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"explanation": "The thoracic duct is the main lymphatic vessel that drains lymph into the venous system, draining lymph from approximately 75% of the body. The thoracic duct travels from T12 to the root of the neck.",
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"explanation": "The ascending aorta is located anterior to the transverse pericardial sinus, which is labelled.",
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"explanation": "The oesophageal and pericardial veins are both small tributaries of the superior vena cava. The left and right brachiocephalic veins are the major vessels that join to form the SVC.",
"id": "10041474",
"label": "d",
"name": "Oesophageal vein and pericardial vein",
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"explanation": "The right subclavian artery is labelled and sits posterior to the subclavian vein. It carries oxygenated blood to the upper limb. Whilst the subclavian arteries are paired vessels, the left and right have different origins. The left subclavian artery arises directly from the aortic arch, whilst the right subclavian originates from the brachiocephalic trunk. The labelled structure lies on the **right**.",
"id": "10041477",
"label": "b",
"name": "Left subclavian artery",
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"explanation": "The right subclavian artery is labelled and sits posterior to the subclavian vein. It carries oxygenated blood to the upper limb. Whilst the subclavian arteries are paired vessels, the left and right have different origins. The left subclavian artery arises directly from the aortic arch, whilst the right subclavian originates from the brachiocephalic trunk.",
"id": "10041478",
"label": "c",
"name": "Left subclavian vein",
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"explanation": "The right subclavian artery is labelled and sits posterior to the subclavian vein. It carries oxygenated blood to the upper limb. Whilst the subclavian arteries are paired vessels, the left and right have different origins. The left subclavian artery arises directly from the aortic arch, whilst the right subclavian originates from the brachiocephalic trunk.",
"id": "10041479",
"label": "d",
"name": "Right subclavian vein",
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"explanation": "The left common carotid artery is a direct branch of the aortic arch and travels upwards towards the head and neck. Here, the labelled structure lies on the **right** and can be identified as the right subclavian artery.",
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"explanation": "The phrenic nerve provides motor information to the diaphragm and sensory information to the central tendon of the diaphragm. Here, the trachea is labelled, which receives sensory innervation from the recurrent laryngeal nerve and parasympathetic innervation from the vagus nerve (CN X).",
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"explanation": "The anterior cutaneous branch of the intercostal nerve innervates the breast and this provides sensory information to the skin surface.",
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"explanation": "The **right** common carotid artery is labelled. The trachea lies medially and the internal jugular vein lies laterally. The oesophagus can be visualised posterior to the trachea.",
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"explanation": "The right common carotid artery is labelled. The trachea lies medially and the internal jugular vein lies laterally. The oesophagus can be visualised posterior to the trachea. The subclavian artery runs posterolateral to the common carotid artery (and the subclavian vein sits anterior to the subclavian artery).",
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"explanation": "The image shows a superior view of the first cervical vertebra of the spine (also termed the atlas). The blue arrow points to the left superior articular facet, which articulates superiorly with the left occipital condyle of the occipital bone of the skull, forming the atlanto-occipital joint.",
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"explanation": "The image shows a superior view of the first cervical vertebra of the spine (also termed the atlas). The structure indicated by the blue arrow articulates with a bony prominence of the occipital bone, the left occipital condyle. However, this is located lateral, not anterior to the foramen magnum of the occipital bone. The joint formed between the occipital condyle and the superior articular facet of the atlas vertebra is called the atlanto-occipital joint.",
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"explanation": "The image shows a superior view of the first cervical vertebra of the spine (also termed the atlas). The blue arrow points to the right transverse foramen, a hole found in the transverse process of the cervical vertebrae, which allows the passage of the vertebral artery, vertebral veins and sympathetic nerves. The anterior spinal artery is one of the branches formed by the union of tributaries from the right and the left vertebral arteries, descending inferior to the basilar artery to supply the anterior 2/3rds of the spinal cord.",
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"explanation": "The image shows a superior view of the first cervical vertebra of the spine (also termed the atlas). The anterior inferior cerebellar artery is a branch of the basilar artery. It is true that the basilar artery arises from the formation of the right and the left vertebral arteries, but the AICA is not a direct branch of the vertebral artery. The blue arrow points to the right transverse foramen, a hole found in the transverse process of the cervical vertebrae, which allows the passage of the vertebral artery, vertebral veins and sympathetic nerves.",
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"explanation": "The image shows a superior view of the first cervical vertebra of the spine (also termed the atlas). The superior cerebellar artery is a branch of the basilar artery. It is true that the basilar artery arises from the formation of the right and the left vertebral arteries, but the AICA is not a direct branch of the vertebral artery. The blue arrow points to the right transverse foramen, a hole found in the transverse process of the cervical vertebrae, which allows the passage of the vertebral artery, vertebral veins and sympathetic nerves.",
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"explanation": "The image shows a prosection of the basal view of the brain, with the brainstem in the centre, the cerebellum posterior to it and the inferior temporal poles to the sides. The cranial nerve providing afferent fibres from the cochlea is the vestibulocochlear nerve (CN VIII), which is located inferolaterally to the structure indicated by the arrow – the trigeminal nerve (CN V), the thickest of the cranial nerves, whose apparent origin is on the anterolateral surface of the pons.",
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"explanation": "The image shows a prosection of a brain viewed from the lateral side, specifically its right hemisphere. The orientation is determined by the position of the cerebellum, which is found at the posterior and inferior aspect of the brain under the occipital lobe which is found posterior. Voluntary motor commands are initiated in the primary motor cortex, located in the precentral gyrus of the frontal lobe. This area is responsible for the planning and execution of voluntary movements, with specific regions corresponding to different body parts in a topographical manner. However, the blue arrow indicates the occipital lobe whose main function is to process visual stimuli received via the optic pathway from the retinas.",
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"explanation": "The image shows a prosection specimen of a brain viewed from the lateral side, specifically its right hemisphere. The orientation is determined by the position of the cerebellum, which is found at the posterior and inferior aspect of the brain under the occipital lobe which is found posterior. Auditory impulses are processed in the superior temporal gyrus of the temporal lobe. However, the blue arrow indicates the occipital lobe whose main function is to process visual stimuli received via the optic pathway from the retinas.",
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"explanation": "The image shows a left lateral view of a skull, with the orbit towards the left side of the image and the occipital bone towards the right side of the image. The blue arrow points to the pterion, the H-shaped suture at the junction between the frontal bone anteriorly, sphenoid bone inferiorly, temporal bone posteriorly and parietal bone superiorly. It is a clinically important point because immediately underneath lies the middle meningeal artery. A fracture of the pterion can result in laceration of the middle meningeal artery, which in turn may result in an epidural haemorrhage.",
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"explanation": "The image shows a left lateral view of a skull, with the orbit towards the left side of the image and the occipital bone towards the right side of the image. The asterion is an anatomical point on the lateral aspect of the skull, created by the junction between the occipital bone posteriorly, the temporal bone anteriorly and the parietal bone superiorly. However, the blue arrow points to the pterion, the H-shaped suture at the junction between the frontal bone anteriorly, sphenoid bone inferiorly, temporal bone posteriorly and parietal bone superiorly.",
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"explanation": "The image shows a left lateral view of a skull, with the orbit towards the left side of the image and the occipital bone towards the right side of the image. The coronal suture is a fused fibrous joint of the superior surface of the skull found at the junction between the frontal and parietal bones. However, the blue arrow points to the pterion, the H-shaped suture at the junction between the frontal bone anteriorly, sphenoid bone inferiorly, temporal bone posteriorly and parietal bone superiorly.",
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"label": "d",
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"explanation": "The image shows a left lateral view of a skull, with the orbit towards the left side of the image and the occipital bone towards the right side of the image. The sagittal suture is a fused fibrous joint of the superior surface of the skull found in the midline at the junction between the right and left parietal bones. However, the blue arrow points to the pterion, the H-shaped suture at the junction between the frontal bone anteriorly, sphenoid bone inferiorly, temporal bone posteriorly and parietal bone superiorly.",
"id": "10041533",
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"explanation": "The image shows a left lateral view of a skull, with the orbit towards the left side of the image and the occipital bone towards the right side of the image. The external acoustic meatus is a canal in the petrous part of the temporal bone, not immediately visible from a lateral view. However, the blue arrow points to the mandibular fossa, which is an oval depression located on the inferolateral aspect of the temporal bone, posterior to the zygomatic process.",
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"explanation": "The image shows a left lateral view of a skull, with the orbit towards the left side of the image and the occipital bone towards the right side of the image. The mastoid process is an inferior projection of the temporal bone palpable immediately posterior to the ear and which serves as an attachment for the sternocleidomastoid muscle. In the image it is visible immediately posterior to the opening of the external acoustic meatus. However, the blue arrow points to the mandibular fossa, which is an oval depression located on the inferolateral aspect of the temporal bone, posterior to the zygomatic process.",
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"explanation": "The image shows an axial view of a section of the spinal cord, where the anterior surface is located at the inferior aspect of the image and the posterior surface is located at the superior aspect of the image. It is a stained prosection in which the grey matter appears white and the white matter appears grey-brown. The anterior median fissure is a deep groove located in the midline of the white matter of the ventral spinal cord, in front of the central canal. However, the blue arrow points to the ventral horn which is a collection of motor neurons which emerge from the spinal cord to innervate skeletal muscles.",
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"explanation": "The image shows an axial view of a section of the spinal cord, where the anterior surface is located at the inferior aspect of the image and the posterior surface is located at the superior aspect of the image. It is a stained prosection in which the grey matter appears white and the white matter appears grey-brown. The anterior grey commissure is a component of the internal spinal cord which connects the right and left ventral horns of grey matter. However, the blue arrow points to the ventral horn which is a collection of motor neurons which emerge from the spinal cord to innervate skeletal muscles.",
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"explanation": "The image shows an axial view of a section of the spinal cord, where the anterior surface is located at the inferior aspect of the image and the posterior surface is located at the superior aspect of the image. It is a stained prosection in which the grey matter appears white and the white matter appears grey-brown. The posterior median sulcus is a superficial groove located in the midline of the white matter of the dorsal spinal cord, posterior to the central canal and medial to the right and left dorsal columns. However, the blue arrow points to the ventral horn which is a collection of motor neurons which emerge from the spinal cord to innervate skeletal muscles.",
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"name": "Ventral horn",
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"explanation": "The image shows a stained prosection of the spinal cord at the C5 cervical level, with the ventral horn and ventral white columns towards the bottom of the image and the dorsal horns and the dorsal white columns towards the top of the image. Light touch and pressure impulses from the body are carried by the anterior spinothalamic tracts in the anterior white matter columns of the spinal cord. However, the blue arrow points to the fasciculus gracilis, one of the ascending tracts of the dorsal columns. The function of the fasciculus gracilis is to carry proprioceptive and vibratory impulses from the lower limb to the thalamus in the brain.",
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"explanation": "The image shows a stained prosection of the spinal cord at the C5 cervical level, with the ventral horn and ventral white columns towards the bottom of the image and the dorsal horns and the dorsal white columns towards the top of the image. Nociceptive and thermal impulses from the body are carried by the lateral spinothalamic tracts bilaterally, which are located in the lateral white matter columns of the spinal cord. However, the blue arrow points to the fasciculus gracilis, one of the ascending tracts of the dorsal columns. The function of the fasciculus gracilis is to carry proprioceptive and vibratory impulses from the lower limb to the thalamus in the brain.",
