Built by medical students

Find what you’re missing.

You already do the reviews. Lacuna reads them and finds the concepts you keep getting wrong: the ones you would never have thought to study.

Join the free beta See what it finds

General medicine

Calcium phosphate abnormal

Choose appropriate management for calcium phosphate abnormal

Where learners go wrong

A common error is treating the low calcium number reflexively while overlooking the phosphate excess and evolving tumour lysis syndrome. Calcium can form calcium-phosphate precipitates, so routine replacement of asymptomatic hypocalcaemia may worsen tissue or renal deposition.

Pathophysiology

Rapid destruction of tumour cells releases intracellular phosphate and potassium. Hyperphosphataemia binds circulating calcium, and the resulting crystal deposition drives acute kidney injury.

Red flags

Seizures, tetany, significant arrhythmia, severe hyperkalaemia, oliguria or anuria, or rapidly worsening kidney function require urgent escalation.

First-line treatment

Urgent supportive care with isotonic IV fluids, discontinuation of contributing agents, and close electrolyte and renal monitoring.

Clinical features

Differential distinction

Investigation

Worked example

Next time

Your study priorities

Focus areas

Concepts that have come up wrong more than once, ranked by how much your reviews point to them.

TopicRelated missesEvidence confidenceStatus

OncologyManagement of calcium phosphate abnormal2 of 895%Persistent

CardiovascularWide pulse pressure in regurgitant flow4 of 991%Persistent

RenalDistinguishing pre-renal from intrinsic injury3 of 788%Persistent

Review analysis

Insights

See what each review tested, how confident the analysis is, and correct anything that looks wrong.

Intake

Reviews received

819reviews from your connected sources

60 analyzed and shown below.

Method and budget

How your reviews were analyzed

On-device analysis always runs and never leaves your machine. AI analysis sends a content-free description of the learning objective to a provider.

387on your device432with AI assistance

What it finds

The mistakes you don’t know you’re making.

One wrong answer is noise. The same idea missed the same way, three weeks apart, in Anki and again in a case: that is a gap, and it is the kind you cannot see from inside your own study.

Your study priorities

Focus areas

Concepts that have come up wrong more than once, ranked by how much your reviews point to them.

TopicRelated missesEvidence confidenceStatus

OncologyManagement of calcium phosphate abnormal2 of 895%Persistent

CardiovascularWide pulse pressure in regurgitant flow4 of 991%Persistent

RenalDistinguishing pre-renal from intrinsic injury3 of 788%Persistent

Written for your mistake

Not a textbook page. The explanation opens on the part you actually got wrong, and ends with the one sentence to carry into the next question.

Across both your sources

The same concept missed in Anki and in a clinical case counts once, not twice. Cross-source matching is the point of connecting both.

Every result is auditable

You can see how each review was understood: topic, objective, confidence, route. You can correct it, and nothing is presented as mastery or competence.

Explanations

An explanation written for your mistake.

Ask for any concept and you get an explanation shaped around the mistake you actually made, not a textbook page to search through. A disease opens on pathophysiology, a drug on mechanism, and whichever part you got wrong is already open.

Pathophysiology
Mechanism
Clinical features
Diagnostic criteria
Differential distinctions
Investigations
First-line treatment
Drug class examples
Red flags
Complications

General medicine

Calcium phosphate abnormal

Choose appropriate management for calcium phosphate abnormal

Where learners go wrong

Pathophysiology

Rapid destruction of tumour cells releases intracellular phosphate and potassium. Hyperphosphataemia binds circulating calcium, and the resulting crystal deposition drives acute kidney injury.

Red flags

Seizures, tetany, significant arrhythmia, severe hyperkalaemia, oliguria or anuria, or rapidly worsening kidney function require urgent escalation.

First-line treatment

Urgent supportive care with isotonic IV fluids, discontinuation of contributing agents, and close electrolyte and renal monitoring.

Clinical features

Differential distinction

Investigation

Worked example

Next time

Any concept, any system, at the depth the concept deserves. It keeps improving as the people using it correct what they find.

The library

Every concept you study, already covered.

Whatever you study is already here, or will be the moment you study it. The library grows from what learners actually review, so it covers your curriculum rather than someone else’s.

