afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Gastroenterology
Which of these is true of hepatic hydatid cysts?
Answer options: option1: They are easily differentiated from other space-occupying lesions on ultrasound
option2: They can appear both as solid and cystic space-occupying lesions on imaging
option3: A diagnostic aspirate of suspected hydatid cysts is indicated in all cases
option4: They are not as frequently seen as pulmonary cysts
option5: They are always present as multiple cysts
Correct answer: option2
Specialty: Gastroenterology
Which of these can be considered diagnostic of amoebiasis?
Answer options: option1: Stool microscopy finding of characteristic binucleate cysts
option2: Stool microscopy finding of highly motile trophozoites
option3: Stool microscopy finding of trophozoites with ingested erythrocytes
option4: Positive anti-amoeba antibodies
option5: Visual inspection of the colon via colonoscopy
Correct answer: option3
Specialty: Pediatrics
40)	The PENTAVALENT infant vaccine protects against:
Answer options: option1: Meningococcus, diphtheria, pertussis, polio, Hib
option2: Diphtheria, tetanus, pertussis, hepatitis B, Hib
option3: Pneumococcus, pertussis, polio, diphtheria, Hib
option4: Meningococcus, pneumococcus, diphtheria, pertussis, tetanus
option5: Diphtheria, pertussis, hepatitis B, Hib, rotavirus
Correct answer: option2
Rationale: N.A
Specialty: Rheumatology
A doctor was considering the diagnosis of scleroderma in a young female. He needed to determine if the patient is actually having limited or diffuse scleroderma. Which investigation will be in support of limited scleroderma

Answer options: option1: ANA
option2: Anti-centromere antibody
option3: Anti-topoisomerase antibody
option4: Anti  Jo antibody
option5: n/a
Correct answer: option2
Specialty: Pediatrics
39)	While bathing her 2-year-old son, a mother feels a mass in his abdomen. A thorough medical evaluation of the child reveals aniridia, hypospadias, horseshoe kidney, and hemihypertrophy. Which of the following is the most likely diagnosis for this child?
Answer options: option1: Neuroblastoma
option2: Wilms tumor
option3: Hepatoblastoma
option4: Rhabdomyosarcoma
option5: Testicular cancer
Correct answer: option2
Specialty: Rheumatology
Concerning SLE, choose the incorrect statement

Answer options: option1: Systemic lupus erythematosus (SLE) results from chronic and recurrent activation of the immune system
option2: Male sex hormones are implicated in the pathogenesis
option3: Environmental factors contribute to initiation of lupus and lupus flares
option4: There is an increase incidence in Klinefelter’s syndrome
option5: n/a
Correct answer: option2
Specialty: Pediatrics
38)	You just evaluated a 4-year-old incompletely immunized boy who has classic varicella lesions and a history that is consistent with this diagnosis. Of the following, the MOST accurate statement is that
Answer options: option1: lesions of both varicella and smallpox follow a 7- to 10-day course from eruption to resolution
option2: lesions of both varicella and smallpox frequently produce deep, pitted scars
option3: varicella lesions appear in stages or crops; smallpox lesions are uniformly in the same stage of development
option4: varicella lesions are concentrated on the face; smallpox lesions are concentrated over bony prominences
option5: varicella lesions are transient vesicles; smallpox lesions are persistent pustules until resolution of the illness
Correct answer: option3
Specialty: Pediatrics
37)	An 18-month-old child presents to the emergency center having had a brief, generalized tonic-clonic seizure. He is now postictal and has a temperature of 40°C. During the lumbar puncture (which ultimately proves to be normal), he has a large, watery stool that has both blood and mucus in it. Which of the following is the most likely diagnosis in this patient
Answer options: option1: Salmonella
option2: Enterovirus
option3: . Rotavirus
option4: Campylobacter
option5: Shigella
Correct answer: option5
Specialty: Rheumatology
A known gouty arthritis patient, also diabetic recently developed monoarticular painful and swollen joint in the lower limb. He was found to have a glomerular filtration rate of 30 ml/min.
Which of the following drugs can he benefit from

Answer options: option1: Allopurinol
option2: Febuxostat
option3: Prednisolone
option4: Methylprednisolone
option5: n/a
Correct answer: option2
Specialty: Pediatrics
35)	During a regular checkup of an 8-year-old child, you note a loud first heart sound with a fixed and widely split second heart sound at the upper left sternal border that does not change with respirations. The patient is otherwise active and healthy. Which of the following heart lesions most likely explains these findings?
Answer options: option1: Atrial septal defect (ASD)
option2: . Ventricular septal defect (VSD)
option3: Isolated tricuspid regurgitation
option4: Tetralogy of Fallot
option5: Mitral valve prolapse
Correct answer: option1
Specialty: Rheumatology
The right knee radiograph of a 62 year old man with body mass index of 31 kg/m2 revealed joint narrowing with subchondral cyst. His past history revealed that he was a footballer. He was also on medications for diabetes since 10 years. All of these explain his condition except