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"explanation": "The image shows a stained prosection of the spinal cord at the C5 cervical level, with the ventral horn and ventral white columns towards the bottom of the image and the dorsal horns and the dorsal white columns towards the top of the image. The blue arrow points to the fasciculus gracilis, one of the ascending tracts of the dorsal columns. It can be differentiated from the cuneate fasciculus by its position, which is more medial compared to that of the cuneate fasciculus. The function of the fasciculus gracilis is to carry proprioceptive and vibratory impulses from the lower limb to the thalamus in the brain.",
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"explanation": "The image shows a stained prosection of the spinal cord at the C5 cervical level, with the ventral horn and ventral white columns towards the bottom of the image and the dorsal horns and the dorsal white columns towards the top of the image. Proprioceptive and vibratory impulses from the upper limbs are carried by the cuneate fasciculus, the ascending tract of the dorsal column, which runs more lateral compared to that indicated by the arrow. However, the blue arrow points to the fasciculus gracilis, one of the ascending tracts of the dorsal columns. The function of the fasciculus gracilis is to carry proprioceptive and vibratory impulses from the lower limb to the thalamus in the brain.",
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"name": "Carries proprioceptive and vibratory impulses from the upper limbs",
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"explanation": "The image shows a stained prosection of the spinal cord at the C5 cervical level, with the ventral horn and ventral white columns towards the bottom of the image and the dorsal horns and the dorsal white columns towards the top of the image. Voluntary motor commands from the primary motor cortex to the spinal cord are carried through the corticospinal tracts, which descend through the anterior and lateral white matter columns of the spinal cord. However, the blue arrow points to the fasciculus gracilis, one of the ascending tracts of the dorsal columns. The function of the fasciculus gracilis is to carry proprioceptive and vibratory impulses from the lower limb to the thalamus in the brain.",
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"label": "e",
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"explanation": "The image shows an anterior view of the brainstem (pons and medulla oblongata) in the centre of the image. The cerebellar hemispheres are seen on either side of the brainstem. The cerebellar tonsils are rounded, inferiorly located lobular extensions on the posterior part of each cerebellar hemisphere, involved in regulating balance and motor coordination. However, the blue arrow indicates the flocculonodular lobe, whose functional equivalent is the vestibulocerebellum, which is involved in controlling balance. The flocculonodular lobe is found inferior to the horizontal fissure, which travels around the cerebellum along its lateral and posterior surfaces, and superior to the posterolateral fissure, which separates it from the posterior lobe of the cerebellum.",
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"explanation": "The image shows an anterior view of the brainstem (pons and medulla oblongata) in the centre of the image. The cerebellar hemispheres are seen on either side of the brainstem. The anterior lobe of the cerebellum is formed by the anterior third of each cerebellar hemisphere and is found superior to the structure indicated by the arrow. However, the blue arrow indicates the flocculonodular lobe, whose functional equivalent is the vestibulocerebellum, which is involved in controlling balance. The flocculonodular lobe is found inferior to the horizontal fissure, which travels around the cerebellum along its lateral and posterior surfaces, and superior to the posterolateral fissure, which separates it from the posterior lobe of the cerebellum.",
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"explanation": "The image shows an anterior view of the brainstem (pons and medulla oblongata) in the centre of the image. The cerebellar hemispheres are seen on either side of the brainstem. The posterior lobe is the largest cerebellar lobe, found posterior and lateral to the horizontal fissure and inferior to the posterolateral fissure. However, the blue arrow indicates the flocculonodular lobe, whose functional equivalent is the vestibulocerebellum, which is involved in controlling balance. The flocculonodular lobe is found inferior to the horizontal fissure, which travels around the cerebellum along its lateral and posterior surfaces, and superior to the posterolateral fissure, which separates it from the posterior lobe of the cerebellum.",
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"explanation": "The image shows an anterior view of the brainstem (pons and medulla oblongata) in the centre of the image. The cerebellar hemispheres are seen on either side of the brainstem. The blue arrow indicates the flocculonodular lobe, whose functional equivalent is the vestibulocerebellum, which is involved in controlling balance. The flocculonodular lobe is found inferior to the horizontal fissure, which travels around the cerebellum along its lateral and posterior surfaces, and superior to the posterolateral fissure, which separates it from the posterior lobe of the cerebellum.",
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"explanation": "The image shows an anterior view of the brainstem (pons and medulla oblongata) in the centre of the image. The cerebellar hemispheres are seen on either side of the brainstem. The vermis is the narrow, midline structure of the cerebellum that connects the two cerebellar hemispheres and plays a critical role in coordinating trunk and posture-related movements. It is located in the midline, on the posterior surface of the cerebellum, and, thus, it is not immediately visible in the image. However, the blue arrow indicates the flocculonodular lobe, whose functional equivalent is the vestibulocerebellum, which is involved in controlling balance. The flocculonodular lobe is found inferior to the horizontal fissure, which travels around the cerebellum along its lateral and posterior surfaces, and superior to the posterolateral fissure, which separates it from the posterior lobe of the cerebellum.",
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"explanation": "The image shows a plain X-ray film of a lateral view of a skull. The face and front of the head are towards the left of the image and the back of the head and the vertebral column are towards the right of the image. The squamous suture is a fibrous joint formed between the parietal bones and the squamous part of the temporal bones, on the lateral aspect of the skull bilaterally. However, the blue arrow indicates the lambdoid suture, the fibrous joint formed between the occipital bone and the temporal and the parietal bones, respectively.",
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"explanation": "The image shows a plain X-ray film of a lateral view of a skull. The face and front of the head are towards the left of the image and the back of the head and the vertebral column are towards the right of the image. The maxillary sinuses are paranasal air sinuses found in the structure of the maxilla bilaterally. They are located more anterior and superficial compared to the structure indicated by the arrow. However, the blue arrow indicates the pituitary fossa, a marked depression at the level of the sphenoid bone of the skull base, which houses the pituitary gland of the brain.",
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"explanation": "The image shows a plain X-ray film of a lateral view of a skull. The face and front of the head are towards the left of the image and the back of the head and the vertebral column are towards the right of the image. The odontoid peg is a bony projection of the C2 cranial vertebra (axis) which articulates with the atlas (C1 vertebra), forming the atlanto-axial joint which allows head rotation. The odontoid peg is found posterior and inferior in the midline compared to the structure indicated by the arrow. However, the blue arrow indicates the pituitary fossa, a marked depression at the level of the sphenoid bone of the skull base, which houses the pituitary gland of the brain.",
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"explanation": "The image shows a basal view of a brain prosection, with the frontal lobe at the top of the image and the cerebellum and brainstem at the bottom of the image. The gyrus rectus is the area of the cortex located immediately medial to the structure indicated by the arrow. However, the blue arrow indicates the olfactory tract, the structure connecting the olfactory bulb on each side with the olfactory cortex where impulses are interpreted.",
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"explanation": "The image shows a basal view of a brain prosection, with the frontal lobe at the top of the image and the cerebellum and brainstem at the bottom of the image. The optic nerve is not visible in this image, as it has been dissected away. The optic chiasm and the optic tracts bilaterally are visible, which lie posterior to the optic nerves. However, the blue arrow indicates the olfactory tract, the structure connecting the olfactory bulb on each side with the olfactory cortex where impulses are interpreted.",
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"explanation": "The image shows a view of the sphenoid bone from the inside of the skull, with the lesser wing in the centre of the image and the greater wing surrounding it. The bone can be recognised by its butterfly shape. The blue arrow indicates the more extensive part of the bone, which is the greater wing, located laterally.",
"id": "10041601",
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"name": "Greater wing of the sphenoid",
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"explanation": "The image shows a view of the sphenoid bone from the inside of the skull, with the lesser wing in the centre of the image and the greater wing surrounding it. The bone can be recognised by its butterfly shape. The parietal bones are paired bones, which overly the parietal lobes of the brain and forming the top of the skull. They are connected by the sagittal suture. However, the blue arrow indicates the more extensive part of the sphenoid bone, which is the greater wing, located laterally.",
"id": "10041605",
"label": "e",
"name": "Parietal bone",
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"explanation": "The image shows a view of the sphenoid bone from the inside of the skull, with the lesser wing in the centre of the image and the greater wing surrounding it. The bone can be recognised by its butterfly shape. The lesser wing of the sphenoid is found in the medial part of the bone, where most of the foramina are located. However, the blue arrow indicates the more extensive part of the bone, which is the greater wing, located laterally.",
"id": "10041602",
"label": "b",
"name": "Lesser wing of the sphenoid",
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"explanation": "The image shows a view of the sphenoid bone from the inside of the skull, with the lesser wing in the centre of the image and the greater wing surrounding it. The bone can be recognised by its butterfly shape. The frontal bones are paired bones located at the anterior aspect of the skull and forming the forehead and the anterior cranial fossa of the skull base. However, the blue arrow indicates the more extensive part of the bone sphenoid, which is the greater wing, located laterally.",
"id": "10041604",
"label": "d",
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"explanation": "The image shows a view of the sphenoid bone from the inside of the skull, with the lesser wing in the centre of the image and the greater wing surrounding it. The glossopharyngeal nerve leaves the skull via the jugular foramen, a large opening of an irregular shape found at the junction between the petrous part of the temporal bone and the occipital bone. However, the blue arrow indicates the foramen rotundum, found inferior to the superior orbital fissure and superomedial to the foramen ovale, both of which are visible in the image. The foramen rotundum allows the passage of the maxillary division of the trigeminal nerve (CN V2) out of the skull.",
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"explanation": "The image shows a view of the sphenoid bone from the inside of the skull, with the lesser wing in the centre of the image and the greater wing surrounding it. The ophthalmic division of the trigeminal nerve (CN V1) exits the skull through the superior orbital fissure, which is found immediately superior to the structure indicated by the arrow, the foramen rotundum. The foramen rotundum allows the passage of the maxillary division of the trigeminal nerve (CN V2) out of the skull.",
"id": "10041607",
"label": "b",
"name": "Allows the passage of the ophthalmic division of the trigeminal nerve",
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"explanation": "The image shows a view of the sphenoid bone from the inside of the skull, with the lesser wing in the centre of the image and the greater wing surrounding it. The middle meningeal artery is a branch of the external carotid artery, which enters the skull through the foramen spinosum, a very small opening in the greater wing of the sphenoid bone, immediately posterior to the foramen ovale. However, the blue arrow indicates the foramen rotundum, found inferior to the superior orbital fissure and superomedial to the foramen ovale, both of which are visible in the image. The foramen rotundum allows the passage of the maxillary division of the trigeminal nerve (CN V2) out of the skull.",
"id": "10041609",
"label": "d",
"name": "Allows the passage of the middle meningeal artery into the skull",
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"explanation": "The image shows a view of the sphenoid bone from the inside of the skull, with the lesser wing in the centre of the image and the greater wing surrounding it. The mandibular division of the trigeminal nerve (CN V3) exits the skull through the foramen ovale, which is found inferolateral to the structure indicated by the blue arrow, the foramen rotundum. The foramen rotundum allows the passage of the maxillary division of the trigeminal nerve (CN V2) out of the skull.",
"id": "10041608",
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"explanation": "The image shows a view of the sphenoid bone from the inside of the skull, with the lesser wing in the centre of the image and the greater wing surrounding it. The blue arrow indicates the foramen rotundum, which is found inferior to the superior orbital fissure and superomedial to the foramen ovale (both of which are visible in the image). The foramen rotundum allows the passage of the maxillary division of the trigeminal nerve (CN V2) out of the skull.",
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"label": "a",
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"explanation": "The image shows an axial view of the brain cut at the level of the diencephalon and the insular lobe, as well as the levels of the third ventricle and the occipital horns of the lateral ventricles. The interhemispheric fissure is in the midline, with the frontal lobes at the top of the image and the splenium of the corpus callosum anterior to the occipital lobes (bottom of the image). The middle cerebral artery originates from the internal carotid artery, and supplies the lateral surface of the frontal, parietal and superior temporal lobes of each hemisphere. However, the blue arrow indicates the medial aspect of the frontal lobe on the left side, whose arterial supply comes from the anterior cerebral artery, a branch of the internal carotid artery.",
