afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Ophthalmology
Ten years old boy complains of itching. On examination, there are mucoid nodules with smooth rounded surface on the limbus, and mucous white ropy mucopurulent conjunctival discharge. He most probably suffers from: 
Answer options: option1: Trachoma
option2: Mucopurulent conjunctivitis
option3: Bulbar spring catarrh
option4: Purulent conjunctivitis
option5: n/a
Correct answer: option3
Specialty: Cardiology
Concerning Diabetes and choice of antihypertensive agents, Which of the following statements is FALSE

Answer options: option1: ACE I/ARBs are the agents of choice at any stage of Hypertensive Diabetic Nephropathy.
option2: Combination of drugs are almost always required in overweight type 2 DM patients
option3: Ideal target blood pressure control is <130/80
option4: Tight blood pressure control do not cause nor exacerbate postural hypotension in them.
option5: n/a
Correct answer: option1
Specialty: Psychiatry
A 52-year-old man is hospitalized after a severe myocardial infarction. On the second day in hospital when his physician comes by on rounds the patient insists on jumping out of bed and doing several pushups to show the physician that ‘they can’t keep a good man down-there is nothing wrong with me!’ Which defense mechanism BEST DESCRIBES this patient’s symptoms?
Answer options: option1: Distortion
option2: Denial
option3: Displacement
option4: Reaction formation
option5: Repression
Correct answer: option2
Specialty: Ophthalmology
A young child suffering from fever and sore throat began to complain of lacrimation. On examination, follicles were found in the lower palpebral conjunctiva with tender preauricular lymph nodes. The most probable diagnosis is: 

Answer options: option1: Trachoma
option2: Staphylococal conjunctivitis
option3: Adenoviral conjunctivitis
option4: Phlyctenular conjunctivitis
option5: n/a
Correct answer: option3
Specialty: Pathology
one of the following is a feature of hemolytic jaundice:
Answer options: option1: pale Stool
option2: Increased urobiliongen
option3: icreased conjugated hyperbilirubinemia
option4: increased serum ALP and GGT
option5: . All of the above
Correct answer: option2
Rationale: High levels of urobilinogen in urine may be a sign that: Your liver is making too much bilirubin because your body breaks down red blood cells faster than it can make them. This condition is called hemolytic anemia. Your liver can't recycle urobilinogen into bile because of liver disease.
Specialty: Cardiology
Concerning diabetes and coronary artery disease which is the most correct statement;


Answer options: option1: Those with poor glycemic control have an increased risk of MI for every 1% increase in HBA1c
option2: The presence of proteinuria but not microalbuminuria is associated with a large increase of CHD
option3: 10yr risk of developing CHD and death related to Cardiovascular events is equal in both Type 1 and type 2 DM pxts
option4: The relative risk of developing MI is equal in both sex (M=F) with or without preexisting CHD.
option5: n/a
Correct answer: option3
Specialty: Psychiatry
A 72-year-old woman is admitted to the burn unit with second-and third-degree burns covering 35% of her body which she suffered in a house fire. At 8 pm on the fourth day she pulls out her intravenous line and begins screaming that people are out to hurt her. Several hours later she is found to be difficult to arouse and is disoriented. Which of the following is the MOST LIKELY diagnosis?
Answer options: option1: Acute stress disorder
option2: Delirium
option3: Acute manic episode
option4: Brief reactive psychosis
option5: Emergence of an underlying dementia
Correct answer: option2
Specialty: Internal_Medicine
A 74-year-old male is found to have stenosis of his left internal carotid artery with a luminal diameter of 69%. This is most accurately characterized as: 
Answer options: option1: Moderate stenosis.
option2: Severe stenosis
option3: A normal finding for his age.
option4: Mild stenosis.
option5: None of the above
Correct answer: option1
Specialty: Ophthalmology
A 12 years old boy receiving long-term treatment for spring catarrh, developed defective vision in both eyes. The likely cause is: 

Answer options: option1: Posterior subcapsular cataract
option2: Retinopathy of prematurity
option3: Optic neuritis
option4: Vitreous hemorrhage
option5: n/a
Correct answer: option1
Specialty: Internal_Medicine
A 73-year old man with extensive smoking history is diagnosed with lung cancer after he presented with cough and mild hemoptysis. On review of systems, he has headaches, which worsen at night. His physical appearance is shown in the image below. Which of the following would you suspect as his diagnosis
Answer options: option1: Phrenic nerve palsy
option2: Pancoast's syndrome
option3: SVC syndrome
option4: CNS metastases
option5: IVC syndrome
Correct answer: option3
Specialty: Ophthalmology
A recurrent bilateral conjunctivitis occurring with the onset of hot weather in young boys with symptoms of burning, itching, and lacrimation with large flat topped cobble stone papillae raised areas in the palpebral conjunctiva is: 


Answer options: option1: Trachoma
option2: Phlyctenular conjunctivitis
option3: Mucopurulent conjunctivitis
option4: Vernal keratoconjunctivitis
option5: n/a
Correct answer: option4
Specialty: Cardiology
Blood pressure management in type 2 diabetes patients, most true statement is ---:.	

