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173,466,376 | false | 20 | null | 6,495,207 | null | false | [] | null | 17,763 | {
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"choices": [
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is suggestive of normal, healthy bone density",
"id": "10026828",
"label": "c",
"name": "1.0 at the femoral neck",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This T score is suggestive of osteopenia. This may progress to osteoporosis if left untreated",
"id": "10026827",
"label": "b",
"name": "-1.5 at the femoral neck",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This T score is suggestive of osteopenia. This may progress to osteoporosis if left untreated",
"id": "10026829",
"label": "d",
"name": "-2.0 at the femoral neck",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Osteoporosis is defined as a T score of -2.5 or less at the femoral neck",
"id": "10026826",
"label": "a",
"name": "-2.5 at the femoral neck",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This T score is suggestive of normal, healthy bone (-1 and above is considered normal)",
"id": "10026830",
"label": "e",
"name": "-0.5 at the femoral neck",
"picture": null,
"votes": 4
}
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"id": "4476",
"name": "Osteoporosis",
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"id": "145",
"name": "Orthopaedics",
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"question": "A 64-year-old woman with a history of Cushing's syndrome presents to A&E with an abnormal fracture of her wrist. There is minimal trauma in her history and doctors consider a diagnosis of osteoporosis.\n\nWhat are the minimum values of her T score which would be consistent with this diagnosis?",
"sbaAnswer": [
"a"
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173,466,377 | false | 21 | null | 6,495,207 | null | false | [] | null | 17,764 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There is no phase 5 of the cardiac cycle",
"id": "10026835",
"label": "e",
"name": "Phase 5",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Class II and class IV antiarrhythmics act on the plateau phase",
"id": "10026832",
"label": "b",
"name": "Phase 2",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Class II antiarrhythmics act on phase 4",
"id": "10026834",
"label": "d",
"name": "Phase 4",
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"votes": 5
},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Class I antiarrhythmics act on phase 0",
"id": "10026833",
"label": "c",
"name": "Phase 0",
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"votes": 5
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "Phase 3 describes the repolarisation phase of the cardiac cycle. Class III antiarrhythmics (including sotalol and amiodarone) significantly prolong the cardiac action potential and, therefore, the refractory period of cardiac tissue. This can result in a prolonged QT interval (which may, paradoxically, cause arrhythmias)",
"id": "10026831",
"label": "a",
"name": "Phase 3",
"picture": null,
"votes": 40
}
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"name": "Class III antiarrhythmics",
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"question": "At which phase of the cardiac cycle do class III antiarrhythmics act?",
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"a"
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173,466,378 | false | 22 | null | 6,495,207 | null | false | [] | null | 17,765 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The bulbus cordis lies ventral to the primitive ventricle. It provides an outflow tract for both ventricles and develops into the right ventricle",
"id": "10026836",
"label": "a",
"name": "Bulbus cordis",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Embryologically connected to the primitive atrium, it develops into the superior vena cava",
"id": "10026839",
"label": "d",
"name": "Right sinus horn",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The primitive ventricle develops into the left ventricle",
"id": "10026837",
"label": "b",
"name": "Primitive ventricle",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The sinus venosus is the confluence of umbilical, vitelline and cardinal veins. It forms right and left sinus horns which develop into the superior and inferior vena cava",
"id": "10026840",
"label": "e",
"name": "Sinus venosus",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The primitive atrium develops into the left and right atria",
"id": "10026838",
"label": "c",
"name": "Primitive atrium",
"picture": null,
"votes": 3
}
],
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"id": "5926",
"name": "Development of valves and outflow tracts",
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"id": "171",
"name": "Embryology",
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"question": "Which of the following embryological structures becomes the right ventricle?",
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"a"
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173,466,379 | false | 23 | null | 6,495,207 | null | false | [] | null | 17,766 | {
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"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gingival hyperplasia (overgrowth of gums) is a potential side effect of calcium channel blockers",
"id": "10026845",
"label": "e",
"name": "Gingival hyperplasia",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Peripheral oedema is a potential side effect of calcium channel blockers.",
"id": "10026843",
"label": "c",
"name": "Peripheral oedema",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Flushing, secondary to vasodilation, is a potential side effect of calcium channel blockers",
"id": "10026844",
"label": "d",
"name": "Flushing",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Changes to hepatic function are very rare.",
"id": "10026842",
"label": "b",
"name": "Decreased hepatic function",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Angioedema describes the swelling of the deep layers of skin. It can occur anywhere in the body but commonly affects eyes, lips and genitalia. It is a side effect of both ARBs and ACE inhibitors.",
"id": "10026841",
"label": "a",
"name": "Angioedema",
"picture": null,
"votes": 19
}
],
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"name": "ACE inhibitors",
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"question": "Which of the following describes a side effect of angiotensin receptor blockers?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
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173,466,380 | false | 24 | null | 6,495,207 | null | false | [] | null | 17,767 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Increased skeletal pump activity increases venous return to the heart and causes ventricular myocytes to stretch to accommodate more blood. This allows the heart to generate a more forceful contraction",
"id": "10026846",
"label": "a",
"name": "Increased skeletal pump activity",
"picture": null,
"votes": 52
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Tachyarrhythmias reduce the time for filling and, therefore, reduce preload and myocyte stretch",
"id": "10026849",
"label": "d",
"name": "Tachyarrhythmias",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Atrial arrhythmias impair the amount of blood entering the ventricles and, therefore, reduce preload",
"id": "10026850",
"label": "e",
"name": "Atrial arrhythmias",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypovolaemia leads to a decreased venous return to the heart which reduces ventricular myocyte stretch, therefore the force of contraction would be less",
"id": "10026847",
"label": "b",
"name": "Hypovolaemia",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Restrictive cardiomyopathy would prevent myocytes from stretching and, therefore, reduces their force of contraction and stroke volume of the left ventricle",
"id": "10026848",
"label": "c",
"name": "Restrictive cardiomyopathy",
"picture": null,
"votes": 3
}
],
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"id": "5927",
"name": "Frank-Starling",
"status": null,
"topic": {
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"id": "159",
"name": "Cardiovascular physiology",
"typeId": 7
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"question": "According to Frank-Starling law, which of the following will increase the stroke volume of the left ventricle?",
"sbaAnswer": [
"a"
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173,466,381 | false | 25 | null | 6,495,207 | null | false | [] | null | 17,768 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This shows a function test reflective of obstructive lung disease (e.g. COPD). FEV1, FVC and TLCO are reduced. FEV1/FVC ratio is not preserved",
"id": "10026852",
"label": "b",
"name": "FEV1 - 2.6, FVC - 4.2, FEV1/FVC ratio - 0.62, reduced TLCO",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The FEV1, FVC, FEV1/FVC ratio values are reflective of obstructive lung disease, however, TLCO is reduced in restrictive lung disease",
"id": "10026854",
"label": "d",
"name": "FEV1 - 2.6, FVC - 4.2, FEV1/FVC ratio - 0.62, increased TLCO",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Restrictive lung disease shows a reduced FEV1, reduced FVC, reduced TLCO with a preserved (>0.7) FEV1/FVC ratio",
"id": "10026851",
"label": "a",
"name": "FEV1 - 3.1, FVC - 4.3, FEV1/FVC ratio - 0.72, reduced TLCO",
"picture": null,
"votes": 31
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The FEV1, FVC, FEV1/FVC ratio values are reflective of restrictive lung disease, however, TLCO is reduced in restrictive lung disease",
"id": "10026853",
"label": "c",
"name": "FEV1 - 3.1, FVC - 4.3, FEV1/FVC ratio - 0.72, increased TLCO",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is reflective of normal lung function",
"id": "10026855",
"label": "e",
"name": "FEV1 - 3.6, FVC - 5.0, FEV1/FVC ratio - 0.72, normal TLCO",
"picture": null,
"votes": 3
}
],
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},
"chapterId": 2693,
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"id": "5928",
"name": "Idiopathic pulmonary fibrosis",
"status": null,
"topic": {
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"id": "132",
"name": "Respiratory",
"typeId": 7
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"question": "Which of the following best describes the results of a lung function test performed on a 59-year-old male with idiopathic pulmonary fibrosis?",
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"a"
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173,466,382 | false | 26 | null | 6,495,207 | null | false | [] | null | 17,769 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The mixing of oxygenated and deoxygenated blood results in cyanosis within the first couple of days of life. It also increases the volume of blood directed to the lungs leading to fluid overload and right-sided heart failure",
"id": "10026856",
"label": "a",
"name": "Cyanosis",
"picture": null,
"votes": 31
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a consequence of coarctation of the aorta, where a segment is narrowed after the aorta branches into vessels supplying the upper limbs. Lower limbs tend to be hypotensive and cyanotic",
"id": "10026858",
"label": "c",
"name": "Increased pulse pressure in the upper extremities",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Wide pulse pressure is characteristic of patent ductus arteriosus. Patent ductus arteriosus is when the ductus arteriosus fails to close leading to a left-right shunt in the atria",
"id": "10026857",
"label": "b",
"name": "Wide pulse pressure",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a characteristic feature of tetralogy of Fallot and occurs during periods of exertion",
"id": "10026859",
"label": "d",
"name": "Hypercyanotic episodes",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Right sided heart failure is a consequence of truncus arteriosus, not left sided. This is due to the increased blood flow to the lungs leading to fluid overload.",
"id": "10026860",
"label": "e",
"name": "Left sided heart failure",
"picture": null,
"votes": 8
}
],
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"name": "Congenital malformations of the heart",
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"question": "Truncus arteriosus is a congenital malformation of the heart where the truncus arteriosus fails to divide resulting in the mixing of blood from the right and left ventricles.\n\nWhich of the following is a consequence of truncus arteriosus?",
"sbaAnswer": [
"a"
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173,466,383 | false | 27 | null | 6,495,207 | null | false | [] | null | 17,770 | {
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"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Resting membrane potential is -90mV, it is shifted to -80mV",
"id": "10026863",
"label": "c",
"name": "Resting membrane potential is shifted from +90mV to +80mV",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This occurs in hypokalaemia and means that cells require more stimulation to become excited",
"id": "10026862",
"label": "b",
"name": "Resting membrane potential is shifted to a more negative value",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The resting potential of cardiomyocytes is shifted from around -90mV to -80mV, this allows cells to be more easily excited",
"id": "10026861",
"label": "a",
"name": "Resting membrane potential is shifted to a less negative value",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Resting membrane potential is shifted from -90mV to -80mV",
"id": "10026864",
"label": "d",
"name": "Resting membrane potential is shifted from +80mV to +90mV",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hyperkalaemia causes the resting membrane potential to be shifted from -90mV to -80mV, this is closer to the threshold potential of 75mV",
"id": "10026865",
"label": "e",
"name": "Hyperkalaemia does not affect the resting membrane potential of cardiomyocytes",
"picture": null,
"votes": 3
}
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"id": "309",
"name": "Biochemistry, cell biology and clinical chemistry",
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"question": "Hyperkalaemia can lead to arrhythmias due to overexcitability of cardiomyocytes.\n\nWhich of the following describes the effect of hyperkalaemia on the resting potential of cardiac cells?",
"sbaAnswer": [
"a"
],
"totalVotes": 62,
"typeId": 1,
"userPoint": null
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173,466,384 | false | 28 | null | 6,495,207 | null | false | [] | null | 17,771 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is within the terminal sac stage; however, it begins 2 weeks earlier at week 26",
"id": "10026870",
"label": "e",
"name": "Week 28",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the beginning of the canalicular stage where terminal bronchioles divide into respiratory bronchioles and primitive alveoli begin to form",
"id": "10026867",
"label": "b",
"name": "Week 16",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the beginning of the pseudoglandular stage where bronchial buds begin to differentiate and tertiary bronchi begin to form",
"id": "10026868",
"label": "c",
"name": "Week 5",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the beginning of the terminal sac stage. Type I pneumocytes are in direct contact with the capillary bed and type II pneumocytes secrete large volumes of surfactant",
"id": "10026866",
"label": "a",
"name": "Week 26",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is when the alveolar stage begins and the number of adult alveoli increases. This continues until the child is around 8 years old",
"id": "10026869",
"label": "d",
"name": "Week 36",
"picture": null,
"votes": 9
}
],
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"id": "4533",
"name": "Development of the lungs",
"status": null,
"topic": {
"__typename": "Topic",
"id": "171",
"name": "Embryology",
"typeId": 7
},
"topicId": 171,
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"question": "Premature babies are at risk of having too little surfactant in their lungs. Surfactant is produced by type II pneumocytes which develop during the terminal sac stage.\n\nAt what week does the terminal sac stage begin?",
"sbaAnswer": [
"a"
],
"totalVotes": 61,
"typeId": 1,
"userPoint": null
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173,466,385 | false | 29 | null | 6,495,207 | null | false | [] | null | 17,772 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the formation of granulation tissue which occurs days to weeks after the initial injury",
"id": "10026873",
"label": "c",
"name": "Mesenchymal cells and inflammatory cells are recruited to the fracture site and form fibrin-rich granulation tissue which provides provisional stability",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Hard callus formation describes the calcification of the soft callus. This occurs weeks after the initial injury",
"id": "10026871",
"label": "a",
"name": "Endochondral ossification results in the calcification of a cartilaginous callus",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes soft callous formation which occurs before hard callus formation",
"id": "10026874",
"label": "d",
"name": "Mesenchymal cells differentiate resulting in chondrogenesis and a fibrocartilaginous network connecting the fracture ends",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes bone remodelling of the hard callus and occurs weeks to months after the initial injury",
"id": "10026872",
"label": "b",
"name": "Osteoclast and osteoblast activity leads to the formation of compact bone at the callus centre and lamellar bone at the callus edges",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This occurs immediately after the initial injury due to disruption of blood vessels surrounding the fracture",
"id": "10026875",
"label": "e",
"name": "A haematoma forms at the site of the fracture and provides a framework for subsequent healing",
"picture": null,
"votes": 3
}
],
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"id": "4209",
"name": "Fracture Healing",
"status": null,
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"__typename": "Topic",
"id": "154",
"name": "Musculoskeletal physiology and disease",
"typeId": 7
},
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"question": "Hard callus formation is essential in fracture healing.\n\nWhich of the following best describes this process?",
"sbaAnswer": [
"a"
],
"totalVotes": 57,
"typeId": 1,
"userPoint": null
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173,466,386 | false | 30 | null | 6,495,207 | null | false | [] | null | 17,773 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "DNP causes the mitochondrial membrane to become leakier. This means fewer protons pass through H+/ATPase and therefore leads to a reduced production of ATP. The energy generated by the electrochemical gradient results in a release of heat and hyperthermia. Oxygen uptake is increased as a result of increased cell metabolism.",
"id": "10026876",
"label": "a",
"name": "Reduced ATP production with increased oxygen uptake and increased heat production",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "DNP reduces the number of protons passing through ATPase and therefore reduces ATP production. Energy is released as heat instead resulting in hyperthermia. Oxygen uptake increases as a result of increased cell metabolism.",
"id": "10026877",
"label": "b",
"name": "No change in ATP production with increased oxygen uptake and increased heat production",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "DNP reduces the number of protons passing through ATPase and therefore reduces ATP production. Energy is released as heat instead resulting in hyperthermia. Oxygen uptake increases as a result of increased cell metabolism.",
"id": "10026880",
"label": "e",
"name": "Increased ATP production with increased oxygen uptake and decreased heat production",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "DNP reduces the number of protons passing through ATPase and therefore reduces ATP production. Energy is released as heat instead resulting in hyperthermia. Oxygen uptake increases as a result of increased cell metabolism.",
"id": "10026879",
"label": "d",
"name": "Reduced ATP production with increased oxygen uptake and decreased heat production",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "DNP reduces the number of protons passing through ATPase and therefore reduces ATP production. Energy is released as heat instead resulting in hyperthermia. Oxygen uptake increases as a result of increased cell metabolism.",
"id": "10026878",
"label": "c",
"name": "Increased ATP production with decreased oxygen uptake and increased heat production",
"picture": null,
"votes": 24
}
],
"comments": [],
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},
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"id": "5930",
"name": "Electron transport chain",
"status": null,
"topic": {
"__typename": "Topic",
"id": "309",
"name": "Biochemistry, cell biology and clinical chemistry",
"typeId": 7
},
"topicId": 309,
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"question": "2,4-Dinitrophenol (DNP) is an illegal drug that can be used for weight loss. It makes the mitochondrial membrane more permeable to protons.\n\nWhich of the following describes the effects of 2,4-DNP on ATP production?",
"sbaAnswer": [
"a"
],
"totalVotes": 56,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,387 | false | 31 | null | 6,495,207 | null | false | [] | null | 17,774 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of heparin",
"id": "10026883",
"label": "c",
"name": "Activation of antithrombin leading to inactivation of thrombin factors Xa and IXa",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Aspirin is an irreversible inhibitor of COX-1 enzymes",
"id": "10026884",
"label": "d",
"name": "Reversible inhibition of COX-2 enzymes preventing thromboxane synthesis",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of action for glycoprotein IIb/IIIa inhibitors, such as abciximab",
"id": "10026882",
"label": "b",
"name": "Blockade of glycoprotein IIb/IIIa binding to fibrinogen",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Aspirin is a cyclooxygenase inhibitor, at low doses it inhibits thromboxane synthesis, thereby preventing platelet aggregation",
"id": "10026881",
"label": "a",
"name": "Irreversible inhibition of COX-1 enzymes preventing thromboxane synthesis",
"picture": null,
"votes": 44
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of action of warfarin",
"id": "10026885",
"label": "e",
"name": "Inhibition of vitamin K epoxide reductase",
"picture": null,
"votes": 0
}
],
"comments": [],
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"__typename": "Chapter",
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4216",
"name": "Aspirin",
"status": null,
"topic": {
"__typename": "Topic",
"id": "169",
"name": "Cardiovascular pharmacology",
"typeId": 7
},
"topicId": 169,
"totalCards": null,
"typeId": null,
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},
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"question": "Low-dose aspirin can be used as an antiplatelet agent in cardiovascular disease.\n\nWhich of the following describes the mechanism by which it does this?",
"sbaAnswer": [
"a"
],
"totalVotes": 63,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,388 | false | 32 | null | 6,495,207 | null | false | [] | null | 17,775 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Her history suggests a diagnosis of familial hypercholesterolaemia. Her strong family history (where all generations are affected) indicates that this is more likely to be autosomal dominant",
"id": "10026887",
"label": "b",
"name": "Autosomal recessive",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Her history suggests a diagnosis of familial hypercholesterolaemia. Her strong family history (where all generations are affected) indicates that this is more likely to be autosomal dominant",
"id": "10026889",
"label": "d",
"name": "Mitochondrial",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Her family history indicates that both males AND females are affected by the condition. X-linked recessive conditions typically show a preference for males as there is only one X chromosome (the other being a Y), therefore they always inherit the disease.",
"id": "10026888",
"label": "c",
"name": "X-linked recessive",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "X-linked dominant disorders can affect males and females of a generation equally; however, it is impossible for a male with an X-linked dominant condition to pass it on to their sons (i.e. her uncle)",
"id": "10026890",
"label": "e",
"name": "X-linked dominant",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Her family history and high cholesterol levels in relation to her age indicate a diagnosis of familial hypercholesterolaemia. This is due to mutations in LDLR, APOB, and PCSK9 genes. It is an autosomal dominant condition.",
"id": "10026886",
"label": "a",
"name": "Autosomal dominant",
"picture": null,
"votes": 40
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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},
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"demo": null,
"entitlement": null,
"id": "5931",
"name": "Autosomal dominant disorders",
"status": null,
"topic": {
"__typename": "Topic",
"id": "312",
"name": "Genetics and molecular medicine",
"typeId": 7
},
"topicId": 312,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
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"difficulty": 1,
"dislikes": 0,
"explanation": "Autosomal dominant",
"highlights": [],
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"question": "A 27-year-old woman presents to her GP with her partner to discuss plans for starting a family. She is concerned about her family history of heart disease, as several relatives have died from myocardial infarctions at a young age. Her maternal grandfather passed away at 45, and both her mother and maternal uncle died at 48 and 52, respectively, from heart attacks. Her 35-year-old brother recently underwent a triple heart bypass. Her grandmother lived to 89 and was healthy, and her father has no known health issues. \n\nRoutine blood tests show that her total cholesterol is 230mg/dL (normal <210mg/dL).\n\n\nGiven her family history, what is the most likely mode of inheritance for this disorder?",
"sbaAnswer": [
"a"
],
"totalVotes": 61,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,389 | false | 33 | null | 6,495,207 | null | false | [] | null | 17,776 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Androgens, retinoic acid and thyroid hormone are all lipid soluble. Activation of this type of receptor exerts control over gene expression",
"id": "10026891",
"label": "a",
"name": "Steroid receptor",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "G protein coupled receptors are transmembrane proteins that translate extracellular signals into intracellular signals. Examples include muscarinic acetylcholine receptors",
"id": "10026892",
"label": "b",
"name": "G protein coupled receptors",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is a major example of an enzyme linked receptor, insulin and growth factor receptors have tyrosine kinase activity",
"id": "10026895",
"label": "e",
"name": "Tyrosine kinase linked receptor",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Activation of ligand gated ion channels allows rapid changes in electrochemical gradients. Examples include GABA and serotonin receptors",
"id": "10026893",
"label": "c",
"name": "Ligand gated ion channel",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Enzyme linked receptors are transmembrane proteins with enzymatic activity. Receptor tyrosine kinases are an example of enzyme linked receptors",
"id": "10026894",
"label": "d",
"name": "Enzyme linked receptor",
"picture": null,
"votes": 4
}
],
"comments": [],
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5932",
"name": "Steroid receptors",
"status": null,
"topic": {
"__typename": "Topic",
"id": "195",
"name": "Pharmacology",
"typeId": 7
},
"topicId": 195,
"totalCards": null,
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},
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"question": "Androgen receptors, retinoic acid receptors and thyroid hormone receptors are all examples of which type of receptor?",
"sbaAnswer": [
"a"
],
"totalVotes": 59,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,390 | false | 34 | null | 6,495,207 | null | false | [] | null | 17,777 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Heberden's nodes are bony spurs that occur close to the DIP joint of the hand. They are a characteristic feature of osteoarthritis of the hands",
"id": "10026896",
"label": "a",
"name": "Heberden's nodes",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is characteristic of rheumatoid and psoriatic arthritis, pain typically worsens with use in osteoarthritis",
"id": "10026900",
"label": "e",
"name": "Pain and stiffness that improves with movement",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Rheumatoid nodules occur close to joints affected by rheumatoid arthritis. They are the most common dermatologic manifestation of rheumatoid arthritis",
"id": "10026898",
"label": "c",
"name": "Freely moveable lumps on the fingers and forearm",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be suggestive of a diagnosis of psoriatic arthritis",
"id": "10026897",
"label": "b",
"name": "Patches of a silver scaly rash",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is characteristic of rheumatoid arthritis. Osteoarthritis of the hands typically affects the DIP and PIP joints",
"id": "10026899",
"label": "d",
"name": "Pain and stiffness affecting the MCP and PIP joints of the hand",
"picture": null,
"votes": 21
}
],
"comments": [],
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"id": "3766",
"name": "Osteoarthritis",
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"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
