afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Orthopedic_Surgery
A 45-year-old African patient presents with a history of chronic knee pain, swelling, and instability, worse with physical activity. Physical examination reveals joint laxity and a positive Lachman test. Imaging reveals a torn anterior cruciate ligament (ACL). Which of the following is the most appropriate treatment option?
Answer options: option1: Conservative management with physical therapy
option2: Open ACL repair
option3: Arthroscopic ACL reconstruction
option4: Knee brace immobilization
option5: Corticosteroid injection into the knee joint
Correct answer: option3
Rationale: Surgical reconstruction of the ACL is often recommended for patients with symptomatic ACL tears, particularly those with instability and functional limitations.
Specialty: Radiology
Which imaging modality is commonly used for the diagnosis and monitoring of liver cirrhosis and related complications in Africa?
Answer options: option1: Bone densitometry
option2: Ultrasound
option3: MRI
option4: Nuclear medicine
option5: PET
Correct answer: option2
Rationale: Ultrasound is commonly used for the diagnosis and monitoring of liver cirrhosis and related complications in Africa. It is a non-invasive, affordable, and widely available modality that can detect signs of liver cirrhosis, such as nodularity, ascites, and portal hypertension.
Specialty: Cardiology
What is the most common cause of heart failure in sub-Saharan Africa?
Answer options: option1: Congenital heart disease
option2: Cardiomyopathy
option3: Coronary artery disease
option4: Rheumatic heart disease
option5: Hypertensive heart disease
Correct answer: option5
Rationale: Hypertensive heart disease is the most common cause of heart failure in sub-Saharan Africa due to the high prevalence of hypertension in the region. Chronic high blood pressure leads to changes in the heart, such as left ventricular hypertrophy, which can progress to heart failure if left untreated.
Specialty: Orthopedic_Surgery
A 60-year-old African patient presents with a history of progressive hip pain, stiffness, and limited range of motion. Imaging reveals joint space narrowing, subchondral sclerosis, and osteophyte formation. Laboratory investigations show elevated levels of serum uric acid. Which of the following conditions is most likely responsible for this presentation?
Answer options: option1: Osteoarthritis
option2: Rheumatoid arthritis
option3: Avascular necrosis
option4: Septic arthritis
option5: Gout
Correct answer: option5
Rationale: Gout is characterized by the deposition of urate crystals in the joints, leading to inflammation, pain, and joint damage, particularly in the hip.
Specialty: Urology
What is a cultural belief in some African communities that may hinder the early detection and treatment of testicular cancer, and how can healthcare providers address this challenge?
Answer options: option1: Belief in traditional healers for the treatment of testicular masses, delaying access to standard medical care
option2: Stigma surrounding genital examinations, resulting in avoidance of healthcare facilities for screening
option3: Association of testicular lumps with infertility, leading to delayed presentation for medical evaluation
option4: Perception of testicular cancer as a punishment for immoral behavior, leading to social isolation and discrimination
option5: Fear of emasculation associated with orchidectomy, causing reluctance to undergo surgical intervention
Correct answer: option3
Rationale: In some African communities, there is an association of testicular lumps with infertility, which may lead to delayed presentation for medical evaluation. Healthcare providers can address this challenge through community education emphasizing the importance of early detection and dispelling misconceptions about testicular health and fertility.
Specialty: Gastroenterology
What is the most common cause of chronic liver disease in Africa?
Answer options: option1: Alcoholic liver disease
option2: Viral hepatitis B
option3: Non-alcoholic fatty liver disease (NAFLD)
option4: Hepatocellular carcinoma (HCC)
option5: Diabetes
Correct answer: option2
Rationale: Chronic hepatitis B infection is highly endemic in Africa and is a major cause of liver cirrhosis and hepatocellular carcinoma.
Specialty: Geriatrics
A 75-year-old African patient presents with recurrent falls and cognitive impairment. Which of the following medications is most likely contributing to these symptoms?
Answer options: option1: Lisinopril
option2: Metformin
option3: Amitriptyline
option4: Aspirin
option5: Simvastatin
Correct answer: option3
Rationale: Amitriptyline is an antidepressant known to cause sedation, dizziness, and cognitive impairment, especially in older adults, increasing the risk of falls.
Specialty: Infectious_Disease
Which of the following is a common etiological agent of typhoid fever in Africa?
Answer options: option1: Salmonella enterica serotype Typhi
option2: Shigella flexneri
option3: Vibrio cholerae
option4: Escherichia coli O157:H7
option5: Yersinia pestis
Correct answer: option1
Rationale: Typhoid fever is caused by Salmonella enterica serotype Typhi and remains a significant public health concern in many African countries.