Answer options: option1: His age
option2: Obesity
option3: Being a male
option4: Being a past footballer
option5: n/a
Correct answer: option3
Specialty: Pediatrics
34)	Which of the following are true of Necrotizing enterocolitis (NEC)?
Answer options: option1: NEC can be entirely prevented by using breast milk instead of formula milk
option2: NEC is twice as likely in babies fed formula milk compared with breast milk
option3: NEC is best diagnosed by careful abdominal examination
option4: NEC only occurs in preterm babies <28 weeks
option5: If a baby develops NEC they will need surgery to remove the affected bowel.
Correct answer: option2
Specialty: Pediatrics
33)	The laboratory informs you that a newborn infant, now 8 days old, has an elevated thyroid stimulating hormone (TSH) nand low thyroxin (T 4) on his newborn screen. If this condition is left untreated, the infant is likely to demonstrate which of the following in the first few months of life?
Answer options: option1: Hyperreflexia
option2: Hyperirritability
option3: Diarrhea
option4: Prolonged jaundice
option5: Hyperphagia
Correct answer: option4
Specialty: Pediatrics
A 6-year-old is admitted to the hospital with a diagnosis of DKA. On physical examination he is found to have fast and deep breathing and is severely dehydrated.
In addition to insulin and possible treatment for infections, what other treatment would you consider? 

Rationale: i)	Careful replacements of fluid deficits 
ii)	Correction of electrolyte imbalances 
iii)	Monitoring for complications of treatment
Specialty: Rheumatology
Choose the correct statement about rheumatoid arthritis

Answer options: option1: Rheumatoid factor  is an autoantibody that binds to the Fc portion of IgE
option2: Anticitrullinated Protein Antibodies does not have prognostic implication in rheumatoid arthritis
option3: Macrophages in the synovium are highly activated and produce many cytokines.
option4: Only T cells are involved in the pathogenesis of rheumatoid arthritis
option5: n/a
Correct answer: option3
Specialty: Pediatrics
32)	A 2 day old baby who is at home and looks visibly jaundiced should
Answer options: option1: Be admitted to hospital for exclusion of sepsis
option2: Have phototherapy in hospital
option3: Be placed in the sunlight, which converts unconjugated bilirubin to a safer form
option4: ) Be placed under phototherapy which converts unconjugated to conjugated bilirubin
option5: Should have their bilirubin measured
Correct answer: option5
Specialty: Pediatrics
31)	A child is born with suspected oesophageal atresia. Which of the following investigations is the most appropriate in the first instance?
Answer options: option1: Pass a nasogastric tube and Chest X-ray
option2: Give 20 mL of contrast medium by bottle and Chest X-ray
option3: Chest X-ray
option4: Abdominal ultrasound to check the kidneys
option5: ) Skeletal survey to look for vertebral anomalies
Correct answer: option1
Specialty: Rheumatology
An obese man in his middle age presented with pain and swollen knee joint. He is hypertensive on diuretic. He also takes alcohol and offals indiscriminately. The most likely diagnosis is

Answer options: option1: Septic arthritis
option2: Osteoarthritis
option3: Gouty arthritis
option4: Palindromic arthritis
option5: n/a
Correct answer: option3
Specialty: Pediatrics
A 6-year-old is admitted to the hospital with a diagnosis of DKA. On physical examination he is found to have fast and deep breathing and is severely dehydrated.
From the history how would differentiate the dehydration in DKA and dehydration in severe gastro-enteritis? 
Rationale: 	
i)	Thirst 
ii)	Polyuria 
iii)	Polydipsia 
iv)	Polyphagia
Specialty: Pediatrics
29)	One of the following is true about Vitamin K in the newborn period.
Answer options: option1: Vitamin K is only required if the baby is going to be breast fed
option2: Vitamin K is easily absorbed from the gut so there is no advantage to intramuscular injection
option3: Vitamin K is a fat soluble vitamin
option4: Too much Vitamin K can lead to bleeding disorders
option5: Vitamin K deficiency is not required if the mother has been given multivitamins in pregnancy
Correct answer: option3
Specialty: Pediatrics
28)	A 16-year-old girl complains of dysuria of 1 week's duration. She was seen 4 days ago at an urgent care facility and was prescribed trimethoprim-sulfamethoxazole because of abnormal urinalysis findings. Although she has taken the antibiotic as directed, she has had no relief from the dysuria. She has no nausea, vomiting, flank pain, vaginal discharge, or fever. Of the following, the MOST appropriate course of action is to
Answer options: option1: add doxycycline to the treatment
option2: inspect her genitalia
option3: inspect her genitalia
option4: order ultrasonography of the kidneys
option5: treat with fluconazole
Correct answer: option3
Specialty: Pediatrics
Write short notes on the anti-infective properties of breast milk.
Rationale: Immunoglobulins : mainly IgA. 