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"question": "A 65-year-old woman presents to her GP with pain and stiffness in her hands when trying to complete her daily activities. The GP suspects osteoarthritis.\n\nWhich of the following would be most suggestive of osteoarthritis?",
"sbaAnswer": [
"a"
],
"totalVotes": 57,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,391 | false | 35 | null | 6,495,207 | null | false | [] | null | 17,778 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient has presented with foot drop. Foot drop is due to an injury of the common peroneal nerve (a terminal branch of the sciatic nerve.) Damage results in loss of function of the ankle and foot dorsiflexors.",
"id": "10026901",
"label": "a",
"name": "Common peroneal nerve",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Like the common peroneal nerve, the tibial nerve is a terminal branch of the sciatic nerve. Injury to this nerve would cause a loss of inversion of the foot",
"id": "10026904",
"label": "d",
"name": "Tibial nerve",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The obturator nerve provided motor innervation to the medial compartment of the thigh. Injury would cause weakness of leg extension and paraesthesia in the groin area",
"id": "10026905",
"label": "e",
"name": "Obturator nerve",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The femoral nerve supplies muscles in the anterior thigh. Injury to the femoral nerve may cause difficulty in walking and straightening the knee, leg or ankle",
"id": "10026902",
"label": "b",
"name": "Femoral nerve",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The saphenous nerve provides sensory innervation of the anterior surface of the leg. Injury would not produce motor symptoms like \"foot drop\"",
"id": "10026903",
"label": "c",
"name": "Saphenous nerve",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"id": "3773",
"name": "Common peroneal nerve injury",
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"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
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"question": "A 36-year-old female presents to the GP with difficulty walking. On examination, she finds it difficult to lift or move her left foot and toes. She is unable to dorsiflex. She recalls that over the past two weeks, she has been kneeling for long amounts of time whilst interacting with children as a nursery worker.\n\nGiven the likely diagnosis, which nerve is likely to be injured nerve?",
"sbaAnswer": [
"a"
],
"totalVotes": 61,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,392 | false | 36 | null | 6,495,207 | null | false | [] | null | 17,779 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Profuse vomiting leads to the expulsion of HCl from the stomach. This results in hypokalaemia, hypochloremic metabolic alkalosis",
"id": "10026907",
"label": "b",
"name": "Profuse vomiting",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is acidotic. Their PaO2 is low and their PaCO2 is high indicating that this is respiratory acidosis. Their base excess and HCO3- are high indicating metabolic compensation which means that this is a chronic respiratory acidosis. A neuromuscular weakness of respiratory muscles or chronic respiratory disease may lead to chronic respiratory acidosis.",
"id": "10026906",
"label": "a",
"name": "Neuromuscular weakness resulting in chronic hypoventilation",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Production of ketoacids in diabetic ketoacidosis results in metabolic acidosis. Compensatory hyperventilation would remove some carbonic acid from the blood and an ABG would show a reduced PaCO2 and elevated PaO2",
"id": "10026910",
"label": "e",
"name": "Diabetic ketoacidosis resulting in compensatory hyperventilation",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Reduced end-organ perfusion means cells require anaerobic respiration to produce ATP. This leads to the production of lactic acid and results in metabolic acidosis. PaO2 and PaCO2 are likely to be normal in acute cases with a low HCO3- and base exces.",
"id": "10026909",
"label": "d",
"name": "Sepsis leading to reduced end-organ perfusion and production of lactic acid by cells",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hyperventilation results in a low PaCO2 and high PaO2. This results in reduced levels of carbonic acid in the blood and leads to respiratory alkalosis",
"id": "10026908",
"label": "c",
"name": "Anxiety attack leading to acute hyperventilation",
"picture": null,
"votes": 7
}
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"name": "Respiratory acidosis",
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"name": "Respiratory",
"typeId": 7
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"question": "An ABG is performed on a 68-year-old female in A&E. It shows the following:\n\n\n||||\n|--------------|:-------:|------------------|\n|pH|7.3|7.35 - 7.45|\n|PaO₂|7.5 kPa|11 - 15|\n|PaCO₂|10.1 kPa|4.6 - 6.4|\n|Bicarbonate|32 mmol/L|22 - 30|\n|Base Excess|+3 mmol/L|-2 to +2|\n\n\nWhich of the following best describes a potential cause of this patient's abnormality?",
"sbaAnswer": [
"a"
],
"totalVotes": 62,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,393 | false | 37 | null | 6,495,207 | null | false | [] | null | 17,780 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Albumin levels decrease during inflammation. This is likely due to reduced production by the liver and increased loss",
"id": "10026911",
"label": "a",
"name": "Albumin",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Lipopolysaccharide binding protein is a positive phase protein that binds to bacterial lipopolysaccharide to induce an immune response",
"id": "10026913",
"label": "c",
"name": "Lipopolysaccharide binding protein",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Fibrinogen is a plasma protein synthesised by the liver. Levels increase during inflammation, therefore, it is a positive acute phase reactant",
"id": "10026915",
"label": "e",
"name": "Fibrinogen",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "C-reactive protein is a positive-phase protein released by the liver in response to inflammation during the acute phase",
"id": "10026912",
"label": "b",
"name": "C-reactive protein",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Synthesis of ferritin increases as a nonspecific response that makes up part of the inflammatory response",
"id": "10026914",
"label": "d",
"name": "Ferritin",
"picture": null,
"votes": 8
}
],
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"id": "5934",
"name": "Acute phase reactants",
"status": null,
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"name": "Biochemistry, cell biology and clinical chemistry",
"typeId": 7
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"question": "Negative phase reactants are acute phase proteins whose concentration decreases as inflammation increases.\n\nWhich of the following is an example of a negative phase reactant?",
"sbaAnswer": [
"a"
],
"totalVotes": 56,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,394 | false | 38 | null | 6,495,207 | null | false | [] | null | 17,781 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Propranolol may be used as a preventive headache medication. It is not contraindicated in migraine.",
"id": "10026918",
"label": "c",
"name": "Migraine with aura",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Propranolol can help with cardiac arrhythmias. It is not contraindicated.",
"id": "10026919",
"label": "d",
"name": "Cardiac arrhythmia",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Beta-blockers, like propranolol, can increase airway reactivity and may interfere with the activity of beta-agonists. They are contraindicated in asthma as a result.",
"id": "10026916",
"label": "a",
"name": "Asthma",
"picture": null,
"votes": 49
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Caution is advised against the use of beta-blockers in diabetic patients as a result of the risk of hypoglycaemia. It is not contraindicated, however.",
"id": "10026920",
"label": "e",
"name": "Diabetes",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There is no contraindication to the use of beta-blockers in patients with COPD.",
"id": "10026917",
"label": "b",
"name": "COPD",
"picture": null,
"votes": 1
}
],
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"id": "5935",
"name": "Propranolol",
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"name": "Pharmacology",
"typeId": 7
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"question": "Which of the following is a contraindication to propranolol?",
"sbaAnswer": [
"a"
],
"totalVotes": 62,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,395 | false | 39 | null | 6,495,207 | null | false | [] | null | 17,782 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "G6PD is a sex linked recessive disease",
"id": "10026922",
"label": "b",
"name": "Autosomal recessive",
"picture": null,
"votes": 31
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "G6PD is a sex linked recessive disease",
"id": "10026924",
"label": "d",
"name": "Mitochondrial",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "G6PD is a sex linked recessive disease",
"id": "10026925",
"label": "e",
"name": "X linked dominant",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "G6PD is an inherited sex-linked recessive disease. The most severe \"Mediterranean\" variant commonly affects those in Southern Europe, Northern Africa and the Middle East Deficiency in G6PD results in haemolytic anaemia which is worse after taking ibuprofen",
"id": "10026921",
"label": "a",
"name": "Sex linked recessive",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "G6PD is a sex linked recessive disease",
"id": "10026923",
"label": "c",
"name": "Autosomal dominant",
"picture": null,
"votes": 8
}
],
"comments": [],
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"id": "5936",
"name": "Sex linked recessive disorders",
"status": null,
"topic": {
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"name": "Genetics and molecular medicine",
"typeId": 7
},
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"question": "A 23-year-old man of Pakistani heritage presents to the GP with intermittent periods of yellow-tinted sclera. He notes that this tends to happen after periods of illness or if he takes ibuprofen. A blood smear shows Heinz bodies and bite cells. The GP suspects a diagnosis of G6PD deficiency.\n\nWhich of the following describes the mode of inheritance of G6PD deficiency?",
"sbaAnswer": [
"a"
],
"totalVotes": 62,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,396 | false | 40 | null | 6,495,207 | null | false | [] | null | 17,783 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Digoxin toxicity typically presents with hyperkalaemia and bradycardia with prolonged PR and QRS complexes. The most common ocular manifestation of dioxin toxicity is yellow/green tinted vision. Treatment of digoxin toxicity is with \"digibind.\"",
"id": "10026926",
"label": "a",
"name": "Digoxin toxicity",
"picture": null,
"votes": 45
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Beta blocker toxicity may produce bradycardia. However, it is also likely to produce hypotension, hypothermia and hypoglycaemia. It would not cause yellow tinted vision",
"id": "10026928",
"label": "c",
"name": "Beta blocker toxicity",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Rivaroxaban toxicity could result in a haemorrhagic stroke which could lead to ocular manifestations like yellow-tinted vision. However, it is unlikely to produce hyperkalaemia seen is this patient",
"id": "10026929",
"label": "d",
"name": "Haemorrhagic stroke secondary to rivaroxaban toxicity",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Early onset dementia may explain her period of confusion, however, it would not explain her hyperkalaemia, bradycardia or yellow tinted vision",
"id": "10026927",
"label": "b",
"name": "Early onset dementia",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A urinary tract infection may produce the symptoms of confusion seen in this patient. However, a UTI is unlikely to produce the bradycardia, hyperkalaemia nor yellow tinted vision that this patient is experiencing",
"id": "10026930",
"label": "e",
"name": "Urinary tract infection",
"picture": null,
"votes": 0
}
],
"comments": [],
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"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4552",
"name": "Digoxin",
"status": null,
"topic": {
"__typename": "Topic",
"id": "169",
"name": "Cardiovascular pharmacology",
"typeId": 7
},
"topicId": 169,
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"question": "An 88-year-old woman with a history of atrial fibrillation and osteoarthritis presents to A&E with her son. He says that she has been complaining of her heart \"feeling funny\" and has become very confused since breakfast. Additionally, she has become distressed and is complaining of \"yellow vision\". Her regular medications include digoxin, rivaroxaban, bisoprolol and paracetamol.\n\nHer bloods show raised serum potassium levels and her ECG shows bradycardia with prolonged PR intervals and QRS complexes.\n\nWhat is the single most likely cause of her presentation?",
"sbaAnswer": [
"a"
],
"totalVotes": 60,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,397 | false | 41 | null | 6,495,207 | null | false | [] | null | 17,784 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The haemoglobin molecule has 4 binding sites for oxygen",
"id": "10026931",
"label": "a",
"name": "4",
"picture": null,
"votes": 60
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The haemoglobin molecule has 4 binding sites for oxygen",
"id": "10026933",
"label": "c",
"name": "2",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The haemoglobin molecule has 4 binding sites for oxygen",
"id": "10026935",
"label": "e",
"name": "5",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The haemoglobin molecule has 4 binding sites for oxygen",
"id": "10026934",
"label": "d",
"name": "3",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The haemoglobin molecule has 4 binding sites for oxygen. Myoglobin, a protein similar to haemoglobin, has capacity to bind to 1 molecule of oxygen",
"id": "10026932",
"label": "b",
"name": "1",
"picture": null,
"votes": 1
}
],
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"id": "5937",
"name": "Haemoglobin",
"status": null,
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"id": "309",
"name": "Biochemistry, cell biology and clinical chemistry",
"typeId": 7
},
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"question": "Haem is the prosthetic group of haemoglobin that allows oxygen to bind to haemoglobin.\n\nWhat is the maximum amount of oxygen molecules that can bind to a molecule of haemoglobin?",
"sbaAnswer": [
"a"
],
"totalVotes": 61,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,398 | false | 42 | null | 6,495,207 | null | false | [] | null | 17,785 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the movement of ions during the cells' resting potential. This is maintained by sodium/potassium pumps.",
"id": "10026940",
"label": "e",
"name": "3 sodium ions are pumped out of the cell and 2 potassium ions are pumped into the cell",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the movement of ions in phase 1 where sodium channels close and potassium channels open briefly.",
"id": "10026938",
"label": "c",
"name": "Potassium ions flow out of the cell through potassium channels",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Phase 0 describes the rapid depolarisation of cardiac cells. This occurs through a net movement of positive sodium ions into the cell causing membrane potential to become more positive",
"id": "10026936",
"label": "a",
"name": "Sodium ions flow into the cell through sodium channels",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes the movement of ions in phase 2. The flow of calcium ions creates a plateau in membrane potential.",
"id": "10026939",
"label": "d",
"name": "Calcium ions flow into the cell through L-type calcium channels",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would cause membrane potential to become more negative and cardiac cells would be unable to reach the threshold potential for depolarisation",
"id": "10026937",
"label": "b",
"name": "Sodium ions flow out of the cell through sodium channels",
"picture": null,
"votes": 2
}
],
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5938",
"name": "Cardiac action potentials",
"status": null,
"topic": {
"__typename": "Topic",
"id": "159",
"name": "Cardiovascular physiology",
"typeId": 7
},
"topicId": 159,
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"question": "Which of the following describes the movement of ions during phase 0 of the cardiac action potential?",
"sbaAnswer": [
"a"
],
"totalVotes": 63,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,399 | false | 43 | null | 6,495,207 | null | false | [] | null | 17,786 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would not cause any of the symptoms experienced by the patient.",
"id": "10026945",
"label": "e",
"name": "Damage to flexor carpi muscles",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would cause the patient's inability to produce a thumbs up but would not cause the wrist drop experienced",
"id": "10026944",
"label": "d",
"name": "Damage to extensor pollicis longus",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Compression of the ulnar nerve occurs at the elbow (Cubital tunnel syndrome) or wrist (ulnar tunnel syndrome). It results in pain/numbness in the forearm and 4th and 5th fingers.",
"id": "10026942",
"label": "b",
"name": "Compression of the ulnar nerve",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This history is characteristic of \"Saturday night palsy\" where the radial nerve is compressed against the spiral groove of the humerus. It results in patients being unable to make a thumbs up, loss of finger extension and wrist drop",
"id": "10026941",
"label": "a",
"name": "Compression of the radial nerve",
"picture": null,
"votes": 49
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would cause the \"wrist drop\" experienced by the patient but would not affect his ability to form a thumbs-up",
"id": "10026943",
"label": "c",
"name": "Damage to extensor carpi muscles",
"picture": null,
"votes": 0
}
],
"comments": [],
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"__typename": "Chapter",
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"demo": null,
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"id": "3950",
"name": "Radial nerve injuries",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
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"question": "A 21-year-old student returns from a night out and falls asleep on a chair with his hand hanging over the back of the seat. When he wakes up he is unable to lift his wrist or make a thumbs up.\n\nWhat is the most likely cause of his symptoms?",
"sbaAnswer": [
"a"
],
"totalVotes": 59,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,400 | false | 44 | null | 6,495,207 | null | false | [] | null | 17,787 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Stopping antibiotic courses early may mean that not all of the pathogens have been destroyed. It is important to complete courses to prevent relapse and antibiotic resistance.",
"id": "10026950",
"label": "e",
"name": "Stop antibiotic courses before the course is due to end if the patient feels better",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Whilst it is important to complete a course of antibiotics, there is little clinical benefit from using longer courses than recommended if the infection was cleared by the initial course.",
"id": "10026949",
"label": "d",
"name": "Use longer courses than recommended antibiotics to ensure that infections are completely cleared",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Vaccination of animals prevents the transmission of infection between animals and reduces the need for antibiotics",
"id": "10026946",
"label": "a",
"name": "Ensure livestock are vaccinated to prevent the spread of disease",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Evidence has shown that infections with delayed treatment have a higher rate of antibiotic resistance. Less severe infections are also more likely to require weaker antibiotics and enable clinicians to preserve the use of strong antibiotics",
"id": "10026947",
"label": "b",
"name": "Delayed treatment of infections until patients need antibiotics",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Overuse of antibiotics in animals who do not need them is a massive factor in widespread antibiotic resistance. Farmers should use vaccinations to prevent the spread of disease, not antibiotics",
"id": "10026948",
"label": "c",
"name": "Use of antibiotics in agriculture to prevent transmission of infection through food and animals",
"picture": null,
"votes": 7
}
],
"comments": [],
"concept": {
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5691",
"name": "Mechanisms of anti-microbial resistance",
"status": null,
"topic": {
"__typename": "Topic",
"id": "148",
"name": "Microbiology",
"typeId": 7
},
"topicId": 148,
"totalCards": null,
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"question": "Which of the following describes a method of preventing widespread anti-microbial resistance?",
"sbaAnswer": [
"a"
],
"totalVotes": 60,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,401 | false | 45 | null | 6,495,207 | null | false | [] | null | 17,788 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "5-lipooxygenase catalyses the conversion of arachidonic acid into 5-HpETE. It is involved in the production of leukotrienes.",
"id": "10026953",
"label": "c",
"name": "5-lipooxygenase",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Cyclo-oxygenase (COX) enzymes 1 and 2 catalyse the conversion of arachidonic acid into prostaglandin H2. NSAIDs are COX inhibitors and prevent the production of prostaglandin H2 and downstream inflammatory mediators.",
"id": "10026951",
"label": "a",
"name": "Cyclo-oxygenase enzymes 1 and 2",
"picture": null,
"votes": 54
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Thromboxane synthase catalyses the formation of thromboxane from prostaglandin H2",
"id": "10026955",
"label": "e",
"name": "Thromboxane synthase",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cytochrome P450 is a hepatic enzyme that catalyses the breakdown of many NSAIDs, such as ibuprofen",
"id": "10026954",
"label": "d",
"name": "Cytochrome P450",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Phospholipase A2 catalyses the conversion of phospholipids into arachidonic acid in response to injury.",
"id": "10026952",
"label": "b",
"name": "Phospholipase A2",
"picture": null,
"votes": 6
}
],
"comments": [],
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5939",
"name": "NSAIDs",
"status": null,
"topic": {
"__typename": "Topic",
"id": "195",
"name": "Pharmacology",
"typeId": 7
},
"topicId": 195,
"totalCards": null,
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},
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"question": "Arachidonic acid is an essential fatty acid that is used in the synthesis of prostaglandins, leukotrienes and thromboxane. Non-steroidal anti-inflammatory drugs inhibit its conversion into these inflammatory mediators.\n\nWhich enzyme do NSAIDs inhibit?",
"sbaAnswer": [
"a"
],
"totalVotes": 62,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,402 | false | 46 | null | 6,495,207 | null | false | [] | null | 17,789 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the expiratory reserve volume",
"id": "10026957",
"label": "b",
"name": "1L",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Vital capacity is equal to inspiratory reserve volume + tidal volume + expiratory reserve volume. Expiratory reserve volume is equal to functional residual capacity - residual volume (2500ml-1500ml=1000ml). Therefore, inspiratory reserve volume is equal to 4.5L - 0.5L - 1l = 3L",
"id": "10026956",
"label": "a",
"name": "3L",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is equal to vital capacity - tidal volume. To calculate inspiratory reserve volume, expiratory reserve volume must also be calculated and then subtracted from vital capacity",
"id": "10026960",
"label": "e",
"name": "4L",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is equal to vital capacity - tidal volume - residual capacity. The residual volume must be added to this to make an inspiratory reserve volume of 3L",
"id": "10026958",
"label": "c",
"name": "1.5L",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is equal to vital capacity - tidal volume - residual volume. To calculate inspiratory reserve volume, expiratory reserve volume must be calculated first which is equal to functional residual capacity - residual volume",
"id": "10026959",
"label": "d",
"name": "2.5L",
"picture": null,
"votes": 4
}
],
"comments": [],
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"id": "5940",
"name": "Respiratory physiology",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
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"question": "A 35-year-old is undergoing some pulmonary function testing.\n\nHis tidal volume is 500ml, his vital capacity is 4.5L, his functional redidual capacity is 2.5L and his residual volume is 1.5L.\n\nPlease calculate his inspiratory reserve volume",
"sbaAnswer": [
"a"
],
"totalVotes": 59,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,403 | false | 47 | null | 6,495,207 | null | false | [] | null | 17,790 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Radial nerve palsy would not affect the ring finger as it is supplied by the ulnar nerve. Palsy of the radial nerve causes wrist drop, loss of finger extension and loss of the ability to make a thumbs up.",
"id": "10026963",
"label": "c",
"name": "Radial nerve palsy",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ulnar nerve palsy would also affect the 4th and 5th fingers of the hands, however, it would produce a sensory deficit in these fingers and the medial portion of the forearm",
"id": "10026962",
"label": "b",
"name": "Ulnar nerve palsy",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Dupuytren's contracture is the abnormal thickening of tissue in the palm. It causes fingers to curl towards the hand. It can be hereditary but it is also linked to smoking, alcoholism and diabetes",
"id": "10026961",
"label": "a",
"name": "Dupuytren's contracture",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Median nerve palsy commonly manifests as carpal tunnel syndrome. It causes pain/numbness/weakness in the first 3 fingers of the hand.",
"id": "10026965",
"label": "e",
"name": "Median nerve palsy",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Flexor tendinopathy may cause fingers to curl over, however, it does not cause the thickening of the skin and it usually causes pain",
"id": "10026964",
"label": "d",
"name": "Flexor tendinopathy",
"picture": null,
"votes": 4
}
],
"comments": [],
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"id": "5941",
"name": "Dupuytren's contracture",
"status": null,
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"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
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"question": "A 53-year-old male presents to his GP after noticing that he is unable to straighten his ring finger on his right hand. He says that this has been progressive over the last year\n\nOn examination, his ring finger is flexed to around 35 degrees and the GP is unable to correct the deformity with passive movement and the skin of his ring finger appears thickened. He is not in any pain. He is a long-term smoker and was diagnosed with type-2 diabetes mellitus 4 years ago.\n\nWhat is the likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 59,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,404 | false | 48 | null | 6,495,207 | null | false | [] | null | 17,791 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Acetylcholine receptors are an example of G-protein coupled receptors",
"id": "10026968",
"label": "c",
"name": "Acetylcholine receptors",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "GABA receptors are an example of ligand gated receptors",
"id": "10026969",
"label": "d",
"name": "GABA receptors",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Serotonin receptors are an example of ligand gated receptors",
"id": "10026970",
"label": "e",
"name": "Serotonin receptors",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Androgen receptors are an example of steroid receptors",
"id": "10026967",
"label": "b",
"name": "Androgen receptors",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Insulin receptors are tyrosine kinase-linked receptors. When insulin binds to its receptor it triggers a signalling cascade that regulates metabolism and cell growth",
"id": "10026966",
"label": "a",
"name": "Insulin receptors",
"picture": null,
"votes": 27
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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},
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"demo": null,
"entitlement": null,
"id": "5942",
"name": "Kinase linked receptors",
"status": null,
"topic": {
"__typename": "Topic",
"id": "195",
"name": "Pharmacology",
"typeId": 7
},
"topicId": 195,
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},
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"multiAnswer": null,
"pictures": [],
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"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following are examples of kinase-linked receptors",
"sbaAnswer": [
"a"
],
"totalVotes": 60,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,405 | false | 49 | null | 6,495,207 | null | false | [] | null | 17,792 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "No stages of respiration take place in the outer membrane",
"id": "10026975",
"label": "e",
"name": "Mitochondrial outer membrane",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The Krebs cycle (citric acid cycle) takes place in the mitochondrial matrix. It yields 12 ATP molecules per cycle",
"id": "10026971",
"label": "a",
"name": "Mitochondrial matrix",
"picture": null,
"votes": 51