Answer options: option1: Salt restrictions is mandatory before pharmacotherapy
option2: Stage III HTN should always be treated irrespective of other co-morbidities
option3: BP of > 140/90 should be treated if there's no evidence of Target organ damage
option4: BP of > 120/80 should be treated if 10yr CHD risk is <10%
option5: n/a
Correct answer: option4
Specialty: Psychiatry
A 45-year-old man with chronic psychotic disorder is interviewed after being admitted to a psychiatric unit. He mimics the examiner's body posture during the interview. Which of the following characterizes the patient’s symptoms?
Answer options: option1: Folie a deux
option2: Concrete thinking
option3: Echolalia
option4: Echopraxia
option5: Fugue
Correct answer: option4
Specialty: Psychiatry
You are a medical intern. The nurse informs you that an 80-year-old man who was admitted for cellulitis seems depressed and mentions passive suicidal thoughts. When you assess him, he sees a ghost in the ward and expresses paranoid ideation against the nursing staff. Which of the following assessments is MOST IMPORTANT to establish the diagnosis?
Answer options: option1: Assess orientation
option2: Assess judgement
option3: Assess recognition
option4: Assess registration and short-term recall
option5: Assess somatic symptoms
Correct answer: option1
Specialty: Emergency_Medicine
. A 20-year old man presents with acute onset of chest pain and shortness of breath. On chest radiograph, he is found to have a 
pneumothorax. Which of the following is an indication for surgical 
treatment of a spontaneous pneumothorax? 

Answer options: option1: Underlying disease like emphysema or cystic fibrosis.
option2: First episode in a patient under the age of 25.
option3: Continuous air leak on initial tube thoracostomy placement.
option4: Large pneumothorax with hemodynamic instability on presentation
option5: None of the above
Correct answer: option4
Specialty: Psychiatry
You assess a 26-year-old woman with a diagnosis of bipolar disorder in the emergency department. She is speaking very quickly and is difficult to interrupt. She scarcely finishes a sentence before starting another. She speaks about a range of topics but her words make sense and the topics are clearly linked to one another. What sign is she exhibiting?
Answer options: option1: Pressure of speech
option2: Dysphasia
option3: Tangentiality
option4: Alogia
option5: Circumstantiality
Correct answer: option1
Specialty: Internal_Medicine
Which of the following is true regarding the shape of the right and left main bronchi andthe risk of aspiration into either? 
Answer options: option1: Because the right main bronchus is narrower than the left, foreign bodies are less likelyto become lodged there
option2: Because the right main bronchus is straighter than the left, foreign bodies are morelikely to become lodged there.
option3: Because the left main bronchus is straighter than the right, foreign bodies are morelikely to become lodged there.
option4: Because of the early bifurcation of the left main  bronchus to secondary bronchi,foreign bodies are less  likely to become lodged there.
option5: None of the above
Correct answer: option2
Specialty: Cardiology
A 65-year-old diabetic male present with worsening episode of recurrent chest pain admitted into ER with features in keeping with autonomic dysfunction, initial ECG showed no overt features. Which is most likely?


Answer options: option1: Stable Angina
option2: Imminent Heart failure
option3: Acute Pericarditis
option4: NSTEMI
option5: n/a
Correct answer: option4
Specialty: Gastroenterology
Which of the following is TRUE concerning hepatitis?
Answer options: option1: There is an approved vaccine for hepatitis C
option2: Hepatitis D is spread through sexual contact
option3: Anti-mitochondrial antibody is present in 80% of cases of autoimmune hepatitis
option4: Corticosteroids are contraindicated in alcoholic hepatitis
option5: Liver biopsy is contraindicated in Non-alcoholic steatohepatitis
Correct answer: option2
Specialty: Pathology
One of the following is not a feature of chronic renal failure:
Answer options: option1: increased serum inorganic phosphate
option2: increased serum creatinine
option3: increased serum urea
option4: decreased serum calcium
option5: increased serum potassium
Correct answer: option1
Rationale: The blood urea nitrogen (BUN) and serum creatinine levels will be elevated in patients with CKD. Hyperkalemia or low bicarbonate levels may be present. Serum albumin levels may also be measured, as patients may have hypoalbuminemia as a result of urinary protein loss or malnutrition.
Specialty: Internal_Medicine
A 23-year old woman with a history of urinary tract 
infection presents 4 days after having started treatment. She 
complains of painful mouth ulcers, fevers, and aches. She has 
no other medical history. Your first step in management 
should be: 