Specialty: Infectious_Disease
What is the primary vector for the transmission of Lassa fever in West Africa?
Answer options: option1: Aedes mosquitoes
option2: Anopheles mosquitoes
option3: Phlebotomine sandflies
option4: Mastomys rodents
option5: Tsetse Fly
Correct answer: option4
Rationale: Lassa fever is primarily transmitted to humans through contact with urine or feces of infected Mastomys rodents.
Specialty: Obstetrics_and_Gynecology
Which of the following is the most common cancer among women in Africa?
Answer options: option1: Breast cancer
option2: Cervical cancer
option3: Ovarian cancer
option4: Endometrial cancer
option5: Prostrate Cancer
Correct answer: option2
Rationale: Cervical cancer is the leading cause of cancer-related deaths among women in Africa, primarily due to limited access to screening and vaccination programs.
Specialty: Dermatology
Which of the following is a common nutritional deficiency disorder in African populations, characterized by symmetric pigmented patches on the skin?
Answer options: option1: Scurvy
option2: Kwashiorkor
option3: Pellagra
option4: Beriberi
option5: Vitiligo
Correct answer: option3
Rationale: Pellagra, caused by niacin deficiency, presents with characteristic skin changes including hyperpigmented and symmetrically distributed patches, particularly in sun-exposed areas
Specialty: Orthopedic_Surgery
 A 35-year-old African patient presents with acute knee pain and swelling following a twisting injury. Physical examination reveals a positive anterior drawer test. Which of the following is the most likely diagnosis?
Answer options: option1: Medial collateral ligament (MCL) injury
option2: Lateral collateral ligament (LCL) injury
option3: Anterior cruciate ligament (ACL) injury
option4: Posterior cruciate ligament (PCL) injury
option5: Meniscus tear
Correct answer: option3
Rationale: The anterior drawer test is used to assess for ACL injury, which is common following a twisting injury to the knee.
Specialty: Neurology
Which of the following is a common presentation of African trypanosomiasis (sleeping sickness) in the neurological stage?
Answer options: option1: Confusion and sleep disturbances
option2: Fever and chills
option3: Jaundice and hepatomegaly
option4: Cutaneous ulcers
option5: All of the above
Correct answer: option1
Rationale: In the neurological stage of African trypanosomiasis, patients often present with confusion, sleep disturbances, and other neurological symptoms.
Specialty: Dermatology
Which of the following is a common presentation of African endemic Buruli ulcer?
Answer options: option1: Painful genital ulcers
option2: Large, painless skin ulcers
option3: Papular rash
option4: Severe itching
option5: None of the above
Correct answer: option2
Rationale: Buruli ulcer often presents with painless skin ulcers that can be large and destructive if left untreated.
Specialty: Oncology
Which of the following is a common etiological factor for the development of hepatocellular carcinoma (HCC) in Africa?
Answer options: option1: Chronic alcohol consumption
option2: Hepatitis B virus (HBV) infection
option3: Non-alcoholic fatty liver disease (NAFLD)
option4: Hepatitis C virus (HCV) infection
option5: Aflatoxin exposure
Correct answer: option5
Rationale: Chronic exposure to aflatoxins from contaminated food is a major risk factor for HCC in Africa, particularly in regions with high rates of aflatoxin contamination.
Specialty: Family_Medicine
Which of the following is NOT a risk factor for sickle cell disease in Nigeria?
Answer options: option1: Malaria
option2: Family history of sickle cell disease
option3: Vitamin D deficiency
option4: Hemoglobin AS genotype
option5: Hemoglobin AC genotype
Correct answer: option5
Rationale: Hemoglobin AC genotype is not a risk factor for sickle cell disease in Nigeria.
Specialty: Pulmonary_Medicine
Which of the following is a common presentation of tuberculosis (TB) in African adults?
Answer options: option1: Pulmonary infiltrates on chest X-ray
option2: Hemoptysis
option3: Night sweats
option4: Weight loss
option5: All of the above
Correct answer: option5
Rationale: TB in African adults can present with pulmonary infiltrates, hemoptysis, night sweats, and weight loss, among other symptoms.
Specialty: Endocrinology
Which African country has the highest prevalence of diabetes mellitus in the continent?
