afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: General_Surgery
 A patient with an opening in the chest wall, such as from a gunshot, stab wound or impalement, resulting in "sucking chest wound" can be said to have:

Answer options: option1: An open pneumothorax
option2: A simple pneumothorax
option3: A massive haemothorax
option4: A pleural effusion
option5: A flail chest
Correct answer: option1
Specialty: General_Surgery
An 18-year old girl is brought to the emergency department with worsening severe lower abdominal pain that started 6 hours ago. Her abdomen is tender particularly in the lower quadrants and there is guarding. She is tachycardic but her blood pressure is 135/78 mmHg. Which one of the following is the most important diagnosis that you should rule out/confirm in this patient?

Answer options: option1: Acute appendicitis
option2: Pelvic inflammatory disease
option3: Acute intestinal obstruction
option4: Ectopic pregnancy
option5: Intestinal obstruction
Correct answer: option4
Specialty: General_Surgery
A 47 year old lady presents to the emergency department with complaints of epigastric pain. She also feels nauseated and has vomited several times over the past 24 hours. The pain did not respond to over the counter antacids which she tried. On examination she was an obese lady. Her liver enzymes were marginally elevated.
What is the most likely diagnosis in this patient

Answer options: option1: Acute appendicitis
option2: Acute cholecystitis
option3: Acute ovarian torsion
option4: Diverticulitis
option5: n/a
Correct answer: option2
Specialty: General_Surgery
A 47 year old lady presents to the emergency department with complaints of epigastric pain. She also feels nauseated and has vomited several times over the past 24 hours. The pain did not respond to over the counter antacids which she tried. On examination she was an obese lady. Her liver enzymes were marginally elevated.
Which ONE of the following is the most appropriate next investigation for this patient?

Answer options: option1: Erect abdominal X-ray
option2: Endoscopy
option3: Ultrasound scan of the abdomen
option4: H1 breath test for Helicobacter Pylori
option5: n/a
Correct answer: option3
Specialty: General_Surgery
A 79-year-old man has had abdominal pain for 4 days. An operation is performed, and a gangrenous appendix is removed. Why does acute appendicitis in elderly patients and in children have a worse prognosis?

Answer options: option1: The appendix is retrocecal.
option2: There may be a delay in establishing the right diagnosis in these age groups.
option3: The appendix is in the pelvic position.
option4: The omentum and peritoneal cavity appear to be less efficient in localizing the disease in these age groups.
option5: B and D.
Correct answer: option5
Specialty: General_Surgery
 A 24-year old male patient comes to the emergency department with complaints of abdominal pain for 1 day. He reports that the pain is progressively worsening and located mainly in the right lower quadrant and does not radiate. He has had 2 episodes of vomiting and reports loss of appetite since the pain began. On examination he is sick-looking. His heart rate is 124/min and blood pressure is 120/78 mmHg. His temperature is 37.8. there is right iliac fossa tenderness but no rebound tenderness. The patient has an elevated C-reactive protein of 201 (normal 0-5). Full hemogram shows Hemoglobin of 14, white cell count of 22 (normal 4-11) with neutrophils of 95%
The ALVARADO score in this patient is

Answer options: option1: 8
option2: 7
option3: 6
option4: 3
option5: n/a
Correct answer: option1
Specialty: General_Surgery
A 20-year old female presents with complaints of general abdominal pain. she reports multiple episodes of diarrhea and vomiting. On examination she is afebrile but appears moderately dehydrated. Her abdomen is moderately tender in the peri-umbilical and epigastric regions. There is no guarding or rebound tenderness. Her white cell count is normal. Which of the following statements correctly describes the next course of management?

Answer options: option1: A diagnosis of acute abdomen should be made and laparotomy performed immediately
option2: An abdominal CT scan is required to determine the pathology
option3: Insert a nasogastric tube to decompress the stomach
option4: Non surgical causes of acute abdomen should be considered
option5: Do an urgent MRI of the abdomen
Correct answer: option4
Specialty: General_Surgery
Which of the following tests should be reviewed to work up a patient for pancreatitis? 

Answer options: option1: Lipase, amylase, triglycerides
option2: Amylase, serum calcium, hemoglobin
option3: Triglycerides, hemoglobin, serum glucose
option4: Alanine aminotransferase (ALT), lipase, serum magnesium
option5: n/a
Correct answer: option1
Specialty: General_Surgery
You are asked to see a 35-year old female who sustained a head injury during a road traffic accident. The patient was stable upon arrival to the emergency department but over the last hour his GCS has fallen from 15/15 to 13/15 and is now is drowsy and complaining of a headache. What is the most appropriate next step to take in the patient’s management?

