the left half of the visual fields of both eyes. This is because the right optic tract carries nerve signals from the right half of both retinas, which receives visual signals from the left half of the visual fields.",
"id": "10025258",
"label": "d",
"name": "Right optic tract",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes peripheral vision loss, essentially a bitemporal hemianopia. If the left optic nerve is damaged, the patient will experience complete left vision loss. This is because the left optic nerve fibres transmit visual signals from the whole of the left eye to the optic tract.",
"id": "10025257",
"label": "c",
"name": "Left optic nerve",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes peripheral vision loss, essentially a bitemporal hemianopia. If the left optic tract is damaged, the patient would experience right (contralateral) homonymous hemianopia, meaning the loss of the right half of the visual fields on both eyes. This is because the left optic tract carries nerve signals from the left half of both retinas, which receives visual signals from the right half of the visual fields.",
"id": "10025259",
"label": "e",
"name": "Left optic tract",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. This vignette describes peripheral vision loss or bitemporal hemianopia. Visual signals from the temporal (outer) sides of each eye are transmitted to the nasal part of the retina. The optic nerve fibres transmit the signal and cross at the optic chiasm to opposite sides of the brain. Therefore, damage or pressure at the optic chiasm could create a tunnel-like visual experience, with the central vision intact.",
"id": "10025255",
"label": "a",
"name": "Optic chiasm",
"picture": null,
"votes": 58
}
],
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"__typename": "Chapter",
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4304",
"name": "Visual Field Loss",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
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"question": "A 43 year old woman schedules an appointment with her ophthalmologist due to concerning changes in her vision. She explains that over the past few weeks, she had been experiencing a persistent issue that is particularly noticeable while driving. She mentioned that when she was on the road, she had difficulty seeing objects and pedestrians at the side of her vision, like having 'tunnel vision'.\n\nWhich of the following is the most likely site of pathology?",
"sbaAnswer": [
"a"
],
"totalVotes": 61,
"typeId": 1,
"userPoint": null
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173,465,451 | false | 7 | null | 6,495,184 | null | false | [] | null | 17,450 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes a case of subdural haematoma, with symptoms developing after a fall. In contrast, meningitis is typically caused by infectious agents such as bacteria or viruses rather than trauma. Meningitis can develop over time, but it typically presents with more acute symptoms, including fever, severe headache, neck stiffness, and altered mental status. Notably, this patient is apyrexial. Meningitis-related abnormalities on imaging might involve contrast enhancement in the meninges or signs of brain inflammation, but not typically evidence of haemorrhage.",
"id": "10025264",
"label": "e",
"name": "Meningitis",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. The patient's history of a fall, gradual onset of symptoms, confusion, neurological deficits, as well as the crescent-shaped hyperdensity on the CT scan are consistent with a subdural haematoma. A subdural haematoma is a collection of blood accumulating between the arachnoid mater and the dura mater. Over time this can increase intracranial pressure, leading to neurological deficits such as muscle weakness on the contralateral side of the haematoma, and altered mental status. It is particularly prevalent in the elderly, as ageing can reduce brain mass, which may lead to stretching and thinning of bridging veins that connect the brain's surface to the dura. These veins are more prone to tearing when subjected to trauma.",
"id": "10025260",
"label": "a",
"name": "Subdural haematoma",
"picture": null,
"votes": 50
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes a case of subdural haematoma, with symptoms worsening over several days. In contrast, ischaemic strokes typically have a sudden and rapid onset of symptoms. Ischaemic strokes usually present with areas of hypodensity on imaging due to the loss of blood flow to affected brain tissue, not hyperdensity as in this vignette. Moreover, ischaemic strokes are not directly caused by head trauma and are instead caused by the occlusion of blood vessels supplying the brain.",
"id": "10025262",
"label": "c",
"name": "Ischaemic stroke",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes a case of subdural haematoma. Epidural haematomas typically result from head trauma. Although the patient had a fall, the neurological deficits show a gradual progression. By contrast, epidural haematomas tend to have a more rapid and sudden onset of symptoms following the initial injury. Furthermore, epidural haematomas typically present as biconvex or lens-shaped hyperdensity on imaging. In this case, the crescent-shaped hyperdensity is more suggestive of a subdural haematoma.",
"id": "10025261",
"label": "b",
"name": "Epidural haematoma",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes a case of subdural haematoma, with symptoms worsening in the days following a trauma. In contrast, subarachnoid haemorrhage classically presents with a sudden and severe 'thunderclap' headache at the onset of bleeding, often described as 'the worst headache of my life'. CT scans normally show hyperdense signals in the subarachnoid space.",
"id": "10025263",
"label": "d",
"name": "Subarachnoid haemorrhage",
"picture": null,
"votes": 2
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4017",
"name": "Subdural haemorrhage",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
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"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
