afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: General_Surgery
74-year-old man has a recent diagnosis of adenocarcinoma of the distal esophagus. He has a long history of reflux and Barrett’s esophagus, and a recent upper endoscopy and biopsies confirmed the diagnosis. A staging workup is planned. What is the best study for assessing T (tumor invasion depth)?

Answer options: option1: Barium swallow
option2: CT scan with oral and intravenous contrast
option3: Upper endoscopy with rebiopsy
option4: Positron emission tomography (PET) scan
option5: Endoscopic ultrasound
Correct answer: option5
Specialty: General_Surgery
The risk of death and recurrent bleeding from a controlled upper GIT lesion is highest in 



Answer options: option1: An 80-year male following an accidentally swallowed fish-bone esophageal injury
option2: A cirrhotic person with varices managed with a liver transplant
option3: A 70 year female with bleeding gastric ulcer resuscitated with 4 pints of blood before sclerotherapy
option4: A duodenal ulcer noted to have a black spot covering the base on endoscopy
option5: A patient with a Mallory-Weiss tear
Correct answer: option3
Specialty: General_Surgery
A 65-year-old man sustains a 50% TBSA burn while burning trash in the backyard. The patient is resuscitated with lactated Ringer (LR) solution using the Parkland formula and a weight of 80 kg. What is the rate of LR given in the first 8 hours? 
Answer options: option1: 100 mL/h
option2: 500 mL/h
option3: 1000 mL/h
option4: 5000 mL/h
option5: 2000 mL/h
Correct answer: option3
Specialty: Oncology
On risk factors for breast cancer: 


 



Answer options: option1: BRCA 1 and BRCA 2 genes risk for breast cancer is about 30-40%
option2: Breast cancer is twice as common in females
option3: Breast cancer is commoner among cousins than the general population
option4: Alcohol consumption does not increase the risk of breast cancer
option5: Breast cancer is commoner in white race than in black race
Correct answer: option5
Specialty: General_Surgery
The nurse in the ward informs you that a patient developed difficulties in breathing and neck swelling 4 hours after thyroidectomy. You are the medical intern on call. What is the next step in the management of this patient? 

 
	 



Answer options: option1: Give oxygen by mask and observe
option2: Call the anesthetist to intubate the patient
option3: Prepare the patient for emergency tracheostomy
option4: Remove all the stitches and call the surgeon on duty
option5: Administer intravenous steroids
Correct answer: option4
Specialty: General_Surgery
Which of the following statements is false regarding direct inguinal hernias?  
  
  
  



Answer options: option1: The most likely cause is the destruction of connective tissue as a result of physical stress.
option2: Direct hernias should be repaired promptly because of the risk of incarceration.
option3: A direct hernia may be a sliding hernia involving a portion of the bladder wall.
option4: A direct hernia may pass through the external inguinal ring
option5: They are less common than indirect hernias
Correct answer: option2
Specialty: General_Surgery
Which of the following is of least concern when preparing a jaundiced patient for a triple bypass surgery? 


 

 

Answer options: option1: Deranged renal functions and urine output
option2: DVT prophylaxis using low molecular weight heparin
option3: increased risk of wound infections
option4: increased nutritional requirements for albumin and glucose before surgery
option5: Liver enzyme levels
Correct answer: option2
Specialty: General_Surgery
You are asked to take consent for a laparoscopic cholecystectomy in a 40-year-old female with acute cholecystitis. What would you ensure the patient understands about the procedure? 
 
 

 


Answer options: option1: You recommend laparoscopy as it has less anesthetic risks than open surgery
option2: The need for DVT prevention  is much less in laparoscopic than in open surgery
option3: An open laparotomy may end up being performed without further consent if need be
option4: The immediate  cost of laparoscopy is cheaper than that of open surgery
option5: The recovery time is significantly shorter with laparoscopy
Correct answer: option3
Specialty: General_Surgery
A 28-year-old man comes to clinic because of an inguinal hernia. He works as a stonemason and first noticed the hernia when he developed a painful bulge while lifting a bag of cement. He has otherwise been healthy and takes no medications. An open inguinal hernia repair with mesh has been recommended. During a discussion of the anticipated risks, which of the following represents the most common complication?

