afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Obstetrics_and_Gynecology
An 18 years old presents with history of urinary leakage per vagina after a recent difficult labour. A dye test performed revealed clear urine in the vagina. The diagnosis is; 

Answer options: option1: Utero- cervico vaginal fistula
option2: Vesico- vaginal fistula
option3: Urethral - vaginal fistula
option4: Uretero-vaginal fistula
option5: Rectovaginal fistula
Correct answer: option2
Specialty: General_Surgery
A 30-year-old male develops an anastomotic leak 5 days after undergoing resection and anastomosis for adhesive small bowel obstruction. Total parenteral nutrition is planned. 
Rationale: Rough estimate: • 25 kcal/kg/day (35 kcal/kg/day for a critically ill or stressed patient)
Calculation of basal energy expenditure (BEE) using the Harris-Benedict equation:
Calculation of BEE using indirect calorimetry and the Weir Equation
Specialty: Obstetrics_and_Gynecology
A para 6+0 mother develops postpartum haemerrhage immediately after delivery. 
All the following are correct concerning her management except; 

Answer options: option1: Take her immediately for emergency hysterectomy
option2: Start oxytocin drip
option3: Cytotec use is beneficial
option4: Massage of uterus is beneficial
option5: Examination without anaesthesia should inform examination with anaesthesia
Correct answer: option1
Specialty: General_Surgery
A 65-year-old female with a history of hypertension underwent surgery for cancer of the right colon. The estimated blood loss was 800 m L and intra-operative urine output was 150 m L. A central venous catheter was inserted. The patient received 3,000 m L of normal saline and 1 unit of packed red blood cells during surgery. Admission to the ICU was requested because the patient was slow to awaken from anesthesia. He arrived in the ICU on mechanical ventilation. Vital signs in the first hour included BP 110/50, HR 120, urine output of 25 m L for the hour, and a temperature of 35.4°C. The patient is not moving. 
What are the next steps in management? 
Rationale: Continuous hemodynamic monitoring
Pain management/sedation
Chest X-ray is needed to evaluate the placement of the central venous catheter (CVC) and endotracheal tube (ETT)
An arterial blood gas (ABG) to assess ventilation/oxygenation
A complete blood count and chemistry panel are indicated to evaluate blood loss and check electrolytes
A fluid challenge. At least 0.5 to 1 mL/kg of urine per hour is generally desirable
Restoring a normal temperature - external warming, devices, warm IV fluids, humidified air delivered by the ventilator, and raising the temperature of the patient’s room
Residual neuromuscular blockade evaluation
Specialty: Obstetrics_and_Gynecology
In twin pregnancy which of the following combination of fetal presentation may be complicated by interlocked twins; 

Answer options: option1: 1st twin cephalic- 2nd twin cephalic
option2: 1st twin cephalic -2nd twin breach
option3: 1st twin breach- 2 twin breach
option4: 1st twin breach -2nd twin cephalic
option5: 1st twin cephalic -2nd twin transverse
Correct answer: option4
Specialty: General_Surgery
List four drugs implicated in the aetiology of acute pancreatitis 
Rationale: antihypertensives (furosemide, enalapril, losartan) , 
antibiotics (Co-trimoxazole, tetracycline) , 
steroids, codeine, antiepileptics (carbamazepine,  Valproic acid), 
thiopurines (azathioprine, mercaptopurine)  antiretrovirals,
chemotherapeutics. steroids ( dexamethasone, prednisolone), 
5-aminosalicylates (e.g. sulphasalazine, mesalazine).
Specialty: Obstetrics_and_Gynecology
A 20 years old para 0+0 at 38 weeks gestation with a B. P 160/110 multg, severe headache and one episode of convulsion one hour ago. Obsteric examination revealed a term fundal height, cephalic presentation and fetal heart rate of 144/min. The cervix is closed 2 cm long, posterior and not effaced. What would be your next plan of action? 