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"question": "An 88 year old woman is brought to the A&E by her family. She admitted to falling 2 days ago, when trying to change a light bulb, but did not seek medical assistance. Since the fall, she has become increasingly confused, wincing as though in pain. She has an extensive past medical history, including hypertension, type 2 diabetes and a previous ischaemic stroke.\n\nUpon examination, the patient is disoriented and lethargic. Neurological examination shows weakness in her right arm and leg, along with a noticeable drift when attempting to lift her right arm. She is apyrexial. A CT head scan shows a left-sided crescent-shaped hyperdensity.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 62,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,452 | false | 8 | null | 6,495,184 | null | false | [] | null | 17,451 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although headaches are reasonably common following a lumbar puncture, they typically resolve within 14 days of the procedure. Furthermore, they are usually worsen in an upright position and are relieved when lying down, which differs to the experience of this patient. Post-lumbar puncture headaches can occur when there is a persistent leak of cerebrospinal fluid (CSF) through the dural puncture site, causing a reduction in CSF pressure. By contrast, this vignette describes symptoms of increased intracranial pressure.",
"id": "10025268",
"label": "d",
"name": "Furosemide treatment",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although headaches are reasonably common following a lumbar puncture, they typically resolve within 14 days of the procedure. Furthermore, they are usually worsen in an upright position and are relieved when lying down, which differs to the experience of this patient. Post-lumbar puncture headaches can occur when there is a persistent leak of cerebrospinal fluid (CSF) through the dural puncture site, causing a reduction in CSF pressure. By contrast, this vignette describes symptoms of increased intracranial pressure.",
"id": "10025266",
"label": "b",
"name": "Post-lumbar puncture",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. The patient has a history of lung cancer, which commonly metastasises to the brain. This vignette describes symptoms of increased intracranial pressure. According to the Monro-Kellie Doctrine, cerebrospinal fluid (CSF), blood volume and brain parenchyma volume exist in equilibrium. Metastatic brain tumours typically form space-occupying lesions within the brain tissue. They increase the brain parenchyma volume, increasing the pressure inside the intracranial cavity. Brain metastases can also obstruct the flow of CSF, leading to a build-up of CSF and increased pressure within the intracranial space.",
"id": "10025265",
"label": "a",
"name": "Intracranial metastasis",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes symptoms of increased intracranial pressure (ICP). By contrast, dehydration could lead to decreased ICP. According to the Monro-Kellie Doctrine, cerebrospinal fluid (CSF), blood volume and brain parenchyma volume exist in equilibrium. Severe dehydration could reduce the volume of cerebrospinal fluid within the intracranial and intraspinal spaces, which could lower ICP. Furthermore, it would be highly unusual for a dehydration headache to last for so long.",
"id": "10025267",
"label": "c",
"name": "Dehydration",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes symptoms of increased intracranial pressure (ICP). Cluster headaches are severe headaches that occur in clusters. They are often described as excruciating pain focused around one eye, and may be associated with other symptoms like tearing, nasal congestion, and restlessness. They are not typically worsened by lying down, and would not last for several weeks.",
"id": "10025269",
"label": "e",
"name": "Cluster headache attacks",
"picture": null,
"votes": 3
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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},
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"demo": null,
"entitlement": null,
"id": "4387",
"name": "Raised intracranial pressure",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
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},
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": "Intracranial metastasis",
"highlights": [],
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"question": "A 66-year-old man presents to A&E with a 3-day history of worsening abdominal discomfort. The pain started as dull and centered around the upper abdomen but has intensified and spread throughout the abdomen. He feels bloated, experiences occasional nausea, and has a reduced appetite. \nHis has osteoarthritis and atrial fibrillation, but he is otherwise fit and well.\nOn physical examination, he appears pale and somewhat distressed. His abdomen is distended, with diffuse tenderness and involuntary guarding. Bowel sounds are faint, and percussion elicits tympany.\nObservations: blood pressure 99/56mmHg, pulse rate 101bpm, respiratory rate 18 breaths per minute, oxygen saturations 100% on room air, temperature 37.6 degrees Celsius.\nAn erect chest x-ray shows the following:\nWhat is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 57,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,453 | false | 9 | null | 6,495,184 | null | false | [] | null | 17,452 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient vignette describes a classic multiple sclerosis (MS) presentation, of a young female presenting with optic neuritis, a common early symptom, along with other MS symptoms. MS is an autoimmune disorder resulting from a combination of genetic predisposition and environmental triggers, such as infections (eg. Epstein-Barr virus) and lack of sunlight exposure. A sedentary lifestyle is not a direct risk factor for MS, but is rather more linked to other health issues, such as obesity and cardiovascular problems.",
"id": "10025271",
"label": "b",
"name": "Sedentary lifestyle",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. This patient vignette describes a classic multiple sclerosis (MS) presentation, of a young female presenting with optic neuritis, a common early symptom, along with other MS symptoms. MS is an autoimmune disorder resulting from a combination of genetic predisposition and environmental triggers, such as infections (eg. Epstein-Barr virus) and lack of sunlight exposure. MS is more common at higher latitudes, for example, in the UK, it is more prevalent in Scotland compared to England. This is because people living at higher latitudes receive less direct sunlight, leading to reduced vitamin D synthesis in the skin, which has been linked to an increased risk of MS.",