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "No stages of respiration take place in the nucleus",
"id": "10026974",
"label": "d",
"name": "Nucleus",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The Krebs cycle takes place in the mitochondrial matrix. Glycolysis takes place in the cytoplasm",
"id": "10026972",
"label": "b",
"name": "Cytoplasm",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The Krebs cycle takes place in the mitochondrial matrix. The electron transport chain takes place in the cytoplasm",
"id": "10026973",
"label": "c",
"name": "Mitochondrial inner membrane",
"picture": null,
"votes": 6
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"id": "2693",
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5943",
"name": "Krebs cycle",
"status": null,
"topic": {
"__typename": "Topic",
"id": "309",
"name": "Biochemistry, cell biology and clinical chemistry",
"typeId": 7
},
"topicId": 309,
"totalCards": null,
"typeId": null,
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"userNote": null,
"videos": []
},
"conceptId": 5943,
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"question": "Where in the cell does the Krebs cycle take place?",
"sbaAnswer": [
"a"
],
"totalVotes": 62,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,406 | false | 50 | null | 6,495,207 | null | false | [] | null | 17,793 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Compartment syndrome is a painful condition caused by an increase in intra-compartment compression. This is often due to trauma and can lead to compression of arteries, veins and nerves resulting in pain, pallor, paraesthesia, pulselessness and, eventually, paralysis.",
"id": "10026976",
"label": "a",
"name": "Compartment syndrome",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Upper extremity deep vein thrombosis is rare but could occur following surgical fixation of an upper extremity fracture. Given this patient's history of trauma, the most likely diagnosis is compartment syndrome",
"id": "10026979",
"label": "d",
"name": "Upper extremity deep vein thrombosis",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Surgery may cause nerve damage which can lead to pain. However, this is more likely to be burning/shooting pain and would not present with paraesthesia like this patient.",
"id": "10026980",
"label": "e",
"name": "Neuropathic pain",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The patient's history does not suggest that this is a normal level of pain, especially as it has not gotten better with pain relief and there is evidence of paraesthesia",
"id": "10026977",
"label": "b",
"name": "Normal post-operative pain",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Post-operative infections will typically appear 3-7 days after surgery. They will normally present with systemic symptoms, such as fever and malaise, alongside pain",
"id": "10026978",
"label": "c",
"name": "Post-operative infection",
"picture": null,
"votes": 3
}
],
"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": "3903",
"name": "Compartment syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
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"question": "A 35-year-old man presents to A&E after a car accident. He has a displaced fracture of his left ulna and is sent to theatres for open reduction and internal fixation. He is complaining of severe, intractable pain in his left arm that is uncontrolled with pain relief. He is also complaining of tingling in the fingers of his left hand which has gotten progressively worse since surgery.\n\nGiven this patient's history, what is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 60,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,407 | false | 51 | null | 6,495,207 | null | false | [] | null | 17,794 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Grapefruit is a CYP450 inhibitor, and, therefore, it inhibits the breakdown of warfarin and makes patients more susceptible to bleeds",
"id": "10026981",
"label": "a",
"name": "Increased consumption of grapefruit",
"picture": null,
"votes": 44
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Spinach is rich in vitamin K and consumption should be limited as it may counteract the actions of warfarin making it less effective and patients susceptible to blood clots",
"id": "10026984",
"label": "d",
"name": "Increased consumption of spinach",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oranges/orange juice is a safe alternative to grapefruit if taking warfarin",
"id": "10026982",
"label": "b",
"name": "Increased consumption of oranges",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Tomatoes are low in vitamin K and do not inhibit CYP450 enzymes. They are safe to consume whilst taking warfarin",
"id": "10026985",
"label": "e",
"name": "Increased consumption of tomatoes",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Kale is rich in vitamin K and consumption should be limited as it may counteract the actions of warfarin making it less effective and patients susceptible to blood clots",
"id": "10026983",
"label": "c",
"name": "Increased consumption of kale",
"picture": null,
"votes": 8
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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},
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"demo": null,
"entitlement": null,
"id": "5944",
"name": "CYP450 enzymes",
"status": null,
"topic": {
"__typename": "Topic",
"id": "195",
"name": "Pharmacology",
"typeId": 7
},
"topicId": 195,
"totalCards": null,
"typeId": null,
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"userNote": null,
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"question": "A 65-year-old man presents to A&E with a nosebleed that \"just won't stop\". It has been bleeding for 30 minutes. Three years ago, he underwent surgery to replace his aortic valve and has been taking warfarin regularly since.\n\nWhen visiting his GP earlier this week, he was diagnosed with hypertension and has been actively making changes to his lifestyle to become healthier.\n\nWhat is the most likely cause of his prolonged nosebleed?",
"sbaAnswer": [
"a"
],
"totalVotes": 62,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,468 | false | 1 | null | 6,495,211 | null | false | [] | null | 17,795 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The transverse ligament spans the suprascapular notch, not the greater scapular notch. The suprascapular nerve passes through this space.",
"id": "10026987",
"label": "b",
"name": "The greater scapular notch is spanned by the transverse ligament",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The clavicle laterally articulates with the acromion of the scapula, forming the acromioclavicular joint.",
"id": "10026988",
"label": "c",
"name": "The clavicle laterally articulates with the coracoid process of the scapula",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The subscapular fossa is visible on the anterior side of the scapula and the posterior side of the scapula has the supraspinous and infraspinous fossae.",
"id": "10026989",
"label": "d",
"name": "The subscapular fossa is visible from the posterior view of the scapula",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The radial groove is a shallow depression in the humerus through which the radial nerve and deep brachial artery travel. This is continued laterally with the deltoid tuberosity.",
"id": "10026986",
"label": "a",
"name": "The radial groove of the humerus is continuous laterally with the deltoid tuberosity",
"picture": null,
"votes": 42
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The lesser tubercle of the humerus is located anteriorly, the greater tubercle is located laterally.",
"id": "10026990",
"label": "e",
"name": "The greater tubercle of the humerus is located anteriorly and the lesser tubercle is located posteriorly",
"picture": null,
"votes": 12
}
],
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"entitlement": null,
"id": "4300",
"name": "Shoulder dislocation",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
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"question": "Which statement regarding the bones of the shoulder joint is correct?",
"sbaAnswer": [
"a"
],
"totalVotes": 121,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,469 | false | 2 | null | 6,495,211 | null | false | [] | null | 17,796 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "These X-ray features are consistent with the diagnosis of rheumatoid arthritis. Erosions and subluxation may also be seen.",
"id": "10026991",
"label": "a",
"name": "Soft tissue swelling, periarticular osteopenia, swan neck deformity, ulnar deviation",
"picture": null,
"votes": 104
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These X-ray features are characteristic of osteoporosis, a systemic skeletal condition characterised by low bone density. Given the diagnosis of rheumatoid arthritis, soft tissue swelling, periarticular osteopenia, swan neck deformity and ulnar deviation are the most likely findings.",
"id": "10026992",
"label": "b",
"name": "Increased radiolucency and cortical thinning",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Normal X-rays may be seen in some other arthropathies, for example, gout. In the early stages of rheumatoid arthritis, X-rays can be normal, however, we are told that this patient has a longstanding diagnosis and deformity in her hands, so we would not expect the X-ray to be normal.",
"id": "10026993",
"label": "c",
"name": "Normal X-ray",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These X-ray findings are seen in osteoarthritis, due to the breakdown of joint cartilage and underlying bone.",
"id": "10026994",
"label": "d",
"name": "Osteophytes, loss of joint space, sub-periosteal cysts and sclerosis",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These X-ray findings are characteristic of osteosarcoma, a type of malignant bone tumour, not rheumatoid arthritis.",
"id": "10026995",
"label": "e",
"name": "Mixed lytic and sclerotic lesion with a 'sunburst’ periosteal reaction",
"picture": null,
"votes": 2
}
],
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},
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"demo": null,
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"id": "3975",
"name": "Rheumatoid Arthritis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "146",
"name": "Rheumatology",
"typeId": 7
},
"topicId": 146,
"totalCards": null,
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"question": "A 68-year-old woman has a longstanding diagnosis of rheumatoid arthritis. She undergoes a review due to experiencing increasing pain, stiffness and deformity in her hands.\n\nWhat are the most likely findings on an X-ray of her hands?",
"sbaAnswer": [
"a"
],
"totalVotes": 121,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,470 | false | 3 | null | 6,495,211 | null | false | [] | null | 17,797 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The 3 heads of the triceps insert into the olecranon, allowing its action to extend the arm and forearm.",
"id": "10026996",
"label": "a",
"name": "The triceps brachii inserts into the olecranon",
"picture": null,
"votes": 82
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "All muscles in the anterior compartment of the arm are innervated by the musculocutaneous nerve. The radial nerve innervates the muscles in the posterior compartment (triceps and anconeus).",
"id": "10026998",
"label": "c",
"name": "The biceps brachii is innervated by the radial nerve",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The short head of the biceps originates from the coracoid process. It is the long head of the biceps that originates from the supraglenoid tubercle.",
"id": "10027000",
"label": "e",
"name": "The short head of the biceps brachii originates from the supraglenoid tubercle",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The coracobrachialis originates from the coracoid process of the scapula and inserts into the medial aspect of the humerus. As it does not span the elbow joint, it cannot work to flex the forearm.",
"id": "10026999",
"label": "d",
"name": "The coracobrachialis aids forearm flexion",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The muscles of the arm are separated into anterior and posterior compartments by medial and lateral muscular septa. These septa span from the medial and lateral aspects of the humerus and are continuous with the deep fascia of the arm.",
"id": "10026997",
"label": "b",
"name": "The muscles of the arm are separated into medial and lateral compartments by anterior and posterior muscular septa",
"picture": null,
"votes": 4
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5945",
"name": "Bicep tendon tear",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
"totalCards": null,
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},
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"question": "Which statement regarding muscles of the arm is correct?",
"sbaAnswer": [
"a"
],
"totalVotes": 118,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,471 | false | 4 | null | 6,495,211 | null | false | [] | null | 17,798 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Klumpke’s palsy, or injury to the C8-T1 nerve root, is often caused by traumatic hyperabduction of the arm. Patients with Klumpke’s palsy have a characteristic ‘claw hand’, with a supinated forearm, extended wrist and flexed fingers (due to paralysis of intrinsic hand muscles, flexor carpi ulnaris and ulnar half of flexor digitorum profundus).",
"id": "10027005",
"label": "e",
"name": "C8-T1 nerve root",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a classical history of radial nerve injury, which often occurs in association with humeral fractures, ‘Saturday night palsy’ or improper use of crutches. Injury to the radial nerve results in loss of extensor function, or ‘wrist drop’, and loss of sensation on the posterior forearm, elbow and dorsum of the hand.",
"id": "10027001",
"label": "a",
"name": "Radial nerve",
"picture": null,
"votes": 111
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Damage to the C5-6 nerve root is also known as Erb’s palsy, which can occur during traumatic lateral bending of the neck, for example during childbirth or a fall. Flaccid muscle paralysis and atrophy of the supraspinatus, infraspinatus, deltoid, biceps and brachialis muscles are seen, resulting in an adducted, medially rotated arm and extended pronated forearm.",
"id": "10027004",
"label": "d",
"name": "C5-6 nerve root",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Damage to the median nerve would result in signs such as an inability to pronate the forearm, weak wrist flexion and ulnar deviation of the wrist. It also causes an inability to flex the distal interphalangeal joints of the second and third digits, resulting in the characteristic ‘Pope blessing’ sign when the patient is asked to make a fist.",
"id": "10027002",
"label": "b",
"name": "Median nerve",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Damage to the ulnar nerve results in a ‘claw hand’ deformity. The ulnar nerve innervates most intrinsic muscles of the hand (apart from the thenar eminence and the lateral two lumbricals), therefore its damage results in metacarpophalangeal joint extension and flexion of the 4th and 5th digit interphalangeal joints. Wasting and paralysis of the hypothenar eminence and other intrinsic hand muscles innervated by the ulnar nerve would also be seen. Sensory loss or changes would be in the ulnar distribution (palmar and dorsal aspects of the medial 1.5 digits).",
"id": "10027003",
"label": "c",
"name": "Ulnar nerve",
"picture": null,
"votes": 2
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3950",
"name": "Radial nerve injuries",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
"totalCards": null,
"typeId": null,
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"userNote": null,
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},
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"question": "A 26-year-old man experiences ‘wrist drop’ and loss of sensation to his posterior forearm, elbow and dorsum of his hand following a fracture of his humeral shaft.\n\nWhich structure is most likely to have been damaged?",
"sbaAnswer": [
"a"
],
"totalVotes": 121,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,472 | false | 5 | null | 6,495,211 | null | false | [] | null | 17,799 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The tubercle of the iliac crest is on its anterolateral side.",
"id": "10027010",
"label": "e",
"name": "The tubercle of the iliac crest is located on its posteromedial side",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The gluteus maximus originates from the external ilium posterior to the posterior gluteal line. It also has some fibres that originate from the dorsal sacrum, coccyx and sacrotuberous ligament.",
"id": "10027008",
"label": "c",
"name": "The gluteus maximus muscle originates from the external ilium anterior to the posterior gluteal line",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The pubic symphysis is a secondary cartilaginous joint.",
"id": "10027007",
"label": "b",
"name": "The pubic symphysis is a primary cartilaginous joint",
"picture": null,
"votes": 54
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The obturator membrane doesn’t cover the whole of the obturator foramen. A small space is left called the obturator canal, through which the obturator nerve and vessels travel.",
"id": "10027009",
"label": "d",
"name": "The obturator membrane spans the whole of the obturator foramen",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The sacroiliac joint is a synovial joint, with excessive movement being prevented by many interosseous ligaments.",
"id": "10027006",
"label": "a",
"name": "The sacroiliac joint is a synovial joint",
"picture": null,
"votes": 30
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3907",
"name": "fractured neck of femur",
"status": null,
"topic": {
"__typename": "Topic",
"id": "145",
"name": "Orthopaedics",
"typeId": 7
},
"topicId": 145,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3907,
"conditions": [],
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"dislikes": 0,
"explanation": null,
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"pictures": [],
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"question": "Which statement regarding the pelvis and its associated structures is correct?",
"sbaAnswer": [
"a"
],
"totalVotes": 119,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,473 | false | 6 | null | 6,495,211 | null | false | [] | null | 17,800 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Defects in type IV collagen result in Alport syndrome, which has characteristic features of renal impairment, eye changes (especially to the lens or cornea), and sensorineural hearing loss.",
"id": "10027014",
"label": "d",
"name": "Type IV collagen",
"picture": null,
"votes": 36
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Defects in fibrillin result in Marfan syndrome, characterised by disproportionally long and slender limbs, anterior chest wall deformity, lens dislocation, heart murmurs and spontaneous pneumothoraces.",
"id": "10027013",
"label": "c",
"name": "Fibrillin",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Defects in type III collagen cause Ehlers-Danlos vascular type which is associated with features such as thin, fragile, translucent skin, short stature, fragile blood vessels that can rupture, and characteristic facial features. The features listed in the vignette are more consistent with classical Ehlers-Danlos.",
"id": "10027012",
"label": "b",
"name": "Type III collagen",
"picture": null,
"votes": 38
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Abnormal forms, or a reduction in Von Willebrand factor result in Von Willebrand disease, the most common inherited bleeding disorder which characteristically causes bruising, epistaxis and menorrhagia. Von Willebrand's disease would not account for the joint hypermobility and skin elasticity described in the vignette.",
"id": "10027015",
"label": "e",
"name": "Von Willebrand factor",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The child in the vignette likely has Ehlers-Danlos classical type (formally called type 1), an autosomal dominant condition associated with elastic skin, bruising and joint hypermobility. This is caused by defects in type V collagen.",
"id": "10027011",
"label": "a",
"name": "Type V collagen",
"picture": null,
"votes": 29
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5946",
"name": "Ehlers Danlos syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "156",
"name": "Medical Genetics",
"typeId": 7
},
"topicId": 156,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
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"id": "17800",
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"question": "A mother brings her 6-year-old son to the GP, concerned that he bruises very easily. Upon further discussion, his mother admits that he also has ‘stretchy skin’ and is ‘very flexible.’ The child’s father also has these features.\n\nGiven the most probable diagnosis, the child is likely to have inherited a defect in which protein?",
"sbaAnswer": [
"a"
],
"totalVotes": 118,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,474 | false | 7 | null | 6,495,211 | null | false | [] | null | 17,801 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The brachial plexus is formed from the roots of the ventral rami of C5-T1 spinal levels. These enter the neck between the anterior and middle scalene muscles, posterior to the subclavian artery.",
"id": "10027016",
"label": "a",
"name": "The nerve roots that form the brachial plexus enter the neck between the anterior and middle scalene muscles",
"picture": null,
"votes": 93
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The axillary nerve branches from the posterior cord to supply the deltoid, teres minor and skin on the upper lateral part of the arm.",
"id": "10027018",
"label": "c",
"name": "The axillary nerve branches from the lateral cord",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The medial brachial and antebrachial cutaneous nerves arise from the medial cord. The superior trunk gives off the nerve to the subclavius and the suprascapular nerves.",
"id": "10027020",
"label": "e",
"name": "The medial brachial and antebrachial cutaneous nerves arise from the superior trunk",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The median nerve is formed from the lateral and medial cords. The radial nerve is formed as a continuation of the posterior cord.",
"id": "10027019",
"label": "d",
"name": "The radial nerve is formed from the lateral and medial cords",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The long thoracic nerve does branch from the roots in the neck, but from spinal levels C5-7.",
"id": "10027017",
"label": "b",
"name": "The long thoracic nerve branches from C6-8 nerve roots in the neck",
"picture": null,
"votes": 2
}
],
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"id": "3909",
"name": "brachial plexus injuries",
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"a"
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173,466,475 | false | 8 | null | 6,495,211 | null | false | [] | null | 17,802 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the function of the articularis genus muscle. The popliteus muscle unlocks and stabilises the knee joint.",
"id": "10027023",
"label": "c",
"name": "The popliteus muscle keeps the suprapatellar bursa taut during leg extension",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The medial meniscus is attached to the tibia, joint capsule and tibial collateral ligament. The lateral meniscus is unattached so is more mobile and less likely to tear.",
"id": "10027024",
"label": "d",
"name": "The medial meniscus is not attached to the joint capsule, so is more mobile and less likely to tear",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The tibial collateral ligament is also known as the medial collateral ligament and attaches to the medial meniscus.",
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"label": "b",
"name": "The tibial collateral ligament attaches to the lateral meniscus",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The popliteus muscle is innervated by the tibial nerve, which consists of fibres from L4-S1. The popliteus unlocks the knee joint by laterally rotating the femur and stabilises the knee by resisting lateral tibial rotation.",
"id": "10027021",
"label": "a",
"name": "The popliteus muscle is innervated by the tibial nerve",
"picture": null,
"votes": 92
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The soleal line is on the posterior surface of the tibia and is where the soleus muscle arises from. The bony prominence on the anterior surface of the tibia is the tibial tuberosity.",
"id": "10027025",
"label": "e",
"name": "The soleal line is located on the anterior surface of the tibia",
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"votes": 8
}
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"name": "Knee Joint",
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173,466,476 | false | 9 | null | 6,495,211 | null | false | [] | null | 17,803 | {
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although 10-20% of patients with myasthenia graves will have a thymoma, this is not the underlying pathophysiology causing the myasthenia gravis symptoms.",
"id": "10027027",
"label": "b",
"name": "Thymoma",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the pathophysiology of multiple sclerosis. Although this commonly presents in women under the age of 40, it would not account for the fatigue seen on EMG. Multiple sclerosis also classically presents with different symptoms, such as unilateral loss of vision with pain upon eye movement (optic neuritis).",
"id": "10027029",
"label": "d",
"name": "Inflammation causes demyelination and axonal loss",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the pathophysiology of amyotrophic lateral sclerosis, the commonest form of motor neurone disease. Degeneration of the corticospinal tract and alpha motor neurons results in the characteristic mix of upper and lower motor neurone signs seen.",
"id": "10027030",
"label": "e",
"name": "Progressive degeneration of the corticospinal tract and alpha motor neurons",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the pathophysiology of Lambert-Eaton myasthenic syndrome, which is characterised by muscle weakness that improves with exercise. Lower limb weakness, hyporeflexia and an incremental response to repetitive stimulation would be seen.",
"id": "10027028",
"label": "c",
"name": "Autoantibodies against presynaptic voltage-gated calcium channels in the peripheral nervous system",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The vignette describes the classical presentation of myasthenia gravis (MG). 85% of MG cases are caused by autoantibodies against the nicotinic acetylcholine receptors at the neuromuscular junction. This blockade stops the acetylcholine from triggering muscle contraction. During repeated or sustained muscle contraction, more receptors become blocked, accounting for the muscle weakness seen with increased activity.",
"id": "10027026",
"label": "a",
"name": "Autoantibodies against the nicotinic acetylcholine receptors at the neuromuscular junction",
"picture": null,
"votes": 100
}
],
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"id": "3859",
"name": "Myasthenia Gravis",
"status": null,
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"__typename": "Topic",
"id": "158",
"name": "Immunology",
"typeId": 7
},
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"question": "A 34-year-old woman presents with double vision and eyelid drooping, which is worse at the end of the day. Upon investigation, all of her reflexes are normal, and an EMG shows a diminishing response of muscle fibres with repetitive electrical stimulation.\n\nWhat is the most likely pathophysiology underlying this condition?",
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"a"
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173,466,477 | false | 10 | null | 6,495,211 | null | false | [] | null | 17,804 | {
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"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The cuboid bone is lateral to the three cuneiform bones.",
"id": "10027034",
"label": "d",
"name": "The cuboid bone is medial to the cuneiform bones",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The long plantar ligament connects the calcaneus to the cuboid and metatarsal bases. The plantar calcaenonavicular, or spring, ligament connects the calcaneus to the navicular, working to support the head of the talus and maintain the medial arch of the foot.",
"id": "10027032",
"label": "b",
"name": "The plantar calcaenonavicular, or spring, ligament connects the calcaneus to the cuboid and metatarsal bases",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "It is the posterior branch of the popliteal artery that enters the foot to divide into the medial and lateral plantar arteries.",
"id": "10027033",
"label": "c",
"name": "The anterior branch of the popliteal artery enters the foot to divide into the medial and lateral plantar arteries",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The lateral plantar nerve provides the sensory supply over the lateral sole of the foot and the plantar surface of the lateral 1.5 digits. The superficial fibular nerve provides the sensory supply over most of the foot dorsum.",
"id": "10027035",
"label": "e",
"name": "The superficial fibular nerve provides the sensory supply over the plantar surface of the lateral 1.5 digits",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The contents of the tarsal tunnel (from medial to lateral) are tibialis posterior, flexor digitorum longus, posterior tibial artery, posterior tibial vein, tibial nerve, flexor hallucis longus.",
"id": "10027031",
"label": "a",
"name": "The tibial nerve passes through the tarsal tunnel",
"picture": null,
"votes": 86
}
],
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"id": "4186",
"name": "Foot fractures",
"status": null,
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"question": "Which statement correctly describes a structure found in the foot?",