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"label": "b",
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"explanation": "The image shows an axial view of the brain cut at the level of the diencephalon and the insular lobe, as well as the levels of the third ventricle and the occipital horns of the lateral ventricles. The interhemispheric fissure is in the midline, with the frontal lobes at the top of the image and the splenium of the corpus callosum anterior to the occipital lobes (bottom of the image). The posterior cerebral artery is a branch of the basilar artery and supplies the occipital, the medial parietal and the medial temporal lobes of the brain. However, the blue arrow indicates the medial aspect of the frontal lobe on the left side, whose arterial supply comes from the anterior cerebral artery, a branch of the internal carotid artery.",
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"label": "c",
"name": "Posterior cerebral artery",
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"explanation": "The image shows an axial view of the brain cut at the level of the diencephalon and the insular lobe, as well as the levels of the third ventricle and the occipital horns of the lateral ventricles. The interhemispheric fissure is in the midline, with the frontal lobes at the top of the image and the splenium of the corpus callosum anterior to the occipital lobes (bottom of the image). The lenticulostriate arteries are small vessels supplying the basal ganglia in the depths of each cerebral hemisphere. Clinically they are important because an occlusion of these vessels can infarct the internal capsule and result in contralateral motor paralysis. However, the blue arrow indicates the medial aspect of the frontal lobe on the left side, whose arterial supply comes from the anterior cerebral artery, a branch of the internal carotid artery.",
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"explanation": "The image shows an axial view of the brain cut at the level of the diencephalon and the insular lobe, as well as the levels of the third ventricle and the occipital horns of the lateral ventricles. The interhemispheric fissure is in the midline, with the frontal lobes at the top of the image and the splenium of the corpus callosum anterior to the occipital lobes (bottom of the image). The anterior communicating artery is a small vessel connecting the left and right anterior cerebral arteries in the circle of Willis at the base of the brain. This artery does not have branches, so it does not supply any particular brain region. However, the blue arrow indicates the medial aspect of the frontal lobe on the left side, whose arterial supply comes from the anterior cerebral artery, a branch of the internal carotid artery.",
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"label": "d",
"name": "Anterior communicating artery",
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"__typename": "QuestionChoice",
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"explanation": "The image shows an axial view of the brain cut at the level of the diencephalon and the insular lobe, as well as the levels of the third ventricle and the occipital horns of the lateral ventricles. The interhemispheric fissure is in the midline, with the frontal lobes at the top of the image and the splenium of the corpus callosum anterior to the occipital lobes (bottom of the image). The blue arrow indicates the medial aspect of the frontal lobe on the left side, whose arterial supply comes from the anterior cerebral artery, a branch of the internal carotid artery.",
"id": "10041611",
"label": "a",
"name": "Anterior cerebral artery",
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"explanation": "The image shows an axial view of the brain cut at the level of the diencephalon and the insular lobe, as well as the levels of the third ventricle and the occipital horns of the lateral ventricles. The interhemispheric fissure is in the midline, with the frontal lobes at the top of the image and the splenium of the corpus callosum anterior to the occipital lobes (bottom of the image). The blue arrow indicates the putamen, which is the lateral-most nucleus of the basal ganglia, a component of the striatum together with the caudate nucleus. It lies lateral to the globus pallidus externus and posterior to the head of the caudate nucleus.",
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"explanation": "The image shows an axial view of the brain cut at the level of the diencephalon and the insular lobe, as well as the levels of the third ventricle and the occipital horns of the lateral ventricles. The interhemispheric fissure is in the midline, with the frontal lobes at the top of the image and the splenium of the corpus callosum anterior to the occipital lobes (bottom of the image). The globus pallidus internus is the medial segment of the globus pallidus, which is the innermost component of the basal ganglia, visible in the image medial to the structure indicated by the arrow. Thus, the blue arrow indicates the putamen, which is the lateral-most nucleus of the basal ganglia, a component of the striatum together with the caudate nucleus. It lies lateral to the globus pallidus externus and posterior to the head of the caudate nucleus.",
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"explanation": "The image shows an axial view of the brain cut at the level of the diencephalon and the insular lobe, as well as the levels of the third ventricle and the occipital horns of the lateral ventricles. The interhemispheric fissure is in the midline, with the frontal lobes at the top of the image and the splenium of the corpus callosum anterior to the occipital lobes (bottom of the image). The caudate nucleus is the most extensive component of the basal ganglia, with a head, body and tail enclosing the thalamus and the other basal ganglia nuclei. It forms part of the striatum, together with the structure indicated by the arrow. However, the blue arrow indicates the putamen, which is the lateral-most nucleus of the basal ganglia, a component of the striatum together with the caudate nucleus. It lies lateral to the globus pallidus externus and posterior to the head of the caudate nucleus.",
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"label": "d",
"name": "Caudate",
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"explanation": "The image shows an axial view of the brain cut at the level of the diencephalon and the insular lobe, as well as the levels of the third ventricle and the occipital horns of the lateral ventricles. The interhemispheric fissure is in the midline, with the frontal lobes at the top of the image and the splenium of the corpus callosum anterior to the occipital lobes (bottom of the image). The thalamus is the largest structure of the diencephalon, being the main relay station for sensory impulses traveling from the periphery to the central nervous system (except for olfactory signals). The thalamus is located posteromedial to the structure indicated by the arrow. However, the blue arrow indicates the putamen, which is the lateral-most nucleus of the basal ganglia, a component of the striatum together with the caudate nucleus. It lies lateral to the globus pallidus externus and posterior to the head of the caudate nucleus.",
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"label": "e",
"name": "Thalamus",
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"explanation": "The image shows an axial view of the brain cut at the level of the diencephalon and the insular lobe, as well as the levels of the third ventricle and the occipital horns of the lateral ventricles. The interhemispheric fissure is in the midline, with the frontal lobes at the top of the image and the splenium of the corpus callosum anterior to the occipital lobes (bottom of the image). The globus pallidus externus is the lateral segment of the globus pallidus, which is the innermost component of the basal ganglia, visible in the image medial to the structure indicated by the arrow. Thus, the blue arrow indicates the putamen, which is the lateral-most nucleus of the basal ganglia, a component of the striatum together with the caudate nucleus. It lies lateral to the globus pallidus externus and posterior to the head of the caudate nucleus.",
"id": "10041618",
"label": "c",
"name": "Globus pallidus externus",
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"explanation": "The image shows a graphic depiction of the orbit with the periorbital fat in situ and the extraocular muscles present within the fat layer. The lateral aspect of the orbit is located to the left of the image, while the medial aspect of the orbit is found to the right of the image. The muscle indicated by the blue arrow is the superior oblique muscle, which lies medial to the superior rectus muscle and the levator palpebrae superioris muscle (which can be seen lateral to the one indicated). The function of the superior oblique muscle, which is innervated by the trochlear nerve (CN IV) is to internally rotate the eyeball.",
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"explanation": "The image shows a graphic depiction of the orbit with the periorbital fat in situ and the extraocular muscles present within the fat layer. The lateral aspect of the orbit is located to the left of the image, while the medial aspect of the orbit is found to the right of the image. Eyeball elevation is a function of the superior rectus muscle, which is innervated by the oculomotor nerve (CN III), and which lies on the superior aspect of the eyeball and orbit, immediately inferior to the levator palpebrae superioris muscle (which elevates the eyelid). However, the muscle indicated by the blue arrow is the superior oblique muscle, which lies medial to the superior rectus muscle and the levator palpebrae superioris muscle (which can be seen lateral to the one indicated). The function of the superior oblique muscle, which is innervated by the trochlear nerve (CN IV), is to internally rotate the eyeball.",
"id": "10041623",
"label": "c",
"name": "Elevation of the eyeball",
"picture": null,
"votes": 0
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"__typename": "QuestionChoice",
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"explanation": "The image shows a graphic depiction of the orbit with the periorbital fat in situ and the extraocular muscles present within the fat layer. The lateral aspect of the orbit is located to the left of the image, while the medial aspect of the orbit is found to the right of the image. Eyelid elevation is a function of the levator palpebrae superioris muscle, which is innervated by the oculomotor nerve (CN III), and which lies immediately superior to the superior rectus muscle and lateral to the muscle indicated by the arrow in the image. However, the muscle indicated by the blue arrow is the superior oblique muscle, which lies medial to the superior rectus muscle and the levator palpebrae superioris muscle (which can be seen lateral to the one indicated). The function of the superior oblique muscle, which is innervated by the trochlear nerve (CN IV), is to internally rotate the eyeball.",
"id": "10041625",
"label": "e",
"name": "Elevation of the eyelid",
"picture": null,
"votes": 6
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"__typename": "QuestionChoice",
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"explanation": "The image shows a graphic depiction of the orbit with the periorbital fat in situ and the extraocular muscles present within the fat layer. The lateral aspect of the orbit is located to the left of the image, while the medial aspect of the orbit is found to the right of the image. Eyeball depression is a function of the inferior rectus muscle, which is innervated by the oculomotor nerve (CN III), and which lies on the inferior aspect of the eyeball and the orbit. However, the muscle indicated by the blue arrow is the superior oblique muscle, which lies medial to the superior rectus muscle and the levator palpebrae superioris muscle (which can be seen lateral to the one indicated). The function of the superior oblique muscle, which is innervated by the trochlear nerve (CN IV), is to internally rotate the eyeball.",
"id": "10041624",
"label": "d",
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"explanation": "The image shows a basal view of the skull base, with the front of the skull at the top, the occipital bone at the bottom, and the foramen magnum in the centre. The glossopharyngeal nerve leaves the skull via the jugular foramen, a large opening of an irregular shape found at the junction between the petrous part of the temporal bone and the occipital bone, posterior to the structure indicated by the blue arrow. This structure is the foramen spinosum, which is a small opening within the greater wing of the sphenoid bone. It is found posterolateral to the larger foramen ovale and anterior to the internal acoustic meatus and the jugular foramen (all of these can be seen in the image).",
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"explanation": "The image shows a coronal view of a dissected left hemisphere. The frontal lobe is at the top of the image and the temporal lobe is at the bottom of the image, with the lateral fissure in between on the right side of the image. The arrow points to the temporal horn of the lateral ventricle which is located deep within the temporal lobe, running antero-inferiorly along the hippocampus and to the tip of the amygdala.",
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"explanation": "The image shows a coronal view of a dissected left hemisphere. The frontal lobe is at the top of the image and the temporal lobe is at the bottom of the image, with the lateral fissure in between on the right side of the image. The occipital horn is the smallest segment of the lateral ventricle running postero-medially into the occipital lobe. This is not the correct answer because the level of the coronal section is more anterior compared to the occipital lobe. However, the arrow points to the temporal horn of the lateral ventricle which is located deep within the temporal lobe, running antero-inferiorly along the hippocampus and to the tip of the amygdala.",
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"explanation": "The image shows a superior view (looking inside) of the bones forming the anterior cranial fossa. The crista galli bony projection of the ethmoid bone is found in the middle of the image. The frontal bones are found laterally. However, the blue arrow indicates the perforated cribriform plate of the ethmoid bone, which allows the passage of the olfactory nerve (CN I) fibres into the brain from the nasal cavity.",
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"explanation": "The image shows a superior view (looking inside) of the bones forming the anterior cranial fossa. The crista galli bony projection of the ethmoid bone is found in the middle of the image. The frontal bones are found laterally. The vomer bone is a midline bone of the face, located between the right and left nasal cavities. It is not visible in the image because this shows the skull base bones from above. However, the blue arrow indicates the perforated cribriform plate of the ethmoid bone, which allows the passage of the olfactory nerve (CN I) fibres into the brain from the nasal cavity.",
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"explanation": "The image shows a representation of the basal view of the brain with the arteries in situ. The frontal lobe is at the top of the image, while the cerebellum is at the bottom of the image. The flocculus and the anteroinferior surface of the cerebellum are supplied by the anterior inferior cerebellar artery (AICA), which is a branch arising from the proximal part of the basilar artery, immediately superior to the union of the vertebral arteries. However, the blue arrow indicates the superior cerebellar artery (SCA) which is a branch of the basilar artery, found immediately inferior to its terminal branches – the posterior cerebral arteries. The function of the SCA is to provide arterial supply to the superior surface of the cerebellar lobes.",
