Podcast
Questions and Answers
A 40-year-old woman presents with a 2-day history of worsening dyspnea and cough. She has a history of rheumatoid arthritis and is currently taking prednisone and methotrexate. Chest X-ray shows bilateral infiltrates. What is the most likely diagnosis?
A 40-year-old woman presents with a 2-day history of worsening dyspnea and cough. She has a history of rheumatoid arthritis and is currently taking prednisone and methotrexate. Chest X-ray shows bilateral infiltrates. What is the most likely diagnosis?
A 30-year-old woman presents with a 2-week history of right upper quadrant pain and jaundice. She has a history of heavy alcohol consumption and smokes 10 cigarettes daily. What is the most likely diagnosis?
A 30-year-old woman presents with a 2-week history of right upper quadrant pain and jaundice. She has a history of heavy alcohol consumption and smokes 10 cigarettes daily. What is the most likely diagnosis?
A 45-year-old man presents with a 6-month history of progressive numbness and weakness in his legs. He has a history of back pain and has been taking narcotics for pain relief. What is the most likely diagnosis?
A 45-year-old man presents with a 6-month history of progressive numbness and weakness in his legs. He has a history of back pain and has been taking narcotics for pain relief. What is the most likely diagnosis?
A 25-year-old woman presents with a 2-day history of fever, headache, and confusion. She has a history of IV drug use and HIV infection. What is the most likely diagnosis?
A 25-year-old woman presents with a 2-day history of fever, headache, and confusion. She has a history of IV drug use and HIV infection. What is the most likely diagnosis?
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A 60-year-old man presents with a 4-week history of worsening shortness of breath, cough, and fatigue. He has a history of smoking 20 cigarettes daily for 30 years. What is the most likely diagnosis?
A 60-year-old man presents with a 4-week history of worsening shortness of breath, cough, and fatigue. He has a history of smoking 20 cigarettes daily for 30 years. What is the most likely diagnosis?
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A 50-year-old woman presents with a 2-year history of worsening fatigue, weight loss, and dark urine. She has a history of rheumatoid arthritis and is currently taking methotrexate. What is the most likely diagnosis?
A 50-year-old woman presents with a 2-year history of worsening fatigue, weight loss, and dark urine. She has a history of rheumatoid arthritis and is currently taking methotrexate. What is the most likely diagnosis?
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What is the primary function of the spleen?
What is the primary function of the spleen?
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What is the term for the abnormal production of red blood cells?
What is the term for the abnormal production of red blood cells?
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Which of the following is a characteristic of sickle cell disease?
Which of the following is a characteristic of sickle cell disease?
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What is the term for the formation of blood clots?
What is the term for the formation of blood clots?
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What is the primary function of platelets?
What is the primary function of platelets?
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What is the term for the abnormal bleeding that occurs due to a deficiency of clotting factors?
What is the term for the abnormal bleeding that occurs due to a deficiency of clotting factors?
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What is the term for the study of blood and blood-forming tissues?
What is the term for the study of blood and blood-forming tissues?
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What is the term for the abnormal increase in white blood cells?
What is the term for the abnormal increase in white blood cells?
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Match the following mood/affective problems with their descriptions:
Match the following mood/affective problems with their descriptions:
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What is included in organic brain syndrome?
What is included in organic brain syndrome?
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Which of the following are urinary problems?
Which of the following are urinary problems?
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Which of the following are recognized major nutritional abnormalities associated with thyroid disorders?
Which of the following are recognized major nutritional abnormalities associated with thyroid disorders?
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Hypothyroidism is a type of thyroid disorder.
Hypothyroidism is a type of thyroid disorder.
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Match the following endocrine conditions with their descriptions:
Match the following endocrine conditions with their descriptions:
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What are some potential causes of earache?
What are some potential causes of earache?
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Abnormal blood film is associated with abnormalities in peripheral blood film (red cell, white cell, and platelets), differential white cell count, and __________.
Abnormal blood film is associated with abnormalities in peripheral blood film (red cell, white cell, and platelets), differential white cell count, and __________.
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Which of the following are haematological malignancies and myeloproliferative disorders?
Which of the following are haematological malignancies and myeloproliferative disorders?
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Immunosuppressive drugs are used to boost the immune system.
Immunosuppressive drugs are used to boost the immune system.
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Match the following congenital abnormalities with their descriptions:
Match the following congenital abnormalities with their descriptions:
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What is a common benign breast condition characterized by a solid lump?
What is a common benign breast condition characterized by a solid lump?
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Which of the following are causes of anaemia?
Which of the following are causes of anaemia?
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Which nerve innervates the superior oblique muscle and causes diplopia on downgaze?
Which nerve innervates the superior oblique muscle and causes diplopia on downgaze?
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In a 33-year-old man complaining of double vision when looking to the right, which nerve is the SINGLE most likely to be involved?
In a 33-year-old man complaining of double vision when looking to the right, which nerve is the SINGLE most likely to be involved?
