afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Rheumatology
About glucocorticoid induced osteoporosis, choose the wrong option 

Answer options: option1: Bone loss is most pronounced in the first few months of use
option2: Fractures occur at higher bone mineral density values than occur in postmenopausal osteoporosis
option3: The glucocorticoid dose and the duration of therapy should be as low as possible to prevent osteoporosis
option4: Glucocorticoids induce positive calcium balance by decreasing intestinal calcium absorption and increasing urinary calcium excretion
option5: n/a
Correct answer: option4
Specialty: Pulmonary_Medicine
A 42-year-old woman on medications for pulmonary tuberculosis complains of numbness and tingling sensation in both hands and feet which developed recently. What could have been added to her medications to help prevent development of these new symptoms?






Answer options: option1: Cobalamin
option2: Pyridoxine
option3: Thiamine
option4: Iron
option5: Niacin
Correct answer: option2
Specialty: Pulmonary_Medicine
A 78-year-old retired plumber presented to the general clinic complaining of gradually worsening difficulty breathing and dull left sided chest pain for the past 4 months. He has a 10-pack year history of smoking. Chest examination findings were reduced chest expansion, stony dull percussion note and reduced breath sounds all on the left. Chest X ray done showed a large left sided pleural effusion and pleural plaques. What is the most likely cause of the pleural effusion?


Answer options: option1: Tuberculosis
option2: Parapneumonic effusion
option3: Small cell lung cancer
option4: Mesothelioma
option5: Squamous cell lung cancer
Correct answer: option4
Specialty: Pulmonary_Medicine
A 52-year-old man who works as a plumber and smokes 15 cigarettes every day presents to the clinic on account of reduced exercise tolerance. There is a quiet wheeze heard on auscultation of the chest. His body mass index is 30 kg/m2. Lung function test done showed FVC of 88%, FEV 1/FVC ratio of 65% and FEV 1/FVC post bronchodilator ratio of 68%. What is the most likely diagnosis?

Answer options: option1: Asbestosis
option2: Asthma
option3: Idiopathic pulmonary fibrosis
option4: Chronic obstructive pulmonary disease
option5: Obesity hypoventilation syndrome
Correct answer: option4
Specialty: Pulmonary_Medicine
A 55-year-old man who has been working for many years in a quarry presents with difficulty breathing on physical activity and cough which has worsened over the past 3 months. There is associated weight loss. Chest X ray done shows bilateral reticulonodular opacities predominantly at the upper lobes. What is the most likely diagnosis?



Answer options: option1: Tuberculosis
option2: Bronchogenic carcinoma
option3: Silicosis
option4: Asbestosis
option5: Idiopathic pulmonary fibrosis
Correct answer: option3
Specialty: Pulmonary_Medicine
A 72-year-old smoker is reviewed following a bronchoscopy and biopsy of a lung lesion that has confirmed to be squamous cell carcinoma of the bronchus.
What electrolyte abnormality is most likely to be found on investigation?

Answer options: option1: Hypocalcaemia
option2: Hyperkalaemia
option3: Hypercalcaemia
option4: Hypokalaemia
option5: Hyperphosphatemia
Correct answer: option3
Specialty: Pulmonary_Medicine
A 31-year-old woman presents to the Emergency Department complaining of
left-sided pleuritic chest pain that is worse on inspiration. She has no cough and no history of fever. Her blood pressure is 80/55 mmHg. CT pulmonary angiogram showed filling defects consistent with pulmonary embolism. What is the appropriate management.



Answer options: option1: Warfarin
option2: Rivaroxaban
option3: Alteplase
option4: Aspirin
option5: Heparin
Correct answer: option3
Specialty: Pulmonary_Medicine
A 49-year-old woman presents to the Emergency Department with a 48-hour history of shortness of breath, fever and cough productive of rusty coloured sputum. Her temperature is 38.9 °C and her blood pressure is 100/70 mmHg. Coarse crackles and decreased breath sounds are heard at the right lung base on auscultation. She has a cold sore at the left-hand corner of her mouth. What is the likely cause of her chest infection?