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"explanation": "The image shows a close view of the inside of the bony orbit on the left side. The blue arrow indicates the superior orbital fissure, which is a triangular opening located at the apex of the orbit in between the greater and the lesser wings of the sphenoid bone, lateral to the optic canal. The inferior ophthalmic vein passes through the inferior orbital fissure, the space in between the lateral wall of the orbit and the floor of the orbit, inferior to the area indicated by the blue arrow, which is the superior orbital fissure.",
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"explanation": "The image shows a prosection of the cerebellum of a brain in a basal view, with the cerebellar hemispheres on each side of the image and the brainstem at the top of the image. The posterior lobe is the largest of the three cerebellar lobes, found on the posterolateral aspect. However, the blue arrow indicates the tonsil of the cerebellum, which is a round lobule on each side, located on the underside of the cerebellar hemispheres. The tonsil is continuous with the vermis in the midline.",
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"explanation": "The image shows a prosection of the cerebellum of a brain in a basal view, with the cerebellar hemispheres on each side of the image and the brainstem at the top of the image. The anterior lobe is found on the anterosuperior aspect of the cerebellum and is connected to the pons through the superior cerebellar peduncles. However, the blue arrow indicates the tonsil of the cerebellum, which is a round lobule on each side, located on the underside of the cerebellar hemispheres. The tonsil is continuous with the vermis in the midline.",
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"explanation": "The image shows a prosection of the cerebellum from a basal view, with the cerebellar hemispheres on each side of the image and the brainstem at the top of the image. The blue arrow indicates the posterior lobe, the most extensive lobe of the cerebellum, located inferior to the horizontal fissure. Its vascular supply is provided by the posterior inferior cerebellar artery, a branch of the vertebral artery on each side.",
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"explanation": "The image shows a prosection of the cerebellum from a basal view, with the cerebellar hemispheres on each side of the image and the brainstem at the top of the image. The superior cerebellar artery supplies the superior aspects of the cerebellar hemispheres, particularly the anterior lobe. It is a branch of the basilar artery. However, the blue arrow indicates the posterior lobe, the most extensive lobe of the cerebellum, located inferior to the horizontal fissure. Its vascular supply is provided by the posterior inferior cerebellar artery, a branch of the vertebral artery on each side.",
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"explanation": "The image shows a prosection of the cerebellum from a basal view, with the cerebellar hemispheres on each side of the image and the brainstem at the top of the image. The basilar artery is the largest vessel of the posterior circulation of the brain and some of its branches supply the cerebellum – the superior and the deeper aspects of the cerebellar hemispheres. However, the blue arrow indicates the posterior lobe, the most extensive lobe of the cerebellum, located inferior to the horizontal fissure. Its vascular supply is provided by the posterior inferior cerebellar artery, a branch of the vertebral artery on each side.",
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"explanation": "The image shows a prosection of the cerebellum from a basal view, with the cerebellar hemispheres on each side of the image and the brainstem at the top of the image. The posterior cerebral artery is a branch of the basilar artery supplying the occipital, the medial parietal and medial temporal lobes of the brain, but not the cerebellum. However, the blue arrow indicates the posterior lobe, the most extensive lobe of the cerebellum, located inferior to the horizontal fissure. Its vascular supply is provided by the posterior inferior cerebellar artery, a branch of the vertebral artery on each side.",
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"explanation": "The image shows a coronal view of a brain and the prosection is cut towards the posterior aspect, as the brainstem and the cerebellum are visible in the centre of the image. The inferior sagittal sinus is a small dural sinus found in the inferior margin of the falx cerebri, travelling superior to the corpus callosum. However, the blue arrow indicates the superior sagittal sinus, the largest of the dural venous sinuses in the brain, which travels in the midline, superior to the falx cerebri of the dura mater in between the frontal, parietal and occipital lobes of the brain.",
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"explanation": "The image shows an anatomical model displaying a mid-sagittal view of the brain, with the nose and frontal lobe to the left of the image and the occipital lobe and the cerebellum to the right of the image. The internal carotid artery is a branch of the common carotid artery which travels into the skull to provide the terminal branches forming the anterior circulation of the brain (in the circle of Willis). However, the blue arrow points to the anterior cerebral artery, which is a terminal branch of the internal carotid artery supplying the medial aspect of the corresponding frontal and parietal lobes.",
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"explanation": "The image shows an anatomical model displaying a mid-sagittal view of the brain, with the nose and frontal lobe to the left of the image and the occipital lobe and the cerebellum to the right of the image. The posterior cerebral artery is a terminal branch of the basilar artery supplying the occipital lobe of the brain. It can be identified towards the posterior aspect of the brain in the image. However, the blue arrow points to the anterior cerebral artery, which is a terminal branch of the internal carotid artery supplying the medial aspect of the corresponding frontal and parietal lobes.",
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"explanation": "The image shows an anatomical model displaying a mid-sagittal view of the brain, with the nose and frontal lobe to the left of the image and the occipital lobe and the cerebellum to the right of the image. The vertebral artery is a branch of the subclavian artery, ascending through the transverse processes of the cervical vertebrae to the skull cavity where it anastomoses with the vertebral artery on the contralateral side to form the basilar artery and provide supply for the posterior circulation of the brain (in the circle of Willis). However, the blue arrow points to the anterior cerebral artery, which is a terminal branch of the internal carotid artery supplying the medial aspect of the corresponding frontal and parietal lobes.",
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"explanation": "The image shows an anatomical model displaying a mid-sagittal view of the brain, with the nose and frontal lobe to the left of the image and the occipital lobe and the cerebellum to the right of the image. The middle cerebral artery is a terminal branch of the internal carotid artery supplying the lateral aspect of the frontal, temporal and parietal lobes of the brain. It is not visible in this image because this shows a medial view of the brain, not a lateral one. However, the blue arrow points to the anterior cerebral artery, which is a terminal branch of the internal carotid artery supplying the medial aspect of the corresponding frontal and parietal lobes.",
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"explanation": "The image shows an axial section through the medulla oblongata, with the anterior surface on the inferior aspect of the image and the posterior surface on the superior aspect of the image. The blue arrow points to one of the two pyramids, which are two swellings on the anterior surface of the medulla, lateral to the anterior median fissure and medial to the olives. The pyramids allow the passage of the white matter fibre bundles emerging from the primary motor cortex and descending as the pyramidal tracts (also termed corticospinal tracts) into the spinal cord. The function of the corticospinal tracts is to provide voluntary motor control over the skeletal muscles of the body.",
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"explanation": "The image shows an axial section through the medulla oblongata, with the anterior surface on the inferior aspect of the image and the posterior surface on the superior aspect of the image. Information about peripheral pain or thermal stimuli is transmitted through the lateral spinothalamic tract, which is one of the ascending tracts of the spinal cord providing impulses to the thalamus and ultimately to the primary motor cortex. However, the blue arrow points to one of the two pyramids, which are two swellings on the anterior surface of the medulla, lateral to the anterior median fissure and medial to the olives. The function of the corticospinal tracts is to provide voluntary motor control over the skeletal muscles of the body.",
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"explanation": "The image shows an axial section through the medulla oblongata, with the anterior surface on the inferior aspect of the image and the posterior surface on the superior aspect of the image. The proprioceptive signals from the muscle spindles and joint receptors are transmitted to the cerebellum through the anterior spinocerebellar tract, an ascending white matter tract located on the lateral aspect of the spinal cord and the inferior medulla oblongata. However, the blue arrow points to one of the two pyramids, which are two swellings on the anterior surface of the medulla, lateral to the anterior median fissure and medial to the olives. The function of the corticospinal tracts is to provide voluntary motor control over the skeletal muscles of the body.",
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"explanation": "The image shows an axial section through the medulla oblongata, with the anterior surface on the inferior aspect of the image and the posterior surface on the superior aspect of the image. Motor coordination, tone, posture and balance are all functions which are regulated by the cerebellum, which lies posterior to the brainstem. However, the blue arrow points to one of the two pyramids, which are two swellings on the anterior surface of the medulla, lateral to the anterior median fissure and medial to the olives. The function of the corticospinal tracts is to provide voluntary motor control over the skeletal muscles of the body.",
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"explanation": "The image shows an axial section through the medulla oblongata, with the anterior surface on the inferior aspect of the image and the posterior surface on the superior aspect of the image. Information about vibration and proprioception from the lower limbs is transmitted through the gracilis fasciculus, which is an ascending white matter tract located on the posterior aspect of the spinal cord and inferior medulla oblongata. It is located medial to the cuneate fasciculus, which transmits the same information from the upper limbs. However, the blue arrow points to one of the two pyramids, which are two swellings on the anterior surface of the medulla, lateral to the anterior median fissure and medial to the olives. The function of the corticospinal tracts is to provide voluntary motor control over the skeletal muscles of the body.",
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"explanation": "The image shows an axial section through the medulla oblongata, with the anterior surface on the inferior aspect of the image and the posterior surface on the superior aspect of the image. The superior olive is a grey matter nucleus located in the inferior aspect of the pons (not visible in this image, as the pons is not represented). It is a relay nucleus on the hearing pathway which receives afferents from both the left and the right sides (binaural convergence). However, the blue arrow points to the inferior olive, which is a grey matter nucleus located within the olive, a swelling found bilaterally on the anterior aspect of the medulla oblongata, lateral to the pyramids.",
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"explanation": "The image shows an axial section through the medulla oblongata, with the anterior surface on the inferior aspect of the image and the posterior surface on the superior aspect of the image. The blue arrow points to the inferior olive, which is a grey matter nucleus located within the olive, a swelling found bilaterally on the anterior aspect of the medulla oblongata, laterally to the pyramids. The olive is delineated anteriorly by the ventrolateral sulcus and posteriorly by the posterolateral sulcus.",
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"explanation": "The image shows an axial section through the medulla oblongata, with the anterior surface on the inferior aspect of the image and the posterior surface on the superior aspect of the image. The pyramids are two paired swellings located on the anterior surface of the medulla oblongata, lateral to the anterior median fissure and medial to the ventrolateral sulcus and the olives. They are the regions where the fibres of the pyramidal tracts pass when descending from the primary motor cortex to the spinal cord. However, the blue arrow points to the inferior olive, which is a grey matter nucleus located within the olive, a swelling found bilaterally on the anterior aspect of the medulla oblongata, lateral to the pyramids.",
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"name": "Pyramid",
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"question": "Identify the name of the anatomical structure indicated by the blue arrow in the image below:\n[lightgallery]",
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"a"
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173,470,532 | false | 50 | null | 6,495,329 | null | false | [] | null | 20,646 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The image shows a basal view of the skull base, with the front of the skull at the top, the occipital bone at the bottom, and the foramen magnum in the centre. The glossopharyngeal nerve leaves the skull via the jugular foramen, a large irregularly shaped opening found at the junction between the petrous part of the temporal bone and the occipital bone. However, the structure indicated by the blue arrow is the foramen ovale, which is a large oval opening in the greater wing of the sphenoid bone, anteromedial to the foramen spinosum. It allows the passage of the mandibular division of the trigeminal nerve (CN V3). ",
"id": "10041739",
"label": "d",
"name": "Allows the passage of the glossopharyngeal nerve out of the skull",
"picture": null,
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"explanation": "The image shows a basal view of the skull base, with the front of the skull at the top, the occipital bone at the bottom, and the foramen magnum in the centre. The middle meningeal artery enters the skull through the foramen spinosum, which is a small opening within the greater wing of the sphenoid bone. It is found posterolateral to the structure indicated by the blue arrow, which is the foramen ovale. The foramen ovale is a large oval opening in the greater wing of the sphenoid bone, anteromedial to the foramen spinosum. It allows the passage of the mandibular division of the trigeminal nerve (CN V3). ",