Answer options: option1: Repeat the GCS score in another 3 hours
option2: Speak with the neurosurgeon on call with a view of taking the patient to theatre
option3: Prescribe adequate analgesia
option4: Request an urgent CT scan of the head
option5: Prescribe an intravenous infusion of mannitol
Correct answer: option4
Specialty: General_Surgery
You see a 48-year old in the surgical ward who is due for an exploratory laparotomy. The anaesthetist tells you that a high dependency unit (HDU) bed has been booked for the patient owing to his comorbidities and will therefore require close monitoring after surgery. The anesthetist tells you that the patient falls under ASA 3. From the list below, choose the definition that best describes an ASA grading of 3.

Answer options: option1: A moribund patient who is not expected to survive without an operation
option2: A patient with mild systemic disease
option3: A normal healthy patient
option4: A patient with severe systemic disease that is a constant threat to life
option5: A patient with severe systemic disease
Correct answer: option5
Specialty: General_Surgery
A 85-year old male patient presents to the emergency department with complaints of severe colicky abdominal pain, vomiting and absolute constipation. Examination reveals a distended tympanic abdomen. Plain abdominal radiograph shows a grossly dilated large bowel arising from the left lower quadrant. The most likely diagnosis in this patient is

Answer options: option1: Sigmoid volvulus
option2: Acute pancreatitis
option3: Paralytic ileus
option4: Gastric cancer
option5: Perforated duodenal ulcer
Correct answer: option1
Specialty: General_Surgery
which of the following scenarios best describes parietal type of abdominal pain?

Answer options: option1: 51-year old with poorly localized abdominal pain
option2: 85-year old female with acute bowel ischemia
option3: 29-year old female with localized right lower quadrant pain
option4: 31-year old male with scrotal pain following trauma
option5: None of the above
Correct answer: option3
Specialty: General_Surgery
 A 3-year-old male weighing 16 kg (35.3 pounds) presents with second and third-degree burns of his anterior trunk, upper back, and right arm, after pulling a large pot of boiling water off the stove onto himself. This is a 23% total body surface area burn. Fluid resuscitation is started based on the Parkland formula. When reassessing this patient 3 hours after starting fluid resuscitation, what would be an appropriate urine output?

Answer options: option1: 0.25 mL/kg/hour
option2: 2.0 mL/kg/hour
option3: 1.0 ml/kg/hour
option4: 3.5 ml/kg/hour
option5: 4.0 ml/kg/hour
Correct answer: option3
Specialty: General_Surgery
45-year-old patient is involved in a road traffic accident and is noted to have bruising all over the chest and he complains of severe chest pain. On examination he has a shallow tachypnoea with indrawing of the chest wall on inspiration. The trachea is central. Oxygen saturation is 86 per cent on air, pulse 110/min, BP 100/65 mmHg. The likely injury this patient has sustained is

Answer options: option1: Cardiac tamponade
option2: Tension pneumothorax
option3: Flail chest
option4: Spinal injury
option5: None of the above
Correct answer: option3
Specialty: General_Surgery
 A 41-year old patient is brought to the emergency department following a fall from a height at a construction site. His Glasgow Coma Scale is reported as 11. The decreased level in consciousness may be due to

Answer options: option1: Decreased cerebral perfusion
option2: Decreased cerebral oxygenation
option3: Direct cerebral injury
option4: All of the above
option5: A and B
Correct answer: option4
Specialty: General_Surgery
Which choice correctly matches percent body volume loss by hemorrhage to signs and symptoms?

Answer options: option1: Ten percent, mild tachycardias, normal capillary refill, and clear sensorium
option2: Fifteen percent, tachycardia, normotensive with widened pulse pressure, and decreased level of consciousness
option3: Twenty percent, tachycardia without palpable pulses and clear sensorium 
option4: Thirty percent, tachycardia, normotensive, and clear sensorium
option5: None of the above are correct
Correct answer: option1
Specialty: General_Surgery
A 22-yearold man is brought to the hospital after crashing his motorcycle into a telephone pole. He is unconscious and in profound shock. He has no open wounds or obvious fractures. The cause of his shock is MOST LIKELY caused by:

Answer options: option1: A subdural hematoma.
option2: An epidural hematoma.
option3: A transected lumbar spinal cord.
option4: A basilar skull fracture
option5: Hemorrhage into the chest or abdomen
Correct answer: option5
Specialty: General_Surgery
A general surgeon contacts you regarding preoperative clearance for an otherwise healthy 42-year-old scheduled for an appendectomy. The patient has no history of excessive bleeding, no family history of bleeding disorders, and is on no medications. He inquires about the need for coagulation studies, which have not been performed. Which of the following is a correct response to this inquiry?

