id
int64
173M
173M
flagged
bool
1 class
index
int64
1
98
questionChoiceId
null
marksheetId
int64
6.49M
6.5M
timeTaken
null
isAnswered
bool
1 class
striked
listlengths
0
0
mark
null
questionId
int64
264
22.8k
question
dict
__typename
stringclasses
1 value
173,457,399
false
7
null
6,494,930
null
false
[]
null
6,457
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Although this is likely a fibroadenoma, the patient should be referred for further investigations", "id": "32284", "label": "b", "name": "Reassure the patient that t...
MarksheetMark
173,457,400
false
8
null
6,494,930
null
false
[]
null
6,458
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "There is no indication for fundoscopy before starting neoadjuvant therapy in a patient with breast cancer", "id": "32292", "label": "e", "name": "Fundoscopy", ...
MarksheetMark
173,457,401
false
9
null
6,494,930
null
false
[]
null
6,459
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "This patient has no risk factors for heart failure. It would be reasonable to check BNP levels as it has a high negative predictive value for heart failure, but, in this context, test...
MarksheetMark
173,457,402
false
10
null
6,494,930
null
false
[]
null
6,460
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Mild hypercalcaemia is a feature of primary adrenal insufficiency of all causes. Infiltrative diseases such as sarcoidosis can cause primary adrenal insufficiency but this is rare", ...
MarksheetMark
173,457,403
false
11
null
6,494,930
null
false
[]
null
6,461
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Hypomagnesaemia can lead to hypocalcaemia, and it is important to check magnesium levels after urgent treatment has been started", "id": "32307", "label": "e", "name...
MarksheetMark
173,457,404
false
12
null
6,494,930
null
false
[]
null
6,462
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "IBD is associated with erythema nodosum. The normal blood tests and absence of gastrointestinal or systemic symptoms would make this unlikely in this case", "id": "32312", ...
MarksheetMark
173,457,405
false
13
null
6,494,930
null
false
[]
null
6,463
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Meningococcal septicaemia can present with a purpuric rash, similar to that seen in small vessel vasculitis. However, the absence of any infective symptoms, normal observations and ch...
MarksheetMark
173,457,406
false
14
null
6,494,930
null
false
[]
null
6,464
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Haematological malignancies can cause erythroderma; however, the lack of systemic symptoms, largely normal blood tests and absence of lymphadenopathy would go against this", "id...
MarksheetMark
173,457,407
false
15
null
6,494,930
null
false
[]
null
6,465
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "This would not be appropriate as hoarseness could be a sign of underlying malignancy", "id": "32326", "label": "d", "name": "Reassure and discharge", "picture"...
MarksheetMark
173,457,408
false
16
null
6,494,930
null
false
[]
null
6,466
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Acetic acid can be used in the very early stages of infection. In this case, the inflammation, discharge and pain favour using a combination antibiotic/steroid ear drop", "id": ...
MarksheetMark
173,457,409
false
17
null
6,494,930
null
false
[]
null
6,467
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Cerumen (ear wax) in the ear canal is one of the most common causes of conductive hearing loss. It would not lead to a change in the appearance of the tympanic membrane", "id": ...
MarksheetMark
173,457,410
false
18
null
6,494,930
null
false
[]
null
6,468
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "A pulmonary embolism of the size needed to cause respiratory accessory muscle usage would be expected to cause a decrease in oxygen saturation and arterial oxygen levels", "id":...
MarksheetMark
173,457,411
false
19
null
6,494,930
null
false
[]
null
6,469
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": true, "explanation": "Given his underlying COPD and age, this patient has high risk characteristics associated with his pneumothorax. As it is greater than 2cm (i.e. amenable to drainage), guidelines sugges...
MarksheetMark
173,457,412
false
20
null
6,494,930
null
false
[]
null
6,470
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "300mg of amiodarone is used in cardiac arrest secondary to VF or VT. However, it is only given after the 3rd shock", "id": "32351", "label": "d", "name": "Administer...
MarksheetMark
173,457,413
false
21
null
6,494,930
null
false
[]
null
6,471
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "TMA is characterised by the formation of thrombi in the small vasculature and associated microangiopathic haemolytic anaemia (MAHA) due to fragmentation of red blood cells. TMA alone ...
MarksheetMark
173,457,414
false
22
null
6,494,930
null
false
[]
null
6,472
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "There is no indication to restart a VRII if the patient's blood glucose is well controlled following conversion to their usual subcutaneous insulin regime", "id": "32360", ...