Answer options: option1: South Africa
option2: Nigeria
option3: Egypt
option4: Kenya
option5: N/A
Correct answer: option2
Rationale: Nigeria has one of the highest prevalences of diabetes mellitus in Africa, with an increasing burden of both type 1 and type 2 diabetes. Factors contributing to this high prevalence include urbanization, sedentary lifestyles, unhealthy diets, and genetic predisposition. The rising incidence of diabetes in Nigeria underscores the importance of public health initiatives to promote awareness, prevention, and management of this endocrine disorder.
Specialty: Pediatrics
Major omphalocele non-operative management in Nigeria
Answer options: option1: alcohol
option2: aqueous mecurochrome
option3: Dermazine cream+sufratulle
option4: Honey
option5: vaseline impregnated with penicillin
Correct answer: option1,option5
Rationale: Vaseline helps prevent excoriation and penicillin as antiseptic.
This vaseline impreginated with penicillin method is employed by many pediatric surgeons in Nigeria for non operative management of major omphalocele.
Specialty: Pediatrics
Common causes of neonatal jaundice in Nigeria include
Answer options: option1: Rh isoimmunization
option2: Septicemia
option3: Prematurity
option4: ABO incompatibility
option5: Hypothyroidism
Correct answer: option1,option2,option3,option4
Rationale: Jaundice is a common finding in pts with ABO incompatibility due to hemolysis
Specialty: Infectious_Disease
A 40-year-old man presents to the clinician with a 2-week history of cough and high-grade fever. He recently immigrated from South Africa. He claims that the fever is off and on, and he has also lost weight during this time. The patient's PPD skin test is positive, and gram staining of sputum reveals acid-fast bacilli. The patient is started on the appropriate therapy. Two weeks later, the patient returns with improvement in his initial symptoms but has begun to develop a tingling sensation in his hands and feet. He claims there has been no change in his diet or lifestyle and has no other symptoms. Which of the following is the best therapy for the patient's new symptoms?
Answer options: option1: Vitamin A
option2: Thiamine
option3: Pyridoxine
option4: Biotin
option5: Niacin
Correct answer: option3
Rationale: This patient was diagnosed with active TB and was most likely given a drug combination of isoniazid, rifampin, ethambutol, and pyrazinamide.

Isoniazid is the most commonly used antibiotic for TB treatment and prophylaxis. Isoniazid inhibits pyridoxine phosphokinase, the enzyme necessary to activate pyridoxine to pyridoxal phosphate.

Because of the pyridoxine phosphokinase deficiency, there is a functional deficiency of pyridoxine which can easily be overcome with pyridoxine supplementation.

Pyridoxine deficiency can present as fatigue, shortness of breath, paresthesias, weight loss, and muscle weakness.
Specialty: Infectious_Disease
Which of the following is a common etiological agent of meningitis in African meningitis belt countries?
Answer options: option1: Neisseria meningitidis
option2: Haemophilus influenzae type b (Hib)
option3: Streptococcus pneumoniae
option4: Listeria monocytogenes
option5: Mycobacterium tuberculosis
Correct answer: option1
Rationale: Neisseria meningitidis is a common cause of meningitis outbreaks in the African meningitis belt, also known as the "meningitis belt."
Specialty: Dermatology
Which of the following is a common presentation of African endemic leprosy?
Answer options: option1: Loss of eyebrows
option2: Painless skin lesions
option3: Enlarged lymph nodes
option4: Red, swollen eyes
option5: None of the above
Correct answer: option2
Rationale: African endemic leprosy often presents with painless skin lesions that may be hypopigmented or erythematous.
Specialty: Emergency_Medicine
What is the most appropriate initial treatment for a patient presenting with status epilepticus in a resource-limited emergency department in Africa?
Answer options: option1: Intramuscular midazolam
option2: Intravenous lorazepam
option3: Intramuscular diazepam
option4: Oral carbamazepine
option5: Intravenous fosphenytoin
Correct answer: option1
Rationale:  Intramuscular midazolam is the most appropriate initial treatment for status epilepticus in a resource-limited emergency department in Africa due to its rapid onset of action and ease of administration.
Specialty: Gastroenterology
Which of the following is a common cause of chronic liver disease in Africa?
Answer options: option1: Hepatitis C virus (HCV)
option2: Hepatitis E virus (HEV)
option3: Hepatitis B virus (HBV)
option4: Human immunodeficiency virus (HIV)
option5: Hepatitis A virus (HAV)
Correct answer: option3
Rationale: Naturally, Hepatitis B virus (HBV) is prevalent in Africa due to factors such as high rates of transmission through perinatal, horizontal, and sexual routes, as well as endemicity in certain regions. HBV can lead to chronic liver disease, making it a common cause of liver-related morbidity and mortality in the continent.