Answer options: option1: A prothrombin time (PT) and partial thromboplastin time (PTT) must be performed before surgery
option2: A bleeding time is sufficient for assessing the risk of bleeding
option3: A normal PT and PTT within the last year is sufficient to clear this patient for surgery
option4: No further testing is necessary to clear this patient for surgery
option5: The patient’s surgery should be withheld
Correct answer: option4
Specialty: General_Surgery
Which of the following statements about head injuries is false?

Answer options: option1: The majority of deaths from auto accidents are due to head injuries.
option2: Head injury alone often produces shock
option3: A rapid and complete neurologic examination is part of the initial evaluation of the trauma patient
option4: Optimizing arterial oxygenation is part of initial therapy.
option5: None of the above
Correct answer: option2
Specialty: General_Surgery
 A 28-year-old male was injured in a motorcycle accident in which he was not wearing a helmet. On admission to the emergency room he was in severe respiratory distress and hypotensive (blood pressure 80/40 mm. Hg), and appeared cyanotic. He was bleeding profusely from the nose and had an obviously open femur fracture with exposed bone. Breath sounds were decreased on the right side of the chest. The initial management priority should be:
Answer options: option1: Control of hemorrhage with anterior and posterior nasal packing.
option2: Tube thoracostomy in the right hemithorax
option3: Endotracheal intubation with in-line cervical traction.
option4: Obtain intravenous access and begin emergency type O blood transfusions.
option5: Obtain cross-table cervical spine film and chest film
Correct answer: option3
Rationale: n/a
Specialty: Internal_Medicine

97. Which of the following shifts oxyhaemoglobin-dissociation curve to the left
Answer options: option1: a.Decreased PH
option2: b.Increased carbon dioxide tension
option3: c.Increased 2, 3 - diphosphoglycerate
option4: d.Increased temperature
option5: e.Foetal haemoglobin
Correct answer: option4
Specialty: Internal_Medicine
96. The following regarding the oxygen-haemoglobin dissociation curve are true except:
Answer options: option1: a.Haemoglobin is most attracted to oxygen when three of its four polypeptide chains are bound to oxygen.
option2: Increasing the temperature denatures the bond between oxygen and haemoglobin
option3: c.2,3-diphosphoglycerate (DPG) deceases the affinity of oxygen for haemoglobin.
option4: d.The foetal dissociation curve is shifted to the left relative to the curve for the normal adult.
option5: e.Carbon monoxide shifts the curve to the right.
Correct answer: option5
Specialty: Internal_Medicine
94. A 50-year-old presents to the emergency room with a sudden onset abdominal pain an hour ago. He is hypotensive with a board-like rigidity of the abdomen. The presence of guarding in the abdomen is suggestive of what type of physiologic pain
Answer options: option1: Sympathetic
option2: Parietal
option3: Referred
option4: Visceral
option5: Parasympathetic
Correct answer: option1
Specialty: General_Surgery
91. Which of the following is not true of Peutz-Jegher’s syndrome
Answer options: option1: a.Polyps mainly arise in the colon
option2: b.It is an Autosomal dominant condition
option3: c.It is associated with melanin pigmentation of buccal mucosa, hands, feet and eyelids
option4: d.The family should be counselled regarding intussusception
option5: e.Screening for malignancy should start in adolescence
Correct answer: option1
Specialty: General_Surgery
90. Which of the following colonic polyps are highly unlikely to be premalignant?
Answer options: option1: a.Juvenile polyp
option2: b.Villous adenoma
option3: c.Tubular adenoma
option4: d.Tubulo-villous adenoma
option5: e.Peutz-Jegher’s syndrome polyps
Correct answer: option1
Specialty: General_Surgery
88. An indirect inguinal hernia whose content consist of a Merkel’s diverticulum is called 
Answer options: option1: a.Littres’ hernia
option2: b.Amyand’s hernia
option3: c.Pantaloon hernia
option4: d.Richter’s hernia
option5: e.Incisional hernia
Correct answer: option1
Specialty: General_Surgery
87. Which of the following is true regarding the incidence of Merkel’s diverticulum?
Answer options: option1: a.It is twice as common in females as in males
option2: b.It commonly occurs at 2 feet away from the ligament of Treitz
option3: c.It is 2cm long
option4: d.It may contain gastric or pancreatic tissues
option5: e.It occurs in 20% of the population
Correct answer: option4
Specialty: Infectious_Disease
85. In critical ill patient which of the following measures would most accurately assess adequacy of protein supplementation
Answer options: option1: a.Oxygen consumption and carbon dioxide production
option2: b.24 hr urine creatinine
option3: c.Midarm muscle circumference
option4: d.Serum prealbumin level
option5: e.Serum ferritin levels
Correct answer: option4
Specialty: Internal_Medicine
82. A 23-year-old girl with Grave's disease has been receiving carbimazole for 3 months. She suddenly complains of sore throat. Proper management should be
Answer options: option1: a.Use of lozenges, analgesics and mouth wash
option2: b.Referral to ENT for esophagoscopy
option3: c.Stop carbimazole and obtain total and differential white blood cell count
option4: d.Admit the patient and give intravenous antibiotics
option5: e.Administer filgrastim to boost the neutrophil count
Correct answer: option3
Specialty: General_Surgery
81. 38-year-old woman who underwent total thyroidectomy for multinodular goitre 6 months ago presents with persistent hoarseness. Which of the following nerves was most likely injured during her operation.
Answer options: option1: a.Superior laryngeal nerve
option2: b.Bilateral recurrent laryngeal nerve
option3: c.Unilateral recurrent laryngeal nerve
option4: d.Hypoglossal nerve
option5: e.Spinal accessory nerve
Correct answer: option1
Specialty: General_Surgery