"id": "10041737",
"label": "b",
"name": "Allows the passage of the middle meningeal artery into the skull",
"picture": null,
"votes": 6
},
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"explanation": "The image shows a basal view of the skull base, with the front of the skull at the top, the occipital bone at the bottom, and the foramen magnum in the centre. The maxillary division of the trigeminal nerve (CN V2) leaves the skull through the foramen rotudum, a large round opening found in the grater wing of the sphenoid bone, anteromedial to the structure indicated by the blue arrow which is the foramen ovale. The foramen ovale a large oval opening in the greater wing of the sphenoid bone, anteromedial to the foramen spinosum. It allows the passage of the mandibular division of the trigeminal nerve (CN V3). ",
"id": "10041738",
"label": "c",
"name": "Allows the passage of the maxillary division of the trigeminal nerve",
"picture": null,
"votes": 1
},
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"explanation": "The image shows a basal view of the skull base, with the front of the skull at the top, the occipital bone at the bottom, and the foramen magnum in the centre. The vestibulocochlear nerve enters the skull via the acoustic meatus, an opening found in the petrous part of the temporal bone. However, the structure indicated by the blue arrow is the foramen ovale, which is a large oval opening in the greater wing of the sphenoid bone, anteromedial to the foramen spinosum. It allows the passage of the mandibular division of the trigeminal nerve (CN V3).",
"id": "10041740",
"label": "e",
"name": "Allows the passage of the vestibulocochlear nerve into the skull",
"picture": null,
"votes": 2
},
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "The image shows a basal view of the skull base, with the front of the skull at the top, the occipital bone at the bottom, and the foramen magnum in the centre. The structure indicated by the blue arrow is the foramen ovale, which is a large oval opening in the greater wing of the sphenoid bone, anteromedial to the foramen spinosum. It allows the passage of the mandibular division of the trigeminal nerve (CN V3). ",
"id": "10041736",
"label": "a",
"name": "Allows the passage of the mandibular division of the trigeminal nerve",
"picture": null,
"votes": 1
}
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"id": "6282",
"name": "Cranial nerve foramina",
"status": null,
"topic": {
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"id": "201",
"name": "Head and neck anatomy",
"typeId": 7
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"question": "Identify the function of the anatomical structure indicated by the arrow in the image below.\r\n[lightgallery]",
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173,470,921 | false | 1 | null | 6,495,349 | null | false | [] | null | 17,391 | {
"__typename": "QuestionSBA",
"choices": [
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a typical description of a basal cell carcinoma. Basal cell carcinomas usually present with the following three features: a pearly rolled edge, central ulceration and fine telangiectasias. They do not commonly present with any pain or bleeding. They are slow-growing and are more likely to appear on sun exposed areas of skin.",
"id": "10024965",
"label": "a",
"name": "Basal cell carcinoma",
"picture": null,
"votes": 151
},
{
"__typename": "QuestionChoice",
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"explanation": "These often appear as irregular red nodules with a scaly or crusty surface and irregular and raised margins. Unlike basal cell carcinomas, they can cause pain and bleeding and grow more quickly, over weeks to months.",
"id": "10024969",
"label": "e",
"name": "Squamous cell carcinoma",
"picture": null,
"votes": 19
},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "These are premalignant skins lesions that often precede the development of squamous cell carcinomas. Actinic keratosis present as lesions with surrounding erythema and a rough or warty surface. They are often described as incredibly itchy lesions on sun exposed areas of skin.",
"id": "10024966",
"label": "b",
"name": "Actinic Keratosis",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Features of melanomas can be recognised using the ABCDE approach, which stands for: Asymmetrical lesion, Border irregularity, Colour variation, Diameter more than 6mm and Evolution over time. Melanomas can also be itchy or bleed and often grow more quickly than basal cell carcinomas.",
"id": "10024967",
"label": "c",
"name": "Malignant melanoma",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "These often have a ‘stuck on’ appearance. They can range in colour from light to black. The lesion described in this question is more likely to be a basal cell carcinoma.",
"id": "10024968",
"label": "d",
"name": "Seborrheic Keratosis",
"picture": null,
"votes": 4
}
],
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"name": "Basal cell carcinoma",
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"question": "A 60-year-old male presents to his GP after noticing a new lesion on his cheek. On closer inspection, you notice a raised, flesh-coloured nodule approximately 4mm in diameter. You notice a pearly rolled edge and an ulceration in the centre of the lesion, with multiple small telangiectasia on the surface of the nodule.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
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"typeId": 1,
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173,470,922 | false | 2 | null | 6,495,349 | null | false | [] | null | 17,392 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ehlers-Danlos syndrome occurs due to a genetic mutation in collagen, not fibrin. Different types of mutations in fibrin can cause bleeding disorders such as hypofibrinogenemia.",
"id": "10024972",
"label": "c",
"name": "Fibrin",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ehlers-Danlos syndrome occurs due to a genetic mutation in collagen, not elastin. Loss of function mutations in the elastin gene can cause the heart defect supravalvular aortic stenosis.",
"id": "10024973",
"label": "d",
"name": "Elastin",
"picture": null,
"votes": 25
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "A mutation of the CFTR gene, otherwise known as the cystic fibrosis transmembrane conductance regulator gene, causes cystic fibrosis. Ehlers-Danlos syndrome is caused by a genetic mutation of collagen.",
"id": "10024971",
"label": "b",
"name": "Cystic fibrosis transmembrane conductance regulator (CFTR)",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Enlers-Danlos syndrome is a group of inherited conditions that cause hypermobile joints, hyperelastic skin and fragile blood vessels. This occurs due to a genetic mutation of collagen.",
"id": "10024970",
"label": "a",
"name": "Collagen",
"picture": null,
"votes": 143
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Keratin is the building block of hair and nails. Mutations in keratin does not cause the development of Ehlers-Danlos syndrome.",
"id": "10024974",
"label": "e",
"name": "Keratin",
"picture": null,
"votes": 1
}
],
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"name": "Ehlers-Danlos syndrome",
"status": null,
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"id": "156",
"name": "Medical Genetics",
"typeId": 7
},
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"question": "A 20-year-old female presents to the emergency department as she has dislocated her shoulder. She has a past medical history of Ehlers-Danlos syndrome.\n\nEhlers-Danlos syndrome is caused by a genetic mutation of which structure?",
"sbaAnswer": [
"a"
],
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173,470,923 | false | 3 | null | 6,495,349 | null | false | [] | null | 17,393 | {
"__typename": "QuestionSBA",
"choices": [
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Ramsey-Hunt syndrome occurs when a herpes zoster infection affects the facial nerve. It is not a complication of glandular fever.",
"id": "10024976",
"label": "b",
"name": "Ramsey-Hunt syndrome",
"picture": null,
"votes": 50
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hodgkin's lymphoma is not a known complication of glandular fever. However, having glandular fever can be assoictaed with a higher risk of developing non-Hodgkin's lymphoma.",
"id": "10024978",
"label": "d",
"name": "Hodgkin's lymphoma",
"picture": null,
"votes": 52
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This question describes a patient with glandular fever. An important complication of glandular fever is splenic rupture. ST-elevation myocardial infarction is not a complication of this condition.",
"id": "10024979",
"label": "e",
"name": "ST-elevation myocardial infarction (STEMI)",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a typical description of glandular fever. An important complication of this condition includes splenic rupture, so individuals are advised to avoid contact sports for a month after diagnosis. Signs of splenic rupture include: abdominal pain, referred shoulder tip pain and tachycardia.",
"id": "10024975",
"label": "a",
"name": "Splenic rupture",
"picture": null,
"votes": 58
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hepatitis A is not a complication of glandular fever. Glandular fever can, however, lead to development of autoimmune hepatitis which is an important complication to monitor for.",
"id": "10024977",
"label": "c",
"name": "Hepatitis A",
"picture": null,
"votes": 14
}
],
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"id": "5815",
"name": "Glandular fever",
"status": null,
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"name": "Emergency Medicine",
"typeId": 5
},
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"question": "An 18-year-old university student presents to her GP with a sore throat and fatigue for the past three weeks. She was prescribed a course of amoxicillin a week ago which she stopped taking as she developed a widespread macular rash. On examination, she is noted to have cervical lymphadenopathy.\n\nWhich of the following is a possible complication of the most likely diagnosis?",
"sbaAnswer": [
"a"
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"totalVotes": 177,
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173,470,924 | false | 4 | null | 6,495,349 | null | false | [] | null | 17,394 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Type 4 hypersensitivity reactions are known as delayed-type hypersensitivity reactions. They involve T lymphocytes and reactions often occur 24 to 72 hours after exposure to an antigen. Examples of type 4 hypersensitivity reactions include contact dermatitis and transplant rejections.",
"id": "10024984",
"label": "e",
"name": "Type 4",
"picture": null,
"votes": 29
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Graves' Disease is a type 5 hypersensitivity reaction. These reactions occur when antibodies bind to cell surface receptors. A further example of a type 5 hypersensitivity reaction is myasthenia gravis. Type 5 reactions are relatively new within the medical literature, and previously Graves' would have been considered a Type 2 reaction, which your university may still be teaching. If this is the case, we would advise clarifying with your university.",
"id": "10024980",
"label": "a",
"name": "Type 5",
"picture": null,
"votes": 35
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Examples of type 3 hypersensitivity reactions include systemic lupus erythematosus, and less commonly post-streptococcal glomerulonephritis. These reactions are mediated by immune complexes.",
"id": "10024981",
"label": "b",
"name": "Type 3",
"picture": null,
"votes": 33
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Type 2 hypersensitivity reactions include rheumatic fever and autoimmune haemolytic anaemia. These reactions take place when either IgG or IgM bind to a cell surface antigen, so are known as cell bound reactions. The patient in this question has Graves' disease, which is a type 5 hypersensitivity reaction.",
"id": "10024983",
"label": "d",
"name": "Type 2",
"picture": null,
"votes": 76
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Type 1 hypersensitivity reactions occur when antigens bind and react to IgE immunoglobulins. Common examples of type 1 hypersensitivity reactions include anaphylaxis, asthma, eczema and hay fever.",
"id": "10024982",
"label": "c",
"name": "Type 1",
"picture": null,
"votes": 7
}
],
"comments": [
{
"__typename": "QuestionComment",
"comment": "bristol teaches graves disease as a type IIb hypersensitivity reaction",
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"name": "Hypersensitivity reactions",
"status": null,
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"id": "158",
"name": "Immunology",
"typeId": 7
},
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"question": "A 15-year-old male attends his GP with a six-month history of weight loss and diarrhoea. On further questioning, he is found to be sweaty and restless, and has had trouble sleeping. On examination, he has diplopia and you notice the upper eyelid is slow to descend on downgaze. The GP suspects a diagnosis of Graves' disease.\n\nWhich type of hypersensitivity reaction is Graves' disease?",
"sbaAnswer": [
"a"
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"totalVotes": 180,
"typeId": 1,
"userPoint": null
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173,470,925 | false | 5 | null | 6,495,349 | null | false | [] | null | 17,395 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a typical presentation of a keloid scar. The description of a smooth, hard growth at the site of trauma is typical of this type of scar. Keloids are most commonly found after injury to the upper chest, sternum, shoulder, face, earlobes and lower legs.",
"id": "10024985",
"label": "a",
"name": "Keloid Scar",
"picture": null,
"votes": 142
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Actinic keratosis are premalignant lesions that often appear before the development of squamous cell carcinoma. They look like thickened papule or plaques and often have surrounding erythematous skin. They have a rough warty surface and can cause pruritis. The patient in this question is likely to have a keloid scar at the site of injury.",
"id": "10024986",
"label": "b",
"name": "Actinic keratosis",
"picture": null,
"votes": 6
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The patient in this question is most likely to have a keloid scar. A pickaxe scar is a type of scar that is often seen if an individual has severe acne.",
"id": "10024987",
"label": "c",
"name": "Pickaxe scar",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypertrophic scars are usually hard and raised. They do not exceed past the borders of the original wound- which makes them different to keloid scars.",
"id": "10024989",
"label": "e",
"name": "Hypertrophic scar",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pitted scars are often seen in individuals with acne. The description of the skin lesion in this question is more typical of a keloid scar.",
"id": "10024988",
"label": "d",
"name": "Pitted scar",
"picture": null,
"votes": 3
}
],
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"demo": null,
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"id": "4675",
"name": "Keloid Scar",
"status": null,
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"id": "144",
"name": "Dermatology",
"typeId": 7
},
"topicId": 144,
