diff --git a/isic/ingest/services/accession/review.py b/isic/ingest/services/accession/review.py
index 10ad7b69..04bc0aa0 100644
--- a/isic/ingest/services/accession/review.py
+++ b/isic/ingest/services/accession/review.py
@@ -2,6 +2,7 @@
 
 from django.contrib.auth.models import User
 from django.core.exceptions import ValidationError
+from django.db import transaction
 from django.utils import timezone
 
 from isic.ingest.models.accession import Accession
@@ -29,22 +30,25 @@ def accession_review_bulk_create(*, reviewer: User, accession_ids_values: dict[i
     accession_reviews = []
     reviewed_at = timezone.now()
 
-    for accession in Accession.objects.select_related("image").filter(
-        pk__in=accession_ids_values.keys()
-    ):
-        if accession.published:
-            raise ValidationError("Cannot review an accession after publish.")
-
-        accession_reviews.append(
-            AccessionReview(
-                accession=accession,
-                creator=reviewer,
-                reviewed_at=reviewed_at,
-                value=accession_ids_values[accession.pk],
+    with transaction.atomic():
+        for accession in (
+            Accession.objects.select_related("image")
+            .filter(pk__in=accession_ids_values.keys())
+            .select_for_update(of=("self",))
+        ):
+            if accession.published:
+                raise ValidationError("Cannot review an accession after publish.")
+
+            accession_reviews.append(
+                AccessionReview(
+                    accession=accession,
+                    creator=reviewer,
+                    reviewed_at=reviewed_at,
+                    value=accession_ids_values[accession.pk],
+                )
             )
-        )
 
-    AccessionReview.objects.bulk_create(accession_reviews)
+        AccessionReview.objects.bulk_create(accession_reviews)
 
 
 def accession_review_delete(*, accession: Accession):
diff --git a/isic/ingest/views/review.py b/isic/ingest/views/review.py
index c70f4d5f..2573fe96 100644
--- a/isic/ingest/views/review.py
+++ b/isic/ingest/views/review.py
@@ -12,6 +12,8 @@
 
 from . import make_breadcrumbs
 
+REVIEW_PER_PAGE = 500
+
 
 def _cohort_review_progress(cohort: Cohort) -> dict:
     num_reviewed = cohort.accessions.reviewed().count()
@@ -20,7 +22,9 @@ def _cohort_review_progress(cohort: Cohort) -> dict:
     return {
         "num_reviewed": num_reviewed,
         "num_reviewable": num_reviewable,
-        "percentage": 0 if num_reviewable == 0 else math.floor(num_reviewed / num_reviewable * 100),
+        "percentage": 0
+        if num_reviewable == 0
+        else math.floor(num_reviewed / num_reviewable * REVIEW_PER_PAGE),
     }
 
 
@@ -45,7 +49,9 @@ def cohort_review(request, cohort_pk):
     if request.GET.get("grouped_by_lesion"):
         return _cohort_review_grouped_by_lesion(request, cohort)
 
-    paginator = Paginator(cohort.accessions.unreviewed().order_by("original_blob_name"), 100)
+    paginator = Paginator(
+        cohort.accessions.unreviewed().order_by("original_blob_name"), REVIEW_PER_PAGE
+    )
     page = paginator.get_page(request.GET.get("page"))
 
     return render(