Answer options: option1: . Add a second antibiotic.
option2: Increase the dose of her antibiotic treatment.
option3: Stop the antibiotic she is currently taking.
option4: Add steroids and an antihistamine to her medications
option5: None of the above
Correct answer: option3
Specialty: Nephrology
A 35-year-old male presents with leg swelling, ascites, and flank pains. Investigations reveal elevated serum cholesterol, reduced serum albumin, and proteinuria 4+. Which of the following is the likely diagnosis in this patient?
Answer options: option1: Dyslipidemia
option2: Urinary tract infection
option3: Nephrotic syndrome
option4: Liver cirrhosis
option5: Malnutrition
Correct answer: option3
Specialty: Dermatology
Which of the following is the correct order of the epidermal layers, fromdeepest to most superficial? 
Answer options: option1: Stratum basale,stratumspinosum,stratumgranulosum,stratum corneum.
option2: Stratum spinosum,stratum basale,stratum granulosum,stratum corneum
option3: Stratum basale,stratumcorneum,stratum spinosum,stratum granulosum.
option4: Stratum spinosum,stratum corneum,stratumbasale,stratum granulosum
option5: None of the above.
Correct answer: option1
Specialty: Plastic_Surgery
A patient is found to have a 3-cm malignant melanoma of the lowerextremity with a thickness of 2.2 mm on biopsy. The appropriate circumferential margin for excision of the lesion is: 
Answer options: option1: . 6 mm
option2: 2 cm
option3: I. 1 cm
option4: 4 cm
option5: 10cm
Correct answer: option2
Specialty: Pathology
Hyperuricemia is seen in 
Answer options: option1: Gout
option2: Nephrotic Syndrome
option3: High Protein diet
option4: Advanced liver cirrhosis
option5: diabetes insipidus
Correct answer: option1
Rationale: Hyperuricemia is a common disorder that affects patients of all ages and genders. The most common manifestation of hyperuricemia is gout, which can be very painful and is amenable to treatment. Hyperuricemia is also associated with uric acid and calcium nephrolithiasis.
Specialty: Nephrology
A 50-year-old male presented with a history of recurrent gastric ulcers and multiple renal stones. What is the most appropriate test to confirm the diagnosis?
Answer options: option1: Serum calcium level
option2: Thyroid T4 level in blood
option3: Fasting blood sugar level
option4: Serum aldosterone level
option5: Long-acting thyroid stimulator
Correct answer: option1
Specialty: Endocrinology
A 22-year-old girl who is diabetic presents with pain in the abdomen, vomiting and shortness of breath. She also gives a 3-day history of fevers and sore throat. Which of the following is the likely cause of her symptoms?
Answer options: option1: Hypoglycaemia
option2: Non-ketotic hyperosmolar
option3: Renal failure
option4: Diabetic ketoacidosis
option5: Gastritis
Correct answer: option4
Specialty: Pathology
which of the following conditions is associated with increased urinary specific graity
Answer options: option1: Pituitary diabetes Insipidus
option2: Chronic Renal failure
option3: Diabetes Mellitus
option4: Nephrogenic Diabetes insipidus
option5: hysterical Polydipsia
Correct answer: option3
Rationale: The urine specific gravity might reach 1.045 to 1.050 as a result of the loss of glucose in the urine. Specifically, in a patient with poor glycemic control elevated blood glucose levels should result in an increased urine specific gravity.
Specialty: Neurology
About Stroke which one of the following is incorrect?
Answer options: option1: Cerebral haemorrhage accounts for more than 40% of acute strokes.
option2: In supratentorial strokes with homonymous hemianopsia, patients cannot see on the hemiplegic side.
option3: Vertigo, vomiting, dysphagia, and Horner's syndrome indicate occlusion of the vertebrobasilar circulation.
option4: Pinpoint pupils and bilateral upgoing plantars could signal a brainstem stroke.
option5: Carotid endarterectomy should be considered for patients with more than 70% stenosis because this is more effective than medical treatment.
Correct answer: option1
Specialty: Endocrinology
A 45-year-old female presents with centripetal obesity, acne, buffalo hump and hirsutism. Her blood pressure is 160/95 mmHg and random blood glucose is 21 mmol/l (3.5-6.1 mmol/l). Which of the following is the most likely diagnosis?
Answer options: option1: Hypogonadism
option2: Hyperthyroidism
option3: Cushing's syndrome
option4: Essential hypertension
option5: Diabetes mellitus
Correct answer: option3
Specialty: General_Surgery
Which of the following structures make up the floor or inferior borderof the inguinal canal? 
Answer options: option1: . The internal oblique and transversus abdominus muscles.
option2: The external and internal oblique aponeuroses.
option3: The inguinal and lacunar ligaments
option4: The transversalis fascia and conjoint tendon
option5: None of the above
Correct answer: option3
Specialty: Endocrinology
A 27-year-old female presents with palpitations, weight loss, polyuria, diarrhea, and increased appetite for 3 weeks. Her past medical history is non-significant. Which of the following investigations is the most appropriate for this patient?
Answer options: option1: Urinalysis
option2: Random blood sugar
option3: Thyroid function tests
option4: Liver function tests
option5: Electrocardiogram
Correct answer: option3
Specialty: General_Surgery
A tissue-based repair of an inguinal hernia joins which two borders of the inguinal canal? 
Answer options: option1: The posterior and the superior (roof) borders
option2: The anterior and the inferior (floor) borders
option3: The anterior and the superior (roof) borders
option4: The posterior and the inferior (floor) borders
option5: Anterior and posterior borders
Correct answer: option4
Specialty: Pathology
Which of the following laboratory findings is pathognomonic of acute glomerulonephritis
Answer options: option1: oliguria
option2: red cell casts
option3: white cell casts
option4: Albuminuria
option5: Dyslipidemia
Correct answer: option2
Rationale: The dysmorphic RBCs- a feature of glomerular hematuria, acanthocytes, and RBC casts are pathognomonic of glomerulonephritis. RBC casts are formed when deformed, and distorted RBCs and white blood cells are encased by the Tamm-Horsfall protein (THP).
Specialty: Neurology
A 20 year old medical student presents with acute onset ascending weakness of the lower limbs. There is associated ophthalmoplegia and ataxic gait. There is a preceding upper respiratory tract infection. What is the likely diagnosis?