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"question": "A 30-year-old male has a new skin lesion. He has a smooth, hard growth on the left side of his nose where he has recently has his nose pierced. The lesion extends beyond the margin of the initial piercing.\n\nWhat is the name given to this skin leison?",
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"a"
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173,470,926 | false | 6 | null | 6,495,349 | null | false | [] | null | 17,396 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Neutrophils play an important role in fighting early stages of bacterial infections as they destroy rapidly dividing bacteria. They are not the cells responsible for producing histamine in allergic reactions.",
"id": "10024994",
"label": "e",
"name": "Neutrophils",
"picture": null,
"votes": 1
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{
"__typename": "QuestionChoice",
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"explanation": "Eosinophils defend against protozoan and parasitic infections. They would not be responsible for releasing histamine in allergic reactions.",
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"label": "b",
"name": "Eosinophils",
"picture": null,
"votes": 19
},
{
"__typename": "QuestionChoice",
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"explanation": "Dendritic cells are antigen-presenting cells that help to trigger the adaptive immune response to an infectious agent. They are not responsible for releasing histamine in allergic reactions.",
"id": "10024992",
"label": "c",
"name": "Dendritic cells",
"picture": null,
"votes": 0
},
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"explanation": "Mast cells are responsible for triggering the inflammatory response. They are present in tissues and are the cells responsible for releasing histamine during allergic reactions.",
"id": "10024990",
"label": "a",
"name": "Mast cells",
"picture": null,
"votes": 155
},
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"__typename": "QuestionChoice",
"answer": false,
"explanation": "Macrophages act to increase body temperature when individuals have a fever. They also act as antigen-presenting cells and are involved in phagocytosis of pathogens. Mast cells are the cells responsible for releasing histamine during allergic reactions.",
"id": "10024993",
"label": "d",
"name": "Macrophages",
"picture": null,
"votes": 1
}
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"question": "A 10-year-old female presents to the emergency department with shortness of breath and facial swelling after eating peanuts.\n\nWhich of the following cell types are responsible for releasing histamine in allergic reactions?",
"sbaAnswer": [
"a"
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"totalVotes": 176,
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173,470,927 | false | 7 | null | 6,495,349 | null | false | [] | null | 17,397 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Antibiotics like macrolides and aminoglycosides act by inhibiting protein synthesis. Trimethoprim instead acts by inhibiting folic acid formation.",
"id": "10024996",
"label": "b",
"name": "Inhibits protein synthesis",
"picture": null,
"votes": 31
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Trimethoprim acts by inhibiting folic acid formation, not by inhibiting the formation of cell walls. Cell wall inhibitors include antibiotics like penicillin, glycopeptides and cephalosporins.",
"id": "10024997",
"label": "c",
"name": "Inhibits cell wall formation",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Antibiotics like rifampicin work by inhibiting the synthesis of RNA. Trimethoprim acts by inhibiting folic acid synthesis.",
"id": "10024998",
"label": "d",
"name": "Inhibits RNA synthesis",
"picture": null,
"votes": 23
},
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"__typename": "QuestionChoice",
"answer": true,
"explanation": "Trimethoprim is an antibiotic that acts by inhibiting folic acid formation.",
"id": "10024995",
"label": "a",
"name": "Inhibits folic acid formation",
"picture": null,
"votes": 90
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Trimethoprim acts by inhibiting folic acid formation. It does not damage DNA, unlike antibiotics such as metronidazole.",
"id": "10024999",
"label": "e",
"name": "Damages DNA",
"picture": null,
"votes": 7
}
],
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"id": "3887",
"name": "Antibiotics",
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"id": "148",
"name": "Microbiology",
"typeId": 7
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"question": "Which of the following options best describes the mechanism of action of trimethoprim?",
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"a"
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173,470,928 | false | 8 | null | 6,495,349 | null | false | [] | null | 17,398 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Antibiotics like metronidazole work by damaging DNA. Statins do not work in this way, but instead by inhibiting HMG-CoA reductase.",
"id": "10025004",
"label": "e",
"name": "Damage DNA",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
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"explanation": "This is the correct answer. Statins inhibit HMG-CoA reductase which, in turn, reduces the amount of cholesterol made by the liver (and also helps the liver remove cholesterol that has already been formed and deposited in the blood).",
"id": "10025000",
"label": "a",
"name": "Inhibit HMG-CoA reductase",
"picture": null,
"votes": 163
},
{
"__typename": "QuestionChoice",
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"explanation": "This is the mechanism of action of warfarin, not statins. Statins inhibit HMG-CoA reductase, which reduces the amount of cholesterol in the blood.",
"id": "10025001",
"label": "b",
"name": "Inhibit vitamin K epoxide reductase complex 1",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Antibiotics like macrolides and tetracycline work to inhibit protein synthesis. Statins instead work by inhibiting HMG-CoA reductase.",
"id": "10025003",
"label": "d",
"name": "Inhibit protein synthesis",
"picture": null,
"votes": 3
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This is the mechanism of action of sulphonamides and trimethoprim. Statins do not work in this way, but instead by inhibiting HMG-CoA reductase.",
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"label": "c",
"name": "Inhibit folic acid formation",
"picture": null,
"votes": 0
}
],
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"id": "5817",
"name": "Statins",
"status": null,
"topic": {
"__typename": "Topic",
"id": "166",
"name": "General pharmacological concepts",
"typeId": 7
},
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"question": "A 45-year-old male found to have a QRESEARCH cardiovasclar risk algorithm (QRISK) score that is over 10%. His GP recommends he begins a medication called atorvastatin.\n\nWhich of the following correctly descibes the mechanism of action of statins?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
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173,470,929 | false | 9 | null | 6,495,349 | null | false | [] | null | 17,399 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This immunoglobin is the only type that is able to pass into the foetal circulation. IgG is also involved in phagocytosis of bacteria and viruses, and is the most abundant type of immunoglobulin found in the blood serum. However, the first immunoglobulin to be secreted in infection is IgM.",
"id": "10025006",
"label": "b",
"name": "IgG",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The defining feature of IgM is that it is the first immunoglobulin to be secreted in response to infection. It is secreted as a pentamer.",
"id": "10025005",
"label": "a",
"name": "IgM",
"picture": null,
"votes": 123
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The role of IgD is less clear than that of the other antibodies. It is possible that it enhances the response of the other classes of antibodies, or helps to block viral replication. It is not the first immunoglobulin to be secreted in infection, this is IgM.",
"id": "10025009",
"label": "e",
"name": "IgD",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "IgA is the most predominant immunoglobulin found in breast milk. It can also be found in secretions of the digestive, respiratory and urogenital systems. The other main role of IgA is to provided protection on cell mucus membranes. It is not the first immunoglobulin to be secreted in infection, this is IgM.",
"id": "10025007",
"label": "c",
"name": "IgA",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "IgE is associated with Type 1 Hypersensitivity reactions. It is synthesized by plasma cells and provides immunity to parasites such as helminths. It is not the first immunoglobulin to be secreted in infection, this is IgM.",
"id": "10025008",
"label": "d",
"name": "IgE",
"picture": null,
"votes": 14
}
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"name": "Antibodies",
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"id": "158",
"name": "Immunology",
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},
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"question": "Which is the first immunoglobulin to be secreted in repsonse to infection?",
"sbaAnswer": [
"a"
],
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"typeId": 1,
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} | MarksheetMark |
173,470,930 | false | 10 | null | 6,495,349 | null | false | [] | null | 17,400 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Ramipril can cause high potassium levels as it blocks the aldosterone pathway, and therefore leads to more potassium being retained in the body. Hyperkalaemia is defined as a serum potassium of higher than 5.5mmol/L.",
"id": "10025010",
"label": "a",
"name": "Ramipril",
"picture": null,
"votes": 124
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Furosemide is a loop diuretic that works by inhibiting the Na-K-Cl co-transporter in the loop of Henle- in the kidney. This means that furosemide causes hypokalaemia, rather than hyperkalaemia.",
"id": "10025011",
"label": "b",
"name": "Furosemide",
"picture": null,
"votes": 32
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Metformin is not a direct cause of hyperkalaemia. Instead, this high potassium level is more likely to be caused by use of an angiotensin-converting enzyme (ACE) inhibitor.",
"id": "10025012",
"label": "c",
"name": "Metformin",
"picture": null,
"votes": 11
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Nicorandil is a vasodilatory drug used used in the treatment of angina. It does not cause hyperkalemia but can, however, have a range of other side effects including headaches, flushing and skin ulceration.",
"id": "10025013",
"label": "d",
"name": "Nicorandil",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Beta blockers can cause a number of side effects including bronchospasm, insomnia and erectile dysfunction. They do not, however, cause hyperkalemia.",
"id": "10025014",
"label": "e",
"name": "Propranolol",
"picture": null,
"votes": 2
}
],
"comments": [],
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"typeId": 7
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"entitlement": null,
"id": "3934",
"name": "hyperkalaemia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "170",
"name": "Clinical Chemistry",
"typeId": 7
},
"topicId": 170,
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"question": "A 71-year-old male attends his GP to receive the results for his routine blood test. His medications include furosemide, metformin, propranolol, ramipril and nicorandil. His potassium levels are found to be 6.0mmol/L (normal range 3.5-5.3 mmol/L).\n\nWhich of the following medications is likely to be the biggest contributor to his hyperkalaemia?",
"sbaAnswer": [
"a"
],
"totalVotes": 173,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,470,931 | false | 11 | null | 6,495,349 | null | false | [] | null | 17,401 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Acute myeloid leukaemia would present with symptoms such as weight loss, frequent infections, tiredness and shortness of breath. This question is more typical of a presentation of haemophilia.",
"id": "10025019",
"label": "e",
"name": "Acute myeloid leukaemia",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a typical description of a patient with haemophilia A. Haemophilia A can vary in severity, but typically presents with bleeding into soft tissues, muscles and joints. It is diagnosed with a factor VIII assay and genetic testing. It is caused by deficiency of clotting factor VIII, an important part of the intrinsic component of the coagulation cascade.",
"id": "10025015",
"label": "a",
"name": "Haemophilia A",
"picture": null,
"votes": 153
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Alexander's disease is a rare genetic bleeding disorder, which would show a deficiency in factor VII, not factor VIII. Alexander's disease presents with easy bruising, frequent nosebleeds and prolonged bleeding after physical injury. It does not commonly present with haemarthroses.",
"id": "10025017",
"label": "c",
"name": "Alexander's disease",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Acute lymphoid leukaemia does occur in children, and can present with increased bleeding. It is an important diagnosis to rule out. However, it would not explain the low levels of Factor VIII. It would also be likely to present with other symptoms such as pallor, frequent infections, weight loss and fatigue.",
"id": "10025018",
"label": "d",
"name": "Acute lymphoid leukaemia",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Haemophilia B would show a deficiency in clotting factor IX, not clotting factor VIII.",
"id": "10025016",
"label": "b",
"name": "Haemophilia B",
"picture": null,
"votes": 12
}
],
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"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3925",
"name": "haemophilia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "157",
"name": "Haematology",
"typeId": 7
},
"topicId": 157,
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},
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"question": "A nine-year-old male attends his GP with recurrent haemarthroses. He undergoes multiple blood tests, which reveal low levels of factor VIII.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 168,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,470,932 | false | 12 | null | 6,495,349 | null | false | [] | null | 17,402 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's dry cough is most likely to be caused by starting an ACE inhibitor, rather than an angiotensin II receptor antagonist (ARB) such as losartan.",
"id": "10025024",
"label": "e",
"name": "Losartan",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's dry cough is most likely to be caused by starting an ACE inhibitor, rather than beginning Indapamide. Indapamide can cause patients to become constipated, cause hyperuricaemia or, in rare cases, agranulocytosis.",
"id": "10025022",
"label": "c",
"name": "Indapamide",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient's dry cough is most likely to have been caused by starting an angiotensin-converting enzyme (ACE) inhibitor such as Ramipril. When an ACE inhibitor is not tolerated in the treatment of hypertension, patients are offers an angiotensin II receptor blocker (ARB) instead.",
"id": "10025020",
"label": "a",
"name": "Ramipril",
"picture": null,
"votes": 148
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's dry cough is most likely to be caused by starting an ACE inhibitor such as ramipril, rather than spironolactone.",
"id": "10025021",
"label": "b",
