$re = '/(> \[!anki]- .+(?:\n[>^].*)*)(?:\n<!-- end of flashcard -->)?/';
$str = '> [!anki]- Title
> Answer
> [!anki]- Title
> Answer
<!-- end of flashcard -->
> [!anki]- Title
> Answer
> Another line
> Another line
> [!anki]- Title
> Answer
^7a6a36';
$subst = "$1\n<!-- end of flashcard -->";
$result = preg_replace($re, $subst, $str);
echo "The result of the substitution is ".$result;
Please keep in mind that these code samples are automatically generated and are not guaranteed to work. If you find any syntax errors, feel free to submit a bug report. For a full regex reference for PHP, please visit: http://php.net/manual/en/ref.pcre.php