Answer options: option1: Start magnesium sulphate intravenous hydralazine and prepare for emergency caesarean section delivery
option2: Start magnesium sulphate then control blood pressure with I.V hydrallazine and insert postraglandin pessary.
option3: Start intravenous valium, hydrallazine drip and prepare for emergency caesarean section delivery.
option4: Start intravenous labetalel drip and prepare for emergency ceasarean section delivery
option5: Start intravenous labetalol and insert prostaglandin pessary
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
A 28 years old woman presents with hirsutism, irregular cycle and obesity. Her testosterone level was mildly elevated. Which of the following is the most likely aetiology 

Answer options: option1: Diabetes
option2: Cushings syndrome
option3: Sheerhans syndrome
option4: Polycystic ovarian disease
option5: None of the above
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
Which of the following is true regarding oval combined contraceptives; 

Answer options: option1: Contains estradiol and estrone
option2: Skipping four pills warrants introduction of emergency contraception(postinor)
option3: Is administered for 28 days then after menses start
option4: Confers antifertility effects through inhibition of ovulation
option5: About 10% of users will develop hypertention.
Correct answer: option4
Specialty: General_Surgery
A 60-year male presents with a palpable right upper quadrant mass suspicious of a hepatocellular carcinoma. He is scheduled for a liver resection surgery.

List 4 important modifiable aetiological factors for HCC.

Rationale: Control alcohol abuse, hepatitis B,C transmission reduction , (screen blood transfusion,, unsafe sex , IV drug use) , screening and treatment of hepatitis carriers ( antiviral drugs), limit  Aflatoxins ingestion, control  Toxin exposures (copper, iron), control smoiking,
Control obesity /diet / NAFLD
Specialty: Obstetrics_and_Gynecology
A 29 years old 40 weeks gestation reports to labour ward with maternal exhaustion. Examining her cervix to be 3 cm dilated and partially effaced. A decision to induce her. How would you proceed? 

Answer options: option1: Insert a forleys catheter extra amniotic under traction then observe for labour
option2: Start oxytocin drip
option3: Perform artificial rupture of membranes and if clear start oxytocin drop
option4: Insert prostaglandin pessary then perform artificial rupture of membranes
option5: Insert misoprostol 25mg into posterior fornix then review after 4 hours
Correct answer: option5
Specialty: General_Surgery
List any 6 common features associated with leg ulcers 
Rationale: Commonly found on the lower leg and ankle
Sunken, asymmetrically shaped wound
The edges of the ulcer are clearly defined from the surrounding skin
The surrounding skin is intact, but inflamed
The surrounding skin may be pigmented, hardened or calloused
Yellowish-white exudate (pus)
Pain, particularly while standing
Varicose veins in the leg.
Venous insufficiency
Arterial ulcers
Neuropathic ulcers
Pressure ulcers
Trauma
Chronic wounds
Co-morbidity
Specialty: Obstetrics_and_Gynecology
A 30-year-old underweight a cardiotocograph (CTG) due to induction for reduced fetal movements. A drop in the fetal heart rate was observed only during the contractions and both were mirror images. This phenomenon is referred to as; 

Answer options: option1: Early deceleration
option2: Late deceleration
option3: Variable deceleration
option4: Early acceleration
option5: Late acceleration
Correct answer: option1
Specialty: General_Surgery
What are the four defects in Tetralogy of Fallot? 
Rationale: Tetralogy of Fallot is a combination of four congenital heart defects. The four defects are Ventricular septal defect (VSD), 
Pulmonary stenosis, 
Overriding aorta and
A thickened right ventricular wall (right ventricular hypertrophy).
Specialty: Obstetrics_and_Gynecology
The following statement is true concerning ectopic pregnancy 

Answer options: option1: Absence of vaginal bleeding excludes diagnosis
option2: Presence of vaginal shoulder tip pain indicates rupture
option3: Characteristic feature is marked vaginal bleeding
option4: Symptoms mainly manifest at 16 weeks gestation
option5: Is mainly diagnosed by beta HCG assay
Correct answer: option2
Specialty: General_Surgery
State four treatment options for patients with Lung Cancer 
Rationale: Surgery:  Pneumonectomy, Lobectomy, Video Assisted Thoracoscopic Surgery (VATS)
Radiotherapy: Inoperable stages, Haemoptysis, Spinal Cord Compression, Mediastinal, Intracranial
Endobronchial treatment: Laser, radiotherapy, photodynamic
Chemotherapy: Small cell carcinoma is more responsive
Specialty: Obstetrics_and_Gynecology
The following contraceptive is contraindicated in patients with stage iv HIV disease. 