Answer options: option1: Klebsiella pneumoniae
option2: Legionella pneumophilia
option3: Mycoplasma pneumoniae
option4: Streptococcus pneumoniae
option5: Staphylococcus aureus
Correct answer: option4
Specialty: Pulmonary_Medicine
A 62-year-old man who smokes 30 cigarettes a day is brought to the hospital on account of increasing confusion and drowsiness over the past 6 days. His wife mentioned he also has a 3-month history of cough and weight loss. He has decreased breath sounds on the left and Chest X ray done showed a hilar mass suspiscious for lung malignancy. His blood tests was significant for hyponatraemia of 122 mmol/L . What is the most probable cause of his symptoms?

Answer options: option1: Adenocarcinoma
option2: Bronchial carcinoid
option3: Small cell lung cancer
option4: Squamous cell cancer
option5: Mesothelioma
Correct answer: option3
Specialty: Pulmonary_Medicine
A 67-year-old woman is admitted to the Emergency Unit with fever and a cough productive of green sputum. Her pulse rate is 101 bpm, blood pressure is 80/60 mmHg and respiratory rate of 32 cpm. She is alert and orientated in space and time. Blood tests reveal leukocytosis with neutrophilia, elevated creatinine and urea level of 8.5 mmol/L . What is her CURB-65 score?
Answer options: option1: 5
option2: 3
option3: 1
option4: 4
option5: 2
Correct answer: option4
Specialty: Pulmonary_Medicine
Chest X ray done for a 45-year-old man with chronic cough shows opacities in the upper lobes. Which of the following in not a cause of predominantly upper lobe opacities?



Answer options: option1: Tuberculosis
option2: Sarcoidosis
option3: Silicosis
option4: Hypersensitivity pneumonitis
option5: Idiopathic pulmonary fibrosis
Correct answer: option5
Specialty: Pulmonary_Medicine
A 54-year-old man who smokes 25 cigarettes and has type 2 diabetes reports to the clinic because of a cough and worsening glycaemic control. He has also noticed weight gain and purplish striae on his abdomen. His fasting blood sugar is 15 mmol/L and blood pressure is 155/98 mmHg. A Chest X ray done showed a left hilar mass. What is the likely cause of his symptoms?


Answer options: option1: Small cell carcinoma of the bronchus
option2: Sarcoidosis
option3: Squamous cell carcinoma bronchus
option4: Adenocarcinoma of the bronchus
option5: Pulmonary tuberculosis
Correct answer: option1
Specialty: Pulmonary_Medicine
What is the right order for the phases of pneumonia?

Answer options: option1: Congestion, Red hepatizaion, Gray hepatization and Resolution
option2: Gray hepatization, Red hepatization, Congestion and Resolution
option3: Red hepatization, Gray hepatization, Congestion and Resolution
option4: Congestion, Gray hepatization, Red hepatization and Resolution
option5: Gray Hepatization, Congestion, Red hepatization and Resolution
Correct answer: option1
Specialty: Pulmonary_Medicine
A 65-year-old male presents with cough and difficulty breathing. He is cyanosed with finger clubbing. A chest x ray done shows bilateral lower reticulonodular opacities. What is the most likely diagnosis?

Answer options: option1: Bronchiectasis
option2: Pulmonary fibrosis
option3: Bronchogenic carcinoma
option4: Chronic bronchitis
option5: Emphysema
Correct answer: option2
Specialty: Nephrology
A 22-year-old female with no significant past medical history presented with haematuria which started after 2 days of fever and sore throat. There is no history of rash, joint pains or diarrhoea. Physical examination was unremarkable. Urinalysis showed blood 3+, protein 1+, dysmorphic RBCs and RBC casts. Complete blood count and renal function tests were normal. What is the most likely diagnosis?

Answer options: option1: Lupus nephritis
option2: Post-streptococcal glomerulonephritis
option3: Goodpasture’s disease
option4: IgA nephropathy
option5: ANCA associated glomerulonephritis
Correct answer: option4
Specialty: Nephrology
A 68-year-old woman is admitted at the medical ward for acute kidney injury. Results of her kidney function test come in showing a potassium level of 7.0 mmol/L . What is the appropriate medication to give next in her management?