"id": "10025270",
"label": "a",
"name": "Geographical location",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient vignette describes a classic multiple sclerosis (MS) presentation, of a young female presenting with optic neuritis, a common early symptom, along with other MS symptoms. MS is an autoimmune disorder resulting from a combination of genetic predisposition and environmental triggers, such as infections (eg. Epstein-Barr virus) and lack of sunlight exposure. In this vignette, this patient drinks about 14 units of wine per week and occasionally exceeds the 14-unit limit with the whisky. Although her drinking habit is borderline excessive, there is currently no link between alcohol consumption and MS risk.",
"id": "10025272",
"label": "c",
"name": "Alcohol consumption",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient vignette describes a classic multiple sclerosis (MS) presentation, of a young female presenting with optic neuritis, a common early symptom, along with other MS symptoms. MS is an autoimmune disorder resulting from a combination of genetic predisposition and environmental triggers, such as infections (eg. Epstein-Barr virus) and lack of sunlight exposure. There is no known direct connection or causative relationship between allergies to specific medications, including ibuprofen, and the development of MS. An allergy to ibuprofen is an immunological response triggered by the release of histamines. In contrast, MS is an autoimmune disease whereby the immune system mistakenly attacks the central nervous system.",
"id": "10025274",
"label": "e",
"name": "Ibuprofen allergy",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient vignette describes a classic multiple sclerosis (MS) presentation, of a young female presenting with optic neuritis, a common early symptom, along with other MS symptoms. MS is an autoimmune disorder resulting from a combination of genetic predisposition and environmental triggers, such as infections (eg. Epstein-Barr virus) and lack of sunlight exposure. Previous conjunctivitis is not typically associated with the development of MS. Bacterial conjunctivitis is commonly caused by *Streptococcus pneumoniae* and *Haemophilus influenzae*.",
"id": "10025273",
"label": "d",
"name": "Previous conjunctivitis",
"picture": null,
"votes": 10
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3745",
"name": "Multiple Sclerosis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
"totalCards": null,
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"highlights": [],
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"question": "A 25 year old Scottish woman presents to her GP with pain in her right eye that has been present for the past week. She complains of episodes of blurry vision, which makes it difficult to work sometimes. She also reports tingling in her hands, fatigue and weakness.\n\nShe does not smoke and has a rather sedentary lifestyle. She usually drinks 5-6 glasses of wine on the weekends and some whisky occasionally as her family owns 'one of Scotland's best distilleries'. She has an allergy to ibuprofen, and experienced an episode of bacterial conjunctivitis in her right eye around 6 months ago.\n\nWhich of the following is a known risk factor for her most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 58,
"typeId": 1,
"userPoint": null
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173,465,454 | false | 10 | null | 6,495,184 | null | false | [] | null | 17,453 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes a case of tension headache, which could be deduced from the bilateral, 'band-like' description of the pain, in addition to stress being an associated factor. Analgesic treatment should follow the WHO pain ladder; typically starting with paracetamol or an NSAID. Since she is allergic to aspirin, the use of aspirin or other NSAIDs, such as ibuprofen or naproxen, should be avoided. Hence, the best drug is paracetamol at this stage. Co-codamol is a mixture of paracetamol and codeine (an opioid). It should only be used when paracetamols and NSAIDs alone have not worked.",
"id": "10025278",
"label": "d",
"name": "Co-codamol",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes a case of tension headache, which could be deduced from the bilateral, 'band-like' description of the pain, in addition to stress being an associated factor. Analgesic treatment should follow the WHO pain ladder; typically starting with paracetamol or an NSAID. Since she is allergic to aspirin, the use of aspirin or other NSAIDs, such as ibuprofen or naproxen, should be avoided. Hence, the best drug is paracetamol at this stage. Sumatriptan is commonly used to treat migraines, which are characterised by severe and classically unilateral head pain, along with other symptoms such as nausea and sensitivity to light and sound. It is not typically used for tension headaches, making this option incorrect.",
"id": "10025279",
"label": "e",
"name": "Sumatriptan",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes a case of tension headache, which could be deduced from the bilateral, 'band-like' description of the pain, in addition to stress being an associated factor. Analgesic treatment should follow the WHO pain ladder; typically starting with paracetamol or an NSAID. Since she is allergic to aspirin, the use of aspirin or other NSAIDs, such as ibuprofen or naproxen, should be avoided. Hence, the best drug is paracetamol at this stage. Codeine is an opioid medication that can be used in the management of severe pain. However it is not typically a first-line treatment for tension-type headaches, and it carries a risk of side effects and dependence when used long-term. Paracetamol should first be trialled.",
"id": "10025277",
"label": "c",