Answer options: option1: Recurrence
option2: Urinary retention
option3: Reduced fertility
option4: Chronic pain
option5: Ischemic orchitis
Correct answer: option4
Specialty: General_Surgery
As a medical superintendent of a hospital initiating laparoscopic surgery, the critical equipment to procure would include the following except 
 
 
 
 
 

Answer options: option1: Gas insufflation systems
option2: High-intensity light source and camera systems
option3: Basic laparoscopic hand instruments
option4: Video recording and image storage devices
option5: None of the above
Correct answer: option4
Specialty: General_Surgery
32-year-old man comes to the emergency department with an acutely incarcerated inguinal hernia. With sedation, the hernia is reduced and he feels better. Eighteen hours later, he complains of increasing abdominal pain and has diffuse tenderness on examination. He most likely had which of the following?

Answer options: option1: Diastasis recti
option2: Petit’s (lumbar) hernia
option3: Epigastric hernia
option4: Amyand’s hernia
option5: Richter’s hernia
Correct answer: option5
Specialty: General_Surgery
A competent lower oesophageal junction prevents the reflux of gastric contents into the esophagus. This function is compromised when 

 
 

 


Answer options: option1: The length of the sphincter is 3 cm or more
option2: The sphincter complex is drawn into the distal oesophagus due to oesophageal fibrosis
option3: The resting pressure of the sphincter is at 20mmHg
option4: A previously obese person loses excess weight
option5: The lower esophageal sphincter relaxes
Correct answer: option2
Specialty: General_Surgery
A 46-year-old man comes to your office 6 months after an open inguinal hernia repair complaining of pain, which has never resolved after his surgery. On further questioning, he complains of radicular pain into the testicle, which worsens with sitting for longer than 10 minutes. On exam, he is hyperesthetic overlying his scar and has numbness over the ipsilateral scrotum and medial thigh. All else is normal. Injury to which nerve is the most likely cause for his pain?

Answer options: option1: Femoral nerve
option2: Hypogastric nerve
option3: Lateral femoral cutaneous nerve
option4: Ilioinguinal nerve
option5: Vagus nerve
Correct answer: option4
Specialty: Pediatrics
Congenital disorders of the genito-urinary system can be easily diagnosed incidentally prenatally using the following investigation 
 	 	 	 	 
	 	 
	 	 	 
 


Answer options: option1: Obstetric Ultrasound
option2: Amniocentesis
option3: Fetal CT
option4: Maternal Urinalysis
option5: MRI
Correct answer: option1
Specialty: Pediatrics
Which one of the following is NOT TRUE about balanitis xerotica obliterans?


 
 

Answer options: option1: It is pre-malignant
option2: Patient can present with a complex urethral stricture
option3: Patient have vitiligo on the glan penis
option4: Patients do not require long-term follow-up
option5: It can cause phimosis
Correct answer: option4
Specialty: Pediatrics
A 4 weeks old baby boy presents with a history of abdominal swelling and difficulty in passing urine. On evaluation and radiological examination, the baby is found to have posterior urethral valves. The parents seek to know the available treatment options from the doctor. All of the following are true except: 






Answer options: option1: Emergency draining of the urine with a stent
option2: Vesicostomy is indicated when the baby is stable
option3: Abrasion of the posterior urethral valves when the baby is stable
option4: Continuous monitoring of renal function is necessary
option5: Urethroplasty is indicated
Correct answer: option5
Specialty: General_Surgery
A 34-year-old male patient presents in casualty with right lower abdominal pain. The patient is evaluated and a CT scan urogram confirms a 2 mm calculi in the right ureter at vesico-ureteric junction. Patient is referred to a urologist for advice. All of the following are true advice 
EXCEPT: 





Answer options: option1: Patient can be managed conservatively as he is being followed up in the clinic
option2: Patient is advised to maintain good hydration
option3: Renal function test are important while on follow-up
option4: Pain management is critical
option5: Emergency ureterolithotomy is indicated
Correct answer: option5
Specialty: General_Surgery
A patient has 5 days of vomiting and generalized, colicky pain. Radiological examination is consistent with your diagnosis of small bowel obstruction. The blood work shows the following: WBC is 12.0, Cr 2.0 (normal <1.1), Na 130, K 2.5, Cl 90 BUN 18. What is your next step in management? 
 

 
. 