"sbaAnswer": [
"a"
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173,466,478 | false | 11 | null | 6,495,211 | null | false | [] | null | 17,805 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The obturator nerve consists of fibres from the ventral rami of L2-4.",
"id": "10027039",
"label": "d",
"name": "The obturator nerve consists of fibres from L4-S1 spinal levels",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The sciatic nerve is the largest nerve in the body, arising from the lumbosacral plexus at nerve roots L4-S3. It travels down the thigh, innervating the posterior thigh muscles. It terminates at the apex of the popliteal fossa by bifurcating into the common fibular and tibial nerves.",
"id": "10027036",
"label": "a",
"name": "The sciatic nerve terminates at the apex of the popliteal fossa by bifurcating into the common fibular and tibial nerves",
"picture": null,
"votes": 86
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The lumbosacral plexus arises from the ventral rami of L1-S4.",
"id": "10027038",
"label": "c",
"name": "The lumbosacral plexus arises from the ventral rami of L2-S2 spinal levels",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The superior gluteal nerve supplies the gluteus medius, gluteus minimus and tensor fasciae muscles. The gluteus maximus is supplied by the inferior gluteal nerve.",
"id": "10027040",
"label": "e",
"name": "The superior gluteal nerve supplies the gluteus maximus, gluteus medius and gluteus minimus muscles",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The femoral nerve travels through the subinguinal gap to supply the obturator externus and muscles of the anterior thigh. The superior and inferior gluteal nerves travel through the greater sciatic foramen.",
"id": "10027037",
"label": "b",
"name": "The femoral nerve travels through the greater sciatic foramen",
"picture": null,
"votes": 7
}
],
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"id": "5948",
"name": "Spinal claudication",
"status": null,
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"id": "135",
"name": "General surgery",
"typeId": 7
},
"topicId": 135,
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"question": "Which statement regarding the anatomy of the lumbosacral plexus is correct?",
"sbaAnswer": [
"a"
],
"totalVotes": 111,
"typeId": 1,
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} | MarksheetMark |
173,466,479 | false | 12 | null | 6,495,211 | null | false | [] | null | 17,806 | {
"__typename": "QuestionSBA",
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"__typename": "QuestionChoice",
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"explanation": "The degeneration of the corticospinal tract and alpha motor neurons is the pathophysiological process underlying amyotrophic lateral sclerosis, the commonest form of motor neurone disease.",
"id": "10027045",
"label": "e",
"name": "Alpha motor neurons",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
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"explanation": "Deposition of intracellular tau protein and extracellular amyloid beta plaques leads to the degeneration of hippocampal neurons in Alzheimer’s disease. This neuronal loss then spreads to other brain areas.",
"id": "10027043",
"label": "c",
"name": "Hippocampal neurons",
"picture": null,
"votes": 1
},
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"__typename": "QuestionChoice",
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"explanation": "Loss of cholinergic and GABAergic neurons in the striatum is the pathophysiological process underlying Huntington’s disease. This occurs due to the expansion of trinucleotide repeats in the Huntingtin gene.",
"id": "10027044",
"label": "d",
"name": "Cholinergic and GABAergic neurons in the striatum",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Inflammation leading to the loss of oligodendrocytes in the central nervous system is the pathophysiological process underlying multiple sclerosis.",
"id": "10027042",
"label": "b",
"name": "Oligodendrocytes",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Degeneration of dopaminergic neurons in the substantia nigra is the pathophysiological process underlying Parkinson’s disease.",
"id": "10027041",
"label": "a",
"name": "Dopaminergic neurons of the substantia nigra",
"picture": null,
"votes": 112
}
],
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"name": "Parkinson's Disease",
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"id": "141",
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"typeId": 7
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173,466,480 | false | 13 | null | 6,495,211 | null | false | [] | null | 17,807 | {
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Wernicke’s area, a region in the superior temporal gyrus of the dominant hemisphere, is supplied by the middle temporal branches of the middle cerebral artery.",
"id": "10027049",
"label": "d",
"name": "Wernicke's area",
"picture": null,
"votes": 2
},
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"__typename": "QuestionChoice",
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"explanation": "Cortical branches of the anterior cerebral artery run into the frontal lobe to supply the majority of the corpus callosum, cingulate gyrus and medial frontal gyrus.",
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"label": "a",
"name": "Corpus callosum",
"picture": null,
"votes": 72
},
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"__typename": "QuestionChoice",
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"explanation": "The blood supply to the basal ganglia is mostly by the lenticulostriate branches of the middle cerebral artery.",
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"picture": null,
"votes": 8
},
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"__typename": "QuestionChoice",
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"explanation": "The primary motor cortex, or precentral gyrus, receives a mixed blood supply. The upper limb areas are supplied by the middle cerebral artery and the lower limb areas are supplied by the anterior cerebral artery, accounting for the respective deficits seen when each of these vessels is affected by stroke.",
"id": "10027048",
"label": "c",
"name": "Upper limb areas of the primary motor cortex",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Broca’s area, a region in the frontal lobe of the dominant hemisphere, is supplied by the middle cerebral artery.",
"id": "10027047",
"label": "b",
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"picture": null,
"votes": 12
}
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"question": "Which of the following structures receives its blood supply from the anterior cerebral artery?",
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173,466,481 | false | 14 | null | 6,495,211 | null | false | [] | null | 17,808 | {
"__typename": "QuestionSBA",
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "The facial nerve does travel through the parotid gland but doesn’t contribute to its innervation. The parasympathetic supply to the parotid gland is by the glossopharyngeal nerve.",
"id": "10027052",
"label": "b",
"name": "The facial nerve gives parasympathetic supply to the parotid gland",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The facial nerve gives motor supply to the facial muscles such as the buccinator. However, the motor supply to the extrinsic tongue muscles is via the hypoglossal and vagus nerves.",
"id": "10027053",
"label": "c",
"name": "The facial nerve gives the motor supply to facial and extrinsic tongue muscles such as the buccinator, mylohyoid and palatoglossus",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The facial nerve innervates the efferent limb of the corneal reflex via the greater petrosal nerve, as this innervates the orbicularis oculi muscle. The afferent limb of the corneal reflex is via the ophthalmic division of the trigeminal nerve.",
"id": "10027054",
"label": "d",
"name": "The facial nerve innervates the afferent limb of the corneal reflex via the greater petrosal nerve",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The terminal sulcus divides the tongue into portions: the anterior 2/3 and posterior 1/3. The taste sensation to the anterior 2/3 is supplied by the chorda tympani branch of the facial nerve.",
"id": "10027051",
"label": "a",
"name": "Taste fibres to the anterior 2/3 of the tongue are supplied by the facial nerve",
"picture": null,
"votes": 100
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The chorda tympani travels with the mandibular trigeminal branch to supply taste sensation to the tongue. The greater petrosal nerve travels with the ophthalmic trigeminal nerve to supply the lacrimal gland.",
"id": "10027055",
"label": "e",
"name": "The chorda tympani travels with the ophthalmic trigeminal nerve to supply the lacrimal gland",
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"votes": 4
}
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173,466,482 | false | 15 | null | 6,495,211 | null | false | [] | null | 17,809 | {
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These findings would likely be the case in vascular dementia, another disease which causes dementia in a characteristic stepwise deterioration pattern.",
"id": "10027060",
"label": "e",
"name": "Microvessel occlusion and stenosis",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the neuropathological hallmark of multiple sclerosis.",
"id": "10027058",
"label": "c",
"name": "Demyelination",
"picture": null,
"votes": 2
},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Lewy bodies are the neuropathological hallmark of Parkinson’s disease. They are also found in Lewy body dementia.",
"id": "10027057",
"label": "b",
"name": "Lewy bodies",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Amyloid beta plaques are extracellular plaques formed from misfolded abnormalities. These, along with neurofibrillary tau tangles, are characteristic of Alzheimer’s disease.",
"id": "10027056",
"label": "a",
"name": "Amyloid beta plaques",
"picture": null,
"votes": 110
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are spherical inclusions in neuronal cytoplasm, found in behavioural variant frontotemporal dementia.",
"id": "10027059",
"label": "d",
"name": "Pick bodies",
"picture": null,
"votes": 1
}
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"question": "An 82-year-old female has been diagnosed with Alzheimer’s disease.\n\nWhat neuropathological finding would be most likely be found upon investigation?",
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"a"
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173,466,483 | false | 16 | null | 6,495,211 | null | false | [] | null | 17,810 | {
"__typename": "QuestionSBA",
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "The larynx is located in the midline of the neck. However, it is inferior to C3-4 level and superior to the first cartilaginous tracheal ring.",
"id": "10027064",
"label": "d",
"name": "The larynx is located in the midline of the neck at C2 level, inferior to the first cartilaginous tracheal ring",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The quadrangular membranes are some of the intrinsic ligaments that shape the inside of the larynx. They connect the lateral epiglottis to the arytenoid and thyroid cartilages, and their lower borders form the vestibular ligaments.",
"id": "10027061",
"label": "a",
"name": "The lower borders of the quadrangular membranes form the vestibular ligaments",
"picture": null,
"votes": 40
},
{
"__typename": "QuestionChoice",
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"explanation": "The mucous membranes are mostly lined with ciliated columnar epithelium, the exception to this being the vocal folds, which are lined with protective stratified squamous epithelium.",
"id": "10027063",
"label": "c",
"name": "The mucous membrane of the larynx mainly consists of stratified squamous epithelium",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The blood supply to the larynx is via the superior and inferior laryngeal arteries, branches of the external carotid arteries.",
"id": "10027062",
"label": "b",
"name": "The blood supply to the larynx is via branches of the internal carotid arteries",
"picture": null,
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},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Closing of the laryngeal sphincter is done by the aryepiglottic muscle and the oblique arytenoid muscles. The posterior cricoarytenoid muscles work to abduct and externally rotate the vocal folds.",
"id": "10027065",
"label": "e",
"name": "The posterior cricoarytenoid muscles work to close the laryngeal sphincter",
"picture": null,
"votes": 22
}
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"name": "Hoarseness",
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"id": "186",
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173,466,484 | false | 17 | null | 6,495,211 | null | false | [] | null | 17,811 | {
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"__typename": "QuestionChoice",
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"explanation": "Right superior quadrantanopia would arise from lesions to the left optic radiation in the temporal lobe.",
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"explanation": "Lesions in the occipital cortex result in contralateral homonymous hemianopia with macular sparing. If the homonymous hemianopia did not have macular sparing, this would suggest a lesion of the optic tract.",
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"label": "c",
"name": "Right homonymous hemianopia with macular sparing",
"picture": null,
"votes": 7
},
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"answer": false,
"explanation": "Lesions in the optic radiation affect the contralateral side, due to the crossing over of fibres at the optic chiasm, so left-sided visual defects are caused by lesions in the right optic radiation.",
"id": "10027070",
"label": "e",
"name": "Left superior quadrantanopia",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Lesions in the optic radiation affect the contralateral side, due to the crossing over of fibres at the optic chiasm, so left-sided visual defects are caused by lesions in the right optic radiation.",
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"label": "d",
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}
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"name": "Anatomy of visual pathways",
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173,466,485 | false | 18 | null | 6,495,211 | null | false | [] | null | 17,812 | {
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"__typename": "QuestionChoice",
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"explanation": "This process occurs during an ischaemic stroke. Blood vessel occlusion may occur due to atherosclerotic plaques in the carotid arteries, for example, or a blood clot may embolise from elsewhere in the body to the brain vessels, causing a blockage. Brain tissue eventually dies due to lack of blood supply.",
"id": "10027073",
"label": "c",
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"__typename": "QuestionChoice",
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"explanation": "Loss of cholinergic and GABAergic neurons in the striatum is the pathophysiological process underlying Huntington’s disease. This occurs due to the expansion of trinucleotide repeats in the Huntingtin gene, which causes intracellular aggregation of abnormal Huntington protein and therefore neuronal death.",
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"explanation": "This is the pathological process underling multiple sclerosis. Loss of oligodendrocytes in multiple sclerosis results in demyelination of neuronal axons, so the neurons are unable to conduct action potentials as effectively, eventually leading to axonal loss.",
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"label": "b",
"name": "Inflammation leading to the loss of oligodendrocytes",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
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"explanation": "This is the pathophysiological process underlying Parkinson’s disease. The neuropathological hallmark of this is Lewy bodies, intracellular aggregates of misfolded alpha-synuclein protein.",
"id": "10027075",
"label": "e",
"name": "Degeneration of dopaminergic neurons in the substantia nigra",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the pathophysiological process that occurs in Alzheimer’s disease. This initially starts in the hippocampus but spreads to other brain areas as the disease progresses.",
"id": "10027074",
"label": "d",
"name": "Neuronal death due to accumulation of intracellular Tau tangles and extracellular amyloid beta plaques",
"picture": null,
"votes": 8
}
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173,466,486 | false | 19 | null | 6,495,211 | null | false | [] | null | 17,813 | {
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "The mastoid antrum is mostly innervated by the glossopharyngeal nerve.",
"id": "10027077",
"label": "b",
"name": "The mastoid antrum in the petrous temporal bone is innervated by the greater petrosal branch of the facial nerve",
"picture": null,
"votes": 26
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{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The crista ampullaris is a ridge of sensory cells in the walls of the ampullae of the inner ear. These cells detect the movement of endolymph as the head moves. This movement is converted to electrical signals which are transmitted by the vestibular branch of the vestibulocochlear nerve.",
"id": "10027076",
"label": "a",
"name": "The crista ampullaris transduces and fires signals via the vestibular branch of the vestibulocochlear nerve",
"picture": null,
"votes": 36
},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "The auriculotemporal branch of the mandibular trigeminal nerve innervates the superoanterior quadrant of the external auditory meatus. The superoposterior quadrant is innervated by the lesser occipital nerve, from C2 spinal level.",
"id": "10027080",
"label": "e",
"name": "The superoposterior quadrant of the external auditory meatus is innervated by the auriculotemporal branch of the mandibular trigeminal nerve",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The superior half of the external tympanic membrane is innervated by the vagus nerve. The inferior half of the external tympanic membrane is innervated by the mandibular trigeminal nerve.",
"id": "10027079",
"label": "d",
"name": "The external tympanic membrane is innervated by the greater auricular nerve from spinal levels C2-3",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The tensor tympani muscle is innervated by the mandibular branch of the trigeminal nerve, working to dampen sound vibrations from the tympanic membrane.",
"id": "10027078",
"label": "c",
"name": "The tensor tympani muscle is innervated by the facial nerve",
"picture": null,
"votes": 20
}
],
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"name": "Middle ear anatomy",
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"name": "Ear, Nose and Throat",
"typeId": 7
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"question": "Which statement regarding the innervation of the ear is correct?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
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173,466,487 | false | 20 | null | 6,495,211 | null | false | [] | null | 17,814 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A cherry-red macula is associated with central retinal artery occlusion, which would classically present with sudden profound visual loss.",
"id": "10027085",
"label": "e",
"name": "Cherry-red macula",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "As their name suggests, these are large haemorrhages on the retina that look like flames. These occur due to pre-capillary arteriole or small vein rupture and occur in hypertensive retinopathy, thrombocytopenia, retinal vein occlusion and trauma.",
"id": "10027084",
"label": "d",
"name": "Flame haemorrhages",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cotton wool spots are commonly seen in diabetic retinopathy. They are small white superficial lesions that occur due to tiny infarctions of the neuroretinal layer. Diabetic retinopathy would present clinically with overall gradually worsening vision which is blurred and patchy and a history of diabetes mellitus.",
"id": "10027083",
"label": "c",
"name": "Cotton wool spots",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pan-retinal photocoagulation is the first-line treatment for proliferative diabetic retinopathy. It is seen as clusters of pale markings on the retina. The patient is presenting with features of age-related macular degeneration, not diabetic retinopathy, so the most likely finding upon fundoscopy is drusen.",
"id": "10027082",
"label": "b",
"name": "Pan-retinal photocoagulation",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The clinical features in the vignette point to a diagnosis of age-related macular degeneration (ARMD). The most common fundoscopy finding in patients with ARMD is drusen, yellow-white flecks around the macular region, due to the deposition of remnants of dead retinal pigment epithelium.",
"id": "10027081",
"label": "a",
"name": "Drusen",
"picture": null,
"votes": 38
}
],
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"id": "4407",
"name": "Age-related macular degeneration",
"status": null,
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"id": "140",
"name": "Ophthalmology",
"typeId": 7
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"question": "A 75-year-old woman has had a gradual reduction in visual acuity, particularly for near-field objects, for the last 12 months. Upon further questioning, these symptoms fluctuate from day to day, and she sometimes experiences glare around objects and difficulty adapting to the dark.\n\nWhat is the most likely finding upon fundoscopy?",
"sbaAnswer": [
"a"
],
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173,466,488 | false | 21 | null | 6,495,211 | null | false | [] | null | 17,815 | {
"__typename": "QuestionSBA",
"choices": [
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Most nosebleeds arise from the anterior part of the nose, commonly from Kisselbach’s plexus- an area of anastomoses between the ethmoid, sphenopalatine and major palatine arteries. Woodruff’s plexus is a common site in posterior nosebleeds.",
"id": "10027088",
"label": "c",
"name": "Woodruff’s plexus is a common site involved in anterior nosebleeds",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The anterior ethmoid nerve arises from the nasociliary nerve, a branch of the ophthalmic trigeminal nerve. The anterior ethmoid nerve supplies the external skin of the nose and the mucous membrane of the nasal vestibule.",
"id": "10027086",
"label": "a",
"name": "The mucous membrane of the nasal vestibule is supplied by the anterior ethmoid nerve",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The nasopalatine nerve is a branch of the maxillary trigeminal nerve, which supplies the skin of the roof and lateral wall of the nose. The mucous glands of the nose are supplied by the greater petrosal nerve, a branch of the facial nerve.",
"id": "10027090",
"label": "e",
"name": "The mucous glands of the nose are innervated by the nasopalatine nerve",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The maxillary trigeminal nerve joins the facial nerve in the pterygopalatine ganglion.",
"id": "10027089",
"label": "d",
"name": "The ophthalmic trigeminal nerve joins the facial nerve in the pterygopalatine ganglion",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The anterior and posterior ethmoidal arteries are branches of the ophthalmic artery, which itself comes from the internal carotid artery.",
"id": "10027087",
"label": "b",
"name": "The anterior and posterior ethmoidal arteries are branches of the maxillary artery",
"picture": null,
"votes": 27
}
],
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"demo": null,
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"id": "5953",
"name": "Epistaxis",
"status": null,
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"id": "186",
"name": "Ear, Nose and Throat",
"typeId": 7
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"topicId": 186,
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"typeId": null,
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"question": "Which statement regarding the neurovascular supply of the nose is correct?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
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173,466,489 | false | 22 | null | 6,495,211 | null | false | [] | null | 17,816 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The weakness and sensory loss of a right-sided stroke would affect the left side, as the primary motor and somatosensory cortices control the contralateral side of the body. Sudden-onset weakness and loss of sensation to the lower, not upper, limb would be more consistent with anterior cerebral artery stroke.",
"id": "10027094",
"label": "d",
"name": "Right anterior cerebral artery stroke",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Bell’s palsy is a lower motor neuron paralysis of the facial nerve. This would present with weakness or paralysis of facial muscles, including those of the forehead. It would not affect the arm or result in aphasia.",
"id": "10027092",
"label": "b",
"name": "Bell's palsy",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Anterior cerebral artery strokes may present similarly to middle cerebral artery strokes. A commonly used differentiator between the two is the area affected by the weakness and loss of sensation. According to the cortical homunculus, the area of primary motor and somatosensory cortices supplied by the anterior cerebral artery represents the lower limb, so sudden-onset weakness and loss of sensation to the lower limb would be more consistent with anterior cerebral artery stroke.",
"id": "10027093",
"label": "c",
"name": "Left anterior cerebral artery stroke",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Posterior cerebral artery strokes are commonly associated with visual defects, due to infarction of the visual cortex in the occipital lobe. The weakness and sensory loss of a right-sided stroke would affect the left side, as the primary motor and somatosensory cortices control the contralateral side of the body.",
"id": "10027095",
"label": "e",
"name": "Right posterior cerebral artery stroke",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The left middle cerebral artery (MCA) supplies the parts of the motor and somatosensory cortices representing the right arm and face, so infarction here causes upper motor neuron signs in these areas. The forehead muscles are spared in unilateral upper motor neuron lesions, such as left MCA stroke. This is due to their bilateral cortical representation, meaning that the alternative pathway can still provide innervation. Aphasia most commonly occurs due to damage to either Broca’s area, Wernicke’s area or both- these areas are supplied by the left MCA. The patient also has multiple risk factors for ischaemic stroke such as hypertension, hypercholesterolaemia and type 2 diabetes mellitus.",
"id": "10027091",
"label": "a",
"name": "Left middle cerebral artery stroke",
"picture": null,
"votes": 103
}
],
"comments": [],
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"id": "3743",
"name": "Ischaemic Stroke",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
},
"topicId": 141,
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"question": "A 67-year-old man with a history of hypertension, hypercholesterolaemia and type 2 diabetes mellitus presents to the emergency department with sudden-onset weakness and loss of sensation to his right arm and face, excluding his forehead. He is also demonstrating aphasia.\n\nWhat is the most likely pathophysiology underlying this presentation?",
"sbaAnswer": [
"a"
],
"totalVotes": 114,
"typeId": 1,
"userPoint": null
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173,466,490 | false | 23 | null | 6,495,211 | null | false | [] | null | 17,817 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The sutures between individual skull bones persist until the neurocranium and viscerocranium reach adult morphology at around 21 years old and ossify after this, mostly completed by around the 5th decade.",
"id": "10027098",
"label": "c",
"name": "The sutures between individual skull bones persist until the start of puberty when they ossify",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The temporal suture is located between the temporal and parietal bones, on the lateral side of the skull.",
"id": "10027097",
"label": "b",
"name": "The temporal suture is located between the temporal bone and the occipital bone",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Fontanelles are present to allow deformation of the skull during birth and to accommodate postnatal growth of skull bones and the developing brain. They are placed in the areas of most growth in the skull vault- the midsagittal line and between the temporal/occipital bones, and mostly close within the first year of life.",
"id": "10027096",
"label": "a",
"name": "The fontanelles, large membranous-filled gaps between skull bones, close mostly in the first year of life",
"picture": null,
"votes": 59
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The maxillary trigeminal nerve exits the intracranial space through the foramen rotundum in the sphenoid bone. The mandibular branch of the trigeminal nerve exits through the foramen ovale.",
"id": "10027099",
"label": "d",
"name": "The maxillary trigeminal nerve leaves the intracranial space through the foramen ovale in the sphenoid bone",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The pterion is the area at which the sutures between the frontal, sphenoid, parietal and temporal bones converge. As it is the point where several bones meet, it is structurally weak. Deep to the pterion is the middle meningeal artery- fracture to the skull at this point often leads to an extradural haematoma.",
"id": "10027100",