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What is the SINGLE most likely structure affected in a 32-year-old patient with an inability to extend the distal phalanx of the ring finger after a cut?
What is the SINGLE most likely structure affected in a 32-year-old patient with an inability to extend the distal phalanx of the ring finger after a cut?
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Which artery descends into the anterior interventricular groove? A. Acute marginal branch B. ______ C. Septal branches D. Circumflex artery E. Right coronary artery
Which artery descends into the anterior interventricular groove? A. Acute marginal branch B. ______ C. Septal branches D. Circumflex artery E. Right coronary artery
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In a 45-year-old man with herpes zoster over the dermatome of the maxillary branch of the trigeminal nerve, which mucosa is MOST likely affected along with the dermatome?
In a 45-year-old man with herpes zoster over the dermatome of the maxillary branch of the trigeminal nerve, which mucosa is MOST likely affected along with the dermatome?
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What is the SINGLE most likely cause of symptoms in a 60-year-old man who had a myocardial infarction 2 weeks ago, presents with dyspnea and pleuritic chest pain, shows widespread ST elevation on ECG, has an enlarged, globular heart on chest X-ray, and has a pericardial friction rub on examination?
What is the SINGLE most likely cause of symptoms in a 60-year-old man who had a myocardial infarction 2 weeks ago, presents with dyspnea and pleuritic chest pain, shows widespread ST elevation on ECG, has an enlarged, globular heart on chest X-ray, and has a pericardial friction rub on examination?
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What is the SINGLE most likely diagnosis in a 62-year-old man with a routine ECG pre-operatively for an elective knee replacement, in sinus rhythm, with gradual prolongation of the PR interval followed by a dropped beat every 3 or 4 QRS complexes?
What is the SINGLE most likely diagnosis in a 62-year-old man with a routine ECG pre-operatively for an elective knee replacement, in sinus rhythm, with gradual prolongation of the PR interval followed by a dropped beat every 3 or 4 QRS complexes?
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A 60 year old man experienced a rupture at the cubital fossa while screwing his cupboard to the wall. What is the SINGLE most likely diagnosis based on the symptoms of weakness on flexion and supination, and a lump in the distal arm?
A 60 year old man experienced a rupture at the cubital fossa while screwing his cupboard to the wall. What is the SINGLE most likely diagnosis based on the symptoms of weakness on flexion and supination, and a lump in the distal arm?
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What important landmark is found above the 5th intercostal space and anterior to the mid-axillary line?
What important landmark is found above the 5th intercostal space and anterior to the mid-axillary line?
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A camel rider sustains an injury to the lateral side of his right leg below the knee, resulting in bruising, tenderness, inability to dorsiflex or evert the foot, and loss of sensation in specific areas. What is the SINGLE most likely anatomical structure affected?
A camel rider sustains an injury to the lateral side of his right leg below the knee, resulting in bruising, tenderness, inability to dorsiflex or evert the foot, and loss of sensation in specific areas. What is the SINGLE most likely anatomical structure affected?
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What nerve is most likely to be involved in a fracture dislocation of the right elbow resulting in loss of sensation in the little finger and ring finger?
What nerve is most likely to be involved in a fracture dislocation of the right elbow resulting in loss of sensation in the little finger and ring finger?
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A 75-year-old woman experiences sudden painless loss of vision in her right eye, with a history of similar episodes. Which artery is most likely involved?
A 75-year-old woman experiences sudden painless loss of vision in her right eye, with a history of similar episodes. Which artery is most likely involved?
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In a patient diagnosed with carcinoma of the head of the pancreas, which structure is in close proximity with the affected area?
In a patient diagnosed with carcinoma of the head of the pancreas, which structure is in close proximity with the affected area?
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After undergoing surgery for varicose veins, a patient complains of numbness on the medial side of their foot. Which nerve is most likely involved?
After undergoing surgery for varicose veins, a patient complains of numbness on the medial side of their foot. Which nerve is most likely involved?
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Following a mandibular fracture, a patient experiences loss of sensation over the chin and mucosal surface of the lower lip. Which nerve is most likely affected?
Following a mandibular fracture, a patient experiences loss of sensation over the chin and mucosal surface of the lower lip. Which nerve is most likely affected?
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A patient struck above the knee experiences loss of motor control in the leg, foot drop, and loss of sensation over specific areas. What is the SINGLE most likely anatomical structure to be affected?
A patient struck above the knee experiences loss of motor control in the leg, foot drop, and loss of sensation over specific areas. What is the SINGLE most likely anatomical structure to be affected?
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In a lateral cervical X-ray for neck injury evaluation, which is the lowest vertebra that should be visible on the X-ray?
In a lateral cervical X-ray for neck injury evaluation, which is the lowest vertebra that should be visible on the X-ray?
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Where can a calculus be lodged in the biliary tree to cause obstructive jaundice following cholecystectomy?
Where can a calculus be lodged in the biliary tree to cause obstructive jaundice following cholecystectomy?
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What structure lies just above the midpoint of the inguinal ligament?