Answer options: option1: Immediate surgery as she has confirmed bowel obstruction with an elevated WBC and renal failure and likely gangrenous bowel and continue resuscitation post-operatively.
option2: Immediate resuscitation with 2.0 L bolus of normal saline, IV K replacement with 20 MeQ bolus immediately, and a blood transfusion if HGB is below normal to minimize fluid required and then consider surgery.
option3: Immediate resuscitation with normal saline or ringer’s lactate in 1.0L boluses until urine output established K replacement after urine output confirmed, check Hgb level and cross-match for possible transfusion and then consider surgery.
option4: Fluid boluses of 2.0L or more of normal saline with concurrent vasopressor treatment to maintain normal blood pressure to maintain kidney perfusion as she is in renal failure and severely dehydrated and then consider surgery
option5: Surgical consultation and planning for possible resection
Correct answer: option2
Specialty: Pediatrics
Which of the following statements about achalasia cardia is true? 

 
 
 

Answer options: option1: Is associated with hyperplasia of the lower oesophageal sphincter
option2: Is due to the absence of ganglion cells in Auerbach's plexus
option3: Most frequently presents in childhood
option4: Barium swallow is NOT useful in making the diagnosis
option5: It improves with age
Correct answer: option2
Specialty: Pediatrics
A neonate has excessive salivation and respiratory distress. Attempts to pass a nasogastric catheter fails because it coils at the back of the throat. A chest film shows a gasless abdomen and right upper lobe atelectasis. The most likely diagnosis is? 


 
 
 

Answer options: option1: Esophageal atresia without fistula
option2: Esophageal atresia with distal tracheoesophageal fistula
option3: “H-type” tracheoesophageal fistula
option4: Esophageal atresia with proximal and distal fistula
option5: Diaphragmatic hernia
Correct answer: option1
Specialty: General_Surgery
A newborn full-term baby boy with a diagnosis of imperforate anus is also at risk to have which one of the following deformities? 

Answer options: option1: Dextrocardia
option2: Rib cage anomaly
option3: Tracheoesophageal fistula
option4: Ulnar skeletal deformity
option5: Limb anomalies
Correct answer: option3
Specialty: General_Surgery
 A 19-year-old man is seen in the emergency department 20 minutes after a high-speed head-on collision with a tree, in which his car caught fire. He was not wearing a seat belt and was ejected from the vehicle. In the emergency department, he is alert, but he does not remember what happened. He admits to drinking a few beers earlier. Blood pressure is 75/40 mmHg and heart rate 140. His airway is patent. Breath sounds are equal bilaterally. Arterial blood gases reveal a Pa O 2 of 140, Sa O 2 of 98%, Pa CO 2 of 34, and p H of 7.33. He has burns to 15% TBSA, involving his anterior trunk and legs. His abdomen is covered with burns but appears distended; tenderness is hard to determine because of painful burn wounds. What is the most likely cause of his hypotension?

Answer options: option1: Smoke inhalation injury
option2: Burn shock
option3: Intra-abdominal hemorrhage
option4: Ethanol intoxication
option5: Closed head injury
Correct answer: option3
Specialty: General_Surgery
Which of the following statements regarding the clinical features of intestinal obstruction is true

Answer options: option1: Vomiting occurs early in high small bowel obstruction
option2: The development of severe pain is indicative of ischemia
option3: Some patients may pass flatus and feces even after the onset of obstruction
option4: All of the above
option5: None of the above
Correct answer: option4
Specialty: General_Surgery

40-year-old woman presented with an ulcerated breast lump measuring 10 X 10 cm. Trucut biopsy showed benign cystosarcoma phylloides tumour. What is the treatment of choice in this case? 


Answer options: option1: Wide exciscion
option2: Quadrantectomy
option3: Simple mastectomy
option4: Microdochectomy
option5: Chemotherapy
Correct answer: option1
Specialty: General_Surgery
Which one of the following statements is TRUE about the treatment of intestinal obstructions? 

Answer options: option1: A child with acute intestinal obstruction due to A. lumbricoides should be dewormed through the NGT immediately to relieve the obstruction.
option2: A child with acute intestinal obstruction due to Hirchisprungs’ disease should be treated by immediate laparotomy and resection of the aganglionic segment
option3: A patient with acute intestinal obstruction due to adhesions for one day should be treated by immediate laparotomy for adhesiolysis
option4: Early acute intestinal obstruction due to sigmoid volvulus is best treated by endoscopic decompression and delayed or elective resection of the sigmoid colon
option5: Conservative management is preferred in all cases
Correct answer: option4
Specialty: General_Surgery
Concerning the parietal peritoneum which of the following statements is true

Answer options: option1: The parietal peritoneum is innervated by somatic nerves
option2: The parietal peritoneum is innervated by autonomic nerves
option3: Pain originating in the parietal peritoneum is poorly localized
option4: Pain from the parietal peritoneum cannot be perceived.
option5: n/a
Correct answer: option1
Specialty: General_Surgery
A patient presents with small bowel obstruction and a history of appendectomy 10 years ago. She is given fluid, an NGT tube, and a Foley catheter. What are the clinical signs or symptoms that indicate the need for surgery?