"label": "e",
"name": "The sutures between the frontal, temporal, sphenoid and ethmoid bones meet at the pterion, causing this area to be structurally weak",
"picture": null,
"votes": 36
}
],
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"id": "5954",
"name": "Basal skull fracture",
"status": null,
"topic": {
"__typename": "Topic",
"id": "186",
"name": "Ear, Nose and Throat",
"typeId": 7
},
"topicId": 186,
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"question": "Which statement correctly describes an aspect of the bony anatomy of the skull?",
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"a"
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173,466,491 | false | 24 | null | 6,495,211 | null | false | [] | null | 17,818 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These features are characteristic of Alzheimer’s disease, a neurodegeneration involving hippocampal neuronal loss and cortical atrophy.",
"id": "10027104",
"label": "d",
"name": "Insidious cognitive impairment and episodic memory loss",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The features listed here are characteristic of progressive supranuclear palsy (PSP), a Parkinson-plus syndrome. PSP can involve some features of Parkinsonism such as bradykinesia and tremor, however, the features of impaired vertical gaze and cognitive impairment are more indicative of PSP than true Parkinson’s disease.",
"id": "10027102",
"label": "b",
"name": "Postural instability and falls, impaired vertical gaze, bradykinesia, cognitive impairment",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These features are the classical triad of features seen in normal pressure hydrocephalus, a reversible cause of dementia. This is most commonly seen in the elderly and is thought to be due to decreased absorption of cerebrospinal fluid at the arachnoid villi.",
"id": "10027105",
"label": "e",
"name": "Urinary incontinence, dementia, slow shuffling gait",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although present in the later stages of multiple neurodegenerative diseases, these features would unlikely be seen alone in Parkinson’s disease, and are more likely to point to a diagnosis of behavioural variant frontotemporal dementia.",
"id": "10027103",
"label": "c",
"name": "Disinhibition, apathy, loss of executive dysfunction",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "These three features are characteristic of Parkinson’s disease. Other features of Parkinson’s disease include postural hypotension due to autonomic dysfunction, mask-like facies, depression, dementia and sleep disturbance.",
"id": "10027101",
"label": "a",
"name": "‘Cogwheel’ rigidity, resting ‘pill-rolling tremor, slow shuffling gait with a stopped posture",
"picture": null,
"votes": 108
}
],
"comments": [],
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"__typename": "Concept",
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"demo": null,
"entitlement": null,
"id": "3747",
"name": "Parkinson's Disease",
"status": null,
"topic": {
"__typename": "Topic",
"id": "141",
"name": "Neurology",
"typeId": 7
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"topicId": 141,
"totalCards": null,
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"question": "Which set of clinical features would most likely be seen in a patient with Parkinson’s disease?",
"sbaAnswer": [
"a"
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"totalVotes": 111,
"typeId": 1,
"userPoint": null
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173,466,492 | false | 25 | null | 6,495,211 | null | false | [] | null | 17,819 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The taste sensation posterior to the terminal sulcus is supplied by the glossopharyngeal nerve, which also supplies touch, temperature and pain sensation to this area.",
"id": "10027109",
"label": "d",
"name": "The taste sensation posterior to the terminal sulcus is supplied by the vagus nerve",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The hypoglossal nerve provides the motor innervation to all tongue muscles (apart from the palatoglossus, which is innervated by the vagus nerve). If the hypoglossal nerve on one side becomes damaged, the tongue deviates laterally towards the side of injury, due to the unopposed action of the genioglossus muscle on the intact side.",
"id": "10027106",
"label": "a",
"name": "Damage to the hypoglossal nerve results in the tongue deviating laterally towards the side of the injury",
"picture": null,
"votes": 89
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The chorda tympani branch of the facial nerve supplies taste sensation to the anterior 2/3 of the tongue. The touch, temperature and pain sensation to this area is supplied by the lingual nerve, a branch of the mandibular trigeminal nerve.",
"id": "10027110",
"label": "e",
"name": "The chorda tympani branch of the facial nerve supplies touch, temperature and pain sensation to anterior 2/3 of the tongue",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The genioglossus and styloglossus muscles are innervated by the hypoglossal nerve whereas the palatoglossus is innervated by the vagus nerve.",
"id": "10027108",
"label": "c",
"name": "The genioglossus, styloglossus and palatoglossus muscles are all innervated by the hypoglossal nerve",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Filiform papillae are touch-detecting papillae located on the anterior 2/3 of the tongue, arranged in rows parallel to the terminal sulcus. Fungiform papillae are club-shaped projections found on the tip and sides of the tongue, which detect taste.",
"id": "10027107",
"label": "b",
"name": "Filiform and fungiform papillae are found across the whole surface of the tongue",
"picture": null,
"votes": 1
}
],
"comments": [],
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"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5907",
"name": "Classification of sensory afferent fibres",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
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"question": "Which statement regarding the anatomy of the tongue is correct?",
"sbaAnswer": [
"a"
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"typeId": 1,
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173,466,493 | false | 26 | null | 6,495,211 | null | false | [] | null | 17,820 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The long and short nerves of the eyeball are branches of the ophthalmic trigeminal nerve within the orbit’s muscular cone.",
"id": "10027113",
"label": "c",
"name": "The optic nerve branches to give off the long and short nerves of the eyeball",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The superior division of the oculomotor nerve supplies the superior rectus and levator palpebrae muscles. The inferior division supplies the inferior rectus, medial rectus and inferior oblique muscles.",
"id": "10027114",
"label": "d",
"name": "The superior division of the oculomotor nerve supplies the superior and medial rectus muscles",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The optic nerve and ophthalmic artery leave the intracranial space to enter the orbit through the optic foramen, an opening in the sphenoid bone.",
"id": "10027111",
"label": "a",
"name": "The optic nerve enters the orbit through the optic foramen and the tendinous ring",
"picture": null,
"votes": 40
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The venous drainage of the orbit mostly occurs via the superior ophthalmic vein to the cavernous sinus. The veins from the forehead and face can also drain via the orbit, presenting a potential risk to track infections of these areas to the cavernous sinus.",
"id": "10027115",
"label": "e",
"name": "The venous drainage of the orbit mostly occurs via the inferior ophthalmic vein and pterygoid plexus to the sigmoid sinus",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The lacrimal artery is a branch of the ophthalmic artery. It runs on the lateral side of the orbit with the lateral rectus muscle to supply the lacrimal gland, eyelids and conjunctiva.",
"id": "10027112",
"label": "b",
"name": "The lacrimal artery runs on the medial side of the orbit with the medial rectus muscle to supply the lacrimal gland, eyelids and conjunctiva",
"picture": null,
"votes": 22
}
],
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"id": "5955",
"name": "Ocular pain",
"status": null,
"topic": {
"__typename": "Topic",
"id": "140",
"name": "Ophthalmology",
"typeId": 7
},
"topicId": 140,
"totalCards": null,
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"question": "Which statement correctly describes structures found in the orbit?",
"sbaAnswer": [
"a"
],
"totalVotes": 111,
"typeId": 1,
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} | MarksheetMark |
173,466,494 | false | 27 | null | 6,495,211 | null | false | [] | null | 13,473 | {
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"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mode of action of the -gliflozins, such as empagliflozin. Sitagliptin inhibits DPP-4, increasing incretin levels which inhibits glucagon secretion.",
"id": "10004634",
"label": "d",
"name": "Sitagliptin inhibits SGLT-2, thereby inhibiting the reabsorption of glucose by the kidneys",
"picture": null,
"votes": 64
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Although insulin is primarily used in patients with type 1 diabetes mellitus, it is also sometimes used in patients with poorly controlled type 2 diabetes mellitus.",
"id": "10004631",
"label": "a",
"name": "Subcutaneous insulin is a direct replacement for endogenous insulin",
"picture": null,
"votes": 179
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mode of action of the -gliptins, such as sitagliptin. Empagliflozin inhibits SGLT-2, thereby inhibiting the reabsorption of glucose by the kidneys.",
"id": "10004633",
"label": "c",
"name": "Empagliflozin inhibits the enzyme DPP-4, resulting in the inhibition of glucagon secretion",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Metformin is the first-line medication used in type 2 diabetes mellitus, however, it works by increasing peripheral sensitivity to insulin and decreasing hepatic gluconeogenesis.",
"id": "10004632",
"label": "b",
"name": "Metformin is the first line medication used in type 2 diabetes mellitus- it stimulates the pancreatic beta cells to secrete insulin",
"picture": null,
"votes": 73
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mode of action of metformin, the first-line medication used in type 2 diabetes mellitus. Gliclazide is a sulfonylurea, which stimulates the pancreatic beta cells to secrete more insulin.",
"id": "10004635",
"label": "e",
"name": "Gliclazide works by increasing peripheral sensitivity to insulin and decreasing hepatic gluconeogenesis",
"picture": null,
"votes": 69
}
],
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"id": "3761",
"name": "Type 2 Diabetes Mellitus",
"status": null,
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"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
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"topicId": 133,
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"question": "Which of the following statements correctly describes a medication used in the treatment of type 2 diabetes mellitus?",
"sbaAnswer": [
"a"
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"typeId": 1,
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} | MarksheetMark |
173,466,495 | false | 28 | null | 6,495,211 | null | false | [] | null | 17,821 | {
"__typename": "QuestionSBA",
"choices": [
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Corticotropin releasing hormone is released from the hypothalamus onto the anterior pituitary gland. The posterior pituitary gland releases oxytocin and vasopressin.",
"id": "10027119",
"label": "d",
"name": "Corticotropin releasing hormone (CRH) is released from the posterior pituitary gland",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Adrenocorticotropic hormone (ACTH) is secreted by the anterior pituitary gland.",
"id": "10027120",
"label": "e",
"name": "Adrenocorticotropic hormone is secreted by the hypothalamus",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cortisol acts on many tissues in the body, but in the brain, it mediates its effects by stimulating both mineralocorticoid receptors and glucocorticoid receptors.",
"id": "10027117",
"label": "b",
"name": "In the brain, cortisol acts on glucocorticoid receptors only",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Epinephrine and norepinephrine are released by the adrenal medulla by sympathetic stimulation and local effects of cortisol. They positively feedback to the pituitary gland, increasing the breakdown of POMC into adrenocorticotropic hormone.",
"id": "10027116",
"label": "a",
"name": "Epinephrine and norepinephrine released by the adrenal medulla feedback to increase the breakdown of POMC into adrenocorticotropic hormone",
"picture": null,
"votes": 42
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Adrenocorticotropic hormone (ACTH) regulates secretion of glucocorticoid hormones from the zona fasciculata of the adrenal cortex.",
"id": "10027118",
"label": "c",
"name": "Adrenocorticotropic hormone is a peptide hormone that regulates the secretion of hormones from the zona reticularis of the adrenal cortex",
"picture": null,
"votes": 35
}
],
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"id": "5956",
"name": "Synthesis and secretion of adrenal cortical hormone",
"status": null,
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"__typename": "Topic",
"id": "175",
"name": "Reproductive Physiology",
"typeId": 7
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"topicId": 175,
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"question": "Which of the following statements correctly describes a hormone involved in the hypothalamic-pituitary-adrenal axis?",
"sbaAnswer": [
"a"
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"totalVotes": 111,
"typeId": 1,
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} | MarksheetMark |
173,466,496 | false | 29 | null | 6,495,211 | null | false | [] | null | 17,822 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Turner’s syndrome is caused by the deletion of a whole X-chromosome, or deletion of its short arm, causing the karyotype 45X. Features of Turner’s syndrome include a webbed neck, short stature, amenorrhoea, renal and cardiac abnormalities and a high FSH and LH.",
"id": "10027123",
"label": "c",
"name": "Turner's syndrome",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Androgen insensitivity syndrome is an X-linked recessive condition involving end-organ resistance to testosterone, which manifests as genetically male children (46XY karyotype) having a female phenotype. Groin swelling due to undescended testes, amenorrhoea, absence of body hair, high FSH and LH and high testosterone levels are seen.",
"id": "10027125",
"label": "e",
"name": "Androgen insensitivity syndrome",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Kleinfelter’s syndrome, or primary hypogonadism, is associated with the karyotype 47XXY. Lack of secondary sexual characteristics such as facial, pubic and armpit hair, small testicles and infertility are key features. Other physical features such as gynaecomastia (enlargement of the breasts) and a tall stature may be present. High FSH and LH with low testosterone are also classical findings in Klinefelter’s syndrome.",
"id": "10027121",
"label": "a",
"name": "Klinefelter's syndrome",
"picture": null,
"votes": 94
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Deletion of the Prader-Willi gene inherited from the father results in Prader-Willi syndrome, which is characterised by childhood obesity, learning difficulties, hypotonia, short stature and infertility.",
"id": "10027122",
"label": "b",
"name": "Prader-Willi syndrome",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Kallman’s syndrome, or hypogonadotropic hypogonadism, is an X-linked recessive disorder, believed to occur due to the failure of GnRH-secreting cells to migrate. Features of Kallman’s syndrome include delayed puberty with normal stature, anosmia, and cryptorchidism (failure of testes descent). Typical blood test findings in Kallman’s syndrome are low testosterone with a high FSH and LH.",
"id": "10027124",
"label": "d",
"name": "Kallman's syndrome",
"picture": null,
"votes": 7
}
],
"comments": [],
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"__typename": "Concept",
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"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4312",
"name": "Delayed puberty",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
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"question": "A 19-year-old male has a telephone consultation with his GP to discuss concerns about his lack of facial, pubic and armpit hair. He is also concerned about his testicles being too small, which is affecting his self-esteem. During a face-to-face follow-up appointment, he is seen to have a tall stature and gynaecomastia. Blood tests show a high FSH and LH and a low testosterone.\n\nWhat is the most likely underlying diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 113,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,497 | false | 30 | null | 6,495,211 | null | false | [] | null | 17,823 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the function of the pineal gland. Melatonin is a hormone related to serotonin and is implicated in the modulation of sleep-wake cycles.",
"id": "10027128",
"label": "c",
"name": "Modulation of sleep-wake cycles through the production of melatonin",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Follicle-stimulating hormone and luteinising hormone are secreted by the gonadotrophin cells of the anterior pituitary gland.",
"id": "10027130",
"label": "e",
"name": "Secretion of sex hormones follicle-stimulating hormone and luteinising hormone",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the function of the parvocellular neurosecretory cells of the medial hypothalamus. Their axons project to the median eminence, where they release hormones into the hypothalamic-pituitary-portal blood vessels.",
"id": "10027129",
"label": "d",
"name": "Production and secretion of thyrotropin-releasing hormone, corticotrophin-releasing hormone and neurotensin",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The magnocellular neurons of the paraventricular nucleus secrete oxytocin and vasopressin, projecting into the posterior pituitary gland.",
"id": "10027126",
"label": "a",
"name": "Projection of neurons to the posterior pituitary gland and secretion of oxytocin and vasopressin",
"picture": null,
"votes": 75
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The corticotrophic cells of the anterior pituitary gland produce and secrete an adrenocorticotrophic hormone (ACTH) in response to corticotrophin-releasing hormone from the hypothalamus. ACTH stimulates the adrenal glands to produce cortisol.",
"id": "10027127",
"label": "b",
"name": "Production and secretion of adrenocorticotrophic hormone",
"picture": null,
"votes": 4
}
],
"comments": [],
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"__typename": "Chapter",
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3897",
"name": "Hormones of the anterior pituitary gland",
"status": null,
"topic": {
"__typename": "Topic",
"id": "167",
"name": "Endocrine physiology",
"typeId": 7
},
"topicId": 167,
"totalCards": null,
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},
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"question": "Which statement best describes the function of the paraventricular nucleus?",
"sbaAnswer": [
"a"
],
"totalVotes": 110,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,498 | false | 31 | null | 6,495,211 | null | false | [] | null | 17,824 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Helicine arterioles do provide some of the blood supply to the male penile erectile tissue, but they are dilated upon parasympathetic stimulation.",
"id": "10027135",
"label": "e",
"name": "Penile erectile tissue is supplied by the helicine arterioles, which are dilated upon sympathetic stimulation",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The bulbospongiosus muscle is a striated muscle covering the penile erectile tissue. It acts to empty the penile urethra during ejaculation and is supplied by the pudendal nerve.",
"id": "10027131",
"label": "a",
"name": "The bulbospongiosus muscle, a striated muscle covering the penile erectile tissue, is supplied by the pudendal nerve",
"picture": null,
"votes": 39
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The testes are covered by the tunica vaginalis, a layer of peritoneum, and tunica albugina, a fibrous outer layer. This double layer provides lubrication, enabling the testes to move around.",
"id": "10027132",
"label": "b",
"name": "The testes are covered by the tunica albugina, a layer of peritoneum, and tunica vaginalis, a fibrous outer layer",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The dartos muscle in the layer surrounding the testes consists of sympathetically innervated smooth muscle which contracts in the cold, making the scrotum smaller to conserve heat. The cremaster muscle is a layer of striated muscle surrounding the spermatic cord, acting to raise the testis when cold.",
"id": "10027133",
"label": "c",
"name": "The cremaster muscle consists of sympathetically innervated smooth muscle, which contracts in the cold to decrease the size of the scrotum",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The sensory supply to the scrotum is provided by 4 nerves: the anterior scrotal nerves supply the anterior surface and root of the penis, the posterior scrotal nerves supply the posterior surface, part of the anterolateral surface is supplied by the genitofemoral nerve and perineal branch of the posterior femoral cutaneous nerve supplies part of the inferior surface.",
"id": "10027134",
"label": "d",
"name": "The sensory supply to the scrotum is entirely provided by the pudendal nerve",
"picture": null,
"votes": 18
}
],
"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": "5957",
"name": "Penile erection",
"status": null,
"topic": {
"__typename": "Topic",
"id": "175",
"name": "Reproductive Physiology",
"typeId": 7
},
"topicId": 175,
"totalCards": null,
"typeId": null,
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},
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"question": "Which statement regarding the anatomy of the male genitalia is correct?",
"sbaAnswer": [
"a"
],
"totalVotes": 108,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,499 | false | 32 | null | 6,495,211 | null | false | [] | null | 17,825 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The thyroid usually drains to the prelaryngeal and tracheal lymph nodes but may drain to the deep cervical nodes or directly into the thoracic duct or right lymphatic duct. The supraclavicular nodes drain structures of the thorax and abdomen.",
"id": "10027140",
"label": "e",
"name": "The lymphatic drainage of the thyroid gland is usually to the supraclavicular lymph nodes",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The thyroid gland is covered anteriorly by pre tracheal fascia and the infrahyoid muscles (sternohyoid and sternothyroid. This enables the thyroid to move up and down with the larynx, but not to ascend above it.",
"id": "10027136",
"label": "a",
"name": "The thyroid gland is covered anteriorly by pre tracheal fascia and the infrahyoid muscles",
"picture": null,
"votes": 55
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The thyroid ima artery is an anatomical variant present in up to 10% of the population, originating from the aortic arch. It is located in the midsagittal plane, anterior to the thyroid isthmus, and therefore sometimes provides difficulty if it becomes necessary to gain anterior access to the airway.",
"id": "10027137",
"label": "b",
"name": "The variant thyroid ima artery originates from the thyrocervical trunk",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The superior laryngeal and recurrent laryngeal nerves, branches of the vagus nerve, provide the parasympathetic supply to the thyroid gland. The sympathetic supply to the thyroid gland is from the sympathetic trunk.",
"id": "10027139",
"label": "d",
"name": "The sympathetic supply to the thyroid gland is from the superior laryngeal and recurrent laryngeal nerves",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The superior and middle thyroid veins drain into the internal jugular veins, and the inferior thyroid veins drain into the brachiocephalic veins.",
"id": "10027138",
"label": "c",
"name": "The inferior thyroid veins drain into the internal jugular veins",
"picture": null,
"votes": 9
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3834",
"name": "Thyroid Axis",
"status": null,
"topic": {
"__typename": "Topic",
"id": "167",
"name": "Endocrine physiology",
"typeId": 7
},
"topicId": 167,
"totalCards": null,
"typeId": null,
"userChapter": null,
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},
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"question": "Which of the following statements regarding the anatomy of the thyroid gland is correct?",
"sbaAnswer": [
"a"
],
"totalVotes": 110,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,500 | false | 33 | null | 6,495,211 | null | false | [] | null | 17,826 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the pathophysiology of type 1 diabetes mellitus, where autoimmune destruction of the insulin-producing beta cells causes a deficiency of insulin, resulting in raised glucose levels.",
"id": "10027142",
"label": "b",
"name": "Autoimmune destruction of the insulin-producing beta cells of the pancreas",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Phaeochromocytoma is a rare catecholamine-secreting tumour resulting in dangerously high levels of noradrenaline and adrenaline in the blood. This results in severe hypertension, headaches, palpitations, sweating and anxiety.",
"id": "10027143",
"label": "c",
"name": "A tumour secreting large amounts of catecholamines",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the pathophysiology of Graves disease. Autoantibodies bind to the thyroid stimulating hormone receptor, stimulating the thyroid gland to produce abnormally high amounts of T3 and T4, which feedback to cause a low TSH level. This results in symptoms such as weight loss, tremor, tachycardia, diarrhoea and exophthalmos.",
"id": "10027145",
"label": "e",
"name": "Autoimmune-mediated chronic stimulation of the thyroid stimulating hormone receptor, resulting in hyperthyroidism",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the pathophysiology of coeliac disease, which is characterised by symptoms such as chronic diarrhoea, bloating and malabsorption. Coeliac disease is often associated with other autoimmune conditions.",
"id": "10027144",
"label": "d",
"name": "Autoimmune disorder primarily affecting the small intestine, where an inflammatory response against gluten-derive peptides occurs",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Addison’s disease presents with features such as lethargy, weakness, hypotension, hyperpigmentation, weight loss, nausea and vomiting, and is sometimes associated with other autoimmune conditions.",
"id": "10027141",
"label": "a",
"name": "Autoimmune destruction of the adrenal glands, reducing the production of cortisol and aldosterone",
"picture": null,
"votes": 112
}
],
"comments": [],
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},
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"id": "5958",
"name": "Adrenal insufficiency",
"status": null,
"topic": {
"__typename": "Topic",
"id": "170",
"name": "Clinical Chemistry",
"typeId": 7
},
"topicId": 170,
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"question": "What is the pathophysiological process underlying Addison’s disease?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,501 | false | 34 | null | 6,495,211 | null | false | [] | null | 17,827 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The germinal epithelium is the posterior fold of the broad ligament within which the ovary, not the uterine artery, lies.",
"id": "10027147",
"label": "b",
"name": "The section of the broad ligament surrounding the uterine artery is called the germinal epithelium",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The inferior mesenteric artery arises from the abdominal aorta and once it crosses the pelvic brim, it becomes the superior rectal artery, supplying much of the rectum.",
"id": "10027146",
"label": "a",
"name": "Once the inferior mesenteric artery crosses the pelvic brim, it becomes the superior rectal artery",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The four fornices of the vagina form a ring around the uterine cervix. The posterior fornix of the vagina is important in that it is covered by the peritoneum.",
"id": "10027149",
"label": "d",
"name": "The anterior fornix of the vagina is significant in that it is covered by peritoneum",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The cardinal ligaments are the strongest of the pelvic ligaments, connecting the cervix to the lateral pelvic wall. They are thickenings of pelvic fascia that add to the muscular support of the uterus. The cervix is attached to the sacrum by the uterosacral ligaments.",
"id": "10027148",
"label": "c",
"name": "The cardinal ligaments attach the cervix to the sacrum",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The internal iliac arteries branch into anterior divisions, which mainly supply pelvic viscera and posterior divisions, which mainly supply pelvic walls. The external iliac vessels supply the lower limbs.",
"id": "10027150",
"label": "e",
"name": "The blood supply to the pelvic viscera mainly comes from the external iliac arteries",
"picture": null,
"votes": 23
}
],
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},
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"demo": null,
"entitlement": null,
"id": "5959",
"name": "Perineal tears",
"status": null,
"topic": {
"__typename": "Topic",
"id": "174",
"name": "Obstetrics",
"typeId": 7
},
"topicId": 174,
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},