Answer options: option1: Stroke
option2: Transverse myelitis
option3: Poliomyelitis
option4: Miller-Fisher syndrome
option5: Botulism
Correct answer: option4
Specialty: General_Surgery
A 24-year old man presents with abdominal pain for the past 2-3 months. He has no vomiting. A CT scan shows a paraduodenal hernia. Which of the following is TRUE of his condition? 
Answer options: option1: It is the most common internal hernia.
option2: It is unlikely to be the source of his pain.
option3: It rarely causes bowel obstruction and for this reason, does notrequire repair.
option4: It is an acquired form of internal hernia.
option5: All of the above
Correct answer: option1
Specialty: General_Surgery
A patient has just undergone a laparotomy for semi-elective excision of amesenteric cyst. You are asked to close the midline laparotomy incision. Which of the following is TRUE about the closure of the incision? 
Answer options: option1: Continuous sutured closure is less likely to result in  incisional herniaformation than interrupted sutured  closure
option2: A rapidly absorbed suture like Vicryl results in lower rates of  incisional hernia formation due to the increased inflammatory reaction that it causes.
option3: You should close the peritoneum to prevent formation of adhesions
option4: The muscle provides the greatest source of strength for the closure
option5: None of the above
Correct answer: option1
Specialty: Neurology
A middle age man presents with acute onset ascending paralysis. He recounts that he had suffered a preceding diarrhoeal illness which he recovered from. Examination reveals flaccid weakness of both lower limbs. Which organism is most likely associated with this presentation?