"name": "Codeine",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This vignette describes a case of tension headache, which could be deduced from the bilateral, 'band-like' description of the pain, in addition to stress being an associated factor. Analgesic treatment should follow the WHO pain ladder; typically starting with paracetamol or an NSAID. Since she is allergic to aspirin, the use of aspirin or other NSAIDs, such as ibuprofen or naproxen, should be avoided. Hence, the best drug is paracetamol at this stage.",
"id": "10025276",
"label": "b",
"name": "Ibuprofen",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. This vignette describes a case of tension headache, which could be deduced from the bilateral, 'band-like' description of the pain, in addition to stress being an associating factor. Analgesic treatment should follow the WHO pain ladder; typically starting with paracetamol or an NSAID. Since she is allergic to aspirin, the use of aspirin or other NSAIDs, such as ibuprofen or naproxen, should be avoided. Hence, the best drug is paracetamol at this stage.",
"id": "10025275",
"label": "a",
"name": "Paracetamol",
"picture": null,
"votes": 38
}
],
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"id": "4211",
"name": "Paracetamol",
"status": null,
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"__typename": "Topic",
"id": "172",
"name": "Pharmacology of the Nervous System",
"typeId": 7
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"question": "A 20 year old female medical student presents to her GP with recurrent band-like tightness and dull pain in both sides of her head for the past month. It is not present on waking but gets gradually worse throughout the day, particularly when she misses meals or is feeling particularly stressed. She denies any nausea or vomiting.\n\nShe has started meditating which has improved her pain somewhat, but not completely. She has no past medical history and does not take any medications. She has had a previous anaphylactic reaction to aspirin.\n\nWhich of the following is the most appropriate treatment?",
"sbaAnswer": [
"a"
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173,465,455 | false | 11 | null | 6,495,184 | null | false | [] | null | 17,454 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient has neuropathic pain, characterised by a burning sensation, tingling and pain. According to NICE recommendations, there are four first-line medications to control neuropathic pain, which are gabapentin, pregabalin, amitriptyline and duloxetine. Since this patient has had a recent myocardial infarction (MI), amitriptyline is contraindicated, because it could cause arrhythmias. Arrhythmias can be particularly dangerous in patients with a recent MI, as the heart may already be vulnerable and more prone to irregular rhythms.",
"id": "10025284",
"label": "e",
"name": "Amitriptyline",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient has neuropathic pain, characterised by a burning sensation, tingling and pain. According to NICE recommendations, there are four first-line medications to control neuropathic pain: gabapentin, pregabalin, amitriptyline and duloxetine. Tramadol, an opioid, is only recommended as an acute rescue option for short term alleviation of flares. Furthermore, tramadol, like other opioids, can affect the cardiovascular system, leading to changes in heart rate and blood pressure. This is not ideal given her recent recovery from myocardial infarction.",
"id": "10025282",
"label": "c",
"name": "Tramadol",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient has neuropathic pain, characterised by a burning sensation, tingling and pain. According to NICE recommendations, there are four first-line medications to control neuropathic pain: gabapentin, pregabalin, amitriptyline and duloxetine. Naproxen, an NSAID, is more effective at reducing inflammation and relieving pain from inflammatory conditions such as arthritis or musculoskeletal injuries. Neuropathic pain is related to nerve damage and dysfunction, and it typically does not involve inflammation.",
"id": "10025283",
"label": "d",
"name": "Naproxen",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient has neuropathic pain, characterised by a burning sensation, tingling and pain. According to NICE recommendations, there are four first-line medications to control neuropathic pain: gabapentin, pregabalin, amitriptyline and duloxetine. Gabapentin, an anticonvulsant, is commonly used to manage neuropathic pain associated with conditions like MS. It works by stabilising overactive nerve cells and reducing abnormal electrical activity, which can help alleviate symptoms of neuropathic pain.",
"id": "10025280",
"label": "a",
"name": "Gabapentin",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient has neuropathic pain, characterised by a burning sensation, tingling and pain. According to NICE recommendations, there are four first-line medications to control neuropathic pain: gabapentin, pregabalin, amitriptyline and duloxetine. Carbamazepine is a first-line medication only for a specific type of neuropathic pain, trigeminal neuralgia, which is characterised by severe, sharp, shooting facial pain.",
"id": "10025281",
"label": "b",
"name": "Carbamazepine",
"picture": null,
"votes": 2
}
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"id": "5827",
"name": "Treatment of neuropathic pain",
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"name": "Pharmacology of the Nervous System",
"typeId": 7
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"question": "A 46 year old patient who has a past medical history of relapsing-remitting multiple sclerosis (MS) is experiencing burning, tingling and pain in her hands. This has significantly impacted her day-to-day living. She was recently discharged from hospital following a myocardial infarction.\n\nWhich of the following drugs is the most suitable to alleviate this patient's pain?",
"sbaAnswer": [
"a"
],
"totalVotes": 55,
"typeId": 1,
"userPoint": null
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173,465,456 | false | 12 | null | 6,495,184 | null | false | [] | null | 17,455 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Folic acid deficiency is associated with an increased risk of neural tube defects in the developing foetus. Spina bifida is a specific form of neural tube defect, characterised by failure of the caudal end of the neural tube to close. By contrast, an atrial septal defect is a form of congenital heart malformation in which there is a hole in the septum between the two atria. Although research has shown some association of congenital heart defects with folic acid levels, it is not as closely linked as neural tube defects. This is therefore not the single best answer.",