80. Which of the following is not likely cause of respiratory distress following thyroidectomy for a non-toxic goitre.
Answer options: option1: a.Tension haematoma
option2: b.Bilateral weakness of the recurrent laryngeal nerves
option3: Tracheomalacia
option4: d.Laryngeal oedema
option5: e.Thyroid storm
Correct answer: option5
Specialty: Other
 A 28-year-old woman had an open-heart surgery for a mitral valve replacement. She developed severe haemorrhagic as a complication such that her renal function was severely impaired. The consequent hyperkalaemia was refractory to medical therapy. What is the most appropriate course of action 
Answer options: option1: a.	Increase the concentration of dextrose solution and dose of insulin
option2: b.	Increase the dose and frequency of calcium gluconate
option3: c.	Revise the surgery
option4: d.	Start haemodialysis
option5: e.	Intubate the patient to support her ventilation
Correct answer: option4
Specialty: General_Surgery
A 42-year-old woman had a modified radical mastectomy on account of a breast carcinoma. During her recovery in the ICU that, the surgical drain that had been left in-situ yielded about 1 L of frank blood 8 hours after the surgery. The patient was taken back to theatre for secure haemostasis. What type of complication is the patient experiencing 
Answer options: option1: a.	Primary haemorrhagic
option2: b.	Reactionary haemorrhage
option3: c.	Secondary haemorrhage
option4: d.	Tertiary haemorrhage
option5: e.	Haemorrhage secondary to surgical site infection
Correct answer: option2
Specialty: Pulmonary_Medicine
In metabolic acidosis, which of the following is likely to occur
Answer options: option1: a.	The bicarbonate levels are high
option2: b.	The potassium levels may increase
option3: c.	The respiratory rate may reduce to compensate for the derangement
option4: d.	The elevation of PCO2 is primarily responsible for the state of patient.
option5: e.	The elevation of PO2 is responsible for the derangement.
Correct answer: option2
Specialty: Pulmonary_Medicine
The Arterial Blood gases of a patient being nurse in the ICU after a Whipple’s procedure are as follows: p H-7.24; PCO 2-60 mmHg; PO 2-54 mmHg; HCO 3-25 mEq/L . The patient is experiencing 
Answer options: option1: a.	Respiratory acidosis
option2: b.	Respiratory alkalosis
option3: c.	Metabolic acidosis
option4: d.	Metabolic alkalosis
option5: e.	Mixed respiratory and metabolic acidosis
Correct answer: option1
Specialty: General_Surgery
74. The most precise diagnostic screening procedure for differentiating benign thyroid nodules from malignant ones is:
Answer options: option1: a.Thyroid ultrasound scan
option2: b.Thyroid Scintigraphy
option3: c.Thyroid hormone suppression
option4: d.Fine needle aspiration biopsy
option5: e.Thyroid function test
Correct answer: option4
Specialty: General_Surgery
The obstructive jaundice that is seen in patients with chronic pancreatitis usually results from which of the following?
Answer options: option1: a.	Sclerosing cholangitis
option2: b.	CBD compression caused by inflammation
option3: c.	Alcoholic hepatitis
option4: d.	Biliary dyskinesia
option5: e.	Splenic vein thrombosis
Correct answer: option2
Specialty: General_Surgery
73. Thyroglossal cyst is 
Answer options: option1: a.Lateral neck mass
option2: b.It does not move on sticking out the tongue but moves with deglutition
option3: c.It is treated by an excision procedure called Sistrunk.
option4: d.Infection is not a complication
option5: e.It is not a differential of a dermoid cyst.
Correct answer: option3
Specialty: General_Surgery
 The day before surgery, a patient with obstructive jaundice was pre-hydrated with about 3 L of crystalloids. This intervention is meant to 
Answer options: option1: a.	Reduce the risk of hypoglycaemia
option2: b.	To prevent hepato-renal syndrome
option3: c.	To reduce the risk of bleeding
option4: d.	To reduce the risk of sepsis
option5: e.	To ensure the patient receives his daily maintenance.
Correct answer: option2
Specialty: General_Surgery