MarksheetMark
173,457,415
false
23
null
6,494,930
null
false
[]
null
6,473
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Cerebral amyloid angiopathy is the most common cause of lobar intracerebral haemorrhage in older adults. A thalamic stroke is more likely to be due to hypertensive vasculopathy", ...
MarksheetMark
173,457,416
false
24
null
6,494,930
null
false
[]
null
6,474
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Unsynchronised DC cardioversion (defibrillation) is used in cases of cardiac arrest in the presence of a shockable rhythm. The shock is delivered at any point in the cardiac cycle", ...
MarksheetMark
173,457,417
false
25
null
6,494,930
null
false
[]
null
6,475
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Insulin can be used for steroid-induced diabetes; however, NovoRapid is a fast-acting insulin and would not help maintain normal glucose levels throughout the day. Intermediate-acting...
MarksheetMark
173,457,418
false
26
null
6,494,930
null
false
[]
null
6,476
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "A thyroglossal cyst would be expected to move upwards on protrusion of the tongue. It would also usually not present with pain", "id": "32379", "label": "b", "name":...
MarksheetMark
173,457,419
false
27
null
6,494,930
null
false
[]
null
6,477
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Cushing's syndrome can be caused by an adrenal lesion such as an adenoma or carcinoma, and imaging may help confirm this diagnosis. However, this would usually be done once a diagnosi...
MarksheetMark
173,457,420
false
28
null
6,494,930
null
false
[]
null
6,478
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Low strength capsaicin cream can be used for the treatment of localised neuropathic pain. This patient's pain is more widespread and so topical treatment is unlikely to be beneficial....
MarksheetMark
173,457,421
false
29
null
6,494,930
null
false
[]
null
6,479
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "The patient has capacity and can communicate his decision. There's no indication of psychiatric illness here so a referral to psychiatry is not indicated or appropriate", "id": ...
MarksheetMark
173,457,422
false
30
null
6,494,930
null
false
[]
null
6,480
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Drivers have a legal duty to inform the Driver and Vehicle Licensing Agency (DVLA) if they have a condition that impairs their ability to drive. A doctor should inform the patient of ...
MarksheetMark
173,457,423
false
31
null
6,494,930
null
false
[]
null
6,481
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "CPR should be discussed with the patient prior to making a decision on whether they should be for it or not.", "id": "32407", "label": "e", "name": "Proceed with ful...
MarksheetMark
173,457,424
false
32
null
6,494,930
null
false
[]
null
6,482
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Shared decision refers to a process where both the doctor and the patient contribute towards making a personalised decision on management", "id": "32412", "label": "e", ...
MarksheetMark
173,457,425
false
33
null
6,494,930
null
false
[]
null
6,483
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Haemochromatosis is a disorder of iron overload and can either be primary (an autosomal recessive disorder that results in an inability to regulate iron absorption) or secondary (due ...
MarksheetMark
173,457,426
false
34
null
6,494,930
null
false
[]
null
6,484
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "This patient has symptoms suggestive of severe colitis, which has the potential to deteriorate significantly. He should be admitted to hospital for investigation and management", ...
MarksheetMark
173,457,427
false
35
null
6,494,930
null
false
[]
null
6,485
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "There is no role for oesophagectomy in Barrett's. Oesophagectomy is a treatment option for oesophageal carcinoma", "id": "32426", "label": "d", "name": "Referral to ...
MarksheetMark
173,457,428
false
36
null
6,494,930
null
false
[]
null
6,486
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": true, "explanation": "Pancreatic pseudocysts are a common complication of acute or chronic pancreatitis. They occur due to damage to the pancreatic ducts, which leads to cystic accumulation of pancreatic ju...
MarksheetMark
173,457,429
false
37
null
6,494,930
null
false
[]
null
6,487
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Faecal calprotectin is a measure of intestinal inflammation. It may be raised in coeliac disease and conditions such as inflammatory bowel disease, colorectal cancer and infectious co...
MarksheetMark
173,457,430
false
38
null
6,494,930
null
false
[]
null
6,488
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "RSV can cause croup; however, parainfluenza is more common. RSV is the most common causative organism in bronchiolitis", "id": "32439", "label": "b", "name": "Respir...
MarksheetMark
173,457,431
false
39
null
6,494,930
null
false
[]
null
6,489
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Urgent breast clinic referral would be warranted if there are signs of a breast abscess. A breast abscess would present with a painful swollen lump in the breast, often with a history...
