When i try to manage random questions

when i try to add something i get this error please help quickly
Error messagePDOException: SQLSTATE[23000]: Integrity constraint violation: 1062 Duplicate entry '109-161-1-1' for key 'PRIMARY': INSERT INTO {quiz_node_relationship} (parent_nid, child_nid, child_vid, question_status, weight, max_score, parent_vid) VALUES (:db_insert_placeholder_0, :db_insert_placeholder_1, :db_insert_placeholder_2, :db_insert_placeholder_3, :db_insert_placeholder_4, :db_insert_placeholder_5, :db_insert_placeholder_6), (:db_insert_placeholder_7, :db_insert_placeholder_8, :db_insert_placeholder_9, :db_insert_placeholder_10, :db_insert_placeholder_11, :db_insert_placeholder_12, :db_insert_placeholder_13), (:db_insert_placeholder_14, :db_insert_placeholder_15, :db_insert_placeholder_16, :db_insert_placeholder_17, :db_insert_placeholder_18, :db_insert_placeholder_19, :db_insert_placeholder_20), (:db_insert_placeholder_21, :db_insert_placeholder_22, :db_insert_placeholder_23, :db_insert_placeholder_24, :db_insert_placeholder_25, :db_insert_placeholder_26, :db_insert_placeholder_27), (:db_insert_placeholder_28, :db_insert_placeholder_29, :db_insert_placeholder_30, :db_insert_placeholder_31, :db_insert_placeholder_32, :db_insert_placeholder_33, :db_insert_placeholder_34), (:db_insert_placeholder_35, :db_insert_placeholder_36, :db_insert_placeholder_37, :db_insert_placeholder_38, :db_insert_placeholder_39, :db_insert_placeholder_40, :db_insert_placeholder_41); Array ( [:db_insert_placeholder_0] => 109 [:db_insert_placeholder_1] => 1 [:db_insert_placeholder_2] => 1 [:db_insert_placeholder_3] => 1 [:db_insert_placeholder_4] => 1 [:db_insert_placeholder_5] => 1 [:db_insert_placeholder_6] => 161 [:db_insert_placeholder_7] => 109 [:db_insert_placeholder_8] => 9 [:db_insert_placeholder_9] => 9 [:db_insert_placeholder_10] => 9 [:db_insert_placeholder_11] => 9 [:db_insert_placeholder_12] => 9 [:db_insert_placeholder_13] => 161 [:db_insert_placeholder_14] => 109 [:db_insert_placeholder_15] => 1 [:db_insert_placeholder_16] => 1 [:db_insert_placeholder_17] => 1 [:db_insert_placeholder_18] => 1 [:db_insert_placeholder_19] => 1 [:db_insert_placeholder_20] => 161 [:db_insert_placeholder_21] => 109 [:db_insert_placeholder_22] => 1 [:db_insert_placeholder_23] => 1 [:db_insert_placeholder_24] => 1 [:db_insert_placeholder_25] => 1 [:db_insert_placeholder_26] => 1 [:db_insert_placeholder_27] => 161 [:db_insert_placeholder_28] => 109 [:db_insert_placeholder_29] => 9 [:db_insert_placeholder_30] => 9 [:db_insert_placeholder_31] => 9 [:db_insert_placeholder_32] => 9 [:db_insert_placeholder_33] => 9 [:db_insert_placeholder_34] => 161 [:db_insert_placeholder_35] => 109 [:db_insert_placeholder_36] => 1 [:db_insert_placeholder_37] => 1 [:db_insert_placeholder_38] => 1 [:db_insert_placeholder_39] => 1 [:db_insert_placeholder_40] => 1 [:db_insert_placeholder_41] => 161 ) in quiz_update_quiz_question_relationship() (line 1749 of /home/ganimhas/public_html/sites/all/modules/quiz/quiz.module).