What structure lies just above the midpoint of the inguinal ligament?
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At the midpoint between the suprasternal notch and pubic symphysis, what landmark is located?
At the midpoint between the suprasternal notch and pubic symphysis, what landmark is located?
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What is the most likely structure to be damaged causing numbness and weakness on the left hand post prolonged arm hanging?
What is the most likely structure to be damaged causing numbness and weakness on the left hand post prolonged arm hanging?
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What structure is most likely affected causing foot drop and sensory loss between the big toe and second toe post sitting cross-legged?
What structure is most likely affected causing foot drop and sensory loss between the big toe and second toe post sitting cross-legged?
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What is the most likely visual defect following a temporal lobe stroke?
What is the most likely visual defect following a temporal lobe stroke?
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Which lymph node is likely involved in a nonhealing ulcer on the right medial malleolus?
Which lymph node is likely involved in a nonhealing ulcer on the right medial malleolus?
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What is the lymphatic drainage of the testes?
What is the lymphatic drainage of the testes?
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Where is the single most likely location of a collection in the peritoneum in a patient with a known posterior gastric ulcer?
Where is the single most likely location of a collection in the peritoneum in a patient with a known posterior gastric ulcer?
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Which vertebrae is likely to be affected in a patient experiencing back pain at the midpoint of the spine at the level of the iliac crest?
Which vertebrae is likely to be affected in a patient experiencing back pain at the midpoint of the spine at the level of the iliac crest?
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Which is the single most likely tendon to have been damaged in a patient who can only extend the interphalangeal joint of the right thumb but not the metacarpophalangeal joint?
Which is the single most likely tendon to have been damaged in a patient who can only extend the interphalangeal joint of the right thumb but not the metacarpophalangeal joint?
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Which is the single most likely nerve to be affected in a patient presenting with outward gaze, ptosis of the right eye, and seeing double?
Which is the single most likely nerve to be affected in a patient presenting with outward gaze, ptosis of the right eye, and seeing double?
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What is the single most likely anatomical structure to be pierced when inserting a drain in the mid-axillary line?
What is the single most likely anatomical structure to be pierced when inserting a drain in the mid-axillary line?
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What is the single most likely associated injury in a patient with pain on the medial side of the left forearm, weakness of finger abduction and adduction, weakness upon adduction of the thumb, and muscle atrophy in the left hand?
What is the single most likely associated injury in a patient with pain on the medial side of the left forearm, weakness of finger abduction and adduction, weakness upon adduction of the thumb, and muscle atrophy in the left hand?
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In a patient with atrial fibrillation, what is the single most appropriate management based on the clinical presentation provided?
In a patient with atrial fibrillation, what is the single most appropriate management based on the clinical presentation provided?
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Based on the ECG provided, what is the single most likely diagnosis for a patient with sudden central chest pain and shortness of breath?
Based on the ECG provided, what is the single most likely diagnosis for a patient with sudden central chest pain and shortness of breath?
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Which of the following may cause the abnormalities of the QRS axis shown on the ECG provided?
Which of the following may cause the abnormalities of the QRS axis shown on the ECG provided?
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A 72 year old woman has had a stroke a month ago. Which is the SINGLE most likely anatomical site to be affected?
A 72 year old woman has had a stroke a month ago. Which is the SINGLE most likely anatomical site to be affected?
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A 35 year old man is due for surgery to remove a glioma. What is the SINGLE most likely anatomical structure to be opened during the surgery?
A 35 year old man is due for surgery to remove a glioma. What is the SINGLE most likely anatomical structure to be opened during the surgery?
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A 69 year old woman has been diagnosed with left ovary carcinoma. What lymph nodes are likely to be removed?
A 69 year old woman has been diagnosed with left ovary carcinoma. What lymph nodes are likely to be removed?
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A 68 year old woman is unable to extend the interphalangeal joint of her right thumb six weeks following a fracture of the right radius. What is the SINGLE most likely tendon to be damaged?
A 68 year old woman is unable to extend the interphalangeal joint of her right thumb six weeks following a fracture of the right radius. What is the SINGLE most likely tendon to be damaged?
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A 12 year old boy presents with a painful swollen knee after a sudden fall on his right knee. The pain is localized below the knee cap. Which SINGLE anatomical structure is most likely to be affected?
A 12 year old boy presents with a painful swollen knee after a sudden fall on his right knee. The pain is localized below the knee cap. Which SINGLE anatomical structure is most likely to be affected?
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A 34 year old man has a white patch on the margin of the mid-third of his tongue. Which is the SINGLE most likely lymph node involved?
A 34 year old man has a white patch on the margin of the mid-third of his tongue. Which is the SINGLE most likely lymph node involved?
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A 45 year old man has a cancer of the posterior oropharynx. What is the SINGLE most likely lymph node to be involved?
A 45 year old man has a cancer of the posterior oropharynx. What is the SINGLE most likely lymph node to be involved?