MarksheetMark
173,457,432
false
40
null
6,494,930
null
false
[]
null
6,491
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "As this patient has symptoms of an untreated sexually transmitted infection, the IUD is contraindicated", "id": "32454", "label": "b", "name": "Offer the copper intr...
MarksheetMark
173,457,433
false
41
null
6,494,930
null
false
[]
null
6,492
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Home blood pressure monitoring (HBPM) is an alternative to ambulatory blood pressure monitoring. HBPM is not indicated if a diagnosis of hypertension has been confirmed with ambulator...
MarksheetMark
173,457,434
false
42
null
6,494,930
null
false
[]
null
6,493
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "A CT head would be indicated if a central cause of vertigo (e.g. stroke) was suspected. Signs of central vertigo on a HINTS exam are a negative head impulse test, bidirectional nystag...
MarksheetMark
173,457,435
false
43
null
6,494,930
null
false
[]
null
6,494
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Warfarin is not used in acute limb ischaemia. Commencement of warfarin would delay any surgical intervention that may be necessary due to its long half-life", "id": "32471", ...
MarksheetMark
173,457,436
false
44
null
6,494,930
null
false
[]
null
6,495
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Endovascular intervention, including thrombolysis, may be indicated in this patient; however, a diagnosis of acute mesenteric ischaemia should first be confirmed by CT angiography", ...
MarksheetMark
173,457,437
false
45
null
6,494,930
null
false
[]
null
6,496
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "A peak flow measurement would not be possible in a patient who is intubated and ventilated", "id": "32480", "label": "c", "name": "Peak flow", "picture": null,...
MarksheetMark
173,457,438
false
46
null
6,494,930
null
false
[]
null
6,497
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Hypocalcemia is an important complication of thyroid surgery due to disruption of parathyroid gland function. However, there are no symptoms of hypocalcemia described", "id": "3...
MarksheetMark
173,457,439
false
47
null
6,494,930
null
false
[]
null
6,498
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "In low-risk patients, clopidogrel should be stopped for at least 7 days before surgery", "id": "32490", "label": "c", "name": "24 hours", "picture": null, ...
MarksheetMark
173,457,440
false
48
null
6,494,930
null
false
[]
null
6,499
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "IM ceftriaxone is the first-line treatment for uncomplicated anogenital gonorrhoea infections in the community. The white discharge and absence of any other genito-urinary symptoms ma...
MarksheetMark
173,457,441
false
49
null
6,494,930
null
false
[]
null
6,500
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Conservative management would be the first-line treatment for genital herpes. Genital herpes would present with painful genital ulceration and it is not associated with buboes", ...
MarksheetMark
173,457,442
false
50
null
6,494,930
null
false
[]
null
6,501
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "TVUS is an invasive examination and would therefore not be the initial investigation of choice. A TVUS may be indicated where the pregnancy test is negative and polycystic ovary syndr...
MarksheetMark
173,457,443
false
51
null
6,494,930
null
false
[]
null
6,502
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Depending on the level of abdominal distention some patients may experience breathlessness due to their inability to take deep breaths. In this case, this would not explain her unilat...
MarksheetMark
173,457,444
false
52
null
6,494,930
null
false
[]
null
6,504
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "A knee x-ray may be helpful in showing a large effusion but the history is not suggestive of a bony injury therefore x-ray will not give you a definitive diagnosis in this case", ...
MarksheetMark
173,457,445
false
53
null
6,494,930
null
false
[]
null
6,505
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": true, "explanation": "This patient has failed anticoagulation with a direct oral anticoagulant (DOAC). The National Institute for Health Care Excellence (NICE) guidance therefore suggests confirming her adh...
MarksheetMark
173,457,446
false
54
null
6,494,930
null
false
[]
null
6,507
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": true, "explanation": "Given the chronicity of this infection and the relative immunosuppression of a patient with poorly controlled diabetes, it is important to rule out osteomyelitis which would require ex...
MarksheetMark
173,457,447
false
55
null
6,494,930
null
false
[]
null
6,508
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "A quinsey is another term for a peritonsillar abscess. This is a more common complication of under-treated bacterial throat infections and often requires incision and drainage. A quin...
MarksheetMark
173,457,448
false
56
null
6,494,930
null
false
[]
null
6,509
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": true, "explanation": "Sensitivity of a test is the ability of a test to correctly identify those with a disease.\n\nSensitivity = true positives / (true positives + false negatives)\n\nSo in this case 80/(8...