"id": "10025288",
"label": "d",
"name": "Atrial septal defect",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Folic acid deficiency is associated with an increased risk of neural tube defects in the developing foetus. Spina bifida is a specific form of neural tube defect, characterised by failure of the caudal end of the neural tube to close. By contrast, an extra copy of chromosome 21 leads to Down syndrome, which is associated with intellectual and developmental delays and characteristic facial features. Folic acid intake does not affect the development of this condition.",
"id": "10025286",
"label": "b",
"name": "Presence of an extra copy of chromosome 21",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Folic acid deficiency is associated with an increased risk of neural tube defects in the developing foetus. Spina bifida is a specific form of neural tube defect, characterised by failure of the caudal end of the neural tube to close. By contrast, Fragile X Syndrome is a genetic disorder caused by an expansion of the CGG trinucleotide repeat in the FMR1 gene on the X chromosome. It is not thought to be caused by folic acid deficiency.",
"id": "10025289",
"label": "e",
"name": "Excess cerebrospinal fluid in the brain",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Folic acid deficiency is associated with an increased risk of neural tube defects in the developing foetus. Spina bifida is a specific form of neural tube defect, characterised by failure of the caudal end of the neural tube to close. By contrast, a ventricular septal defect is a form of congenital heart malformation in which there is a hole in the septum between the two ventricles. Although research has shown some association of congenital heart defects with folic acid levels, it is not as closely linked as neural tube defects. This is therefore not the single best answer.",
"id": "10025287",
"label": "c",
"name": "Ventricular septal defect",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. Folic acid deficiency is associated with an increased risk of neural tube defects in the developing foetus. The neural tube is the embryonic structure that eventually gives rise to the brain and spinal cord. Spina bifida is a specific form of neural tube defect, characterised by failure of the caudal end of the neural tube to close, meaning the spinal cord and vertebrae do not fully develop, resulting in an exposed or open area of the spinal cord. This incomplete closure of the caudal end of the neural tube typically occurs within the first few weeks of pregnancy.",
"id": "10025285",
"label": "a",
"name": "Failure of the caudal end of the neural tube to close",
"picture": null,
"votes": 51
}
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"demo": null,
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"id": "3840",
"name": "Spina Bifida",
"status": null,
"topic": {
"__typename": "Topic",
"id": "171",
"name": "Embryology",
"typeId": 7
},
"topicId": 171,
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"question": "A 30 year old woman is pregnant with her third baby. She consults her GP, who prescribes folic acid tablets to take for the duration of her pregnancy. The patient is curious about the reason for this.\n\nWhich of the following developmental defects are most likely to be caused by folic acid deficiency?",
"sbaAnswer": [
"a"
],
"totalVotes": 52,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,457 | false | 13 | null | 6,495,184 | null | false | [] | null | 17,456 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Synaptic pruning only occurs after birth and continues into adolescence. The early postnatal phase is marked by an extraordinary level of neural plasticity, allowing the brain to adapt and learn from new experiences and environmental stimuli. As a child progresses through infancy and early childhood, selective elimination and weakening of synapses that are less frequently used or are less essential for efficient neural circuitry occurs.",
"id": "10025294",
"label": "e",
"name": "Synaptic pruning",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Formation of bilaminar embryonic disc occurs approximately on day 9 post-fertilisation. After implantation, the inner cell mass differentiates into the epiblast and the hypoblast. These two layers are separated by a thin basal lamina and form the bilaminar disc.",
"id": "10025292",
"label": "c",
"name": "Formation of bilaminar disc",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gastrulation occurs in the week 2 post-fertilisation. The process of gastrulation converts the bilaminar disc into a trilaminar disc. Through gastrulation, the three primary germ layers, ectoderm, mesoderm and endoderm are formed.",
"id": "10025291",
"label": "b",
"name": "Gastrulation",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Myelination occurs in the third trimester around week 30 post-fertilisation and continues well into adulthood. During the embryonic and foetal stages, oligodendrocytes in the central nervous system and Schwann cells in the peripheral nervous system are responsible for producing myelin. After birth, myelination continues, and it is most pronounced in the early years of life. Myelination is essential for the development of motor skills, sensory perception, and cognitive functions by allowing rapid neuronal conduction.",
"id": "10025293",
"label": "d",
"name": "Myelination",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Neurulation occurs in weeks 3-4 post-fertilisation and stimulates the development of the nervous system. The process starts with the formation of a flat, thickened sheet of ectodermal cells called the neural plate along the dorsal surface of the embryo. The neural plate will eventually give rise to the central nervous system.",
"id": "10025290",
"label": "a",
"name": "Neurulation",
"picture": null,
"votes": 28
}
],
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"typeId": 7