Answer options: option1: Combined oral contraceptive
option2: Progestin only contraceptive.
option3: Depot medroxy progesterone acetate
option4: Levornogestral implant
option5: Intrauterine contraceptive Device (IUCD)
Correct answer: option5
Specialty: General_Surgery
Name five(5) symptoms and for each symptom indicate the associated mechanism (s) in patients with mediastinal tumours? 
Rationale: Cough:      Airway narrowing, Compression
Chest Pain:  Chest wall and nerve invasion
Dyspnoe:   Airway compromise, pleural effusion, pericardial tamponade, pulmonary stenosis, heart   failure
Haemoptysis: Airway invasion, pulmonary stenosis, heart failure
Dysphagia:    Oesophageal narrowing, obstruction, dysmotility
Hoarseness:  Vocal cord paralysis
Facial swelling:  SVC syndrome
Specialty: General_Surgery
Give six investigations for a patient who presents with pleural effusion 
Rationale: High LDH,
CEA levels
Pleural fluid cytology, 
Needle biopsy,
Open pleural biopsy,
Lung biopsy
Thoracoscopy, 
Videothoracoscopy, 
CXR, 
Echo, 
CT, Contrast CT
Thoracocentesis is mainstay of treatment .
Specialty: Obstetrics_and_Gynecology
A mother at 36 weeks gestation is confirmed to have fetal growth restriction. The management will be; 

Answer options: option1: Start mother on parenteral feeds
option2: Increase the dose of maternal nutritional supplements
option3: Administer high-calorie diet to the mother for the next four weeks
option4: Deliver the baby
option5: None of the above
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
A 28-year-old presents with a pap smear result reaching HSIL. Which of the following is the most appropriate management strategy? 

Answer options: option1: Exam and a pap smear in one year's time
option2: Colposcopy with endocervical curetting for histology
option3: Cryotherapy
option4: Loop electrosurgical excision procedure (LEEP) OR cervical conization
option5: Hysterectomy
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
A 32-year-old Para 2+1 presents with one year history amenorrhea following evacuation of the uterus due to septic incomplete abortion. Her hormonal profile is normal. What is the likely diagnosis 

Answer options: option1: Premature menopause
option2: latrogenic ovarian failure
option3: Hypothalamic pituitary amenorrhea
option4: Sheehan's syndrome
option5: Asherman's syndrome
Correct answer: option5
Specialty: Obstetrics_and_Gynecology
A Para 1+1 with no living children has a D & C for a partial molar pregnancy. The couple would like to conceive as soon as possible. Which of the following is the appropriate recommendation to them? 

Answer options: option1: Attempt pregnancy 2 months after D&cx
option2: Attempt pregnancy once beta-HCG normalizes
option3: Avoid pregnancy for 3 years
option4: Use Depo Provera contraceptive for one year then conceive
option5: Attempt conception 6 months after a negative beta HCG level
Correct answer: option5
Specialty: Obstetrics_and_Gynecology
Which of the following explanations would justify delayed cord clamping in the third stage of labour? 

Answer options: option1: To facilitate delivery of the placenta
option2: To prevent birth asphyxia
option3: To facilitate resuscitation of the baby
option4: To improve bonding between the mother and her baby
option5: To prevent anaemia in the baby
Correct answer: option5
Specialty: Obstetrics_and_Gynecology
Which of the following diameters is associated with full flexion of the fetal head at engagement? 

Answer options: option1: Submentobregmatic diameter
option2: Mentovertical diameter
option3: Suboccipitobregmatic diameter
option4: Occipitofrontal diameter
option5: Suboccipitofrontal diameter
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
The loading dose of magnesium sulfate is given via

Answer options: option1: I.V over 5 minutes, followed by deep I.M injection into each button
option2: I.V over 5 minutes followed by deep I.M injection into one buttock
option3: Simultaneous I.V and I.M injections
option4: I.V bolus, followed by deep I.M injection into each buttock
option5: a and c
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
Diastolic blood pressure 90 mmitg or more before 20 weeks of gestation is symptomatic of; 

Answer options: option1: Mild pre-eclampsia
option2: Chronic hypertension
option3: Superimposed mild pre-eclampsia
option4: Pregnancy-induced hypertension
option5: All of the above
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
Regarding Fertilization & implantation: 