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A 36 year old male involved in a street fight presents with bruises and deformity of his lower right knee. The X-ray shows a fracture of the neck of the fibula. What is the SINGLE most associated nerve injury?
A 36 year old male involved in a street fight presents with bruises and deformity of his lower right knee. The X-ray shows a fracture of the neck of the fibula. What is the SINGLE most associated nerve injury?
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Which reflex and innervating spinal nerves are correctly paired?
Which reflex and innervating spinal nerves are correctly paired?
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A 23 year old man is having difficulty in speaking following a stab wound to the right of his neck. On tongue protrusion test, the tip of the tongue is deviated to the right. Which nerve is the SINGLE most likely to be affected in this patient?
A 23 year old man is having difficulty in speaking following a stab wound to the right of his neck. On tongue protrusion test, the tip of the tongue is deviated to the right. Which nerve is the SINGLE most likely to be affected in this patient?
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What anatomical landmark correlates to the tip of the 9th costal cartilage?
What anatomical landmark correlates to the tip of the 9th costal cartilage?
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A 63 year old woman presents with an inability to flex the proximal interphalangeal joint of her fingers of the left hand. What structure is most likely to be injured in her case?
A 63 year old woman presents with an inability to flex the proximal interphalangeal joint of her fingers of the left hand. What structure is most likely to be injured in her case?
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A 63 year old lady with a BMI of 32 has pigmentation on her legs and dilated veins on the lateral aspect of her ankles. Which structure would be involved?
A 63 year old lady with a BMI of 32 has pigmentation on her legs and dilated veins on the lateral aspect of her ankles. Which structure would be involved?
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A 15 year old boy complains of double vision when climbing down the stairs and looking to the right since he was hit in the face. What is the SINGLE most likely nerve to be affected?
A 15 year old boy complains of double vision when climbing down the stairs and looking to the right since he was hit in the face. What is the SINGLE most likely nerve to be affected?
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Which nerve is responsible for the contraction of the external anal sphincter muscle?
Which nerve is responsible for the contraction of the external anal sphincter muscle?
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Which of the following nerves is involved in the knee jerk reflex?
Which of the following nerves is involved in the knee jerk reflex?
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A patient presents with a stab wound to the right of the neck and has difficulty speaking. On tongue protrusion test, the tip of the tongue is deviated to the right. Which nerve is most likely damaged?
A patient presents with a stab wound to the right of the neck and has difficulty speaking. On tongue protrusion test, the tip of the tongue is deviated to the right. Which nerve is most likely damaged?
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Which muscle is innervated by the C6 & C7 nerve roots?
Which muscle is innervated by the C6 & C7 nerve roots?
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Which nerve is responsible for the contraction of the quadriceps muscle?
Which nerve is responsible for the contraction of the quadriceps muscle?
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A patient presents with a fracture of the humerus and has lost sensation over the deltoid region. Which nerve is most likely damaged?
A patient presents with a fracture of the humerus and has lost sensation over the deltoid region. Which nerve is most likely damaged?
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Which anatomical landmark is located above the 5th intercostal space and anterior to the mid-axillary line?
Which anatomical landmark is located above the 5th intercostal space and anterior to the mid-axillary line?
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A patient presents with a injury to the lateral side of the leg below the knee, resulting in bruising, tenderness, inability to dorsiflex or evert the foot, and loss of sensation in specific areas. Which nerve is most likely damaged?
A patient presents with a injury to the lateral side of the leg below the knee, resulting in bruising, tenderness, inability to dorsiflex or evert the foot, and loss of sensation in specific areas. Which nerve is most likely damaged?
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Which cranial nerve is responsible for finger abduction and adduction?
Which cranial nerve is responsible for finger abduction and adduction?
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What is the anatomical landmark located at the level of the 9th rib?
What is the anatomical landmark located at the level of the 9th rib?
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Which muscle is responsible for full extension of the thumb?
Which muscle is responsible for full extension of the thumb?
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What is the artery that descends into the anterior interventricular groove?
What is the artery that descends into the anterior interventricular groove?
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Which nerve is responsible for innervating the extensor digitorum muscle?
Which nerve is responsible for innervating the extensor digitorum muscle?
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What is the superficial vein that travels on the lateral aspect of the ankle?
What is the superficial vein that travels on the lateral aspect of the ankle?
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Which anatomical structure is located about 2.5 cm above the midpoint of the inguinal ligament?
Which anatomical structure is located about 2.5 cm above the midpoint of the inguinal ligament?
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What is the level at which the skin at the medial malleolus drains into the inguinal lymph nodes?
What is the level at which the skin at the medial malleolus drains into the inguinal lymph nodes?
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Which cranial nerve is responsible for the movement of the superior oblique muscle?
Which cranial nerve is responsible for the movement of the superior oblique muscle?
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What is the anatomical landmark found above the 5th intercostal space and anterior to the mid-axillary line?
What is the anatomical landmark found above the 5th intercostal space and anterior to the mid-axillary line?
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Which abdominal structure is in close proximity to the head of the pancreas?