"name": "Spironolactone",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's dry cough is most likely to be caused by starting an ACE inhibitor, not a calcium channel blocker like amlodipine. Calcium channel blockers can have a range of side effects, including abdominal pain, peripheral oedema or gingival hyperplasia.",
"id": "10025023",
"label": "d",
"name": "Amlodipine",
"picture": null,
"votes": 12
}
],
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"typeId": 7
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"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "4215",
"name": "ACE inhibitors",
"status": null,
"topic": {
"__typename": "Topic",
"id": "169",
"name": "Cardiovascular pharmacology",
"typeId": 7
},
"topicId": 169,
"totalCards": null,
"typeId": null,
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"videos": []
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
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"highlights": [],
"id": "17402",
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"question": "A 58-year-old man is started on a new medication for hypertension by his GP. Eight days later, he returns to his GP complaining of a dry cough.\n\nWhich of the following medications is the patient most likely to have been started on?",
"sbaAnswer": [
"a"
],
"totalVotes": 167,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,470,933 | false | 13 | null | 6,495,349 | null | false | [] | null | 17,403 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "The most likely diagnosis in this woman is pulmonary embolism. This is due to the classic triad of symptoms: sudden onset shortness of breath, pleuritic chest pain and haemoptysis. Her observations of tachycardia and tachypnoea further confirm this diagnosis. The best initial investigation for this woman would be a CT pulmonary angiogram, which would likely show a filling defect in the pulmonary vasculature.",
"id": "10025025",
"label": "a",
"name": "CT pulmonary angiogram",
"picture": null,
"votes": 131
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is presenting with a pulmonary embolism after a long flight (one of the risk factors for a pulmonary embolism). The best initial investigation for this woman would be a CT pulmonary angiogram.",
"id": "10025029",
"label": "e",
"name": "Blood pressure",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The most likely diagnosis in this woman in pulmonary embolism. The best initial investigation for this woman would be a CT pulmonary angiogram.",
"id": "10025026",
"label": "b",
"name": "Doppler ultrasound",
"picture": null,
"votes": 7
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This would be the best initial investigation for a pulmonary embolism if the patient had renal impairment, a contrast allergy or was pregnant. The question mentions none of these criteria, so the best initial investigation for this woman would be a CT pulmonary angiogram.",
"id": "10025027",
"label": "c",
"name": "V/Q scan",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "An echocardiogram can be a useful investigation if you want to check for signs of right heart strain or hypotension in patients with high-risk pulmonary embolisms. However, the best initial investigation in this woman’s case would be to conduct a CT pulmonary angiogram.",
"id": "10025028",
"label": "d",
"name": "Echocardiogram",
"picture": null,
"votes": 8
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3724",
"name": "Pulmonary Embolism",
"status": null,
"topic": {
"__typename": "Topic",
"id": "132",
"name": "Respiratory",
"typeId": 7
},
"topicId": 132,
"totalCards": null,
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"userNote": null,
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},
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"difficulty": 1,
"dislikes": 0,
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"highlights": [],
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"question": "A 33-year-old female presents to A+E with shortness of breath that began four hours ago. She also reports having chest pain that is worse breathing in and has brought up some small flecks of bright red blood when coughing. She has recently returned from a two-week holiday in Australia. On examination, she has a heart rate of 120 and respiratory rate of 18. Her oxygen saturations are 90%. She has a temperature of 38.0.\n\nWhich of the following is the most appropriate initial investigation?",
"sbaAnswer": [
"a"
],
"totalVotes": 165,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,470,934 | false | 14 | null | 6,495,349 | null | false | [] | null | 17,404 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "*Legionella pneumoniae* presents with fevers, muscle pain, shortness of breath, and a dry cough. It causes low sodium levels and deranged LFTs on blood results.",
"id": "10025030",
"label": "a",
"name": "*Legionella pneumoniae*",
"picture": null,
"votes": 72
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "*Streptococcus pneumoniae* is one of the most common causes of community-acquired pneumonia so is a good differential. However, the low sodium and deranged LFTs here are indicative of a legionella pneumonia.",
"id": "10025034",
"label": "e",
"name": "*Streptococcus pneumoniae*",
"picture": null,
"votes": 52
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "*Pneumocystis jirovecii* usually presents as a lower respiratory tract infection in patients who are immunosuppressed e.g. those who are HIV-positive and have a CD4 count is under 200 cells/uL. This patient is most likely to have an infection caused by *legionella pneumoniae* given their blood results.",
"id": "10025033",
"label": "d",
"name": "*Pneumocystis jirovecii*",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "*Mycoplasma pneumoniae* would typically appear present with flu-like symptoms and a possible rash. It also has the potential to cause autoimmune haemolytic anaemia. This patient is most likely to have an infection caused by *legionella pneumoniae* given their blood results.",
"id": "10025031",
"label": "b",
"name": "*Mycoplasma pneumoniae*",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "*Klebsiella pneumoniae* usually affects patients with weakened immune systems, which includes elderly patients and those with diabetes. It is also a common cause of aspiration pneumonia so may be seen in patients with risk factors for aspiration, such as alcoholics. The patient would usually describe having ‘’red currant’’ sputum.",
"id": "10025032",
"label": "c",
"name": "*Klebsiella pneumoniae*",
"picture": null,
"votes": 12
}
],
"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": "5818",
"name": "Pneumonia (Infectious Diseases)",
"status": null,
"topic": {
"__typename": "Topic",
"id": "194",
"name": "Infectious Diseases",
"typeId": 7
},
"topicId": 194,
"totalCards": null,
"typeId": null,
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"userNote": null,
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},
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"id": "17404",
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"question": "A 23-year-old female presents to A&E with a non-productive cough and fever for five days. She is diagnosed with a lower respiratory tract infection. Blood results show low sodium levels and deranged liver function tests (LFTs).\n\nGiven the likely diagnosis, which of the following is the most likely causative organism?",
"sbaAnswer": [
"a"
],
"totalVotes": 166,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,470,935 | false | 15 | null | 6,495,349 | null | false | [] | null | 17,405 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Adenosine is a treatment option used to terminate episodes of SVT. However, vagal manoeuvres such as the valsalva manoeuvre should be attempted before adenosine is given.",
"id": "10025036",
"label": "b",
"name": "Adenosine",
"picture": null,
"votes": 24
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "In rare cases, a pacemaker can be inserted to prevent recurrent episodes of SVT. However, in this case it would first be appropriate to attempt vagal manoeuvres to try to terminate this patients SVT.",
"id": "10025039",
"label": "e",
"name": "Pacemaker",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is currently experiencing an epiosde of supraventricular tachycardia (SVT). The first-line treatment for SVT is to conduct vagal manoeuvres, such as the valsalva manoeuvre where a patient can close their mouth, clamp their nose shut and exhale. Another example of a vagal manoeuvre in this stage would be carotid artery massage.",
"id": "10025035",
"label": "a",
"name": "Valsalva manoeuvre",
"picture": null,
"votes": 105
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Verapamil is a treatment option used to terminate episodes of SVT. However, vagal manoeuvres such as the valsalva manoeuvre should be attempted before adenosine is given.",
"id": "10025037",
"label": "c",
"name": "Verapamil",
"picture": null,
"votes": 28
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Catheter ablation of an accessory pathway is a treatment option to terminate episodes of SVT. However, vagal manoeuvres such as the valsalva manoeuvre should be attempted before adenosine is given.",
"id": "10025038",
"label": "d",
"name": "Catheter ablation of an accessory pathway",
"picture": null,
"votes": 5
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5819",
"name": "Emergency Management of Supraventricular tachycardia",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
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},
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"conditions": [],
"difficulty": 1,
"dislikes": 0,
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"question": "A 23-year-old female attends the emergency department complaining of palpations for the last 15 minutes. She describes feeling dizzy and lightheaded. An ECG is conducted which shows a narrow complex tachycardia with a rate of 150bpm.\n\nWhich of the following is the most appropriate initial management for this patient?",
"sbaAnswer": [
"a"
],
"totalVotes": 163,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,470,936 | false | 16 | null | 6,495,349 | null | false | [] | null | 17,406 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Lifestyle modifications always play a part in the management of hypertension. However, this patient has consistently high blood pressure despite taking amlodipine so lifestyle modifications alone would not be enough. This patient requires the addition of another treatment to control their blood pressure.",
"id": "10025043",
"label": "d",
"name": "Advise lifestyle modifications",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's blood pressure has remained above 140/90 despite treatment with amlodipine. Therefore, she requires the addition of a second medication to control her blood pressure.",
"id": "10025044",
"label": "e",
"name": "Continue with current regime",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is currently taking the maximum dose of amlodipine and therefore you cannot increase the dose further. This patient therefore requires the addition of another agent to control their blood pressure. In this case, NICE guidelines suggest the addition of an ARB such as losartan.",
"id": "10025041",
"label": "b",
"name": "Increase dose of amlodipine",
"picture": null,
"votes": 14
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Spironolactone is a potassium-sparing diuretic that can be used in management of hypertension through its effects on the renin-angiotensin-aldosterone system (RAAS). However, it is not used before a calcium channel blocker and an ACE inhibitor or ARB have been tried together.",
"id": "10025042",
"label": "c",
"name": "Spironolactone",
"picture": null,
"votes": 21
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient requires a second-line treatment to control their blood pressure. As she is already taking a calcium channel blocker (amlodipine), she should be given an angiotensin receptor blocker (ARB). ARBs are the preferred choice over angiotensin-converting enzyme (ACE) inhibitors for patients of African-Caribbean origin.",
"id": "10025040",
"label": "a",
"name": "Add in losartan",
"picture": null,
"votes": 125
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
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"highlights": [],
"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3701",
"name": "Hypertension",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3701,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17406",
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"question": "A 64-year-old female presents to the GP for a blood pressure review. She is currently taking amlodipine 10mg once a day. She is of African-Caribbean origin. Her blood pressure reading comes back as 151/96.\n\nWhat is the most appropriate next step in management?",
"sbaAnswer": [
"a"
],
"totalVotes": 165,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,470,937 | false | 17 | null | 6,495,349 | null | false | [] | null | 17,407 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient is presenting with symptoms of an aortic dissection- chest pain described as 'tearing' radiating to the back. He also has a background of hypertension and Marfan's syndrome (two important risk factors). Therefore, this patient requires a CT angiogram to confirm this diagnosis.",
"id": "10025045",
"label": "a",
"name": "CT angiogram",
"picture": null,
"votes": 142
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is most likely to be having an aortic dissection. A chest X-ray can be useful in ruling out other causes of his chest pain, but the definitive diagnostic investigation is a CT angiogram.",
"id": "10025047",
"label": "c",
"name": "Chest X-ray",
"picture": null,
"votes": 15
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is most likely to be having an aortic dissection. The definitive diagnostic investigation for an aortic dissection is a CT angiogram.",
"id": "10025048",
"label": "d",
"name": "Blood pressure",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is most likely to be having an aortic dissection. An ECG can be useful in ruling out other causes of his chest pain, but the definitive diagnostic investigation is a CT angiogram.",
"id": "10025046",
"label": "b",
"name": "ECG",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is most likely to be having an aortic dissection. The definitive diagnostic investigation for an aortic dissection is a CT angiogram.",
"id": "10025049",
"label": "e",
"name": "CT head",
"picture": null,
"votes": 0
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3707",
"name": "Aortic Dissection",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
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"userNote": null,
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},
"conceptId": 3707,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17407",
"isLikedByMe": null,
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"question": "A 60-year-old male presents to the emergency department with chest pain. He describes the pain as 'tearing' and radiating to his back. He has a past medical history of hypertension and Marfan's syndrome. On observation, his heart rate is 89, blood pressure 116/79 and oxygen saturations 93%.\n\nWhich investigation will confirm the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 166,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,470,938 | false | 18 | null | 6,495,349 | null | false | [] | null | 17,408 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Tricuspid regurgitation would also present as a pan-systolic murmur. However, this type of murmur would be found at the left sternal border of the fifth intercostal space, rather than in the mid-clavicular line. Therefore, the murmur in this question is most likely to be mitral regurgitation.",
"id": "10025051",
"label": "b",