Specialty: Infectious_Disease
The standard diagnostic test for latent TB infection in Africa is:
Answer options: option1: Chest X-ray
option2: Sputum smear microscopy
option3: Blood test for TB antibodies
option4: Tuberculin skin test (TST)
option5: None of the above
Correct answer: option2
Rationale: Sputum smear microscopy is a simple, inexpensive, and effective test for diagnosing active TB in resource-limited settings like many African countries.
Specialty: Pediatrics
How low is the rate of survival of a pre-mature children in a primary health care centre in Nigeria?
Answer options: option1: 28 weeks
option2: 22 weeks
option3: 30 weeks
option4: 16 weeks
option5: 19 weeks
Correct answer: option1
Rationale: The rationale behind the answer is due to the lack of necessary health care facilities in the primary health care in Nigeria.
Survival of preterm infants is a function of both their biological maturity and technological advancement of any given setting. While technological advancement has continued to show marked improvement in developed countries with increasing survival of extremely preterm babies 11,17, the same cannot be said of the developing countries. especially in Africa where there is poor health infrastructure, poverty, mass illiteracy, gross gender inequality and numerous conflicts, and lack of equipment, manpower, and support services necessary to float a functioning neonatal intensive care service.
Specialty: Emergency_Medicine
Which of the following is a common complication of untreated group A streptococcal pharyngitis in children in Africa?
Answer options: option1: Peritonsillar abscess
option2: Acute otitis media
option3: Otitis externa
option4: Sinusitis
option5: Rheumatic heart disease
Correct answer: option5
Rationale: Untreated group A streptococcal pharyngitis in children can lead to rheumatic heart disease, a significant cause of morbidity and mortality in Africa, particularly in resource-limited settings.
Specialty: Pathology
Kaposi's sarcoma is primarily caused by human herpesvirus 8 (HHV-8) and is more prevalent in Africa compared to other regions.
Answer options: option1: True
option2: False
option3: N/A
option4: N/A
option5: N/A
Correct answer: option1
Rationale: Kaposi's sarcoma is associated with HHV-8 infection and has a higher incidence in Africa, particularly among individuals with HIV/AIDS.
Specialty: Cardiology
In a rural African setting with limited access to specialized cardiac care, a patient presents with symptoms of infective endocarditis. Which of the following is a common complication of infective endocarditis that may require surgical intervention?
Answer options: option1: Aortic regurgitation
option2: Mitral regurgitation
option3: Ventricular septal defect
option4: Atrial fibrillation
option5: Aortic dissection
Correct answer: option1
Rationale: Infective endocarditis may lead to aortic regurgitation, which can result in left ventricular dysfunction and may require surgical repair.
Specialty: Emergency_Medicine
Which of the following is a common cause of obstetric emergencies in Africa?
Answer options: option1: Ovarian torsion
option2: Uterine rupture
option3: Placenta previa
option4: Ectopic pregnancy
option5: Preeclampsia
Correct answer: option5
Rationale: Preeclampsia is a common cause of obstetric emergencies in Africa, characterized by hypertension and proteinuria after 20 weeks of gestation, often leading to eclampsia and other severe complications if left untreated.
Specialty: Neurology
In the management of status epilepticus the following drugs may be given intravenously in Nigeria:
Answer options: option1: Hydralazine
option2: Phenytoin sodium
option3: Amiodarone
option4: Paraldehyde
option5: Carbamazepine
Correct answer: option2
Rationale: Phenytoin can be administered intravenously with close monitoring of the ECG.
Specialty: Neurosurgery
What is the most common cause of maternal mortality in sub-Saharan Africa?
Answer options: option1: Hemorrhage
option2: Hypertensive disorders of pregnancy
option3: Sepsis
option4: Abortion
option5: Obstructed labor
Correct answer: option1
Rationale: The most common cause of maternal mortality in sub-Saharan Africa is indeed hemorrhage. Hemorrhage refers to excessive bleeding during pregnancy, childbirth, or the postpartum period. It can occur due to various reasons, such as uterine atony (inability of the uterus to contract effectively), placental abruption (premature separation of the placenta from the uterus), or ruptured uterus.
Specialty: Family_Medicine
Which of the following is a common cause of chronic kidney disease (CKD) in African populations?