Which abdominal structure is in close proximity to the head of the pancreas?
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Which nerve is responsible for the innervation of the extensor carpi radialis brevis muscle in the upper limb?
Which nerve is responsible for the innervation of the extensor carpi radialis brevis muscle in the upper limb?
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Which muscle is responsible for the abduction of the thumb?
Which muscle is responsible for the abduction of the thumb?
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Which nerve is responsible for the innervation of the flexor digitorum profundus muscle in the upper limb?
Which nerve is responsible for the innervation of the flexor digitorum profundus muscle in the upper limb?
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What is the anatomical structure pierced when inserting a drain in the mid-axillary line?
What is the anatomical structure pierced when inserting a drain in the mid-axillary line?
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Which nerve root injury is associated with movement disorders affecting the intrinsic muscles of the hand?
Which nerve root injury is associated with movement disorders affecting the intrinsic muscles of the hand?
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Which cranial nerve is responsible for the movement of the superior oblique muscle?
Which cranial nerve is responsible for the movement of the superior oblique muscle?
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What is the anatomical landmark located above the 5th intercostal space and anterior to the mid-axillary line?
What is the anatomical landmark located above the 5th intercostal space and anterior to the mid-axillary line?
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Which muscle is innervated by the radial nerve and is responsible for extension of the wrist?
Which muscle is innervated by the radial nerve and is responsible for extension of the wrist?
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What is the name of the tendinous intersection of the rectus abdominis muscle?
What is the name of the tendinous intersection of the rectus abdominis muscle?
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Which nerve is responsible for the innervation of the intercostal muscles?
Which nerve is responsible for the innervation of the intercostal muscles?
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What is the name of the muscle that is innervated by the ulnar nerve and is responsible for adduction of the thumb?
What is the name of the muscle that is innervated by the ulnar nerve and is responsible for adduction of the thumb?
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Which artery is responsible for the blood supply to the liver?
Which artery is responsible for the blood supply to the liver?
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What is the name of the nerve that is responsible for the innervation of the deltoid muscle?
What is the name of the nerve that is responsible for the innervation of the deltoid muscle?
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Which of the following nerves is responsible for the contraction of the external anal sphincter muscle on stroking the skin around the anus?
Which of the following nerves is responsible for the contraction of the external anal sphincter muscle on stroking the skin around the anus?
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Which of the following muscles is responsible for wrist extension with radial deviation?
Which of the following muscles is responsible for wrist extension with radial deviation?
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Which of the following spinal nerves is responsible for the knee jerk reflex?
Which of the following spinal nerves is responsible for the knee jerk reflex?
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Which of the following nerves is responsible for the contraction of the quadriceps muscle?
Which of the following nerves is responsible for the contraction of the quadriceps muscle?
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A 23-year-old man is having difficulty speaking following a stab wound to the right of his neck. On tongue protrusion test, the tip of the tongue is deviated to the right. Which nerve is most likely affected?
A 23-year-old man is having difficulty speaking following a stab wound to the right of his neck. On tongue protrusion test, the tip of the tongue is deviated to the right. Which nerve is most likely affected?
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Which of the following muscles is responsible for plantar flexion of the foot?
Which of the following muscles is responsible for plantar flexion of the foot?
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Which of the following spinal nerves is responsible for the innervation of the biceps brachii muscle?
Which of the following spinal nerves is responsible for the innervation of the biceps brachii muscle?
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Which of the following nerves is responsible for the innervation of the triceps brachii muscle?
Which of the following nerves is responsible for the innervation of the triceps brachii muscle?
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Which nerve is responsible for finger abduction and adduction?
Which nerve is responsible for finger abduction and adduction?
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What is the anatomical landmark at the level of the first lumbar vertebra?
What is the anatomical landmark at the level of the first lumbar vertebra?
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Which muscle is responsible for full extension of the right thumb?
Which muscle is responsible for full extension of the right thumb?
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Which vein is the only one that travels on the lateral aspect of the ankle?
Which vein is the only one that travels on the lateral aspect of the ankle?
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Which artery appears to be a direct continuation of the left coronary artery?
Which artery appears to be a direct continuation of the left coronary artery?
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What is the anatomical landmark where the fundus of the gallbladder approaches the surface?
What is the anatomical landmark where the fundus of the gallbladder approaches the surface?
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Which nerve is responsible for innervating the superior oblique muscle?
Which nerve is responsible for innervating the superior oblique muscle?
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What is the SINGLE most likely structure affected in a patient with an inability to extend the distal phalanx of the ring finger?
What is the SINGLE most likely structure affected in a patient with an inability to extend the distal phalanx of the ring finger?