"name": "Tricuspid regurgitation",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Pulmonary stenosis is an ejection systolic murmur that is heard at the left sternal border of the second intercostal space. This is a pan-systolic murmur heard best in the fifth intercostal space at the mid-clavicular line, and is therefore more likely to be mitral regurgitation.",
"id": "10025053",
"label": "d",
"name": "Pulmonary stenosis",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Hypertrophic obstructive cardiomyopathy would produce an ejection-systolic murmur, rather than a pan-systolic murmur. It would be heard best at the fourth intercostal space on the left sternal border.",
"id": "10025054",
"label": "e",
"name": "Hypertrophic obstructive cardiomyopathy",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Aortic stenosis is an ejection systolic murmur, rather than a pan-systolic murmur. It is heard best in the second intercostal space at the right sternal border. The patient in this question is therefore most likely to have mitral regurgitation.",
"id": "10025052",
"label": "c",
"name": "Aortic stenosis",
"picture": null,
"votes": 9
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "Mitral Regurgitation is a pan-systolic murmur heard best in the fifth intercostal space at the mid-clavicular line.",
"id": "10025050",
"label": "a",
"name": "Mitral Regurgitation",
"picture": null,
"votes": 129
}
],
"comments": [],
"concept": {
"__typename": "Concept",
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"__typename": "Chapter",
"explanation": null,
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"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "5820",
"name": "Differentials of Pan-systolic murmur",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 5820,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17408",
"isLikedByMe": null,
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"question": "You are called to conduct a cardiology examination on an 89-year-old female on the cardiology ward. On examination, you hear a pansystolic murmur at the fifth intercostal space in the mid -clavicular line.\n\nWhich of the following is the most likely cause of her murmur?",
"sbaAnswer": [
"a"
],
"totalVotes": 162,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,470,939 | false | 19 | null | 6,495,349 | null | false | [] | null | 17,409 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient describes episodes of chest pain that begins on exertion and is always relieved by rest. This is most likely a presentation of stable angina. NSTEMIs would present with additional symptoms like pain radiating to the jaw, nausea and vomiting and shortness of breath.",
"id": "10025059",
"label": "e",
"name": "Non-ST-elevation myocardial infarction (NSTEMI)",
"picture": null,
"votes": 1
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient describes episodes of chest pain that begins on exertion and is always relieved by rest. This is most likely a presentation of stable angina.",
"id": "10025058",
"label": "d",
"name": "Anxiety",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Patients with unstable angina would experience symptoms when at rest. Symptoms of this would not be relieved by rest and occur at random. Therefore, this presentation is most likely to be caused by stable angina.",
"id": "10025056",
"label": "b",
"name": "Unstable angina",
"picture": null,
"votes": 12
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient describes episodes of chest pain that begins on exertion and is always relieved by rest. This is most likely a presentation of stable angina. STEMI's would present with additional symptoms like pain radiating to the jaw, nausea and vomiting and shortness of breath.",
"id": "10025057",
"label": "c",
"name": "ST elevation myocardial infarction (STEMI)",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient describes episodes of cardiac-type chest pain that begins on exertion and is always relieved by rest. This is a description of stable angina.",
"id": "10025055",
"label": "a",
"name": "Stable Angina",
"picture": null,
"votes": 152
}
],
"comments": [],
"concept": {
"__typename": "Concept",
"chapter": {
"__typename": "Chapter",
"explanation": null,
"files": null,
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"id": "2693",
"pictures": [],
"typeId": 7
},
"chapterId": 2693,
"demo": null,
"entitlement": null,
"id": "3721",
"name": "Stable angina",
"status": null,
"topic": {
"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
"totalCards": null,
"typeId": null,
"userChapter": null,
"userNote": null,
"videos": []
},
"conceptId": 3721,
"conditions": [],
"difficulty": 1,
"dislikes": 0,
"explanation": null,
"highlights": [],
"id": "17409",
"isLikedByMe": null,
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"question": "A 70-year-old male presents to his GP complaining of episodes of central crushing chest pain. On further questioning, you find that he has had five episodes similar to this in the past last week, and the pain begins on exertion and is always relieved by rest.\n\nWhich of the following is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 165,
"typeId": 1,
"userPoint": null
} | MarksheetMark |
173,470,940 | false | 20 | null | 6,495,349 | null | false | [] | null | 17,410 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "First-degree heart block would present on an ECG as a PR interval over 200ms. This ECG shows complete dissociation between P waves and QRS which is typical of third-degree heart block.",
"id": "10025063",
"label": "d",
"name": "First-degree heart block",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's ECG is typical of third-degree heart block, not a STEMI. A STEMI would show an elevated ST segment in a regional pattern on the ECG.",
"id": "10025064",
"label": "e",
"name": "ST-elevation myocardial infarction (STEMI)",
"picture": null,
"votes": 0
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Mobitz type II heart block is a type of second-degree heart block where there is intermittent non-conducted P waves while the PR interval remains the same. This patient's ECG describes third-degree heart block. Third-degree heart block is classically described as complete dissociation between P waves and QRS complexes.",
"id": "10025062",
"label": "c",
"name": "Second-degree heart block Mobitz type II",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Mobitz type I heart block is a type of second-degree heart block commonly caused by a conduction system failure at the His-Purkinje system. An ECG will show increasingly prolonging PR intervals until there is a non-conducted P wave. The PR interval is longest just before the dropped beat, and then the cycle repeats again.",
"id": "10025061",
"label": "b",
"name": "Second-degree heart block Mobitz type I",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient's ECG describes third-degree heart block. Third degree heart block is classically described as complete dissociation between P waves and QRS complexes.",
"id": "10025060",
"label": "a",
"name": "Third-degree heart block",
"picture": null,
"votes": 147
}
],
"comments": [],
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},
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"id": "3699",
"name": "Heart Block",
"status": null,
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"__typename": "Topic",
"id": "134",
"name": "Cardiology",
"typeId": 7
},
"topicId": 134,
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"question": "A 40-year-old female presents to the emergency department with palpations for ten hours. An ECG shows complete dissociation between P waves and QRS complexes with a rate of 46.\n\nWhat is the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 163,
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} | MarksheetMark |
173,470,941 | false | 21 | null | 6,495,349 | null | false | [] | null | 17,411 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is presenting with Cushing's syndrome, and therefore a dexamethasone suppression test would be the diagnostic test of choice. You could conduct a HbA1c if you suspected diabetes mellitus, but the diagnosis of Cushing's Syndrome would be confirmed with a dexamethasone suppression test.",
"id": "10025069",
"label": "e",
"name": "HbA1c",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient is presenting with the signs and symptoms of Cushing's syndrome. A fluid deprivation test would be the test of choice for diabetes insipidus. Diabetes insipidus would present with symptoms like excessive thirst and producing large amounts of urine.",
"id": "10025068",
"label": "d",
"name": "Fluid deprivation test",
"picture": null,
"votes": 2
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This is a typical presentation of a patient with Cushing's syndrome: low mood, weight gain, proximal myopathy and abdominal striae. Cushing's syndrome can also cause a moon-shaped face, a \"buffalo hump\" on the back, diabetes mellitus and hypokalaemia. The diagnostic investigation of choice for Cushing’s syndrome is a dexamethasone suppression test.",
"id": "10025065",
"label": "a",
"name": "Dexamethasone suppression test",
"picture": null,
"votes": 139
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The patient in the question is presenting with with central obesity, proximal weakness, depression and abdominal striae are typical of Cushing’s syndrome. A short synacthen test is the test of choice for adrenal sufficiency, not Cushing’s disease. Adrenal insufficiency would present with symptoms like hypotension, fatigue and weakness, gastrointestinal symptoms, and skin pigmentation.",
"id": "10025066",
"label": "b",
"name": "Short synacthen test",
"picture": null,
"votes": 18
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "The patient in the question is presenting with with central obesity, proximal weakness, depression and abdominal striae are typical of Cushing’s syndrome. 24-hour plasma metanephrines would be the correct test if you suspected a pheochromocytoma. This would present with episodes of hypertension, anxiety and headaches. Therefore, the correct answer to this question is to conduct a dexamethasone suppression test.",
"id": "10025067",
"label": "c",
"name": "24-hour plasma metanephrines",
"picture": null,
"votes": 4
}
],
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"name": "Cushing's syndrome",
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"id": "133",
"name": "Endocrinology",
"typeId": 5
},
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"question": "A 19-year-old female presents to her GP with low mood. She describes experiencing weight gain, particularly around her abdomen, over the last six months despite attempts to loose weight. On examination, you notice weakness in all four proximal limbs, as well as circular hump on the back and a circular-shaped face.\n\nWhich of the following investigations would confirm the most likely diagnosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 165,
"typeId": 1,
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} | MarksheetMark |
173,470,942 | false | 22 | null | 6,495,349 | null | false | [] | null | 17,412 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Diabetic ketoacidosis requires acidosis with a pH of less than 7.3, not more than 7.3. Other criteria include hyperglycaemia (a blood glucose over 11mmol/L) and ketosis (blood ketones above 3mmol/L).",
"id": "10025074",
"label": "e",
"name": "pH more than 7.3",
"picture": null,
"votes": 8
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "To diagnose diabetic ketoacidosis, there are three criteria. First, there must be hyperglycaemia, i.e a blood glucose above 11mmol/L. Next, there must be blood ketones above 3mmol/L. Finally, there should be acidosis with a pH of less than 7.3.",
"id": "10025070",
"label": "a",
"name": "Hyperglycaemia over 11mmol/L",
"picture": null,
"votes": 136
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "To diagnose diabetic ketoacidosis, there are three criteria. First, there must be hyperglycaemia, i.e a blood glucose above 11mmolL, not under 20mmol/L. Next, there must be blood ketones above 3mmol/L and acidosis with a pH of less than 7.3.",
"id": "10025072",
"label": "c",
"name": "Hyperglycaemia under 20mmol/L",
"picture": null,
"votes": 5
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Diabetic ketoacidosis requires the production of blood ketones to be above 3mmol/L, not below.",
"id": "10025071",
"label": "b",
"name": "Blood ketones under 3mmol/L",
"picture": null,
"votes": 4
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "Diabetic ketoacidosis requires there to be hyperglycaemia, i.e a blood glucose of 11mmol/L or above.",
"id": "10025073",
"label": "d",
"name": "Hyperglycaemia under 11mmol/L",
"picture": null,
"votes": 8
}
],
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"name": "Diabetic ketoacidosis",
"status": null,
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"__typename": "Topic",
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"name": "Endocrinology",
"typeId": 5
},
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"question": "An 18-year-old male is found unconscious by his parents after six hours of nausea and vomiting. His parents tell you he has been complaining of excessive thirst and passing urine more frequently for the last month. When you examine him, you notice a sweet acetone smell to his breath.\n\nWhich of the following is included in the diagnostic criteria for diabetic ketoacidosis?",
"sbaAnswer": [
"a"
],
"totalVotes": 161,
"typeId": 1,
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} | MarksheetMark |
173,470,943 | false | 23 | null | 6,495,349 | null | false | [] | null | 17,413 | {
"__typename": "QuestionSBA",
"choices": [
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's GCS is 7, not 5. She scores a 1 in eye opening response, a 2 in verbal response (due to incomprehensible sounds) and a 4 in motor response.",
"id": "10025078",
"label": "d",
"name": "5",
"picture": null,
"votes": 17
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's GCS is 7, not 6. She scores a 1 in eye opening response, a 2 in verbal response (due to incomprehensible sounds) and a 4 in motor response.",
"id": "10025077",
"label": "c",
"name": "6",
"picture": null,
"votes": 41
},
{
"__typename": "QuestionChoice",
"answer": true,
"explanation": "This patient's GCS is 7. She scores a 1 for eye opening response as she does not open her eyes. She is making incomprehensible sounds, scoring a 2 for verbal response. She flexes to withdraw from pain, meaning she scores a 4 in motor response.",
"id": "10025075",
"label": "a",
"name": "7",
"picture": null,
"votes": 65
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's GCS is 7, not 8. She scores a 1 in eye opening response, a 2 in verbal response (due to incomprehensible sounds) and a 4 in motor response.",
"id": "10025076",
"label": "b",
"name": "8",
"picture": null,
"votes": 22
},
{
"__typename": "QuestionChoice",
"answer": false,
"explanation": "This patient's GCS is 7, not 4. She scores a 1 as she does not open her eyes, a 2 in verbal response (due to incomprehensible sounds) and a 4 in motor response.",
"id": "10025079",
"label": "e",
"name": "4",
"picture": null,
"votes": 15
}
],
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"id": "4108",
"name": "Glasgow Coma Scale (GCS)",
"status": null,
"topic": {
"__typename": "Topic",
"id": "152",
"name": "Neuroscience",
"typeId": 7
},
"topicId": 152,
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"question": "A 90-year-old female is brought in to the emergency department after being found unconscious in her home. She does not open her eyes but is making incomprehensible sounds. She flexes to withdraw from pain.\n\nWhat is her Glasgow Coma Scale score?",
"sbaAnswer": [
"a"
],
"totalVotes": 160,
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} | MarksheetMark |
Subsets and Splits