MarksheetMark
173,457,449
false
57
null
6,494,930
null
false
[]
null
6,510
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "This is incorrect as this is the risk of developing diabetes in the placebo group", "id": "32551", "label": "d", "name": "0.72", "picture": null, "votes"...
MarksheetMark
173,457,450
false
58
null
6,494,930
null
false
[]
null
6,513
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Whilst a CT of his abdomen and pelvis would be useful in aiding diagnosis, at the moment his renal function is poor and contrast is best avoided", "id": "32564", "label": ...
MarksheetMark
173,457,451
false
59
null
6,494,930
null
false
[]
null
6,514
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Whilst hypertension requires aggressive treatment in IgA nephropathy, 5mg is a high starting dose as patients are usually started at 1.25-2.5mg and then gradually increased at two wee...
MarksheetMark
173,457,452
false
60
null
6,494,930
null
false
[]
null
6,515
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Whilst vascular dementia may be the precipitating factor for his cognitive decline; it would not account for the changes in his blood tests", "id": "32574", "label": "b", ...
MarksheetMark
173,457,453
false
61
null
6,494,930
null
false
[]
null
6,516
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "This is the next step if two doses of benzodiazepines do not work and the patient continues to be in status epilepticus. Be aware that phenytoin infusions are likely to cause a drop i...
MarksheetMark
173,457,454
false
62
null
6,494,930
null
false
[]
null
6,517
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "This is less likely to be the case here as the movements described are not typical of a tonic-clonic seizure where the movements are more synchronous jerking of the limbs, with the he...
MarksheetMark
173,457,455
false
63
null
6,494,930
null
false
[]
null
6,518
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "A lumbar puncture in Guillain-Barré Syndrome typically shows an elevated cerebrospinal fluid (CSF) protein with a normal cell count. LP findings do not correlate with severity of ill...
MarksheetMark
173,457,456
false
64
null
6,494,930
null
false
[]
null
6,519
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Infection is a common cause of falls in the elderly. Common sources are urine and chest; however, there is nothing in the history suggestive of infection; therefore, whilst this is al...
MarksheetMark
173,457,457
false
65
null
6,494,930
null
false
[]
null
6,520
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Multiple Sclerosis is a definite cause of a medical third nerve palsy. However, the normal MRI Head, lack of any previous neurological history and significant vascular risk factors in...
MarksheetMark
173,457,458
false
66
null
6,494,930
null
false
[]
null
6,521
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Whilst liver function tests would help confirm whether this was true jaundice, they would not help diagnose the underlying cause", "id": "32605", "label": "c", "name...
MarksheetMark
173,457,459
false
67
null
6,494,930
null
false
[]
null
6,522
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Asking the mother to lie in the left lateral position can shift weight off the maternal vessels and correct cord compression, however as the foetal blood sampling is abnormal, the foe...
MarksheetMark
173,457,460
false
68
null
6,494,930
null
false
[]
null
6,523
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "This is a reasonable differential diagnosis; however, as he has never suffered with this before, this would need to be a diagnosis of exclusion given the patient's age and comorbiditi...
MarksheetMark
173,457,461
false
69
null
6,494,930
null
false
[]
null
6,524
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": true, "explanation": "This patient has untreated hyperthyroidism and has symptoms suggestive of thyroid eye disease that has gone untreated, and her symptoms suggest optic nerve compression. It is important...
MarksheetMark
173,457,462
false
70
null
6,494,930
null
false
[]
null
6,525
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "A foreign body may cause irritation and lead to inflammation of the eye; however, this history does not suggest trauma to the eye", "id": "32626", "label": "d", "nam...
MarksheetMark
173,457,463
false
71
null
6,494,930
null
false
[]
null
6,527
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": true, "explanation": "This patient remains unwell despite broad-spectrum antibiotics. As a prosthesis is involved, he will likely need a surgical washout of the joint in theatres and may even need removal o...
MarksheetMark
173,457,464
false
72
null
6,494,930
null
false
[]
null
6,528
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "This would indicate hypoxaemia, commonly seen respiratory failure in conditions such as chronic obstructive pulmonary disease (COPD). Hypoxaemia is not a common finding in DKA", ...
MarksheetMark
173,457,465
false
73
null
6,494,930
null
false
[]
null
6,529
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Levetiracetam is an antiepileptic medication that can be used in the treatment of childhood epilepsy. However, this child has only had one self-limiting episode and does not yet have ...