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Study Notes
Haematology Study Notes
Question Format
- Questions are formatted with a unique number and topic name
- The topic name is followed by an HTML format indicator
- Clinical scenario question stems are provided, followed by five answer choices
- Correct answers are prefixed with = and suffixed with # and an explanation
- Incorrect answers are prefixed with ~ and suffixed with # and an explanation of why the answer is wrong
Exam Preparation
- The questions are designed for AKT and PLAB1 preparation
- The questions are intended to help doctors prepare for their exam and pass to get GMC registration
- Questions are in the form of clinical scenarios and match the required level of difficulty
Question Structure
- Each question block is separated by an empty line
- The correct answer is explained and justified
- Incorrect answers are explained and justified with reasons why they are incorrect and why the correct answer is correct
Haematology
- Abnormal blood film: peripheral blood film, differential white cell count, pancytopenia, bone marrow failure, ESR, hyperviscosity syndrome
- Haematological malignancies and myeloproliferative disorders: leukaemia, myeloma, paraproteinemia, amyloidosis
- Bleeding disorders: intrinsic and extrinsic pathways, anticoagulants, thrombophilia, inherited bleeding disorders, anaemia of any cause
- Immunodeficiency disorders: immunosuppressive drugs, anaemia of chronic disease, sideroblastic anaemia, macrocytic anaemia, haemolytic anaemia, sickle cell anaemia, thalassaemia
Cardiovascular
- Chest pain: acute myocardial infarction, acute coronary syndrome, angina pectoris
- Heart murmurs: any cause
- Hypertension: all causes, including risk factors
- Palpitations: bradycardia, narrow complex tachycardia, atrial fibrillation and flutter, broad complex tachycardia, pacemakers
- Peripheral arterial disease: aneurysms, ischaemic limb, occlusions
- Peripheral venous problems: VTE, DVT, risk factors, varicose veins, inflammatory conditions
Breast Lump and/or Pain
- Cancer
- Infection: abscess, puerperal mastitis
- Benign: fibro-adenoma, fibro-adenosis, fat necrosis, cysts
- Nipple discharge
Developmental Problems
- Congenital abnormalities: VSD, ASD, PDA, aortic stenosis, pulmonary stenosis, coarctation of the aorta, Fallot's tetralogy
- Developmental delay: endocrine problems, metabolic disorders, malabsorption, inadequate diet
- Psychological and social: non-accidental injury, sexual abuse, emotional deprivation, bullying, manifestations of neglect
Digestive
- Abdominal mass: organomegaly, hernias, ascites
- Abdominal pain: perforation, obstruction, ischaemia, aneurysm, bleeding, dysphagia
- Upper GI problems: nausea and vomiting, infections, pyloric stenosis, drug-induced, constipation
- Lower GI problems: faecal incontinence, spurious diarrhoea, encopresis, cancer, ulceration, bleeding, abnormal anatomy
ENT
- Earache: any cause
- Hearing problems: any cause
- Hoarseness and stridor: any cause
- Nasal symptoms: cancer, bleeding, nasal obstruction, infections, trauma
Endocrine
- Diabetes mellitus: type 1, type 2, complications, diabetic foot care, hypoglycaemia/hyperglycaemia
- General: hyperparathyroidism, hypoparathyroidism, multiple endocrine neoplasia
- Adrenal: Addisonian crisis, Addison's disease, hyperaldosteronism, phaeochromocytoma, virilism
- Thyroid disorders: cancer, hyperthyroidism, hypothyroidism, thyroid eye disease, goitre, nodules
Eye
- Eye pain: cancer, sinusitis, glaucoma, migraine
- Orbital swelling: cancer, infection, thyroid disease, cysts: congenital and acquired
- Red eye: infection, conjunctivitis, iritis, trauma, scleritis/episcleritis
- Visual impairment: tumours, arterial and venous, lens, degenerative, hereditary, systemic conditions, infections, detached retina
Haemostatic
- Acid-base imbalance and blood gas abnormalities
- Electrolyte abnormalities: sodium, potassium, glucose, calcium, magnesium
Infectious Disease
- Hospital-acquired infection: infection control, MRSA, C.diff
- Serious infection: HIV, AIDS, Hep B, TB
- Travel medicine and tropical infections: any cause### Medical Conditions and Symptoms
- Urethral Discharge: causes include Infection, Cancer, Foreign body, and STI
- Vaginal Discharge: causes include Pruritis vulvae, Normal physiological, Cancer, and Infection
- Viral Infections: include Exanthemata, Mumps, Measles, Rubella, Herpes simplex, Herpes zoster, Viral meningitis, and Influenza
- Mental Health:
- Alcohol and drug misuse and dependence
- Anxiety disorders, including Generalized anxiety disorder, Phobias, and OCD
- Deliberate self-harm and suicidal risk
- Eating Problems, including Anorexia and Bulimia nervosa
- Learning and communication problems, including Intellectual disability and Acquired brain injury
- Medically-unexplained physical symptoms, including Somatisation disorders
- Mood/affective problems, including Depressive disorders and Bipolar disorders
- Organic Brain Syndrome, including Delirium, Dementia, and Encephalopathy