Answer options: option1: Obstructive uropathy
option2: Hypertension
option3: Glomerulonephritis
option4: Polycystic kidney disease
option5: Diabetes mellitus
Correct answer: option2
Rationale: Hypertension is a common cause of chronic kidney disease (CKD) in African populations, emphasizing the importance of blood pressure control in preventing CKD progression.
Specialty: Allergy_and_Immunology
A 60-year-old African patient presents with fatigue, palpitations, and dyspnea on exertion. Laboratory investigations reveal normocytic anemia, thrombocytopenia, and a positive direct antiglobulin test (DAT). Which of the following conditions is most likely responsible for this presentation?
Answer options: option1: Autoimmune hemolytic anemia (AIHA)
option2: Thrombotic thrombocytopenic purpura (TTP)
option3: Iron deficiency anemia
option4: Hereditary spherocytosis
option5: Myelodysplastic syndrome (MDS)
Correct answer: option1
Rationale: Autoimmune hemolytic anemia (AIHA) is characterized by the destruction of red blood cells mediated by autoantibodies, leading to normocytic anemia and a positive direct antiglobulin test (DAT).
Specialty: Medical_Genetics
A 5-year-old African child presents with developmental delay, microcephaly, and facial dysmorphism. Genetic testing reveals a deletion on chromosome 5 p. Which of the following conditions is most likely associated with this chromosomal abnormality?
Answer options: option1: Down syndrome
option2: Cri-du-chat syndrome
option3: Turner syndrome
option4: Fragile X syndrome
option5: Prader-Willi syndrome
Correct answer: option2
Rationale: Cri-du-chat syndrome, characterized by a deletion on the short arm of chromosome 5, presents with distinctive features including developmental delay, microcephaly, and a high-pitched cry resembling a cat.
Specialty: Endocrinology
What is the most common cause of Cushing's syndrome in Africa?
Answer options: option1: Autoimmune disease
option2: Prolonged glucocorticoid therap
option3: Adrenal gland tumor
option4: Ectopic ACTH production
option5: Pituitary adenoma
Correct answer: option2
Rationale: Prolonged glucocorticoid therapy is the most common cause of Cushing's syndrome in Africa, as in other parts of the world. The use of glucocorticoid medications for conditions such as asthma, arthritis, and other inflammatory diseases can lead to an excess of cortisol in the body, resulting in Cushing's syndrome.
Specialty: Urology
What is a common indigenous herbal remedy used in Nigeria for the management of benign prostatic hyperplasia (BPH), and what is its proposed mechanism of action?
Answer options: option1: Saw palmetto extract, inhibiting 5-alpha-reductase enzyme activity
option2: Yohimbe bark extract, increasing nitric oxide production and improving blood flow to the prostate
option3: Garlic bulb extract, reducing prostatic inflammation and oxidative stress
option4: African plum tree bark extract, blocking adrenergic receptors in the prostate
option5: Ginseng root extract, promoting apoptosis of prostatic epithelial cells
Correct answer: option1
Rationale: Saw palmetto extract is a commonly used indigenous herbal remedy in Nigeria for the management of BPH. It is believed to exert its effects by inhibiting 5-alpha-reductase enzyme activity, thereby reducing the conversion of testosterone to dihydrotestosterone and mitigating prostatic hyperplasia.
Specialty: Dermatology
Which of the following is a common manifestation of African endemic yaws?
Answer options: option1: Painful genital ulcers
option2: Bony deformities
option3: Painless chancre
option4: Recurrent fever
option5: None of the above
Correct answer: option2
Rationale: African endemic yaws can lead to bony deformities, especially in children, due to chronic inflammation.
Specialty: Pediatrics
What is the most common cause of malnutrition in children in Africa?
Answer options: option1: Lack of access to food
option2: Poor sanitation
option3: Infectious diseases
option4: Lack of education
option5: Political instability
Correct answer: option3
Rationale: Infectious diseases play a significant role in contributing to malnutrition among children in Africa. There are several reasons for this. Many infectious diseases, increase the nutritional needs of the body. The body requires additional energy and nutrients to fight off the infection, leading to increased nutrient demands.They can also lead to loss of appetite, reduced food intake, and impaired nutrient absorption. Fever, gastrointestinal symptoms, and other symptoms associated with infections can contribute to poor appetite and decreased absorption of nutrients from the diet. Certain infectious diseases, particularly diarrheal diseases, can cause significant nutrient loss through vomiting and diarrhea. This leads to a depletion of essential nutrients from the body. Finally, some infections can interfere with nutrient utilization and metabolism. For example, malaria can disrupt the body's ability to use nutrients effectively, leading to malnutrition.