Proteins : Lactoferrin (bind iron, bactericidal, antiviral, and anti- inflammatory), Lysozyme (lyses bacteria), Casein (growth – promoting factor for Bifidobacterium bifidium), Fibronectin, Protectin, Compliment

Glycoconjugates and oligosaccharides  (ligands for microorganisms and viruses)

Lipids : Free Fatty Acids and monoglycerides (lytic action on pathogens)

Immunomodulating Agents ( cytokines)

Anti- inflammatory components : Antioxidants (Vitamins A, C, and E), Enzymes ( catalase, glutathione peroxidase), Prostaglandins, Enzyme inhibitors, Protease inhibitors, Growth factors

Cells 

Nucleotides (promote growth of Lactobacillus bifidus)

Enzymes  (lysozyme, peroxidase, catalase)
Specialty: Rheumatology
A woman in her child bearing age gave a history of recurrent abortions. Her medical history is that of polyarthritis and photosensitivity skin rash. Which investigation will be useful in making the diagnostic aetiology of her abortions?  

Answer options: option1: Ds DNA
option2: Anti Ro/SSA
option3: Anti La/SSB
option4: Anti Beta 2 glycoprotein 1 antibodies
option5: n/a
Correct answer: option4
Specialty: Pediatrics
27)	Which one of the following is true of the Apgar score?
Answer options: option1: An Apgar score of 9 at 1 minute usually means the baby does not need resuscitation
option2: APGAR score stands for ‘Aiway-Pulse-Glucose-Alertness-Reflexes’
option3: If the Apgar score is 5 at 1 minute then all you need to do is repeat it at 5 minutes and it will have usually gone up
option4: Apgar scores are better than umbilical cord blood gases for assessing asphyxiated babies
option5: The Apgar score requires Heart Rate, Breathing, Tone, Reflexes and Colour to be each scored 1, 2 or 3
Correct answer: option1
Specialty: Pediatrics
26)	A primiparous woman whose blood type is O positive gives birth at term to an infant who has A-positive blood and a hematocrit of 55%. A total serum bilirubin level obtained at 36 hours of age is 12 mg/dL . Which of the following additional laboratory findings would be characteristic of ABO hemolytic disease in this infant?
Answer options: option1: A normal reticulocyte count
option2: A positive direct Coombs test
option3: Crescent-shaped red blood cells in the blood smear
option4: Elevated hemoglobin
option5: Petechiae
Correct answer: option2
Specialty: Pediatrics
25)	Which one of the following criteria indicate a good screening test?
Answer options: option1: It can be used at any stage of the disease
option2: ) It detects disease as soon as it causes tissue damage
option3: ) It will detect even untreatable conditions
option4: It can detect diseases before the patient knows they have the disorder
option5: Usually the most expensive tests are the best tests
Correct answer: option4
Specialty: Pediatrics
24)	Upon entering your examination room, you find a father who is visibly upset. He has brought his 1-month-old and 2-year-old daughters to see you today because his wife was recently diagnosed with tuberculosis. As you question him further, he tells you that his wife's physician told him that his wife's chest radiograph was abnormal and she was "smear-positive." He hands you results from the health department stating that he and his daughters all had negative skin tests and chest radiographs. His wife is at the health department today to start medicines against tuberculosis, and he wants to know if there is anything that should be done for the children. Of the following, the MOST appropriate treatment is to
Answer options: option1: administer the bacille Calmette-Guérin vaccine
option2: begin isoniazid therapy
option3: provide reassurance
option4: remove the children from the home for 3 months
option5: repeat the skin test in 1 month
Correct answer: option2
Specialty: Pediatrics
22)	A mentally retarded 14-year-old boy has a long face, large ears, micropenis, and large testes. Chromosome analysis is likely to demonstrate which of the following?
Answer options: option1: Trisomy 21
option2: . Trisomy 18
option3: c. Trisomy 13
option4: Fragile X syndrome
option5: Williams syndrome
Correct answer: option4
Specialty: Pediatrics
21)	Which of the following statements is true regarding puberty in girls?
Answer options: option1: The first sign of puberty is usually pubic hair
option2: Puberty is precocious if it occurs before the age of 10 years
option3: Puberty is delayed if onset is after the age of 16 years
option4: Menarche usually occurs towards the end of puberty
option5: The growth spurt occurs late in puberty
Correct answer: option4
Specialty: Infectious_Disease
If the venipuncture site is inadequately disinfected, blood cultures are often contaminated with 
Answer options: option1: clostridium tetanii
option2: E. coli
option3: sterptococcus pyogenes
option4: staphylococcus Aureus
option5: staphylococcus epidermidis
Correct answer: option5
Rationale: .
Specialty: Pediatrics
ampicillin and an aminoglycoside
Answer options: option1: ampicillin and an aminoglycoside
option2: clindamycin and a third-generation cephalosporin
option3: meropenem and an aminoglycoside
option4: . piperacillin and an aminoglycoside
option5: vancomycin and a third-generation cephalosporin
Correct answer: option1
Specialty: Pediatrics
What are the long-term side effects of oral corticosteroid use in children. 