 
 

Answer options: option1: Vomiting
option2: Constipation
option3: Peritonitis
option4: Abdominal distension
option5: Abdominal tenderness
Correct answer: option3
Specialty: General_Surgery
A 16-year form 2 student at Starehe Boy Centre, from Lokichogio, is admitted at Kiambu Hospital with abdominal distention with cystic liver mass with septations. Intraoperatively, a cystic mass with daughter cysts was identified. Partial cystectomy done. What is the most appropriate postoperative management of this condition? 

Answer options: option1: Metronidazole for 10days
option2: Praziquantel for 5 days
option3: Albendazole for 28 days
option4: Mebendazole for 28 days
option5: Surgical re-exploration
Correct answer: option3
Specialty: General_Surgery
A 20 year-old female was involved in a road traffic trauma and was rushed to the casualty because of massive external bleeding. Her estimated weight was 40 kg. The patient’s estimated total blood volume (TBV) was 1,750 mls. Initially, six units of p RBCs were given followed by another 9 units given over the next 2 hours. Two doses of FFP (10 ml/kg) were also administered. What is the next appropriate step with regard to the patient’s developing dilutional coagulopathy? 

Answer options: option1: Order PT, aPTT, platelet count, and fibrinogen level STAT and order more FFP (10 ml/kg), platelets (10 ml/kg), and 3 pooled units of cryoprecipitate.
option2: Order platelets (10 ml/kg) and more FFP (10 ml/kg) x 3 doses.
option3: Order platelets only and then PT, aPTT, fibrinogen.
option4: Order more pRBCs (emergency release) and give platelets (10 ml/kg), then  order more FFP (10 ml/kg).
option5: Administer vitamin K and continue to monitor coagulation parameters.
Correct answer: option1
Specialty: General_Surgery
Which of the following statements are FALSE with respect to performing thoracentesis? 

Answer options: option1: The patient should be positioned sitting at the edge of the bed, leaning forward, with their arms resting on a table
option2: Once the level of effusion is determined by clinical exam, the site of needle entry should be 1 to 2 intercostal spaces below the level of effusion
option3: The needle should be inserted along the superior edge of the rib in order to avoid  injury to the intercostal vessels and nerve
option4: A chest X-ray is mandatory before and after the procedure.
option5: The needle may be inserted at any level along the hemithorax midline
Correct answer: option5
Specialty: General_Surgery
Which ONE of the following is the main treatment difference between cancer of the colon and cancer of the rectum? 
Answer options: option1: There is no difference both are treated primarily with surgical excision that includes the mesentery to remove all draining nodes before any other treatment
option2: Colon cancer requires chemoradiation if the nodes are positive but rectal cancer requires only radiation if the nodes are positive
option3: Rectal cancer, but not colon cancer, should always be considered for preoperative neoadjuvant chemoradiation as it confers a survival advantage and increases the chance of negative margins with surgery.
option4: Colon cancer does not respond to chemotherapy
option5: Rectal cancer can often be treated with local excision while colon cancer requires more extensive resection.
Correct answer: option3
Specialty: General_Surgery
A young man has severe abdominal pain, a temperature of 39.0 C, a heart rate of 120, and a BP of 95/60. On abdominal examination, he has involuntary guarding and no bowel sounds. Which of the following are the best next steps of resuscitation for this patient with severe sepsis? 







Answer options: option1: Give 1.0L bolus of normal saline, IV ceftriaxone, and flagyl, place O2 via nasal prongs.
option2: Give 20 ml/kg bolus of crystalloid, IV Keflex and flagyl, place a foley catheter and admit to ICU
option3: Give blood transfusion if Hgb &lt;11, 1.0L bolus of D5W and IV  clindamycin
option4: Give norepinephrine to keep BP&gt; 100, give crystalloid fluid at maintenance and IV antibiotics.
option5: Give 10 ml/kg bolus of crystalloid and broad-spectrum IV antibiotics
Correct answer: option1
Specialty: General_Surgery
A 48-year-old diabetic man, who has already undergone an amputation of his left foot from gangrene last year, presents with three days history of bloody diarrhoea. What would be the clinical symptoms he would exhibit that would suggest he has a vascular cause of his GI bleeding? 