Answer options: option1: Fertilization occurs in the inner third of the fallopian tube.
option2: The sperm head penetrates through the corona radiata & zona pellucida while the tail remains outside.
option3: The 2nd meiotic division is completed before fertilization.
option4: Implantation occurs at the morula stage.
option5: The trophoblast invades the endometrium & differentiates into an outer cytotrophoblast & an inner syncytiotrophoblast
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
Mrs. Aketch came to the antenatal clinic at 32 weeks gestation feeling dizzy and weak. Laboratory investigations revealed she has anaemia. The MOST likely type of anaemia would be: 

Answer options: option1: Iron deficiency anaemia
option2: Physiological anaemia
option3: Anemia due to ascaris lumbricoides
option4: Megaloblastic anaemia
option5: Haemolytic anaemia
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
When performing abdominal aortic compression to control postpartion hemorrhage, the point of compression 

Answer options: option1: Just below and slightly to the right of the umbilicus
option2: Just below and slightly to the left of the umbilicus
option3: Just above and slightly to the right of the umbilicus
option4: Just above and slightly to the left of the umbilicus
option5: None of the above
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
If manual removal of the placenta is performed 

Answer options: option1: Give ergometrine prior to the procedure
option2: Give antibiotics 24 hrs after the procedure
option3: Place one hand in the uterus and use the other hand to apply traction on the cord
option4: Place one hand in the uterus and one hand on the abdomen to provide counter traction on the uterine fundus
option5: All of the above
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
If the uterus is inverted following childbirth all of the following are true except; 

Answer options: option1: The uterine fundus is felt on abdominal palpation
option2: There may be slight or intense pain
option3: The inverted uterus may be apparent at the valve
option4: The uterine fundus is not felt on abdominal palpation-
option5: None of the above
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
When diagnosing iron deficiency anaemia which one of the following applies? 

Answer options: option1: Serum ferritin is more than 12 g/dL
option2: Lead is less than 20 g/dL.
option3: Free erythrocyte protoporphyrin greater than 35 g/dL.
option4: B12, B6, folate levels are increased.
option5: Serum iron binding capacity may double
Correct answer: option5
Specialty: Obstetrics_and_Gynecology
Tears of the cervix, vagina or perineum should be suspected when there is immediate postpartum hemorrhage and; 

Answer options: option1: A complete placenta and a contracted uterus
option2: An incomplete placenta and a contracted uterus
option3: A complete placenta and an atonic uterus
option4: An incomplete placenta and an atonic uterus
option5: All of the above
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
Disseminated intravascular coagulopathy is suspected following when bedside clotting test is done if; 

Answer options: option1: Bleeding fails to stop within 7 minutes from a 1mm incision made on the inner aspect of a forearm
option2: A clot fails to form within 7 minutes when calcium gluconet is added to a 3ml test tube of blood
option3: A clot forms within 7 minutes
option4: A clot fails to form after 7 minutes or a soft clot form that breaks down easily
option5: Clot form but pale in colour.
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
Mrs Musa is a postnatal mother who is showing a lot of interest in taking care of her baby. Regarding the psychological phases of puerperium, she is in the: 

Answer options: option1: Taking-in phase
option2: Taking-on phase
option3: Taking-hold phase
option4: Letting-go phase
option5: Anxiety phase
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
Which one of the following interventions is NOT advised during vaginal term delivery of a patient with mitral stenosis? 

Answer options: option1: Ergometrine injection.
option2: Frusemide (Lasix) injection.
option3: Vacuum delivery
option4: Oxygen by mask
option5: Oxytocin injection
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
Which of the following criteria is not used in the WHO prognostic scoring system for choriocarcinoma? 

Answer options: option1: Age of the patient
option2: Serum levels of beta hCG.
option3: Patient's ABO blood group
option4: Metastases to the lungs
option5: Size of largest tumour
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
One of the following statements is correct about vulval and vaginal conditions 

Answer options: option1: Desquamative inflammatory vaginitis occurs mainly in the postmenopausal women.
option2: The causative organism in Toxic Shock Syndrome is streptococcus
option3: Vaginal discharge is the commonest presentation of foreign body in the vagina amongst toddlers
option4: Vulval warts in 3rd trimester is treated by cauterization to allow for a vaginal delivery.
option5: Stab incision followed by drainage of pus, is the advocated treatment of Bartholin's abscess
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
Which of the following statements is INCORRECT? 