MarksheetMark
173,457,466
false
74
null
6,494,930
null
false
[]
null
6,530
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "This patient has clearly stated that she is already having intercourse with her boyfriend and is requesting contraception. Refusing to provide her with treatment is unsafe and not in ...
MarksheetMark
173,457,467
false
75
null
6,494,930
null
false
[]
null
6,531
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "This newborn has a positive Ortolani and therefore investigation and prompt treatment are indicated", "id": "32657", "label": "e", "name": "Reassure and discharge", ...
MarksheetMark
173,457,468
false
76
null
6,494,930
null
false
[]
null
6,532
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "A single dose of oral corticosteroid (such as prednisolone or dexamethasone) may be given in the initial treatment of croup. If the child is too unwell to take the steroid orally, it ...
MarksheetMark
173,457,469
false
77
null
6,494,930
null
false
[]
null
6,533
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": true, "explanation": "This is a case of bronchiolitis, the most common respiratory presentation in children under the age of two years old, peaking between the ages of three and six months. It is usually co...
MarksheetMark
173,457,470
false
78
null
6,494,930
null
false
[]
null
6,534
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Benzodiazepines such as lorazepam are used in the treatment of serotonin syndrome, which occurs as a result of high levels of serotonin in the body. It is an uncommon but serious side...
MarksheetMark
173,457,471
false
79
null
6,494,930
null
false
[]
null
6,535
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Patients started on risperidone should be monitored for prolactin concentration at the start of therapy, at six months, and then yearly. Clozapine can cause agranulocytosis and theref...
MarksheetMark
173,457,472
false
80
null
6,494,930
null
false
[]
null
6,536
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "This is a reasonable differential as the signs and symptoms of alcohol and opiate withdrawal are very similar, however, dilated pupils are more commonly associated with opiate withdra...
MarksheetMark
173,457,473
false
81
null
6,494,930
null
false
[]
null
6,537
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "There is no evidence to suggest that this patient has an advanced directive or care plan in place stating that they do not want active treatment. Therefore, you should initiate treatm...
MarksheetMark
173,457,474
false
82
null
6,494,930
null
false
[]
null
6,538
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "An ABG would help determine if this patient has type one or type two respiratory failure; however, it would not provide an underlying diagnosis", "id": "32690", "label": "...
MarksheetMark
173,457,475
false
83
null
6,494,930
null
false
[]
null
6,539
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": true, "explanation": "The criteria for LTOT in COPD are patients either a PaO2 <7.3 when stable or PaO2 7.3–8 kPa when stable and also have either secondary polycythaemia, peripheral oedema, or evidence of ...
MarksheetMark
173,457,476
false
84
null
6,494,930
null
false
[]
null
6,540
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Oral steroids are reasonable in symptomatic sarcoid; however, intravenous pulsed steroids are rarely indicated in sarcoidosis", "id": "32699", "label": "b", "name": ...
MarksheetMark
173,457,477
false
85
null
6,494,930
null
false
[]
null
6,541
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "The National Institute for Health and Care Excellence (NICE) recommends that nicotine replacement therapy (NRT) with varenicline OR bupropion, as appropriate, to people planning to st...
MarksheetMark
173,457,478
false
86
null
6,494,930
null
false
[]
null
6,542
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Warfarin is an anticoagulant that is sometimes used in patients who are pro-coagulant or who have venous thrombosis, particularly if they have failed treatment with a direct oral anti...
MarksheetMark
173,457,479
false
87
null
6,494,930
null
false
[]
null
6,543
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Steroid injections may be of benefit in reducing her symptoms but are not always effective and carry risks, including that of introducing infection; as she has diabetes, this risk is ...
MarksheetMark
173,457,480
false
88
null
6,494,930
null
false
[]
null
6,544
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "300mg of aspirin would be the treatment of choice if this patient were suspected of having a transient ischaemic attack (TIA); however, whilst TIAs can present with blindness, they do...
MarksheetMark
173,457,481
false
89
null
6,494,930
null
false
[]
null
6,545
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "This is infection/inflammation of the testis and epididymis. It is often caused by sexually transmitted infections such as chlamydia but also caused by viral causes such as mumps. Pat...
MarksheetMark
173,457,482
false
90
null
6,494,930
null
false
[]
null
6,546
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Whilst the stone is 6mm and therefore unlikely to pass spontaneously, the main issue here is the infected obstructed system that requires urgent intervention. If she was not septic, t...