Answer options: option1: Early satiety with weight loss but without abdominal pain
option2: Recent travel history with consumption of lake water as diabetics are more susceptible to water-borne infections
option3: Chronic history of recurring bouts of bloody diarrhoea with pain and occasional jaundice
option4: Presence of claudication symptoms in the lower extremities
option5: Post-prandial peri-umbilical pain and cramping with weight loss from food avoidance
Correct answer: option5
Specialty: General_Surgery
A 39-year-old male presents with severe epigastric abdominal pain and vomiting. He prefers to sit bending forward. He has a tinge of jaundice and his abdomen is tender with an echymotic periumbilical region. What should be considered in this patient’s evaluation? 






Answer options: option1: A perforated duodenal ulcer is the most likely cause of his pain
option2: Associated fever and joint pains would exclude an autoimmune  aetiology of his condition
option3: History of a preceding endoscopic procedure is significant in the history taking
option4: A low  serum calcium report is of aetiological significance in his laboratory workup
option5: Pancreatitis is an unlikely cause
Correct answer: option3
Specialty: General_Surgery
A 65 yrs old male present with severe low back pain and weakness of both lower limb. He also has history of straining to pass urine. On evaluation, he is found to have PSA of 50 ng/ml and a lumbasacral x-ray shows sclerotic lesion on the lumbar vertebrae. The patient is advised to undergo more evaluation to confirm his sickness. All the following are true about evaluation test EXCEPT? 
Answer options: option1: Prostatic trucut biopsy is indicated to confirm his disease
option2: More radiological test are required to evaluate the extent of the disease
option3: Urethral catheterization is indicated to monitor his urine output
option4: Renal function
option5: None of the above
Correct answer: option3
Specialty: General_Surgery
A 25-year old woman, injured in a motor vehicular crash is admitted to the emergency department Hi pupils react sluggishly and his eyes open to painful stimuli. He does not follow commands but she moans periodically. His right arm is deformed and does not respond to painful stimulus; however, his left hand reaches purposefully toward the painful stimulus. Both legs are extended. His GCS score is

Answer options: option1: 2
option2: 4
option3: 6
option4: 9
option5: 12
Correct answer: option4
Specialty: General_Surgery
The physiologic hypervolemia of pregnancy has clinical significance in the management of the severely injured gravid woman by

Answer options: option1: Reducing the need for blood transfusion
option2: Increasing the risk of pulmonary edema
option3: Complicating the management of head injury
option4: Reducing the volume of fluid required for resuscitation
option5: Increasing the volume of blood loss to produce maternal hypotension
Correct answer: option5
Specialty: General_Surgery
A 35-year-old lady presented with a breast lump, 2 cm X 2 cm, next to the nipple. There were three mobile axillary nodes. There was no skin involvement and not fixed to the pectoral muscle. Trucut biopsy of the lump showed duct carcinoma. Sentinel node biopsy was negative. There was no evidence of distant metastases. Given this information ONLY, the best option of her management is:
Answer options: option1: Do simple mastectomy, chemotherapy, and radiotherapy.
option2: Do simple mastectomy, axillary lymph node dissection, chemotherapy and radiotherapy
option3: Do modified radical mastectomy, chemotherapy, radiotherapy, tamoxifen, and Herceptin
option4: Do modified radical mastectomy, chemotherapy and radiotherapy
option5: Do conservation breast surgery, axillary lymph node biopsy, chemotherapy and radiotherapy
Correct answer: option5
Specialty: General_Surgery
A newly admitted patient has burns on both lower limbs. The burned areas appear white and leather like. No blisters or bleeding are present. The patient states that she feels very little pain. This injury can likely be categorized as

Answer options: option1: Superficial burn
option2: Partial thickness superficial
option3: Deep partial thickness burn
option4: Full thickness burn
option5: 4th degree burn
Correct answer: option4
Specialty: General_Surgery
 A potentially life-threatening condition in which air and pressure rapidly accumulate in the pleural space and, if not treated, can result in a mediastinal shift is called:

Answer options: option1: An open pneumothorax
option2: A tension pneumothorax
option3: An iatrogenic pneumothorax
option4: A spontaneous pneumothorax
option5: Cardiac tamponade
Correct answer: option2