Everything you have studied

Concept library

Every concept your reviews have touched, with how it is going and when you last saw it.

OncologyRepeatedly missedCalcium phosphate abnormalLast reviewed Sep 18

CardiovascularGetting thereAortic regurgitationLast reviewed Sep 18

RenalSolidAcute tubular necrosisLast reviewed Sep 18

EndocrineSolidThyroid function interpretationLast reviewed Sep 18

NeurologyNot yet seenStroke territory localisationLast reviewed Sep 18

RespiratoryGetting thereObstructive versus restrictiveLast reviewed Sep 18

Your library, and everyone’s

See only the concepts your own reviews have touched, or the whole communal library that every learner is improving.

Explanations that stay current

When someone corrects a fact, it is corrected everywhere it appears, so what you read has survived every learner who met it before you.

It gets better as you use it

The library grows from ordinary study rather than curation, so the concepts your cohort actually reviews are the ones that get deepest.

Peer review

Every fact has someone’s name on it.

AI writes the first draft. The people using it correct what is wrong, and approved reviewers put their name to what is right.

AI-written

Thiazides are first-line for hypertension in most patients.

Attested · 3 reviewers

Thiazides are first-line for hypertension in patients over 55, or of Black African or Caribbean origin at any age. ACE inhibitors come first otherwise.

A learner reading this spotted the missing qualifier. One correction, and every explanation built on that fact changed with it.

Auditable by design

Nothing about you is guessed at.

Before Lacuna tells you a concept is a problem, you can see exactly which reviews led it there and how sure it was about each one. Disagree with any of them and say so.

Your recent activity

Recent reviews

Open one to confirm or correct how it was mapped.

The confidence score shows how sure Lacuna is about this topic. It does not measure how well you know it.

Diagnostic imagingMusculoskeletal tumour workup → Diagnostic imaging · Clinical decisionANKI · AI analysis · Sep 20, 11:53 p.m.86%Clear match

Loop diureticsDiuretics → Loop diuretics · NKCC2 inhibition · Understanding mechanismANKI · On-device analysis · Sep 20, 11:53 p.m.98%Clear match

Interpretation needs reviewUnmapped topic · task not classifiedANKI · On-device analysis · Sep 20, 11:52 p.m.41%Needs review

How it works

Study the way you already do.

1Review as usual

An Anki add-on and a browser extension record that a review happened and how it went.

2Each review is mapped

A model assigns the topic and learning objective. You can see and correct every mapping.

3Patterns surface

Versioned, deterministic code decides when a repeat becomes a focus area. Not the model.

4You study smarter

An explanation written for the mistake you actually made, checked by other learners.

Where it runs

No new place to study.

Lacuna works inside the tools you already open. Nothing to migrate, no deck to import.

Study sources

Connections

Connect Anki or any question bank. Install the connector once and reviews sync automatically from there.

Connected2 active installations819reviews received

Anki

Reviews sync automatically after each session.

1 installationAnki on Mac

Question banks

After you submit an answer, Lacuna records the outcome.

1 installationCARDS in Chrome

Plans

Free during the beta.

Plans differ by how much AI analysis you get, how many devices you connect, and how far back your history goes. Analysis on your own device never runs out, and nothing is charged automatically.

Pulse

One learner, one device. Everything stays yours.

25AI analyses / month

1connected device

14 daysof history kept

On-device analysis is unlimited.

Signal

Your full history, across Anki and your question bank.

1,000AI analyses / month

5connected devices

365 daysof history kept

Peer-review points add to this allowance.

Atlas

For programs running Lacuna across a cohort.

5,000AI analyses / month

10connected devices

730 daysof history kept

Adds privacy-preserving cohort analytics.

These allowances are initial beta controls, not final prices.

Privacy

Your cards never leave your device.

Lacuna needs to know that you reviewed something and whether you got it right. It does not need to see it.

What Lacuna receives

That a review happened, the concept it belongs to, and whether you got it right.

What it never receives

Card fronts and backs, note fields, question and answer text, images, screenshots.

Turning on AI analysis sends a concept name and objective, never your material. You switch it on per device, and it works without it.

Start with the reviews you have already done.

Connect Anki or a question bank, keep studying exactly as you do now, and let Lacuna find what keeps going wrong.

Join the free beta