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"question": "Which statement regarding the anatomy of female pelvic structures is correct?",
"sbaAnswer": [
"a"
],
"totalVotes": 107,
"typeId": 1,
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} | MarksheetMark |
173,466,502 | false | 35 | null | 6,495,211 | null | false | [] | null | 17,828 | {
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"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are general symptoms often seen in both haematological and non-haematological malignancy, but would not specifically point to a diagnosis of Hodgkin’s lymphoma.",
"id": "10027154",
"label": "d",
"name": "Anaemia, fever, weight loss, lymphadenopathy",
"picture": null,
"votes": 27
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Hodgkin’s lymphoma is a malignant proliferation of lymphocytes, the pathological hallmark of which is the Reed-Sternberg cell- a giant, multinucleate cell derived from B lymphocytes. The other features listed above are also classically seen in Hodgkin’s lymphoma.",
"id": "10027151",
"label": "a",
"name": "Reed-Sternberg cells, lymphadenopathy, weight loss, splenomegaly",
"picture": null,
"votes": 57
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are features seen in acute promyelocytic leukaemia. This is a subtype of acute myeloid leukaemia seen in younger patients and generally carries a good prognosis.",
"id": "10027155",
"label": "e",
"name": "Disseminated intravascular coagulation, Auer rods, PML/RARa gene fusion",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are features of chronic myeloid leukaemia, another type of haematological malignancy. The presence of the Philadelphia chromosome, a shortened chromosome 22 containing an abnormal BCR-ABL fusion gene, is the Gold standard of CML diagnosis.",
"id": "10027152",
"label": "b",
"name": "Philadelphia chromosome, splenomegaly, leucocytosis, severe anaemia",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are features of multiple myeloma, a haematological malignancy involving neoplastic proliferation of monoclonal plasma cells in the bone marrow.",
"id": "10027153",
"label": "c",
"name": "Hypercalcaemia, anaemia, renal insufficiency, bone pain, high free serum light chains",
"picture": null,
"votes": 3
}
],
"comments": [],
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"__typename": "Concept",
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},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5960",
"name": "Hodgkin's lymphoma",
"status": null,
"topic": {
"__typename": "Topic",
"id": "157",
"name": "Haematology",
"typeId": 7
},
"topicId": 157,
"totalCards": null,
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},
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"question": "Which set of findings would most likely point to a diagnosis of Hodgkin’s lymphoma?",
"sbaAnswer": [
"a"
],
"totalVotes": 107,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,503 | false | 36 | null | 6,495,211 | null | false | [] | null | 17,829 | {
"__typename": "QuestionSBA",
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{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The oogonium is a diploid cell produced in utero. It is arrested at prophase I until puberty, where FSH triggers the completion of meiosis I.",
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"label": "a",
"name": "The oogonium is a diploid cell held at prophase I until puberty",
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Meiosis I is completed at the start of puberty, following FSH, not LH production and secretion. This produces the secondary oocyte, which completes meiosis II after fertilisation.",
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"label": "c",
"name": "Meiosis II is completed at the start of puberty, following LH production and secretion",
"picture": null,
"votes": 16
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Meiosis I is completed at the start of puberty, following FSH production and secretion. This produces the secondary oocyte, which is arrested at metaphase II until fertilisation.",
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"label": "e",
"name": "The secondary oocyte is arrested at prophase I",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The primary oocyte is diploid, and produces two haploid cells of unequal size: the first polar body (smaller cell) and the secondary oocyte (larger cell).",
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"label": "d",
"name": "Before ovulation, the primary oocyte completes meiosis I, producing two diploid cells of unequal size",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Following fertilisation, the secondary oocyte splits into two haploid cells of unequal size. The larger cell is the ovum and the smaller cell is the second polar body. These cells are both haploid.",
"id": "10027157",
"label": "b",
"name": "The smaller cell formed by the secondary oocyte after fertilisation is the ovum",
"picture": null,
"votes": 12
}
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"id": "4517",
"name": "Development of the female reproductive system",
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"id": "171",
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"question": "Which statement correctly describes an aspect of oogenesis?",
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"a"
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173,466,504 | false | 37 | null | 6,495,211 | null | false | [] | null | 17,830 | {
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"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Implantation is the stage of development when the blastocyst adheres to and invades the uterine wall. This occurs a few days before gastrulation when the primary germ layers are formed.",
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"label": "e",
"name": "The blastocyst adheres to and invades the uterine wall",
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"votes": 1
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Organogenesis is the process of the formation and development of the organs. This starts between week 3 and week 8 of embryonic development, and continues until birth.",
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"label": "c",
"name": "Formation and development of the organs",
"picture": null,
"votes": 2
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Gastrulation is the stage of embryonic development in which the pluripotent stem cells form the primary germ layers: endoderm, ectoderm and mesoderm.",
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"label": "d",
"name": "Pluripotent stem cells form primary germ layers",
"picture": null,
"votes": 2
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the process of blastulation. The blastula becomes the gastrula, which forms the primary germ layers during gastrulation.",
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"label": "b",
"name": "Formation of the blastula from the morula",
"picture": null,
"votes": 3
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{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Neurulation is the folding process that transforms the neural plate into the neural tube, occurring after the formation of the primary germ layers.",
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"label": "a",
"name": "The neural plate folds into the neural tube",
"picture": null,
"votes": 101
}
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"id": "3874",
"name": "Neurulation",
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"question": "What happens during the developmental stage of neurulation?",
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173,466,505 | false | 38 | null | 6,495,211 | null | false | [] | null | 17,831 | {
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"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Oncogenes code for oncoproteins, which act to promote cell division and tumour growth. One of the methods by which they do this is by binding to tumour suppressor genes, inactivating them.",
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"label": "a",
"name": "The proteins they code for bind to and inactivate tumour suppressor genes, allowing rapid uncontrolled cell division",
"picture": null,
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is one of the actions of the p53 tumour suppressor gene, which has several mechanisms of action aiming to maintain genomic stability.",
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"label": "e",
"name": "They initiate apoptosis if there becomes irreparable DNA damage in a cell",
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"votes": 8
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The elongation of telomeres is not well characterised. Shortening of the telomeres of chromosomes happens as cells divide as we age, and is associated with ageing and the development of disease (e.g. cancer). Oncogenes may have effects to increase telomere shortening.",
"id": "10027168",
"label": "c",
"name": "They allow elongation of telomeres, protecting cancer cells from apoptosis",
"picture": null,
"votes": 32
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pro-apoptotic proteins that interact with mitochondria to trigger apoptosis include BAX and BAK. These are regulated by a complex protein system, including pro-survival BCL2-like proteins. In tumour cells, oncogenes act to prevent apoptosis, so that cells can grow and divide in a rapid, uncontrolled way.",
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"label": "b",
"name": "They both directly and indirectly interact with mitochondria to trigger apoptosis",
"picture": null,
"votes": 3
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Mutations or down regulation of tumour suppressor genes, not oncogenes, is a common mechanism tumour cells use to become resistant to cytotoxic drugs.",
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"label": "d",
"name": "Mutation or down regulation of oncogenes allows tumour cells to be highly resistant to cytotoxic drugs",
"picture": null,
"votes": 6
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"id": "4315",
"name": "Molecular basis of cancer",
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"__typename": "Topic",
"id": "182",
"name": "Cancer Biology",
"typeId": 7
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"topicId": 182,
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"question": "Which statement describes how oncogenes may affect tumour growth?",
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"a"
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173,466,506 | false | 39 | null | 6,495,211 | null | false | [] | null | 17,832 | {
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"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The migration of the thyroid along the thyroglossal duct happens at week 7 of development. The thyroglossal duct eventually regresses and destroys at the end of week 7.",
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"label": "e",
"name": "At week 12 of development, the thyroid begins to migrate along the thyroglossal duct",
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The inferior parathyroid glands develop from the 3rd pharyngeal pouch. The 4th pharyngeal pouch is where the superior parathyroid glands develop from",
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"label": "d",
"name": "The inferior parathyroid glands develop from the 4th pharyngeal pouch",
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{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The inferior parathyroid glands develop from the 3rd pharyngeal pouch and the superior glands from the 4th pharyngeal pouch. As the thyroid migrates down into the neck through the thyroglossal duct, the inferior parathyroid glands are pulled downwards to their final position below the superior glands.",
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"label": "a",
"name": "The inferior parathyroid glands start to develop above the superior glands and are pulled to their final position when the thyroid gland migrates downwards",
"picture": null,
"votes": 46
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The thyroid gland develops as an epithelial proliferation at the foramen cecum of the developing tongue at week 4 of development.",
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"label": "b",
"name": "The thyroid gland develops as an epithelial proliferation at the foramen cecum of the developing tongue at week 10",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The superior parathyroid glands develop from the 4th pharyngeal pouch. The 2nd pharyngeal pouch is where the tonsil develops from.",
"id": "10027173",
"label": "c",
"name": "The superior parathyroid glands develop from the 2nd pharyngeal pouch",
"picture": null,
"votes": 6
}
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"id": "5961",
"name": "Thyroglossal cyst",
"status": null,
"topic": {
"__typename": "Topic",
"id": "186",
"name": "Ear, Nose and Throat",
"typeId": 7
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"question": "Which statement best describes an aspect of thyroid or parathyroid gland development?",
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"a"
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"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,507 | false | 40 | null | 6,495,211 | null | false | [] | null | 17,833 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Human chorionic gonadotrophin is produced by the placenta and maintains the corpus luteum in early pregnancy. Its levels significantly decrease at week 15-16 of pregnancy.",
"id": "10027179",
"label": "d",
"name": "Human chorionic gonadotrophin levels rise until week 26-28 of pregnancy, then suddenly reduce to undetectable levels",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Progesterone is mostly produced by the corpus luteum until around week 10 of pregnancy. After this, progesterone is mostly produced by the placenta.",
"id": "10027176",
"label": "a",
"name": "The corpus luteum is the main source of progesterone until week 10 of pregnancy",
"picture": null,
"votes": 67
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Oxytocin is produced at the start of labour, stimulating uterine muscle (myometrium) contractions. It is produced and secreted by the posterior pituitary gland, not the placenta.",
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"label": "b",
"name": "Oxytocin, produced by the placenta, stimulates myometrial contraction at the start of labour",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The increase in oxytocin, not progesterone, at the beginning of labour triggers prostaglandin production, which helps to increase uterine contractions.",
"id": "10027180",
"label": "e",
"name": "Increased prostaglandin production at the start of labour is triggered by progesterone",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Prolactin does cause enlargement of the mammary glands during pregnancy, preparing them for milk production. It is produced and secreted by the anterior pituitary gland, not the posterior pituitary gland.",
"id": "10027178",
"label": "c",
"name": "Prolactin, produced by the posterior pituitary gland, causes mammary gland enlargement",
"picture": null,
"votes": 7
}
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"demo": null,
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"id": "4251",
"name": "Pregnancy hormones",
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"topic": {
"__typename": "Topic",
"id": "175",
"name": "Reproductive Physiology",
"typeId": 7
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"topicId": 175,
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"question": "Which statement regarding hormones in pregnancy is correct?",
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"a"
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"totalVotes": 109,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,508 | false | 41 | null | 6,495,211 | null | false | [] | null | 17,834 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypospadia, the second most common congenital abnormality of the male reproductive tract, is when the urethral meatus is not situated in the head of the penis.",
"id": "10027183",
"label": "c",
"name": "The meatus of the urethra is not situated in the head of the penis",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Monorchism is when there is only one testicle in the scrotum. This can be as a result of cryptorchidism, or other reasons such as surgical removal of a testicle (orchiectomy).",
"id": "10027185",
"label": "e",
"name": "Only one testicle is present within the scrotum",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Aphallia is a very rare developmental abnormality resulting from the failed formation of the fatal genital tubercle.",
"id": "10027181",
"label": "a",
"name": "Absence of the phallus (penis or clitoris)",
"picture": null,
"votes": 103
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cryptorchidism is the failure of one or both testes to descend into the scrotum. This is the most common birth defect of the male genital tract and is classified according to the position of the undescended testicle.",
"id": "10027182",
"label": "b",
"name": "The failure of one or both testes to descend into the scrotum",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Anorchia is when a person with an XY karyotype is born without testes. If the testes fail to develop within the first 8 weeks of life, the infant will develop female genitalia.",
"id": "10027184",
"label": "d",
"name": "Being born without testes",
"picture": null,
"votes": 2
}
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"id": "5962",
"name": "Congenital malformations of the male and female reproductive systems",
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"__typename": "Topic",
"id": "171",
"name": "Embryology",
"typeId": 7
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"question": "Which statement describes the developmental abnormality aphallia?",
"sbaAnswer": [
"a"
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"typeId": 1,
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} | MarksheetMark |
173,466,509 | false | 42 | null | 6,495,211 | null | false | [] | null | 17,835 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Passive euthanasia occurs when a patient is intentionally let to die, for example by withholding artificial life-supporting treatment (e.g. ventilation or nutritional support). Passive euthanasia may be voluntary (when the patient consents), which is legal in the USA, or involuntary (when the patient does not consent).",
"id": "10027186",
"label": "a",
"name": "Passive euthanasia",
"picture": null,
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Manslaughter is the crime of ending someone's life unintentionally or without planning.",
"id": "10027190",
"label": "e",
"name": "Manslaughter",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Active euthanasia is when a presume deliberately does something that causes the death of a patient, for example directly administering the patient with a lethal dose of a drug that results in their death.",
"id": "10027189",
"label": "d",
"name": "Active euthanasia",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Involuntary euthanasia is the term used when the person does not want to die. Passive euthanasia may be voluntary or involuntary.",
"id": "10027187",
"label": "b",
"name": "Involuntary euthanasia",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Assisted suicide describes assisting someone with a long-term progressive condition, or without illness, to end their life. In cases of assisted suicide, the fatal action/drug dose is self-administered. For example, the partner of a terminally ill patient stockpiling enough paracetamol for the patient to self-administer a fatal dose.",
"id": "10027188",
"label": "c",
"name": "Assisted suicide",
"picture": null,
"votes": 1
}
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"name": "Euthanasia",
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"id": "184",
"name": "Ethics and Law",
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"topicId": 184,
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"question": "Which legal term best describes the action of intentionally leaving a patient to die, for example by withholding artificial life-supporting treatment?",
"sbaAnswer": [
"a"
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"typeId": 1,
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173,466,510 | false | 43 | null | 6,495,211 | null | false | [] | null | 17,836 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes metabolism, one of the phases of pharmacokinetics (liberation, absorption, distribution, metabolism, excretion). Pharmacokinetics is the overall term used to describe how the body affects a certain drug.",
"id": "10027192",
"label": "b",
"name": "Pharmacokinetics is the study of the breakdown of a drug into metabolites",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes affinity. Efficacy is the ability of a ligand to produce a functional biological response when it binds to its target receptor.",
"id": "10027194",
"label": "d",
"name": "Efficacy is the strength with which a ligand binds to its receptor at a certain concentration",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Antagonists are substances that have affinity but no efficacy for a certain receptor. These may bind to the main active site, or an alternative (allosteric) site to mediate this effect. Allosteric modulators are any substances that bind to an alternative site on the receptor to that of the endogenous agonist and may have a range of effects on the receptor activity.",
"id": "10027193",
"label": "c",
"name": "Allosteric modulators are substances that have affinity but no efficacy for a certain receptor",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Pharmacodynamics is the study of the physiological and biochemical effects of a substance on the body, from a molecular to a phenotypic level.",
"id": "10027191",
"label": "a",
"name": "Pharmacodynamics is the term used to describe the physiological and biochemical effects of a substance",
"picture": null,
"votes": 49
},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "This describes efficacy. Affinity is the strength with which a ligand binds to its receptor at a certain concentration.",
"id": "10027195",
"label": "e",
"name": "Affinity is the ability of a ligand to produce a functional biological response when it binds to its target receptor",
"picture": null,
"votes": 12
}
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"id": "172",
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"typeId": 7
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"question": "Which statement correctly describes a term used in pharmacology?",
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"a"
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173,466,511 | false | 44 | null | 6,495,211 | null | false | [] | null | 17,837 | {
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{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Cross-sectional studies are observational studies, so no intervention (drug) is given. They are carried out at a single point in time, assessing the prevalence of disease in groups exposed to risk factors and those not exposed to the risk factor. As the exposure and disease factors are measured at the same time, it is difficult to establish cause and effect.",
"id": "10027197",
"label": "b",
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"explanation": "Case-control studies are a type of observational study where a group with a disease and a group of controls without the disease are selected, and their past exposure (risk factor) status is compared, and are not used to assess the effect of an intervention (drug). All observational studies, such as case-control studies, are subject to influence by confounding factors.",
"id": "10027198",
"label": "c",
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},
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"__typename": "QuestionChoice",
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"explanation": "Cohort studies involve the classification of participants based on their risk factor status at baseline, and following-up to determine who develops the disease outcome. This requires large numbers of participants, resulting in cohort studies being time-consuming and expensive. Cohort studies are not used to assess the efficacy of an intervention.",
"id": "10027199",
"label": "d",
"name": "Cohort study, as this is cheaper and quicker than other types of observational study",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "A randomised control trial (RCT) is an interventional trial and is used to assess the efficacy of a particular intervention (e.g. treatment for a specific disease). The act of randomising the participants reduces confounding factors and bias, so any differences in outcome can be attributed to the effect of the intervention- in this case, the new drug.",
"id": "10027196",
"label": "a",
"name": "Randomised control trial, as you can attribute any differences in observed outcome to the new drug",
"picture": null,
"votes": 76
},
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"__typename": "QuestionChoice",
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"explanation": "One of the weaknesses of randomised control trials is that they often don’t mimic the clinical, real-life treatment situation, for example, due to the trial being a highly controlled setting, often with strict inclusion and exclusion criteria.",
"id": "10027200",
"label": "e",
"name": "Randomised control trial, as this mimics the clinical real-life treatment situation",
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"question": "A group of researchers would like to assess the clinical efficacy of a new drug.\n\nWhich of the following study designs would be most appropriate for this and why?",
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173,466,512 | false | 45 | null | 6,495,211 | null | false | [] | null | 17,838 | {
"__typename": "QuestionSBA",
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Activation of NMDA receptors requires the binding of two co-agonists, glutamate and glycine, which bind to separate sites on the extracellular domains, allowing channel opening and ion influx.",
"id": "10027205",
"label": "e",
"name": "Activation of NMDA receptors requires the binding of two co-agonists, glutamate and aspartate",
"picture": null,
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"__typename": "QuestionChoice",
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"explanation": "This is the structure of G-protein coupled receptors. NMDA receptors are ligand-gated ion channels, not G-protein coupled receptors, which consist of 4 different subunits, each with 3 transmembrane domains.",
"id": "10027204",
"label": "d",
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},
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"__typename": "QuestionChoice",
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"explanation": "Memantine is an uncompetitive antagonist of the receptor, decreasing its action by entering the receptor channel after it has been opened, physically blocking ion influx into the postsynaptic cell.",
"id": "10027203",
"label": "c",
"name": "Its action is enhanced by memantine, a drug used in the treatment of Alzheimer’s disease",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The NDMA receptor is one of four types of ionotropic glutamate receptors, meaning that ligand binding opens a central ion pore, allowing ion influx into the postsynaptic cell.",
"id": "10027202",
"label": "b",
"name": "It is one of two types of metabotropic glutamate receptors",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "In the receptors’ resting conformation, magnesium ions are tightly bound to the receptor pore, restricting activation and ion entry. With sufficiently strong depolarisation, the magnesium ion is displaced from the pore, allowing a large influx of cations into the postsynaptic cell.",
"id": "10027201",
"label": "a",
"name": "They are blocked by magnesium ions in a voltage-dependent manner",
"picture": null,
"votes": 48
}
],
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173,466,513 | false | 46 | null | 6,495,211 | null | false | [] | null | 17,839 | {
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"__typename": "QuestionChoice",
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"label": "a",
"name": "The proportion of those who test positive for a disease that actually have the disease",
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"__typename": "QuestionChoice",
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"explanation": "This is the definition of the 95% confidence interval. For example, if the prevalence of a disease is measured as 0.7% (CI 0.63-0.85%), we can be 95% sure that the true value of the prevalence is between 0.63% and 0.85%.",
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"explanation": "This is the definition of the statistical concept ‘number needed to treat’ (NNT). For example, if a drug has an NNT of 8, it means that 8 patients would have to be treated with the drug to prevent 1 additional detrimental outcome.",
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"label": "d",
"name": "The number of patients over a certain time period that would need treatment to prevent a particular detrimental outcome",
"picture": null,
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the definition of sensitivity, which is used in the evaluation of diagnostic tests. Ideally, diagnostic tests should be highly sensitive and highly specific.",
"id": "10027208",
"label": "c",
"name": "The probability that an individual with a disease will test positive for the disease",
"picture": null,
"votes": 39
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the definition of specificity, which is a measure used to evaluate the suitability of diagnostic tests. Ideally, diagnostic tests should be highly sensitive and highly specific.",
"id": "10027207",
"label": "b",