Answer options: option1: Salmonella typhi
option2: Clostridium tetani
option3: Campylobacter jejuni
option4: Streptococcus pneumoniae
option5: Vibrio cholerae
Correct answer: option3
Specialty: Oncology
A woman is found to have a melanoma in the epigastric region of her abdominal wall. If it has metastasized to the lymph nodes, where would you expect to find lymph node enlargement
Answer options: option1: Deep inguinal lymph nodes
option2: Deep inguinal lymph nodes
option3: Superficial inguinal lymph nodes
option4: Internal mammary lymph nodes
option5: Axillary lymph nodes
Correct answer: option5
Specialty: Urology
A 19-year-old female is on treatment for a urinary tract infection. Her response to treatment in the past 3 days is satisfactory. Which of the following is not a common pathogen in urinary tract infections?
Answer options: option1: Escherichia coli
option2: Proteus mirabilis
option3: Klebsiella aerogenes
option4: Enterococcus faecalis
option5: Streptococcus pneumoniae
Correct answer: option5
Specialty: General_Surgery
A 56-year old man with a history of two episodes of alcohol induced pancreatitis in the remote past presents to your outpatient clinic with complaints of vague abdominal and right flank pain and right-sided scrotalswelling. On your physical exam, you identify a right-sided hydrocele. Ultrasound shows right mild hydronephrosis. Which of the following is themost likely diagnosis? 
Answer options: option1: Ureterolithiasis(ureteralstone)
option2: Recurrent pancreatitis
option3: Mesenteric adenitis
option4: Retroperitonealfibrosis
option5: None of the above
Correct answer: option4
Specialty: Hematology
Multiple Myeloma is characterised by 

Answer options: option1: Osteolytic lesions
option2: normal serum protein leve
option3: Lymphocytic bone marrow infiltration
option4: polyglonal gammopathy
option5: Low serum protein level
Correct answer: option1
Rationale: Multiple myeloma causes osteolytic lesions or lytic lesions. These are areas of bone destruction created by accumulations of cancerous plasma cells in the bone marrow. The cancer prevents these areas of bone from regenerating as they should. Osteolytic lesions are painful.
Specialty: General_Surgery
. A 53-year old man with a BMI of 36 presents to your outpatient clinic with complaints of an incisional hernia following a laparotomy for trauma many years ago. On examination, his hernia defect measures 10 cm x 15 cm. It is bothersome to him because of its appearance, and he stateshe would like to be more physically active but finds it difficult. It is easily reducible. Which of the following statements is TRUE about the management of this hernia? 
Answer options: option1: It does not need to be repaired because it is unlikely to incarcerate or strangulate.
option2: It should be repaired because the risk of incarceration and  strangulation is very high over hislifetime.
option3: Weight loss would likely decrease his risk of recurrence following repair.
option4: Primary tissue repair would likely result in a 10-15% recurrence rate
option5: None of the above
Correct answer: option3
Specialty: Neurology
A 30 year old female presents with weakness of the lower limbs. On examination there is loss of proprioception and vibration sense. Here full blood count reveals increased mean corpuscular volume (MCV). What is the likely diagnosis?

Answer options: option1: Tropical spastic paraplegia
option2: Tabes dorsalis
option3: Subacute combined degeneration of the cord
option4: Multiple sclerosis
option5: Transverse myelitis
Correct answer: option3
Specialty: Plastic_Surgery
A 56-year old man with a history of elephantiasis is diagnosed with
angiosarcoma of his lower extremity. Which of the following imaging modalities is most necessary for his metastatic workup? 

Answer options: option1: MRI of the brain
option2: . Bone scan
option3: . CT of the chest
option4: CT of the abdomen
option5: A and C
Correct answer: option3
Specialty: Geriatrics
A 70-year-old woman with chronic obstructive pulmonary disease has a T 8 vertebral compression deformity noted on a lateral chest x-ray taken for evaluation of a cough. The deformity was not present 1 year ago. The patient does not have back pains and cannot recall any injury to her back. She has not been taking corticosteroids and has no evidence of tuberculosis. Which of the following statements is consistent with this patient’s clinical data?
Answer options: option1: Osteomalacia
option2: Osteomyelitis
option3: Osteoporosis
option4: Osteopetrosis
option5: Osteogenesis imperfecta
Correct answer: option3
Specialty: Plastic_Surgery
A 45-year old male presents with a painless mass of his thigh that he states has been present since he hit his thigh on a table 2 months ago. On exam, he has a 6-cm sub fascial lesion. Which biopsy type would you recommend based on this information? 
Answer options: option1: Core needle biopsy
option2: Excisional biopsy
option3: This does not require biopsy at this time given the history of trauma
option4: Incisional biopsy
option5: A and B
Correct answer: option1
Specialty: Rheumatology
 All of the following statements regarding rheumatoid arthritis are true except?
Answer options: option1: The full blood count may show pancytopenia
option2: Patients may have a false positive syphilis test
option3: Autoimmune haemolytic anaemia may occur
option4: Compared to CRP, ESR is more predictive of disease activity
option5: Serum complement levels are increased during active disease
Correct answer: option5