MarksheetMark
173,457,483
false
91
null
6,494,930
null
false
[]
null
6,547
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Hyponatreamia can be a sign of paraneoplastic syndromes such as syndrome of inappropriate ADH. It is not in keeping with tumour lysis syndrome", "id": "32736", "label": "d...
MarksheetMark
173,457,484
false
92
null
6,494,930
null
false
[]
null
6,548
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Pleural effusions can be associated with malignancy, and these are usually exudative. Pleural effusions are usually associated with reduced air entry and dull percussion notes as oppo...
MarksheetMark
173,457,485
false
93
null
6,494,930
null
false
[]
null
6,549
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": true, "explanation": "She is ambulatory and capable of all self-care but unable to carry out any work activities. She is up and about more than 50% of the day", "id": "32743", "label": "a", ...
MarksheetMark
173,457,486
false
94
null
6,494,930
null
false
[]
null
6,550
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Nebulised salbutamol is used in the treatment of airway inflammation. As this patient does not currently have symptoms of airway inflammation, this is not currently indicated, and the...
MarksheetMark
173,457,487
false
95
null
6,494,930
null
false
[]
null
6,511
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "This is incorrect as the horizontal line on a forest plot indicates the confidence intervals as opposed to the range of the data sets. A wide confidence interval indicates instability...
MarksheetMark
173,457,630
false
1
null
6,494,934
null
false
[]
null
6,551
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Ropinirole is a dopamine agonist used to treat Parkinson's. Side effects include postural hypotension, hallucinations and movement disorders. It is unlikely to lead to third degree he...
MarksheetMark
173,457,631
false
2
null
6,494,934
null
false
[]
null
6,552
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Hypotension and raised jugular venous pressure may occur in pneumothorax, especially a tension pneumothorax. However, this is likely to be accompanied by sudden onset pleuritic chest ...
MarksheetMark
173,457,634
false
3
null
6,494,934
null
false
[]
null
6,553
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "The left anterior descending artery supplies the anterior section of the heart. An anterior STEMI would usually show ST elevation in V1, V2, V3 and V4. Anterior infarcts have the poor...
MarksheetMark
173,457,638
false
4
null
6,494,934
null
false
[]
null
6,554
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Indapamide is a thiazide-type diuretic, it inhibits sodium reabsorption in the distal convoluted tubules. It is more likely to lead to hypokalaemia than hyperkalaemia", "id": "3...
MarksheetMark
173,457,641
false
5
null
6,494,934
null
false
[]
null
6,555
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Anticoagulation should be avoided in Dressler's syndrome due to the risk of haemorrhage into the pericardium and cardiac tamponade", "id": "32775", "label": "c", "na...
MarksheetMark
173,457,645
false
6
null
6,494,934
null
false
[]
null
6,556
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": true, "explanation": "First degree atrioventricular heart block involves a prolongation of the PR interval of more than 200ms. In this case, the ECG shows a PR interval of greater than 300ms. The ECG also s...
MarksheetMark
173,457,648
false
7
null
6,494,934
null
false
[]
null
6,557
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Metformin is the first line treatment for type 2 diabetes mellitus. Common side effects include nausea, diarrhoea and abdominal pain. An important, rare side effect is lactic acidosis...
MarksheetMark
173,457,650
false
8
null
6,494,934
null
false
[]
null
6,558
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Chemotherapy may be recommended if the tumour was malignant", "id": "32791", "label": "d", "name": "Chemotherapy", "picture": null, "votes": 92 }, ...
MarksheetMark
173,457,654
false
9
null
6,494,934
null
false
[]
null
6,559
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "Be careful to multiply the sodium concentration by two rather than square it", "id": "32796", "label": "d", "name": "13933.5 mOsmo/kg", "picture": null, ...
MarksheetMark
173,457,656
false
10
null
6,494,934
null
false
[]
null
6,560
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "This is highly unlikely given nothing in the history is mentioned about possible overdose or suicidal ideation. Furthermore, ethylene glycol poisoning would result in a high anion gap...
MarksheetMark
173,457,659
false
11
null
6,494,934
null
false
[]
null
6,561
{ "__typename": "QuestionSBA", "choices": [ { "__typename": "QuestionChoice", "answer": false, "explanation": "The white cell count is slightly raised. However, it is not raised above the levels required to score a point in the Glasgow score. The Glasgow score is used to assess whether a patie...
MarksheetMark