- Personality and behavioural disorders, including Emotionally unstable personality disorder and Antisocial personality disorder
- Psychosis, including Schizoaffective disorder
Musculoskeletal
- Back and Neck: disorders and injuries
- Connective tissue Disorders: including Rheumatoid arthritis, Osteoarthrosis, Psoriatic arthritis, and Gout
- Foot and Ankle: disorders and injuries
- Hand and Wrist: disorders and injuries
- Hip: disorders and injuries
- Knee: disorders and injuries
- Rheumatological problems: including Rheumatoid arthritis, Osteoarthrosis, Psoriatic arthritis, and Gout
- Skeletal: disorders and injuries, including Disorders of calcium homeostasis, Infections, Tumours, and Fractures
- Upper limb: disorders and injuries
Neurological
- Blackouts and Faints: causes and types
- Cranial Nerve Problems: including Visual field defects, Multiple sclerosis, and Bell's palsy
- Falls: causes and types
- Headache: causes and types
- Movement Disorders: including Tremor, Chorea, Athetosis, and Parkinson's disease
- Peripheral Nerve Problems: including Neuropathies, Mononeuropathies, and Polyneuropathies
- Seizure: causes and types
- Speech and Language: disorders and impairments
- Weakness and Fatigue: causes and types
Renal
- Urine Abnormalities: including Blood, Protein, pH, and Volumes
- Renal Calculi: including Nephrolithiasis and Ureterolithiasis
- Renal Problems: including Acute kidney injury, Chronic kidney disease, and Renal failure
- Urinary Excretion: including Oliguria and Polyuria
- Urinary Symptoms: including Dysuria, Frequency, and Incontinence
Reproductive
- Contraception: methods and types
- Fertility Problems: including Male and Female infertility
- Normal Pregnancy and Care: including prenatal diagnosis and role of folic acid
- Pelvic Mass: including Ectopic pregnancy and Pelvic inflammatory disease
- Problems in Pregnancy: including Antepartum haemorrhage, Postpartum haemorrhage, and Miscarriage
Respiratory
- Breathlessness: causes and types
- Chest Pain: causes and types
- Cough and Haemoptysis: causes and types
- Respiratory Failure: causes and types
- Wheeze and Stridor: causes and types
Seriously Ill Patient
- Collapse: causes and types
- Fever and Infection: causes and types
- Multiple Trauma: including head injury and intra-abdominal injury
- Shock: causes and types
Skin
- Bites and Stings: including Insect, Fish, Scorpion, Snake, and Human bites
- Bullous Disorders: including Pemphigus and Pemphigoid
- Dermatological Manifestations of Systemic Disease: including Endocrine, Cancer, and Connective tissue disorders
- Extreme of Temperature: including Burns, Frostbite, Hyperthermia, and Hypothermia
- Hair and Nail: including Excess hair, Hair loss, and Nail changes in systemic diseases### Anatomy and Physiology
Biliary System
- Hepatopancreatic ampulla (Ampulla of Vater) is formed by the pancreatic duct and common bile duct, opening into the second part of the duodenum.
Neurology
- Radial nerve (C5-T1): motor functions include extension of forearm, wrist, and fingers; sensory functions include the dorsal aspect of the root of the thumb and the area between the 1st and 2nd metacarpals; damage leads to wrist drop and loss of extension of the wrist and fingers.
- Common peroneal nerve: innervates the muscles in the anterior compartment of the leg, responsible for dorsiflexion of the foot at the ankle joint; sensory functions include the webbed space of skin between the great toe and the second toe; damage leads to foot drop and loss of dorsiflexion of the foot.
- Ulnar nerve (C8-T1): sensory loss in the little finger and a variable area of the ring finger; injury level determines severity of claw deformity.
- Trochlear nerve (IV): innervates the superior oblique muscle; diplopia on downgaze (looking downwards).
Lymphatic System
- Skin at the medial malleolus drains into inguinal lymph nodes.
Orthopedics
- Transpyloric plane: located halfway between the jugular notch and the upper border of the pubic symphysis, passes through the pylorus of the stomach, the tips of the ninth costal cartilages, and the lower border of the first lumbar vertebra.
- Deep inguinal ring: located about 2.5 cm above the midpoint of the inguinal ligament.
Surgery
- Chest drain insertion: important landmark above the 5th intercostal space and anterior to the mid-axillary line.
Ophthalmology
- Central retinal artery: supplies the retina; occlusion leads to sudden painless loss of vision, often with a history of amaurosis fugax (temporary loss of vision).
Oncology
- Carcinoma of the head of the pancreas: commonly presents with jaundice due to obstruction of the common bile duct.
Neurosurgery
- Cervical spine injury: a lateral cervical X-ray should extend up to C7/T1 to rule out cervical fractures.
Orthopedic Injuries
- Biceps tendon rupture: weakness and lump at distal arm, leading to weakness of flexion and supination.
- Peroneal strike: a temporarily disabling blow to the common peroneal nerve, causing loss of motor control of the leg, accompanied by numbness and painful tingling sensation from the point of impact down to the leg.