"name": "The probability that an individual without a disease will test negative for the disease",
"picture": null,
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}
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"id": "178",
"name": "Medical Statistics",
"typeId": 7
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"question": "What is the definition of positive predictive value?",
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173,466,514 | false | 47 | null | 6,495,211 | null | false | [] | null | 17,840 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Case-control studies may find a correlation or association between a certain exposure (a risk factor for a particular disease) and an outcome (the disease itself). However, as the study is retrospective, it cannot be proved that this link is definitely causal.",
"id": "10027215",
"label": "e",
"name": "They are useful in confirming causal relationships between certain exposures and outcomes",
"picture": null,
"votes": 18
},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Case-control studies may use different methods to obtain data. If the measures of health outcomes used were subjective, for example, self-reporting symptoms on a questionnaire, this could lead to false reporting by subjects. However, objective measures such as antibody levels or past medical documentation could not be falsely reported by the subject.",
"id": "10027212",
"label": "b",
"name": "Subjects are less likely to falsely report health outcomes in a case-control study",
"picture": null,
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "In case-control studies, a group of subjects with the disease and a group of controls without the disease are selected, and their past exposure (risk factor) status is compared. Case-control studies are good for studying rare conditions, as a group of subjects with the disease is selected at the beginning of the study.",
"id": "10027211",
"label": "a",
"name": "They are useful in the study of rare diseases",
"picture": null,
"votes": 78
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A confounding factor is something that is associated with the exposure (risk factor) and outcome (condition X) and can distort the apparent relationship between them. All observational studies, such as case-control studies, are subject to influence by confounding factors.",
"id": "10027213",
"label": "c",
"name": "They reduce the chance of results being affected by confounding factors",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Double-blinding is a feature where neither the subjects nor the researchers or clinicians know which group the subjects are in, and aims to reduce bias in the study. This can be implemented in interventional studies, such as randomised control trials, but does not apply to observational studies such as case-control studies.",
"id": "10027214",
"label": "d",
"name": "They can be double-blinded, reducing bias",
"picture": null,
"votes": 3
}
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"name": "Observational studies",
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"id": "178",
"name": "Medical Statistics",
"typeId": 7
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"question": "Which statement best describes an advantage of case-control studies?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
"userPoint": null
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173,466,515 | false | 48 | null | 6,495,211 | null | false | [] | null | 17,841 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "GMC guidance states that doctors have a professional duty to offer assistance, taking into account their own safety, competence and availability of other options for care.",
"id": "10027220",
"label": "e",
"name": "The doctor should not offer to help as there is no duty of care",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "To win a claim for clinical negligence, the claimant must prove that a duty of care existed, that this duty was breached and that harm was caused by the breach. As there is no legal duty of care in this situation, the doctor is not at risk of a negligence claim. The doctor should still offer help though, because there is a professional duty to do so.",
"id": "10027218",
"label": "c",
"name": "The doctor should offer to help as he is at risk of a negligence claim if he does not",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Although there is indeed no Good Samaritan law in the UK, and therefore there is no legal duty of doctors to help injured or ill people, GMC guidance states that doctors have a professional duty to offer assistance.",
"id": "10027219",
"label": "d",
"name": "The doctor should not offer to help, as there is no Good Samaritan law in place in the UK",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "There is no Good Samaritan law in the UK, and therefore there is no legal duty of doctors to help injured or ill people in situations like this. If the collapse had happened inside the GP surgery when the GP was working, there would be a legal duty for the doctor to offer assistance.",
"id": "10027217",
"label": "b",
"name": "The doctor should offer to help as there is a legal duty to do so",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "GMC guidance states that doctors have a professional duty to offer assistance, taking into account their own safety, competence and availability of other options for care. Failure to offer assistance in an emergency could prompt disciplinary action by the GMC.",
"id": "10027216",
"label": "a",
"name": "The doctor should offer assistance as there is a professional duty to do so",
"picture": null,
"votes": 104
}
],
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"name": "Legal Duty of Care",
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"name": "Ethics and Law",
"typeId": 7
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"question": "A GP is travelling by train on his way to a family holiday when a call goes out for medical assistance as a person in another carriage has just collapsed.\n\nWhich statement best describes the duty of care of a GP in this scenario?",
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"a"
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173,466,516 | false | 49 | null | 6,495,211 | null | false | [] | null | 17,842 | {
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"choices": [
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mode of action of non-depolarising muscle relaxants, such as atracurium and vecuronium, which are competitive antagonists of the nicotinic receptor.",
"id": "10027223",
"label": "c",
"name": "It competes with acetylcholine for the nicotinic receptor orthosteric binding site but does not activate the receptor",
"picture": null,
"votes": 26
},
{
"__typename": "QuestionChoice",
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"explanation": "Depolarising agents are agonists of the nicotinic acetylcholine receptor. They bind to the orthosteric ligand binding site, causing receptor activation and cation influx into the motor end plate.",
"id": "10027224",
"label": "d",
"name": "It binds to an allosteric site on the nicotinic acetylcholine receptor",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Depolarising agents are agonists of the postsynaptic nicotinic acetylcholine receptor, causing receptor activation and cation influx into the motor end plate. They do not inhibit presynaptic acetylcholine release.",
"id": "10027225",
"label": "e",
"name": "It inhibits the presynaptic release of acetylcholine",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Depolarising agents are agonists of the nicotinic acetylcholine receptor, causing receptor activation and cation influx into the motor end plate.",
"id": "10027221",
"label": "a",
"name": "It activates the nicotinic acetylcholine receptor, allowing cation influx",
"picture": null,
"votes": 53
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Suxamethonium is an agonist of the nicotinic acetylcholine receptor, like acetylcholine. As suxamethonium is not broken down by acetylcholinesterase, it produces a more prolonged depolarisation of the motor end plate but doesn’t have any inhibitory effect on the breakdown of acetylcholine itself.",
"id": "10027222",
"label": "b",
"name": "It inhibits the breakdown of acetylcholine",
"picture": null,
"votes": 4
}
],
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"id": "5965",
"name": "Suxamethonium",
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"id": "172",
"name": "Pharmacology of the Nervous System",
"typeId": 7
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"question": "What is the mode of action of the depolarising agent suxamethonium?",
"sbaAnswer": [
"a"
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"typeId": 1,
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173,466,517 | false | 50 | null | 6,495,211 | null | false | [] | null | 17,843 | {
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"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are effects associated with long-term glucocorticoid use, for example in the treatment of autoimmune conditions.",
"id": "10027229",
"label": "d",
"name": "Osteoporosis, facial erythema, acne, central obesity, skin thinning",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are side effects associated with lithium, a mood-stabilising drug often used in the treatment of bipolar affective disorder.",
"id": "10027228",
"label": "c",
"name": "Diabetes insipidus, lethargy, hypothyroidism, metallic taste in the mouth",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Metabolic side effects, such as weight gain, type 2 diabetes mellitus, hyperlipidaemia, and anticholinergic side effects, such as dry mouth, constipation, urine retention and blurred vision, commonly occur with the 2nd generation, ‘atypical’ antipsychotics. These may also occur with the 1st generation antipsychotics, but less commonly and to a lesser degree. Extrapyramidal and hyperprolactinaemia side effects are more characteristic of the 1st generation antipsychotic drugs.",
"id": "10027227",
"label": "b",
"name": "Weight gain, type 2 diabetes mellitus, hyperlipidaemia, dry mouth, constipation",
"picture": null,
"votes": 16
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are side effects of bisphosphonates and pyrophosphate analogues used in the prevention and treatment of osteoporosis. An acute phase response involving fever, myalgia and arthralgia is common, whereas oesophagitis and osteonecrosis of the jaw are rare.",
"id": "10027230",
"label": "e",
"name": "Oesophagitis, fever, myalgia, arthralgia, osteonecrosis of the jaw",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "1st generation, or ’typical’, antipsychotics are associated with a wide range of side effects, the most characteristic being extrapyramidal side effects, such as tardive dyskinesia, akathisia, rigidity and tremor. They are also associated with hyperprolactinaemia, causing sexual dysfunction, osteoporosis, amenorrhoea, galactorrhea and gynecomastia. A variety of others may also occur, such as metabolic and anticholinergic side effects, but these are less specific to 1st generation antipsychotics and may occur with a range of medications.",
"id": "10027226",
"label": "a",
"name": "Rigidity, tremor, sexual dysfunction, tardive dyskinesia, galactorrhea",
"picture": null,
"votes": 85
}
],
"comments": [],
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"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5966",
"name": "Typical antipsychotics",
"status": null,
"topic": {
"__typename": "Topic",
"id": "172",
"name": "Pharmacology of the Nervous System",
"typeId": 7
},
"topicId": 172,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
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"question": "Which set of side effects are most characteristic of 1st generation (‘typical’) antipsychotic medications, such as haloperidol?",
"sbaAnswer": [
"a"
],
"totalVotes": 110,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,608 | false | 1 | null | 6,495,215 | null | false | [] | null | 17,844 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The paranephric fat layer is the most superficial while the renal capsule is the deepest layer.",
"id": "10027235",
"label": "e",
"name": "Perinephric fat, renal fascia, renal capsule, paranephric fat",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer as this is the anatomically correct order from superficial to deep. The paranephric fat separates the kidney from the abdominal wall muscles. The renal fascia is a dense, elastic connective tissue layer that separates the paranephric and perinephric fat. The perinephric fat is a simple connective tissue that protects the kidney and its associated vasculature from external physical stimulation such as temperature changes. Lastly, the renal capsule is composed mainly of tough fibres which help protect the kidney from damage due to trauma or injuries.",
"id": "10027231",
"label": "a",
"name": "Paranephric fat, renal fascia, perinephric fat, renal capsule",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The paranephric fat is superficial to the renal fascia and is the outermost layer. In addition, the renal capsule is the first layer surrounding the kidneys and, therefore the deepest.",
"id": "10027232",
"label": "b",
"name": "Perinephric fat, renal capsule, renal fascia, paranephric fat",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer as this is the order from deep to superficial",
"id": "10027233",
"label": "c",
"name": "Renal capsule, perinephric fat, renal fascia, paranephric fat",
"picture": null,
"votes": 10
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The paranephric fat is superficial to the renal fascia and is the outermost layer. In addition, the renal capsule is the first layer surrounding the kidneys and, therefore the deepest.",
"id": "10027234",
"label": "d",
"name": "Renal fascia, paranephric fat, renal capsule, perinephric fat",
"picture": null,
"votes": 4
}
],
"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": "5332",
"name": "Kidneys",
"status": null,
"topic": {
"__typename": "Topic",
"id": "197",
"name": "Abdominal anatomy",
"typeId": 7
},
"topicId": 197,
"totalCards": null,
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"question": "Which is the correct order of tissues, from superficial to deep, surrounding the kidneys?",
"sbaAnswer": [
"a"
],
"totalVotes": 55,
"typeId": 1,
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} | MarksheetMark |
173,466,609 | false | 2 | null | 6,495,215 | null | false | [] | null | 17,845 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The cells of the zona glomerulosa produce mineralocorticoids such as aldosterone.",
"id": "10027239",
"label": "d",
"name": "The cells of the zona glomerulosa produce glucocorticoids",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. Chromaffin cells in the adrenal medulla contain secretory granules which synthesize and store adrenaline and noradrenaline. An easy way to remember the adrenal cortical histology and function from superficial to deep is the saying \" GFR, the deeper you go, the sweeter it gets \" I.e. Salt (zona glomerulosa, aldosterone), Sugar (zona fasciculata, glucocorticoids) and Sex (zona Reticularis, androgens)",
"id": "10027236",
"label": "a",
"name": "The cells of the adrenal medulla produce adrenaline and noradrenaline",
"picture": null,
"votes": 37
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The cells of the zona fasciculata produce glucocorticoids such as cortisol.",
"id": "10027237",
"label": "b",
"name": "The cells of the zona fasciculata produce androgens",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The cells of the zona reticularis produce androgens such as dehydroepiandrosterone (DHEA).",
"id": "10027238",
"label": "c",
"name": "The cells of the zona reticularis produce mineralocorticoids",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The cortical parenchymal cells do not contain secretory granules as they do not store the hormones they secrete.",
"id": "10027240",
"label": "e",
"name": "The cells of the adrenal cortex contain numerous secretory granules",
"picture": null,
"votes": 3
}
],
"comments": [],
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"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4074",
"name": "Adrenal glands",
"status": null,
"topic": {
"__typename": "Topic",
"id": "197",
"name": "Abdominal anatomy",
"typeId": 7
},
"topicId": 197,
"totalCards": null,
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"highlights": [],
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"question": "Which of the following statements about the adrenal parenchymal cells is correct?",
"sbaAnswer": [
"a"
],
"totalVotes": 47,
"typeId": 1,
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} | MarksheetMark |
173,466,610 | false | 3 | null | 6,495,215 | null | false | [] | null | 17,846 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. A useful way to remember retriperitoneal structures is the mnemonic \"SAD PUCKER\": Suprarenal (I.e. adrenal gland), Aorta (and IVC), Duodenum (except first part), Pancreas (except tail), Ureter, Colon, Kidney, Esophagus, and Rectum.",
"id": "10027241",
"label": "a",
"name": "Pancreatic tail",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The oesophagus lies behind the posterior sheath of the peritoneum and is, therefore, a retroperitoneal organ.",
"id": "10027244",
"label": "d",
"name": "Oesophagus",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The retroperitoneum contains the large vessels of the abdomen and pelvis, which include the aorta and its branches as well as the inferior vena cava (IVC) and its tributaries.",
"id": "10027245",
"label": "e",
"name": "Aorta",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The adrenal gland is located in the retroperitoneal space, between T11 and L1, anteromedial to the upper pole of the kidney.",
"id": "10027242",
"label": "b",
"name": "Adrenal gland",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Aside from the duodenojejunal flexure, which is the first part of the duodenum, the second and third parts are retroperitoneal.",
"id": "10027243",
"label": "c",
"name": "Duodenum second part",
"picture": null,
"votes": 10
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4082",
"name": "Intraperitoneal and retroperitoneal organs",
"status": null,
"topic": {
"__typename": "Topic",
"id": "197",
"name": "Abdominal anatomy",
"typeId": 7
},
"topicId": 197,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 4082,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17846",
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"likes": 0,
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"pictures": [],
"prescribeAnswer": null,
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"psaSectionId": null,
"qaAnswer": null,
"question": "Which of the following structures is intraperitoneal?",
"sbaAnswer": [
"a"
],
"totalVotes": 47,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,611 | false | 4 | null | 6,495,215 | null | false | [] | null | 17,847 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The abdominal aorta begins at T12 and ends at L4.",
"id": "10027247",
"label": "b",
"name": "T10",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. L3 is the level where the inferior mesenteric artery branches off the abdominal aorta.",
"id": "10027249",
"label": "d",
"name": "L3",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. The superior mesenteric artery branches off the abdominal aorta at the vertebral level L1 about 1cm lower than the coeliac trunk.",
"id": "10027246",
"label": "a",
"name": "L1",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. L4 is the level where the bifurcation into right common iliac and left common iliac occurs.",
"id": "10027250",
"label": "e",
"name": "L4",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. T12 is the level where the coeliac artery branches off the abdominal aorta.",
"id": "10027248",
"label": "c",
"name": "T12",
"picture": null,
"votes": 2
}
],
"comments": [],
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5331",
"name": "Abdominal aorta",
"status": null,
"topic": {
"__typename": "Topic",
"id": "197",
"name": "Abdominal anatomy",
"typeId": 7
},
"topicId": 197,
"totalCards": null,
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"qaAnswer": null,
"question": "At what level does the superior mesenteric artery branch off the abdominal aorta?",
"sbaAnswer": [
"a"
],
"totalVotes": 47,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,612 | false | 5 | null | 6,495,215 | null | false | [] | null | 17,848 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. This describes the epithelium of the cutaneous zone, which is below the pectinate line. the cutaneous zone is histologically equal to the skin, is strongly pigmented and is associated with skin-associated structures such as sweat glands, sebaceous glands, hair follicles, and other structures.",
"id": "10027253",
"label": "c",
"name": "Stratified squamous keratinized epithelium",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The upper two-thirds of the anal canal, which is derived from endoderm and lies above the pectinate line, is lined by simple columnar epithelium.",
"id": "10027255",
"label": "e",
"name": "Simple cuboidal epithelium",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. The anal canal is divided into the colorectal, transitional, anoderm (\"white zone\"), and cutaneous (squamous) zones. The pectinate (dentate) line divides the anal canal into upper two-thirds (derived from endoderm) and lower one-third (derived from ectoderm). The colorectal zone lies above the pectinate line and has simple columnar epithelium. The transitional zone has a mix of simple columnar and stratified squamous epithelium. The anoderm has stratified non-keratinized epithelium and lastly, the cutaneous zone has stratified squamous keratinized epithelium.",
"id": "10027251",
"label": "a",
"name": "Simple columnar epithelial cells",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. This describes the epithelium of the transitional zone, which contains transverse mucous folds with crypts and anal glands.",
"id": "10027254",
"label": "d",
"name": "A mix of simple columnar and stratified squamous epithelia",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. This describes the epithelium of the anoderm, which is below the pectinate line. The anoderm is densely packed with sensory neurons that detect whether the intestinal content is solid, liquid or gaseous.",
"id": "10027252",
"label": "b",
"name": "Stratified squamous non-keratinized epithelium",
"picture": null,
"votes": 16
}
],
"comments": [],
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"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5343",
"name": "Anal canal",
"status": null,
"topic": {
"__typename": "Topic",
"id": "197",
"name": "Abdominal anatomy",
"typeId": 7
},
"topicId": 197,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
"conceptId": 5343,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
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"psaSectionId": null,
"qaAnswer": null,
"question": "What type of epithelium lines the anal canal proximal to the pectinate line?",
"sbaAnswer": [
"a"
],
"totalVotes": 46,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,613 | false | 6 | null | 6,495,215 | null | false | [] | null | 17,849 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The body of the pancreas is in the midline of the human body, posterior to the stomach and the left of the superior mesenteric vessels. Given its anatomical relations, a tumour in this part of the pancreas is more likely to cause abdominal and/or back pain and would not result in a gradual painless distension of the gall bladder over time. As such, it is not consistent with the presentation in the question which describes the Courvoisier's sign.",
"id": "10027260",
"label": "e",
"name": "Body of the pancreas",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. A painlessly enlarged gall bladder resulting in a palpable mass in the right upper quadrant with associated jaundice is known as Courvoisier's sign. This is unlikely to be caused by cholelithiasis and normally due to a chronic obstruction, such as a pancreatic head cancer or a cholangiocarcinoma, which causes raised biliary back pressure and results in gradual distension of the gall bladder over time without pain as there is no acute damage. This is distinct from a palpable gall bladder with no jaundice, seen in Mirizzi's syndrome, and non palpable painless gall bladder with jaundice, seen in shrunken fibrotic and calcified gall bladder secondary to repeated acute inflammation (\"porcelain gall bladder).",
"id": "10027256",
"label": "a",
"name": "Head of the pancreas",
"picture": null,
"votes": 36
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The neck of the pancreas is located superior to the superior mesenteric vessels. Given its anatomical relation, a tumour in this part of the pancreas would not result in a gradual distension of the gall bladder over time, as such, it is not consistent with the presentation in the question which describes the Courvoisier's sign.",
"id": "10027259",
"label": "d",
"name": "Neck of the pancreas",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The pancreatic tail lies within close proximity to the spleen hilum and is contained within the splenorenal ligament with the splenic vessels. It is also the only part of the pancreas that is not retroperitoneal, therefore intraperitoneal. Abdominal pain and weight loss are more likely with pancreatic tail cancer. As such, a tumour in this part of the pancreas would not result in a gradual painless distension of the gall bladder over time and is not consistent with the presentation in the question which describes the Courvoisier's sign.",
"id": "10027257",
"label": "b",
"name": "Tail of pancreas",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The uncinate process of the pancreas is a projection arising from the inferior aspect of the pancreatic head and lies posterior to the superior mesenteric vessels and close in proximity to the third part of the duodenum. A tumour here is less likely to cause jaundice and more likely to obstruct the third part of the duodenum. Given its anatomical relation, a tumour in this part of the pancreas would not result in a gradual distension of the gall bladder over time without pain, as such, it is not consistent with the presentation in the question which describes the Courvoisier's sign.",
"id": "10027258",
"label": "c",
"name": "Uncinate process",
"picture": null,
"votes": 1
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5325",
"name": "Pancreas",
"status": null,
"topic": {
"__typename": "Topic",
"id": "197",
"name": "Abdominal anatomy",
"typeId": 7
},
"topicId": 197,
"totalCards": null,
"typeId": null,
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"videos": []
},
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
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"highlights": [],
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"multiAnswer": null,
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"qaAnswer": null,
"question": "Peter, a 67-year-old patient, presents to the GP with jaundice and a non-tender palpable mass in the right upper quadrant. The doctor suspects malignancy.\n\nFrom the clinical findings, which location is the most likely source of cancer?",
"sbaAnswer": [
"a"
],
"totalVotes": 48,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,614 | false | 7 | null | 6,495,215 | null | false | [] | null | 17,850 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer as this is the anatomically correct order from anterior to posterior. The renal hilus consists of the renal vein which drains into the inferior vena cava, the renal artery which is the branch of the abdominal aorta, and the renal pelvis which is the funnel-shaped dilated part of the ureter in the kidney formed by the convergence of the major calyces.",
"id": "10027261",
"label": "a",
"name": "Renal vein, renal artery, renal pelvis",
"picture": null,
"votes": 13
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The renal vein is the most anterior structure in the renal hilus, followed by the renal artery and lastly, the renal pelvis. The order of these structures can also be remembered with the handy mnemonic \"VAD\" (renal Vein, renal Artery and renal Duct i.e. ureter)",
"id": "10027264",
"label": "d",
"name": "Renal pelvis, renal vein, renal artery",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The renal vein is the most anterior structure in the renal hilus, followed by the renal artery and lastly, the renal pelvis. The order of these structures can also be remembered with the handy mnemonic \"VAD\" (renal Vein, renal Artery and renal Duct i.e. ureter)",
"id": "10027265",
"label": "e",
"name": "Renal vein, renal pelvis, renal artery",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The renal vein is the most anterior structure in the renal hilus, followed by the renal artery and lastly, the renal pelvis. The order of these structures can also be remembered with the handy mnemonic \"VAD\" (renal Vein, renal Artery and renal Duct i.e. ureter)",
"id": "10027262",
"label": "b",
"name": "Renal artery, renal vein, renal pelvis",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer as this is the order from posterior to anterior.",
"id": "10027263",
"label": "c",
"name": "Renal pelvis, renal artery, renal vein",
"picture": null,
"votes": 7
}
],
"comments": [],
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"id": "5332",
"name": "Kidneys",
"status": null,
"topic": {
"__typename": "Topic",
"id": "197",
"name": "Abdominal anatomy",
"typeId": 7
},
"topicId": 197,
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"question": "What is the arrangement of the following in an anterior-to-posterior order?",
"sbaAnswer": [
"a"
],
"totalVotes": 40,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,615 | false | 8 | null | 6,495,215 | null | false | [] | null | 17,851 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. It is important to note that the inner part of the adrenal gland is the adrenal medulla while the outer part is the adrenal cortex. The cortex is further divided into three zones from superficial to deep. An easy way to remember the adrenal cortical histology and function from superficial to deep is the saying \" GFR, the deeper you go, the sweeter it gets \" I.e. Salt (zona glomerulosa, aldosterone), Sugar (zona fasciculata, glucocorticoids) and Sex (zona Reticularis, androgens).",