Rationale: Glucocorticoids are important in the treatment of many inflammatory, allergic, immunologic and malignant disorders. The toxicity of glucocorticoids is one of the most common causes iatrogenic illness. 

The adverse events of glucocorticoids are more common in patients receiving high doses over a long period of time. 

Glucocorticoids have adverse effects on many organ systems for example: 

Skin and soft tissue, skin thinning and purpura, non-melanoma skin cancers , Cushingoid appearance and weight gain 

The eye, the risks of both cataracts and glaucoma is increased in patients with glucocorticoids 

Cardiovascular disease, is associated with an increased risk of ischaemic heart disease, heart failure and atherosclerosis 

Gastrointestinal tract, increase the risk of gastric bleeding. 
Kidney and systemic hypertension 

Genitourinary and reproductive system, can cause long-term menstrual irregularities in woman and can lower fertility in both men and women 

Musculoskeletal, osteoporosis one of this most serious side-effects, Vetebral fractures, Osteonecrosis, Muscle weakness 

Growth, growth impairment is commonly seen in children receiving glucocorticoids, effect is most pronounced in daily therapy may be less with an alternate day regime. 

Central nervous system, glucocorticoids induce a range of psychiatric and cognitive symptoms such as mood disorders psychosis memory impairment 

All children receiving high-dose long-term glucocorticoids should be actively monitored for long-term side-effects.
Specialty: Psychiatry
 In alcohol dependence
.  

Answer options: option1: women have a higher incidence of physical complications at lower levels of intake than men
option2: there is no relationship between the quantity of alcohol consumed and mortality figures
option3: prevalence is related to the price of alcohol
option4: drinking protects against coronary heart disease
option5: the CAGE is a reliable screening test in the general population
Correct answer: option3
Specialty: Pediatrics
17)	Which of the following is a sign of abnormal gross motor development:
Answer options: option1: Running at age 2 years
option2: Climbing and descending stairs at age 2 years
option3: Changing from lying to sitting position at age 9–12 months
option4: Crawling at age 18 months
option5: Pedalling a tricycle at age 3 years
Correct answer: option4
Specialty: Pediatrics
Andrew, a 3-year-old boy was brought to a clinic because he had been sick with diarrhea for the last 3 days. He is well nourished, and low-grade fever, if this boy was having severe dehydration which signs would he have? 