Answer options: option1: Oral contraceptive pills delay the onset of menopause.
option2: Premature menopause is cessation of menstruation before the age of 40
option3: Menopause is the final menstruation which occurs during the climacteric
option4: Pre-menopause is the time during climacteric when the menses become irregular
option5: Climacteric is the phase during which a woman passes from the reproductive stage to non-reproductive stage
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
Which of the following statements is correct regarding post-menopause? 

Answer options: option1: FSH and LH are characteristically low
option2: A fibroid uterus tends to grow bigger
option3: The endometrium is characteristically thick on Ultrasonography
option4: The women have a tendency to get fractures
option5: Genital atrophy hardly ever occurs
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
A 17-year-old, pregnant woman was brought to maternity ward, because was found to have generalized convulsion at the central market. O/E: (positive finding) unconscious, pale +, BP 156/100 mmHg, hyperreflexia, urine dipstick for protein +; F/L 35 cm. V/E Cervix effaced, dilated 4 cm, station –1. How do you manage this patient? 

Answer options: option1: General measure, prophylactic antibiotic and immediate C/section.
option2: General measures, antihypertensive, MgSO4, resuscitation of the patient, foetal assessment and emergency c/section.
option3: General measures, antihypertensive, anticonvulsant and augmentation.
option4: General measures, BP control, fit control, mother stabilization and conservative management.
option5: None of the above is true
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
A 56-year-old lady presented with a small cervical lesion which bled to touch, she reported that she had difficulty closing her left eye. She had nausea and loss of appetite. She had a staring gaze and paresis on the right. No other pelvic lesions were found. 

Answer options: option1: This is Ca Cervix stage four
option2: The condition can be diagnosed by ultrasound
option3: The diagnosis can be suspected from the previous history and confirmed by Laboratory investigations
option4: She has Burkitt’s lymphoma
option5: None of the above
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
Emily is on Mg SO 4 post-delivery for prevention of eclampsia. Which of the following is NOT a feature of Mg SO 4 toxicity? 

Answer options: option1: Depressed respiration
option2: Brisk tendon reflexes
option3: Diminished tendon reflexes
option4: Reduced urine output
option5: None of the above
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
Emily is a primigravida at 37 weeks. She is diagnosed to have pre-eclampsia with severe features. Her BISHOP score is 7 and fetal BPP 10/10. Regarding her delivery plan: 

Answer options: option1: Induction of labor should be commenced as well as Magnesium sulfate.
option2: Emergency cesarean section should be done after steroids administration
option3: Emergency cesarean section should be done immediately
option4: Induction of labor should be done after administration of Magnesium sulfate (MgSO4)
option5: None of the above
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
Rose is a primigravida at 24 weeks gestation. Her BMI is 32. She presents with right calf pain and swelling. Which of the following statements regarding her condition is TRUE? 

Answer options: option1: An elevated D-Dimer is diagnostic
option2: Real time ultrasonography is the investigation modality of choice.
option3: The drug of choice is Warfarin
option4: Hospitalization is not a risk factor of her presentation
option5: None of the above
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
Aria is a 24-year-old para 1+0 at 14 weeks, she had a preterm birth with neonatal demise in the previous pregnancy. She has had transvaginal cervical scan indicating a cervical length of 2.4 cm. She is informed of risk of preterm labor later during this pregnancy. Regarding her management, which of the following is appropriate? 

Answer options: option1: Strict bed rest, oral Salbutamol and Pheobarbitone
option2: Avoidance of sexual intercourse
option3: Micronized per vaginal progesterone up to 36 weeks
option4: Use of Ascard (Aspirin 75mg) once daily up to 28 weeks
option5: All of the above
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
During fetal surveillance:-

Answer options: option1: In late decelerations of fetal heart rate, the peak of the contraction occurs after the nadir of the deceleration
option2: Fetal heart rate increases with increasing gestation
option3: Placental grading is one of the markers of the biophysical profile (BPP)
option4: Fetal heart rate accelerations of 15 bpm above baseline rate are a nonreassuring finding
option5: An early deceleration of the fetal heart rate is a normal finding
Correct answer: option5