"id": "10027270",
"label": "e",
"name": "1: Adrenal medulla, 2: Zona reticularis, 3: Zona fasciculata, 4: Zona glomerulosa",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The outer part, the adrenal parenchyma, consists of the cortical cells where three concentric zones can be distinguished, namely the outer (zona glomerulosa), middle (zona fasciculata) and inner zone (zona reticularis). The inner part, the adrenal medulla, appears fairly homogenous. While the medulla is labelled correctly, the cortical zones are not labelled correctly in this option. An easy way to remember the adrenal cortical histology and function from superficial to deep is the saying \" GFR, the deeper you go, the sweeter it gets \" I.e. Salt (zona glomerulosa, aldosterone), Sugar (zona fasciculata, glucocorticoids) and Sex (zona Reticularis, androgens).",
"id": "10027267",
"label": "b",
"name": "1: Zona fasciculata, 2: Zona glomerulosa, 3: Zona reticularis, 4: Adrenal medulla",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. While the medulla is labelled correctly, the cortical zones are not labelled correctly in this option. An easy way to remember the adrenal cortical histology and function from superficial to deep is the saying \" GFR, the deeper you go, the sweeter it gets \" I.e. Salt (zona glomerulosa, aldosterone), Sugar (zona fasciculata, glucocorticoids) and Sex (zona Reticularis, androgens).",
"id": "10027268",
"label": "c",
"name": "1: Zona glomerulosa, 2: Zona reticularis, 3: Zona fasciculata, 4: Adrenal medulla",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer.",
"id": "10027269",
"label": "d",
"name": "1: Adrenal medulla , 2: Zona fasciculata, 3: Zona reticularis, 4: Zona glomerulosa",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer as the parts are labelled accurately from superficial to deep. The outer part, the adrenal parenchyma, consists of the cortical cells where three concentric zones can be distinguished, namely the outer (zona glomerulosa), middle (zona fasciculata) and inner zone (zona reticularis). The inner part, the adrenal medulla, appears fairly homogenous. In the adrenal cortex, the cells of the zona glomerulosa produce mineralocorticoids such as aldosterone, cells of the zona fasciculata produce glucocorticoids such as cortisol, and lastly, cells of the zona reticularis produce androgens such as dehydroepiandrosterone (DHEA). An easy way to remember the adrenal cortical histology and function from superficial to deep is the saying \" GFR, the deeper you go, the sweeter it gets \" I.e. Salt (zona glomerulosa, aldosterone), Sugar (zona fasciculata, glucocorticoids) and Sex (zona Reticularis, androgens). As for the adrenal medulla, it consists of chromaffin cells that contain secretory granules which synthesize and store adrenaline and noradrenaline.",
"id": "10027266",
"label": "a",
"name": "1: Zona glomerulosa, 2: Zona fasciculata, 3: Zona reticularis, 4: Adrenal medulla",
"picture": null,
"votes": 33
}
],
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"typeId": 7
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"chapterId": 2693,
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"id": "4074",
"name": "Adrenal glands",
"status": null,
"topic": {
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"id": "197",
"name": "Abdominal anatomy",
"typeId": 7
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"topicId": 197,
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"pictures": [
{
"__typename": "Picture",
"caption": null,
"createdAt": 1701429148,
"id": "2310",
"index": 0,
"name": "Adrenal gland (cortex).jpeg",
"overlayPath": null,
"overlayPath256": null,
"overlayPath512": null,
"path": "images/ju8rmntr1701430385899.jpg",
"path256": "images/ju8rmntr1701430385899_256.jpg",
"path512": "images/ju8rmntr1701430385899_512.jpg",
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"question": "This is an image of a histological specimen of the adrenal gland labelled 1-4.\n\nWhich of the following options shows the correct parts for each labelled number?\n[lightgallery]",
"sbaAnswer": [
"a"
],
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"typeId": 1,
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173,466,616 | false | 9 | null | 6,495,215 | null | false | [] | null | 17,852 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The superior one-half of the anterior surface of the right kidney is associated with a layer of peritoneum separating it from the liver, where the potential space separating the liver and kidney is known as the hepatorenal pouch of Morison. This pouch is normally empty but may be filled with fluid due to certain pathological conditions such as haemoperitoneum and ascites. As this structure is not located on the superior pole of the kidney, it is not the correct answer.",
"id": "10027272",
"label": "b",
"name": "Hepatorenal pouch of Morison",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The left colic flexure (splenic flexure) is located at the lateral part of the inferior pole of the left kidney",
"id": "10027275",
"label": "e",
"name": "Left colic flexure",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. The abdominal organs are not paired, as such, the right kidney and left kidney relations differ in several ways. However, in both kidneys, the adrenal gland (suprarenal gland) is located on the superior pole.",
"id": "10027271",
"label": "a",
"name": "Adrenal gland",
"picture": null,
"votes": 40
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The right colic flexure (hepatic flexure) is located at the lateral part of the inferior pole of the right kidney",
"id": "10027273",
"label": "c",
"name": "Right colic flexure",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The right colic flexure (hepatic flexure) is located at the medial part of the inferior pole of the kidney",
"id": "10027274",
"label": "d",
"name": "Jejunum",
"picture": null,
"votes": 2
}
],
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"id": "5332",
"name": "Kidneys",
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"id": "197",
"name": "Abdominal anatomy",
"typeId": 7
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"question": "Which of the following structures is found on the superior pole of the kidneys?",
"sbaAnswer": [
"a"
],
"totalVotes": 43,
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173,466,617 | false | 10 | null | 6,495,215 | null | false | [] | null | 17,853 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The common hepatic artery is a branch of the coeliac artery, which divides into two terminal branches at the superior aspect of the duodenum, namely the hepatic artery proper and the gastroduodenal artery. The hepatic artery proper provides 25% of the blood supply to the liver.",
"id": "10027278",
"label": "c",
"name": "Common hepatic artery",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The cystic branch of the right hepatic artery supplies the gall bladder.",
"id": "10027280",
"label": "e",
"name": "Cystic branch of the right hepatic artery",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. While it does supply the non-parenchymal structures of the liver with oxygenated blood, it makes up 25% of the blood supply of the liver. The hepatic portal vein supplies 75% of the blood supply to the liver and thus, is the main supply.",
"id": "10027277",
"label": "b",
"name": "Hepatic artery proper",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. The liver has a dual blood supply where the main component is the hepatic portal vein which supplies the liver parenchyma with partially deoxygenated blood and nutrients from the small intestine. It allows the liver to perform functions related to the gut such as detoxification. The hepatic artery proper is the other component of the dual blood supply, supplying 25% of the blood supply. It is derived from the coeliac trunk and supplies the non-parenchymal structures of the liver with oxygenated blood",
"id": "10027276",
"label": "a",
"name": "Hepatic portal vein",
"picture": null,
"votes": 30
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The gastroduodenal artery is one of the branches of the common hepatic artery which branches into the right gastroepiploic artery and the superior pancreatoduodenal artery. These supply the stomach and the greater omentum, and the head of the pancreas respectively.",
"id": "10027279",
"label": "d",
"name": "Gastroduodenal artery",
"picture": null,
"votes": 4
}
],
"comments": [],
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"chapterId": 2693,
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"id": "5329",
"name": "Liver",
"status": null,
"topic": {
"__typename": "Topic",
"id": "197",
"name": "Abdominal anatomy",
"typeId": 7
},
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"question": "Which vessel is the main supply of blood and nutrients to the liver from the gastrointestinal tract?",
"sbaAnswer": [
"a"
],
"totalVotes": 44,
"typeId": 1,
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} | MarksheetMark |
173,466,618 | false | 11 | null | 6,495,215 | null | false | [] | null | 17,854 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. The splenic (left colic) flexure lies inferior to the spleen. The transverse colon extends from the hepatic (right colic) flexure to the splenic (left colic) flexure, which then turns downwards as the descending colon.",
"id": "10027281",
"label": "a",
"name": "Splenic flexure/ Left colic flexure",
"picture": null,
"votes": 23
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The tail of the pancreas, as well as the left kidney, lies medial to the spleen.",
"id": "10027285",
"label": "e",
"name": "Tail of the pancreas",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The diaphragm, as well as the left lung and the 9-11th ribs, lie posterior to the spleen.",
"id": "10027283",
"label": "c",
"name": "Diaphragm",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The stomach lies anterior to the spleen.",
"id": "10027282",
"label": "b",
"name": "Stomach",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The left kidney, as well as the tail of the pancreas, lies medial to the spleen.",
"id": "10027284",
"label": "d",
"name": "Left kidney",
"picture": null,
"votes": 10
}
],
"comments": [],
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"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5344",
"name": "Spleen",
"status": null,
"topic": {
"__typename": "Topic",
"id": "197",
"name": "Abdominal anatomy",
"typeId": 7
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"topicId": 197,
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"question": "Which of the following structures lies inferior to the spleen?",
"sbaAnswer": [
"a"
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"typeId": 1,
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173,466,619 | false | 12 | null | 6,495,215 | null | false | [] | null | 17,855 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Somatotrophs in pars distalis produce growth hormone.",
"id": "10027287",
"label": "b",
"name": "Somatotrophs in pars distalis",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Corticotropic basophils in the pars intermedia secrete melanocyte-stimulating hormone (MSH).",
"id": "10027289",
"label": "d",
"name": "Basophils in pars intermedia",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Basophils in pars tuberalis surround the infundibular stem, which is a collection of axons that project into the pituitary gland from the hypothalamus and stores anti-diuretic hormone (or vasopressin) and oxytocin.",
"id": "10027290",
"label": "e",
"name": "Basophils in pars tuberalis",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. The anterior lobe (adenohypophysis) of the pituitary gland consists of three parts: pars distalis (or pars anterior), pars intermedia, and pars tuberalis. The pars distalis consists of chromophils (acidophils and basophils) and chromophobes. Acidophils consist of somatotrophs and mammotrophs (or lactotrophs), which produce growth hormone and prolactin respectively. Basophils consist of gonadotrophs that produce follicle-stimulating hormone (FSH) and luteinizing hormone (LH), corticotrophs which produce adrenal corticotropic hormone (ACTH), and thyrotrophs which produce thyroid-stimulating hormone (TSH).",
"id": "10027286",
"label": "a",
"name": "Acidophils in pars distalis",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Gonadotrophs in pars distalis produce follicle-stimulating hormone (FSH) and luteinizing hormone (LH).",
"id": "10027288",
"label": "c",
"name": "Gonadotrophs in pars distalis",
"picture": null,
"votes": 11
}
],
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"entitlement": null,
"id": "5315",
"name": "Pituitary gland",
"status": null,
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"id": "196",
"name": "Neuroanatomy",
"typeId": 7
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"topicId": 196,
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"question": "Which of the following cells synthesises prolactin?",
"sbaAnswer": [
"a"
],
"totalVotes": 42,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,620 | false | 13 | null | 6,495,215 | null | false | [] | null | 17,856 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. Basophils consist of gonadotrophs that produce follicle-stimulating hormone (FSH) and luteinizing hormone (LH), corticotrophs which produce adrenal corticotropic hormone (ACTH), and thyrotrophs which produce thyroid-stimulating hormone (TSH).",
"id": "10027291",
"label": "a",
"name": "Basophils in pars distalis",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The posterior lobe (neurohypophysis) of the pituitary gland consists of the pars nervosa and the infundibulum. The infundibulum is continuous with the median eminence located at the base of the hypothalamus, where neurosecretory cells release hypothalamic-releasing hormones into the portal capillary bed for transport to the anterior pituitary.",
"id": "10027295",
"label": "e",
"name": "Neurosecretory cells in the median eminence",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Corticotropic basophils in the pars intermedia secrete melanocyte-stimulating hormone.",
"id": "10027292",
"label": "b",
"name": "Basophils in pars intermedia",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Neurons of the supraoptic and paraventricular nuclei in the hypothalamus, located in the supraoptic region, synthesize anti-diuretic hormone (or vasopressin) and oxytocin. These hypothalamic hormones are stored in axons containing Herring's bodies, filled with neurosecretory granules, in the pars nervosa of the neurohypophysis.",
"id": "10027294",
"label": "d",
"name": "Neurons of the supraoptic and paraventricular nuclei in the hypothalamus",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Chromophobes stain poorly with H&E staining and are the progenitor cells, also known as resting or undifferentiated chromophils.",
"id": "10027293",
"label": "c",
"name": "Chromophobes in pars distalis",
"picture": null,
"votes": 7
}
],
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"name": "Pituitary gland",
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"typeId": 7
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"question": "Which of the cells of the anterior pituitary secrete adrenal corticotropic hormone (ACTH)?",
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} | MarksheetMark |
173,466,621 | false | 14 | null | 6,495,215 | null | false | [] | null | 17,857 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Pioglitazone is an example of a thiazolidinedione. Thiazolidinediones increase peripheral insulin sensitivity, thus lowering blood glucose levels. It is an add-on option for dual therapy or an alternative initial treatment if metformin is not tolerated. Thiazolidinediones are contraindicated in heart failure, hepatic impairment, and bladder cancer.",
"id": "10027299",
"label": "d",
"name": "Thiazolidinediones",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Metformin is an example of a biguanide that lowers blood glucose levels by increasing peripheral insulin sensitivity and enhancing hepatic glucose uptake. It is offered as initial treatment if the person fails to meet the recommended HbA1c target of < 48mmol/mol (6.5%) with lifestyle changes. It is contraindicated in patients with severe renal or hepatic impairment.",
"id": "10027297",
"label": "b",
"name": "Biguanide",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Dapagliflozin is an example of an SGLT2 inhibitor. SGLT2 is the major co-transporter for glucose reabsorption in the proximal convoluted tubule. As such, SGLT2 inhibitors increase urinary glucose excretion, consequently reducing blood glucose levels. SGLT2 inhibitors are an add-on option for dual therapy or an alternative initial treatment if metformin is not tolerated. Important adverse effects include urogenital infections and it is contraindicated in severe renal impairment.",
"id": "10027300",
"label": "e",
"name": "SGLT2 inhibitor",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. GLP-1 agonists stimulate insulin secretion and simultaneously reduce glucagon secretion. It is contraindicated in patients with renal impairment and/or a history of pancreatitis.",
"id": "10027296",
"label": "a",
"name": "GLP-1 agonist",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Gliclazide is an example of a sulfonylurea. Sulfonylureas stimulate pancreatic beta cells to produce insulin. It is an add-on option for dual therapy or an alternative initial treatment if metformin is not tolerated. Sulfonylureas are contraindicated in type 1 diabetes mellitus and patients with severe renal or hepatic impairment.",
"id": "10027298",
"label": "c",
"name": "Sulfonylurea",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5967",
"name": "Anti-diabetic drugs",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5967,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17857",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
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"psaSectionId": null,
"qaAnswer": null,
"question": "A 50-year-old woman visits her general practitioner for a routine diabetes check-up. She has type two diabetes mellitus. She has a BMI of 32kg/m2 and struggles with glycemic control. She is currently on metformin and dapagliflozin. The doctor suggests adding another drug, exenatide, to help her control her blood glucose levels.\n\nWhat class of drug is exenatide?",
"sbaAnswer": [
"a"
],
"totalVotes": 40,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,622 | false | 15 | null | 6,495,215 | null | false | [] | null | 17,858 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. A random blood glucose of ≥ 11.1mmol/l or fasting plasma glucose of ≥ 7mmol/l is one of the results which is sufficient for diagnosis of type 1 diabetes mellitus in symptomatic patients. However, it does not assess endogenous insulin production.",
"id": "10027305",
"label": "e",
"name": "Random blood glucose and Fasting plasma glucose",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. The presence of urinary ketones may suggest concurrent DKA. It does not assess endogenous insulin production.",
"id": "10027304",
"label": "d",
"name": "Urine ketones",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. A HbA1C of ≥ 48mmol/mol (6.5%) is one of the results which is sufficient for diagnosis of type 1 diabetes mellitus in symptomatic patients. However, it does not assess endogenous insulin production.",
"id": "10027302",
"label": "b",
"name": "HbA1c",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Identification of specific antibodies (e.g. anti-GAD, ICA, IAA) helps in confirming the diagnosis of type 1 diabetes mellitus as it indicates the autoimmune nature. However, it is not part of the diagnostic criteria and it does not assess endogenous insulin production.",
"id": "10027303",
"label": "c",
"name": "Auto-antibodies testing",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. C-peptide and insulin are packaged into vesicles in the Golgi apparatus and are secreted in equal concentrations. As such, low C-peptide levels would indicate low endogenous insulin levels, which is characteristic of type 1 diabetes mellitus as it is an autoimmune condition where the destruction of insulin-producing beta cells in the pancreas results in insulin deficiency.",
"id": "10027301",
"label": "a",
"name": "C-peptide levels",
"picture": null,
"votes": 24
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5968",
"name": "Diabetes Mellitus Type 1",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5968,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17858",
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"question": "An 18-year-old male is visiting his GP for an army medical assessment. He is normal weight, but complains of polyuria, fatigue and weight loss without trying. His sister and mother have type one diabetes.\n\nWhich of the following investigations can help assess his endogenous insulin production?",
"sbaAnswer": [
"a"
],
"totalVotes": 39,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,623 | false | 16 | null | 6,495,215 | null | false | [] | null | 17,859 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. While this is a good test to determine whether it is Cushing's disease (Pituitary source), a more ideal investigation would be to start with a low-dose dexamethasone suppression test to confirm cortisol excess. Lack of suppression with low dose suggests Cushing's syndrome such as exogenous steroid use or cortisol producing adrenal adenoma, lack of suppression with low dose but suppression with high dose suggests Cushing's disease, and lastly, lack of suppression by both low or high dose suggests ectopic ACTH source such as an ACTH producing tumour.",
"id": "10027308",
"label": "c",
"name": "High-dose dexamethasone suppression test",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. While it is a useful follow-up investigation to localize tumour(s) that may be secreting ACTH or cortisol, it is important to confirm cortisol excess with preliminary diagnostic investigations first.",
"id": "10027309",
"label": "d",
"name": "CT chest and abdomen",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. While it is a useful follow-up investigation to localize an ACTH-secreting pituitary tumour (Cushing's disease), it is important to confirm cortisol excess with preliminary diagnostic investigations first.",
"id": "10027310",
"label": "e",
"name": "MRI of the Pituitary",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. While this is a good test to localise the source of cortisol excess by determining whether it is ACTH-dependent or ACTH-independent causes.",
"id": "10027307",
"label": "b",
"name": "Plasma ACTH levels",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. The clinical presentation of this patient suggests cortisol excess. As such, to determine cortisol excess, a positive result must be obtained from 2 of the following 3 investigations; Late-night salivary cortisol, 24-hour urinary free cortisol, and a low-dose dexamethasone suppression test.",
"id": "10027306",
"label": "a",
"name": "Late-night salivary cortisol",
"picture": null,
"votes": 11
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3764",
"name": "Cushing's syndrome",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3764,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17859",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
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"psaSectionId": null,
"qaAnswer": null,
"question": "A 40-year-old man presents with weight gain around his truncal area, stretch marks on his stomach and bruises on his limbs despite having no recollection of injury. He has a past medical history of asthma and is on daily prednisolone.\n\nWhat is the most appropriate first-line investigation to carry out?",
"sbaAnswer": [
"a"
],
"totalVotes": 40,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,624 | false | 17 | null | 6,495,215 | null | false | [] | null | 17,860 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Toxic multinodular goitre is when there are multiple thyroid nodules producing thyroid hormones which, as the name suggests, lead to goitre. This patient does not have a nodular goitre.",
"id": "10027313",
"label": "c",
"name": "Toxic multinodular goitre",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. De-Quervain's (subacute) thyroiditis is the painful inflammation of the thyroid thought to be triggered by a viral infection. It generally occurs in women aged 20 to 50 years old, but it also presents with features this patient did not have such as a high temperature and pain in the neck and/or jaw and/or ear.",
"id": "10027314",
"label": "d",
"name": "De-Quervain's thyroiditis",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Features of hyperthyroidism such as restlessness, mood changes such as depression and anxiety and so forth can overlap with features of anxiety disorder, as such, it is an important diagnosis to consider. However, it should be considered as a separate diagnosis, especially in a patient who presents with other hyperthyroidism associated features.",
"id": "10027315",
"label": "e",
"name": "Anxiety disorder",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. Raised free T4 and low TSH, along with the clinical features, imply hyperthyroidism. Hyperthyroidism mostly affects women and the elderly, and Grave's disease is the predominant cause. Grave's disease is an autoimmune condition involving thyroid receptor antibodies (Anti-TSH) which bind to TSH receptors and result in increased thyroid hormone synthesis and follicular enlargement (may manifest as goitre). Other manifestations include Grave's ophthalmoplegia, thyroid acropachy, and pretibial myxoedema, where the first two are present in this patient in the form of proptosis and finger clubbing respectively.",
"id": "10027311",
"label": "a",
"name": "Grave's disease",
"picture": null,
"votes": 34
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Hashimoto's thyroiditis is an autoimmune cause of hypothyroidism involving autoantibodies to thyroid peroxidase (Anti-TPO) and thyroglobulin (Anti-thyroglobulin) antibodies. In rare cases, initial destruction of the thyroid gland can release the thyroid hormones and cause temporary transient hyperthyroidism, known as hashitoxicosis, which is almost always followed by hypothyroidism. In most circumstances, thyroid function tests would show a low T4 and raised TSH, unlike the raised free T4 and low TSH in this patient.",
"id": "10027312",
"label": "b",
"name": "Hashimoto's thyroiditis",
"picture": null,
"votes": 3
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3959",
"name": "Hyperthyroidism",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3959,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17860",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
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"question": "A 48-year-old woman complains of feeling hot all the time alongside diarrhoea, anxiety and restlessness. On examination, her positive findings include finger clubbing, mild proptosis and a heart rate of 98 beats per minute. Her TFT results show Free T4 of 35pmol/L (9 - 25 pmol/L) and TSH 0.1mu/L (0.3 - 4.2 mU/L).\n\nWhat is her most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 40,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,466,625 | false | 18 | null | 6,495,215 | null | false | [] | null | 17,861 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Propranolol is a beta-blocker that can be used for symptomatic relief of symptoms associated with increased sympathetic activity. It acts as an adjunct.",
"id": "10027320",
"label": "e",
"name": "Propranolol",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Carbimazole is normally the first line anti thyroid drug of choice due to having fewer adverse effects compared to propylthiouracil, but it is not first-line in pregnant patients in the first trimester.",
"id": "10027317",
"label": "b",
"name": "Carbimazole",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Radio-iodine is used as definitive management when anti-thyroid drugs are not tolerated or if the disease relapses. It is not a first-line anti-thyroid treatment in a pregnant patient in the first trimester.",
"id": "10027319",
"label": "d",
"name": "Radio-iodine",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is the correct answer. Propylthiouracil is an anti-thyroid drug. Anti-thyroid drugs are the first-line treatment for most patients, where carbimazole is preferred over propylthiouracil. However, for pregnant women or those planning a pregnancy, propylthiouracil is preferred in the first trimester.",
"id": "10027316",
"label": "a",
"name": "Propylthiouracil",
"picture": null,
"votes": 20
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is not the correct answer. Levothyroxine is an analogue of T4 and is used to replace thyroid levels in patients with hypothyroidism.",
"id": "10027318",
"label": "c",
"name": "Levothyroxine",
"picture": null,
"votes": 6
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3959",
"name": "Hyperthyroidism",
"status": null,
"topic": {
"__typename": "Topic",
"id": "133",
"name": "Endocrinology",
"typeId": 5
},
"topicId": 133,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3959,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17861",
"isLikedByMe": null,
"learningPoint": null,
"likes": 0,
"multiAnswer": null,
"pictures": [],
"prescribeAnswer": null,
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"psaSectionId": null,
"qaAnswer": null,
"question": "A 32-year-old pregnant female, with a concurrent diagnosis of hyperthyroidism, is being reviewed by her endocrinologist. She is currently in trimester one of pregnancy and is having her first child.\n\nGiven the above, what medication should be used to treat her hyperthyroidism?",
"sbaAnswer": [
"a"
],
"totalVotes": 41,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
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