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"id": "3874",
"name": "Neurulation",
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"id": "171",
"name": "Embryology",
"typeId": 7
},
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"question": "A 32 year old woman is looking to conceive her first baby. She asks her gynaecologist what happens during embryological development.\n\nWhich of the following occurs in weeks 3-4 post-fertilisation?",
"sbaAnswer": [
"a"
],
"totalVotes": 51,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,458 | false | 14 | null | 6,495,184 | null | false | [] | null | 17,457 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. The spinothalamic tract (also referred to as the anterolateral system) is an ascending pathway of the spinal cord. It is responsible for the transmission of pain, temperature, and crude touch to the somatosensory region of the thalamus.",
"id": "10025295",
"label": "a",
"name": "Temperature",
"picture": null,
"votes": 48
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pressure sensation is the perception of mechanical pressure applied to the skin. It is transmitted primarily through the dorsal column pathway. The spinothalamic tract transmits pain, temperature and crude touch while the dorsal column transmits vibration, proprioception, and fine touch.",
"id": "10025298",
"label": "d",
"name": "Pressure",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Vibration sensation involves the perception of rapid oscillations or vibrations applied to the skin. Vibration sensation is carried by the dorsal column pathway. The spinothalamic tract transmits pain, temperature and crude touch while the dorsal column transmits vibration, proprioception, and fine touch.",
"id": "10025297",
"label": "c",
"name": "Vibration",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Two-point discrimination is the ability to distinguish between two separate points of contact on the skin. It is mediated by the dorsal column pathway. Spinothalamic tract transmits pain, temperature and crude touch while dorsal column transmits vibration, proprioception, and fine touch.",
"id": "10025296",
"label": "b",
"name": "Two point discrimination",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Kinesthesia is the conscious awareness of limb movement and position. It relies on proprioceptive signals carried by the dorsal column system. The spinothalamic tract does not play a role in conveying information related to muscle sense. It transmits pain, temperature and crude touch while the dorsal column transmits vibration, proprioception, and fine touch.",
"id": "10025299",
"label": "e",
"name": "Kinesthesia",
"picture": null,
"votes": 1
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"typeId": 7
},
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"id": "5828",
"name": "Spinothalamic tracts",
"status": null,
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"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
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"question": "A 45 year old man is reviewed in a neurology clinic following changes to his sensory perception of stimuli. He experienced a spinal injury in a road traffic accident the previous year, and although he is gradually regaining functionality in his limbs has noted ongoing sensory problems.\n\nWhich of the following sensory modalities is transmitted via the spinothalamic tract?",
"sbaAnswer": [
"a"
],
"totalVotes": 52,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,459 | false | 15 | null | 6,495,184 | null | false | [] | null | 17,458 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The phenomenon described is a sleep disorder known as sleepwalking or somnambulism. Sleepwalking usually occurs during the deepest stage of non-rapid eye movement (NREM) sleep, in N3 (slow-wave sleep), rather than during the initial sleep onset (N1) stage, which is a lighter stage of sleep.",
"id": "10025302",
"label": "c",
"name": "Stage 1 of NREM",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The phenomenon described is a sleep disorder known as sleepwalking or somnambulism. Sleepwalking typically occurs during non-rapid eye movement (NREM) sleep, specifically in the stage of N3, which is also referred to as slow-wave sleep. N3 is the deepest stage of NREM sleep and is associated with reduced arousal thresholds, making it more likely for sleepwalking episodes to occur during this phase.",
"id": "10025300",
"label": "a",
"name": "Stage 3 of NREM",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The phenomenon described is a sleep disorder known as sleepwalking or somnambulism. During wakefulness, the brain is in a state of consciousness. By contrast, sleepwalking is a disorder in which individuals engage in complex behaviours during sleep without conscious awareness. Therefore, sleepwalking usually occurs during the deepest stage of non-rapid eye movement (NREM) sleep, in N3 (slow-wave sleep). The reduced arousal thresholds make it more likely for sleepwalking episodes to occur during this phase.",
"id": "10025304",
"label": "e",
"name": "Wake stage",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The phenomenon described is a sleep disorder known as sleepwalking or somnambulism. Sleepwalking usually occurs during the deepest stage of non-rapid eye movement (NREM) sleep, in N3 (slow-wave sleep), rather than the N2 stage, which is relatively lighter.",
"id": "10025303",
"label": "d",
"name": "Stage 2 of NREM",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The phenomenon described is a sleep disorder known as sleepwalking or somnambulism. Sleepwalking typically occurs during non-rapid eye movement (NREM) sleep, specifically in the stages of N3. By contrast, REM sleep is a distinct phase characterised by rapid eye movements, vivid dreaming, and temporary large muscle paralysis to prevent acting out dreams.",
"id": "10025301",
"label": "b",
"name": "REM",
"picture": null,
"votes": 23
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4310",
"name": "Phases of sleep",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