Rationale: a)	Lethargy/ unconsciousness
b)	Sunken eyes
c)	Unable to drink/ drink poorly
d)	Skin pinch goes back very slowly (>2 seconds)
Specialty: General_Surgery
A 75-year-old male presents with painful inability to pass urine for 10 hours at the emergency room. After initial assessment, attempts to pass a urethral catheter fail. What is the next logical step? 
Answer options: option1: abdominopelvic ultrasound
option2: Pelvic ultrasound
option3: stab cystostomy
option4: micturating cystourethrogram
option5: n/a
Correct answer: option3
Specialty: Pediatrics
16)	An 8-month-old infant arrives to the emergency department (ED) with a 2-day history of diarrhea and poor fluid intake. Your quick examination reveals a lethargic child; his heart rate is 180 beats per minute, his respiratory rate is 30 breaths per minute, and his blood pressure is low for age. He has poor skin turgor, 5-second capillary refill, and cool extremities. Which of the following fluids is most appropriate management for his condition?
Answer options: option1: haemacoel
option2: Oral Rehydration Solution
option3: Normal saline
option4: Whole blood
option5: Dextrose 5% in water (D5W)
Correct answer: option3
Specialty: Pediatrics
15)	When assessing a child with vomiting, which of the following statements is true of vomiting in children
Answer options: option1: Projectile vomiting is diagnostic of pyloric stenosis
option2: Green coloured vomiting in newborns is a sign of gastro-oesophageal reflux
option3: Cows milk protein intolerance does not cause vomiting in breast fed babies
option4: Cows milk protein intolerance does not cause vomiting in breast fed babies
option5: Antibiotics are indicated for bacterial gastroenteritis
Correct answer: option3
Specialty: Pediatrics
14)	Two weeks after a viral syndrome, a 9-year-old boy presents to your clinic with a complaint of several days of weakness of his mouth. In addition to the drooping of the left side of his mouth, you note that he is unable to completely shut his left eye. His smile is asymmetric, but his examination is otherwise normal. Which of the following is the most likely diagnosis? 
Answer options: option1: Guillain-Barré syndrome
option2: Botulism
option3: Cerebral vascular accident
option4: Brainstem tumor
option5: . Bell palsy
Correct answer: option5
Specialty: Pediatrics
In children with bronchospasm which one of the following statements is true?
Answer options: option1: Breathlessness is due to cough
option2: Inspiratory phase of breathing is prolonged
option3: Peak flow is impaired and reversed by bronchodilators
option4: Tend to have shallow breaths at the extreme of expiration
option5: Wheeze is not seen in children under 2 years of age
Correct answer: option3
Specialty: Pediatrics
12)	A 3-year old child with sickle cell anemia is evaluated for lassitude and pallor. Hematologic findings include: Hgb 3.0 g/dl; WBC 25 k; retic count 0.1%. Of the following, the infectious agent most likely associated with severe anemia in this child is: 
Answer options: option1: Hemophillus influenzae
option2: Streptococcus pneumoniae
option3: Parvovirus B19
option4: CMV
option5: EBV
Correct answer: option3
Specialty: Internal_Medicine
What is the rationale for the treatment modalities in hyperkalemia?

Rationale: Sodium bicarbonate – moves potassium  into cell
Salbutamol – moves potassium into cell
Calcium gluconate – stabilizes myocardium
Insulin / glucose – moves potassium into cell
Kayexalate – ion exchange resin – binds potassium for excretion
Dialysis – removes potassium
Specialty: Pulmonary_Medicine
A patient presents with cough, wheeze and breathlessness. He has a 40-pack-year smoking history. He is afebrile and his echocardiogram is normal. A D-Dimer test is normal. Which one of the following is TRUE?
Answer options: option1: Pulmonary oedema is the most likely diagnosis
option2: Repeat echocardiogram is advised
option3: Community acquired pneumonia must be ruled out
option4: Pulmonary embolism is present
option5: Findings are consistent with chronic bronchitis
Correct answer: option5
Specialty: Hematology
How does hydroxyurea decrease the frequency of sickle cell crises? 


Rationale: i) Stimulates the production of fetal haemoglobin that have high affinity for oxygen thereby preventing hypoxia that triggers RBCs sickling
ii) it increases surface area of red blood cell by making them bigger, rounder and flexible there by reducing sickling of the RBCs
iii) It helps in hydrating RBCs thereby reducing dehydration that triggers sickling of RBCS
iv) It increases production of Nitric Oxide (NO2) to stimulate vasodilation that prevents RBCs sickling
Specialty: Pediatrics
10)	A 4-year-old boy, is noted to have intermittent watery diarrhea, nausea, belching, and abdominal pain. His weight is less than the fifth percentile for his age. Which of the following studies would be most helpful in making the diagnosis?
Answer options: option1: CBC and differential
option2: ESR
option3: . Abdominal ultrasound
option4: Liver function studies
option5: Stool microscopy for ova and parasites
Correct answer: option5
Specialty: Pulmonary_Medicine
Which of the following is TRUE of asthma?
Answer options: option1: It is characterized by low FEV1: FVC ratio (Forced Expiratory Volume 1s: Forced Vital Capacity ratio)
option2: Wheeze is always present
option3: Salbutamol is a preventer medication
option4: Due to side effects, corticosteroids have a limited role in the management
option5: If treated early, it is amenable to cure
Correct answer: option1
Specialty: Hematology
What would be your advice to the mother to prevent sickle cell crisis? 


Rationale: i)	Tell the mother to give enough water and breast feed the child adequately to prevent dehydration which triggers sickling of RBCs
ii)	Tell her to control hypothermia by insulating the baby adequately since hypothermia also triggers sickling of RBCs
iii)	The mother should not let the child to do very intense exercises which leads to hypoxia that triggers sickling of RBCs