Reflexes and Innervation
- Anal reflex: Contraction of external anal sphincter muscle on stroking the skin around the anus; Innervated by S2-S4
- Ankle reflex: Plantar flexion of the foot caused by striking the Achilles tendon; Innervated by S1&S2 via Sciatic nerve
- Knee (patella) reflex: Contraction of the quadriceps muscle caused by striking the patellar ligament; Innervated by L3 & L4 via Femoral nerve
- Biceps reflex: Flexion at the elbow caused by striking the biceps brachii tendon; Innervated by C5 & C6 via Musculocutaneous nerve
- Brachioradialis (supinator reflex): Wrist extension with radial deviation caused by striking the brachioradialis; Innervated by C6 & C7 via Radial nerve
- Triceps reflex: Extension caused by striking the triceps brachii tendon; Innervated by C6 & C7 via Radial nerve
Nerve Injuries
- Right oculomotor nerve: Associated with difficulty in speaking and tongue protrusion test deviating to the right
- T1 nerve root injury: Presents with movement disorders affecting the intrinsic muscles of the hand (e.g., adduction or abduction of the digits), paraesthesiae, and pain
- C8 nerve root lesion: Presents with abnormalities of thumb movement primarily and an inability to extend the elbow against resistance
- Ulnar nerve injury: Leads to the classic ‘claw hand’ deformity, originates from the C8-T1 nerve roots, and is associated with sensory loss over the little finger and a variable area of the ring finger
Anatomy
- Extensor digitorum: Responsible for extending the distal phalanx of the finger
- Ulnar nerve: Sensory loss is over the little finger and a variable area of the ring finger (palmar & dorsal), determines severity of claw deformity
- Short saphenous vein: Travels on the lateral aspect of the ankle
- Great or long saphenous vein: Travels on the medial aspect of the ankle
- Left anterior descending (LAD) artery: Appears to be a direct continuation of the left coronary artery, descends into the anterior interventricular groove
- Medial malleolus: Skin drains into inguinal lymph nodes
- First lumbar vertebra: Level with the anterior end of the ninth rib, also known as the transpyloric plane, where the pylorus of the stomach is located
- Deep inguinal ring: Located about 2.5 cm above the midpoint of the inguinal ligament
- Extensor pollicis longus: Responsible for full extension of the right thumb
- Fundus of the gall-bladder: Approaches the surface behind the anterior end of the ninth right costal cartilage, close to the lateral margin of the Rectus abdominis
Reflexes and Innervation
- Anal reflex: Contraction of external anal sphincter muscle on stroking the skin around the anus; Innervated by S2-S4
- Ankle reflex: Plantar flexion of the foot caused by striking the Achilles tendon; Innervated by S1&S2 via Sciatic nerve
- Knee (patella) reflex: Contraction of the quadriceps muscle caused by striking the patellar ligament; Innervated by L3 & L4 via Femoral nerve
- Biceps reflex: Flexion at the elbow caused by striking the biceps brachii tendon; Innervated by C5 & C6 via Musculocutaneous nerve
- Brachioradialis (supinator reflex): Wrist extension with radial deviation caused by striking the brachioradialis; Innervated by C6 & C7 via Radial nerve
- Triceps reflex: Extension caused by striking the triceps brachii tendon; Innervated by C6 & C7 via Radial nerve
Nerve Injuries
- Right oculomotor nerve: Associated with difficulty in speaking and tongue protrusion test deviating to the right
- T1 nerve root injury: Presents with movement disorders affecting the intrinsic muscles of the hand (e.g., adduction or abduction of the digits), paraesthesiae, and pain
- C8 nerve root lesion: Presents with abnormalities of thumb movement primarily and an inability to extend the elbow against resistance
- Ulnar nerve injury: Leads to the classic ‘claw hand’ deformity, originates from the C8-T1 nerve roots, and is associated with sensory loss over the little finger and a variable area of the ring finger
Anatomy
- Extensor digitorum: Responsible for extending the distal phalanx of the finger
- Ulnar nerve: Sensory loss is over the little finger and a variable area of the ring finger (palmar & dorsal), determines severity of claw deformity
- Short saphenous vein: Travels on the lateral aspect of the ankle
- Great or long saphenous vein: Travels on the medial aspect of the ankle
- Left anterior descending (LAD) artery: Appears to be a direct continuation of the left coronary artery, descends into the anterior interventricular groove
- Medial malleolus: Skin drains into inguinal lymph nodes
- First lumbar vertebra: Level with the anterior end of the ninth rib, also known as the transpyloric plane, where the pylorus of the stomach is located
- Deep inguinal ring: Located about 2.5 cm above the midpoint of the inguinal ligament
- Extensor pollicis longus: Responsible for full extension of the right thumb
- Fundus of the gall-bladder: Approaches the surface behind the anterior end of the ninth right costal cartilage, close to the lateral margin of the Rectus abdominis
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Review and prepare for your AKT and PLA exams with these haematology study notes. Questions and answers are formatted for easy learning and retention.