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"question": "A 66 year old man attends his GP surgery with his wife due to a concerning pattern of behaviour. The patient's wife reports that he has started getting out of bed at night and walking around the house without seeming to wake up. These episodes are becoming extremely disruptive to the rest of the household, and they are worried that he may fall down the stairs. The patient has no memory of these episodes upon waking, but notes he does feel very tired.\n\nIn which of the following sleep phases is this phenomenon most likely to occur?",
"sbaAnswer": [
"a"
],
"totalVotes": 45,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,465,460 | false | 16 | null | 6,495,184 | null | false | [] | null | 17,459 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. Eye-opening response score is 4 for spontaneous opening, verbal response is 4 as he is confused, and motor response is 5 as he moves to localised pain. The total GCS score is 13.",
"id": "10025305",
"label": "a",
"name": "13",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the correct answer. Eye-opening response score is 4 for spontaneous opening, verbal response is 4 as he is confused, and motor response is 5 as he moves to localised pain. The total GCS score is 13.",
"id": "10025308",
"label": "d",
"name": "12",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the correct answer. Eye-opening response score is 4 for spontaneous opening, verbal response is 4 as he is confused, and motor response is 5 as he moves to localised pain. The total GCS score is 13.",
"id": "10025309",
"label": "e",
"name": "14",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the correct answer. Eye-opening response score is 4 for spontaneous opening, verbal response is 4 as he is confused, and motor response is 5 as he moves to localised pain. The total GCS score is 13.",
"id": "10025307",
"label": "c",
"name": "11",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Eye-opening response score is 4 for spontaneous opening, verbal response is 4 as he is confused, and motor response is 5 as he moves to localised pain. The total GCS score is 13.",
"id": "10025306",
"label": "b",
"name": "10",
"picture": null,
"votes": 7
}
],
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"id": "5829",
"name": "The Glasgow Coma Scale",
"status": null,
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"question": "A 30 year old patient is assessed in A&E following a serious road traffic collision. He is able to answer questions fluently, but the content of his responses does not make much sense, and he believes he is in the supermarket. He is not able to follow instructions to move his limbs, but when pressure is applied to the patient’s supraorbital notch, he reaches towards the pressure site and his hand goes above the clavicle. His eyes open spontaneously.\n\nWhich of the following Glasgow Coma Scale (GCS) scores best describes this patient's consciousness level?",
"sbaAnswer": [
"a"
],
"totalVotes": 53,
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} | MarksheetMark |
173,465,461 | false | 17 | null | 6,495,184 | null | false | [] | null | 17,460 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. Narcolepsy is a neurological disorder characterised by disturbances in the sleep-wake cycle and is often linked to a deficiency of hypocretin (also known as orexin), a neuropeptide produced by neurons in the posterior lateral hypothalamus. Hypocretin/orexin plays a critical role in regulating wakefulness and maintaining arousal. It promotes alertness and prevents transitions into sudden sleep episodes. The posterior lateral hypothalamus contains the neurons that produce hypocretin/orexin. Dysfunction of these neurons can lead to narcolepsy.",
"id": "10025310",
"label": "a",
"name": "Posterior lateral hypothalamus",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "It is important to note that the midbrain reticular formation is indeed involved in the regulation of arousal and wakefulness, but the specific neuropeptide mentioned here, hypocretin, is produced by cells in the hypothalamus.",
"id": "10025311",
"label": "b",
"name": "Midbrain reticular formation",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "It is important to note that while the intralaminar nucleus in the thalamus is indeed involved in the regulation of arousal and wakefulness, hypocretin is primarily produced in the hypothalamus.",
"id": "10025314",
"label": "e",
"name": "Intralaminar nucleus in the thalamus",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The suprachiasmatic nucleus is a critical component of the hypothalamus involved in regulating the body's circadian rhythms and the sleep-wake cycle. Although it does influence the timing of sleep and wakefulness, hypocretin is primarily produced in the hypothalamus.",
"id": "10025313",
"label": "d",
"name": "Suprachiasmatic nucleus in the hypothalamus",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The ventral tegmental area is primarily associated with the reward system and the release of dopamine. Although it has an impact on motivation and mood, it is not directly involved in the regulation of the sleep-wake cycle or arousal system. Hypocretin is primarily produced in the hypothalamus.",
"id": "10025312",
"label": "c",
"name": "Ventral tegmental area",
"picture": null,
"votes": 4
}
],
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"id": "5830",
"name": "Anatomy of the arousal system",
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"question": "A 29 year old female with a new diagnosis of narcolepsy discusses her condition in neurology clinic. The clinician explains that narcolepsy is associated with low levels of the neuropeptide hypocretin. This neuropeptide acts across several brain regions, including one that is involved in the arousal system.\n\nWhich of the following brain regions contains the orexin-producing neurons implicated in narcolepsy?",
"sbaAnswer": [
"a"
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"totalVotes": 41,
"typeId": 1,
"userPoint": null
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173,465,462 | false | 18 | null | 6,495,184 | null | false | [] | null | 17,461 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. Declarative memory is a category of long-term memory that includes facts, knowledge, and events that can be consciously recalled and verbally expressed. It can be further categorised into semantic memory, episodic memory, autobiographical memory and visual memory. It is distributed widely across the neocortex and is impaired in the early stages of Alzheimer's dementia.",