72. Which of the following is incorrect concerning varicose veins?
Answer options: option1: a.Males are commonly affected than females.
option2: b.They occur due to incompetent valves
option3: c.They are prone to bleeding
option4: d.Brodie-Trendelenburg test aid in diagnosis
option5: e.Sclerotherapy is one of the modalities of treatment
Correct answer: option1
Specialty: General_Surgery
Patients with obstructive jaundice are more prone to bleeding because of 
Answer options: option1: a.	Poor absorption of fat from the GIT
option2: b.	Poor absorption of vitamin K from the GIT
option3: c.	Reduced levels of urobilinogen
option4: d.	Increased sensitivity platelets to osmotic changes in the blood
option5: e.	None of the above
Correct answer: option2
Specialty: General_Surgery
71. A 40-year model complains of pain in the right ankle when walking for moderate to long distances. She noticed some subcutaneous varicosities just below the right knee. What is the most likely diagnosis 
Answer options: option1: Varicose veins of the short saphenous system
option2: b.Deep Vein thrombosis
option3: Superficial thrombophlebitis
option4: d.Varicose ulcers
option5: e.Cellulitis of the foot
Correct answer: option1
Specialty: General_Surgery
A 39-year-old Ghanaian was diagnosed with TB of the GIT. The granulomatous lesions appeared to be denser along the ileum. What is the most appropriate intervention for this patient 
Answer options: option1: a.	Prepare for resection of the ileum to prevent spread
option2: b.	Resect the ileum and the adjacent jejunum and ascending colon
option3: c.	Refer to the public health specialist for start of anti-TB
option4: d.	To start steroids
option5: e.	Watchful waiting
Correct answer: option3
Specialty: General_Surgery
A 55-year-old woman who is being managed for DVT with warfarin started bleeding from GIT. Further assessment revealed that she had deranged liver and renal function. To prevent pulmonary embolism which of the following should be done urgently
Answer options: option1: a.	Continue warfarin therapy
option2: b.	Stop the warfarin therapy and watchfully wait
option3: c.	To insert an IVC filter
option4: d.	To treat the liver for 6 weeks before restarting the warfarin
option5: e.	Apply TED stockings
Correct answer: option3
Specialty: General_Surgery
A 57-year-old male with no surgical history presents with 2 days of abdominal pain, nausea, and vomiting. On exam he is distended and tympanic and is mildly tender without rebound or guarding. An erect abdominal x-ray revealed multiple dilated loops of small bowel with air-fluid levels. His last bowel movement was 1 day ago. He has not passed flatus for over a day. a. Which of the following is the best management option? 
Answer options: option1: Which of the following is the best management option?
option2: b.Admission, observation, steroids
option3: c.Diagnostic laparoscopy
option4: d.Exploratory laparotomy
option5: e.Admission, observation
Correct answer: option4
Specialty: General_Surgery
A 65-year-old woman diagnosed with non-metastatic adenocarcinoma at the mid-section of the ascending colon. What is the most appropriate operative treatment the patient needs
Answer options: option1: a.	Limited right hemicolectomy
option2: b.	Standard right hemicolectomy
option3: c.	Extended right hemicolectomy
option4: d.	Extended left hemicolectomy
option5: e.	Pancolectomy
Correct answer: option2
Specialty: General_Surgery
67. Which of the following describes the associations between Sister Mary Joseph's nodule and gastric cancers?
Answer options: option1: a.A metastatic left axillary lymph node
option2: b.A metastatic left supra-clavicular lymph node
option3: Ovarian mass from gastric metastasis
option4: d.Umbilical metastasis suggesting carcinomatosis
option5: e.Anterior nodule on rectal examination suggesting drop metastasis
Correct answer: option4