"id": "10025315",
"label": "a",
"name": "Declarative memory",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Implicit memory, also known as non-declarative memory, consists of memories that are outside of conscious awareness. This includes memory of skills or actions that can be performed without thinking. Implicit memory is typically preserved in early stages of Alzheimer's dementia.",
"id": "10025319",
"label": "e",
"name": "Implicit memory",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Working memory refers to the short-term storage and manipulation of information for brief periods, typically seconds to minutes. Advanced Alzheimer's dementia can affect short-term memory to some extent, but it is the long-term memory that is more profoundly impacted and is more noticeably impaired during early stages.",
"id": "10025316",
"label": "b",
"name": "Working memory",
"picture": null,
"votes": 31
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Long-term memory includes both declarative memory and procedural memory. Although declarative memory is impaired in early-stage Alzheimer's dementia, procedural memory, which is responsible for the learning and execution of motor skills and habits, tends to be relatively preserved in the early stages. Procedural memory is closely associated with the basal ganglia and the cerebellum, whereas declarative long-term memory is more widely distributed across the neocortex.",
"id": "10025317",
"label": "c",
"name": "Long-term memory",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Sensory memory is a very brief stage of memory that involves the temporary storage of sensory information for very short periods, typically fractions of a second to a few seconds. Sensory memory is not typically impaired in early-stage Alzheimer's dementia.",
"id": "10025318",
"label": "d",
"name": "Sensory memory",
"picture": null,
"votes": 1
}
],
"comments": [],
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"name": "Memory",
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"question": "A 80 year old gentleman has just been diagnosed with Alzheimer's disease. His daughter is keen to learn more about the different types of memory.\n\nWhich of the following types of memory is most commonly impaired in the initial stages of Alzheimer's disease?",
"sbaAnswer": [
"a"
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"totalVotes": 49,
"typeId": 1,
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173,465,463 | false | 19 | null | 6,495,184 | null | false | [] | null | 17,462 | {
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{
"__typename": "QuestionChoice",
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"explanation": "The amygdala is most associated with emotional processing, particularly in the generation of fear and emotional responses. It is not a primary regulator of motor behaviours like teeth grinding and tidying obsessions. The correct answer is the basal ganglia, which has a role in the coordination of movements and regulating repetitive or habitual behaviours.",
"id": "10025322",
"label": "c",
"name": "Amygdala",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The thalamus serves as a relay station for sensory information and plays a role in alertness and consciousness. Although it plays a vital role in processing sensory input, it is not a primary regulator of motor behaviours like teeth grinding and tidying obsessions. The correct answer is the basal ganglia, which has a role in the coordination of movements and regulating repetitive or habitual behaviours.",
"id": "10025323",
"label": "d",
"name": "Thalamus",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The occipital cortex is part of the brain involved in the processing and perception of visual information. It does not generate motor responses. By contrast, the basal ganglia is associated with regulating repetitive or habitual behaviours, making this option incorrect.",
"id": "10025321",
"label": "b",
"name": "Occipital cortex",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The hypothalamus is primarily responsible for regulating various essential functions, including temperature, hunger, thirst, and the body's circadian rhythm. It is more linked to autonomic functions, hormonal regulation, and basic survival behaviours. The correct answer is the basal ganglia, which has a role in the coordination of movements and regulating repetitive or habitual behaviours.",
"id": "10025324",
"label": "e",
"name": "Hypothalamus",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. The basal ganglia (striatum) are a collection of subcortical forebrain nuclei that function in the coordination of movements and regulating repetitive or habitual behaviours. Dysregulation of the basal ganglia can lead to the development of obsessive-compulsive disorder (OCD) and related behaviours, where individuals may have an overwhelming urge to perform certain actions repeatedly (obsessions) and feel compelled to do them (compulsions), as in this vignette.",
"id": "10025320",
"label": "a",
"name": "Basal ganglia",
"picture": null,
"votes": 13
}
],
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"id": "3823",
"name": "Basal ganglia circuits",
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"id": "152",
"name": "Neuroscience",
"typeId": 7
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"question": "A 19 year old male teenager visits the GP with his mother, who is concerned about his mental health. He has started to perform certain behaviours obsessively, even when there seems to be no reason for them, such as turning the lights on and off and repetitive cleaning. He is otherwise fit and well, although has been to see the GP recently due to a teeth grinding habit that is still ongoing.\n\nWhich of the following brain structures is most likely implicated in this patient's behaviour?",
"sbaAnswer": [
"a"
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"totalVotes": 49,
"typeId": 1,
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} | MarksheetMark |
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