Answer options: option1: Calcium resonium
option2: Insulin and dextrose
option3: Calcium gluconate
option4: Salbutamol
option5: Patiromer
Correct answer: option3
Specialty: Nephrology
A 19-year-old man is seen at the Renal clinic with history of recurrent haematuria. He also complains of hearing loss. On further questioning, it is found out that his brother also suffers from kidney disease and hearing loss. Blood pressure checked is 130/78 mmHg. Abdominal examination is unremarkable. Urine dipstick done shows blood 1+ and no protein. What is the most likely cause of this patient’s haematuria?

Answer options: option1: IgA nephropathy
option2: Congenital nephrotic syndrome
option3: Post streptococcal glomerulonephritis
option4: Alport syndrome
option5: Autosomal dominant polycystic kidney disease
Correct answer: option4
Specialty: Nephrology
An 18-year-old female returns to the hospital 72 hours after being prescribed amoxicillin for pharyngitis. She is worried that her symptoms are getting worse. She has developed a skin rash and has suffered more fevers over the past 24 hours. Her blood pressure is 141/84 mmHg and her heart rate is 88 bpm and regular. Full blood count shows marked eosinophilia and kidney function test reveals elevated creatinine. Urine test shows protein 1+ and blood 1+. What is the most likely diagnosis?

Answer options: option1: IgA nephropathy
option2: Goodpasture’s disease
option3: Acute interstitial nephritis
option4: Post streptococcal glomerulonephritis
option5: Eosinophilic granulomatosis with polyangiitis
Correct answer: option3
Specialty: Nephrology
A 65-year-old woman who has end stage kidney disease and on haemodialysis reports with severe bone pains and lethargy. Blood tests shows elevated serum calcium, elevated serum phosphate and elevated parathyroid hormone. Alkaline phosphatase levels are normal. Which of the following is the most likely diagnosis?

Answer options: option1: Osteomalacia
option2: Paget disease
option3: Primary hyperparathyroidism
option4: Secondary hyperparathyroidism
option5: Tertiary hyperparathyroidism
Correct answer: option5
Specialty: Nephrology
Which statement concerning proteinuria is true?

Answer options: option1: Proteinuria can be caused by standing for prolonged periods.
option2: The commonest protein found in urine is gamma globulin.
option3: Proteinuria never occurs in pregnancy.
option4: Proteinuria always indicates kidney disease.
option5: Proteinuria is harmless unless associated with haematuria.
Correct answer: option1
Specialty: Nephrology
A 16-year-old male presents with vomiting and haematuria. He had been given antibiotics for pharyngitis three weeks earlier. Blood pressure is 150/98 mmHg. Urine dipstick done showed blood 3+ and protein 1+. Elevated creatinine and urea levels are seen on renal function test. What is the most likely diagnosis?

Answer options: option1: Anti-glomerular basement membrane disease
option2: IgA nephropathy
option3: Acute interstitial nephritis
option4: ANCA associated glomerulonephritis
option5: Post streptococcal glomerulonephritis
Correct answer: option5
Specialty: Nephrology
A 38-year-old woman presents with sudden onset left sided weakness. She mentions she has been unwell for the past few days with fever and diarrhoea. She has bruising and petechiae on both upper and lower limbs. Blood tests are significant for reduced haemoglobin, severe thrombocytopenia, elevated creatinine and hyperkalaemia. Urine dipstick shows protein 1+ and blood +. What is the most likely cause of the renal impairment?

Answer options: option1: Lupus nephritis
option2: Post streptococcal glomerulonephritis
option3: Thrombotic thrombocytopenic purpura
option4: Haemolytic uraemic syndrome
option5: ANCA associated glomerulonephritis
Correct answer: option3
Specialty: Nephrology
A 19-year-old man is presents with haematuria, hypertension and a mildly elevated creatinine level. His father has haematuria, renal impairment and deafness. His sister also has haematuria but does not have renal impairment and her hearing is normal. His blood pressure is 152/90 mmHg, and his pulse is 72 bpm and regular. His abdomen is soft and non-tender, with no masses. What defect is most likely to be found explaining these symptoms?

Answer options: option1: Cystic fibrosis transmembrane conductance receptor
option2: Epithelial sodium channel
option3: Polycystin-1
option4: Type IV collagen
option5: Aquaporin 4
Correct answer: option4
Specialty: Nephrology
A 50-year-old man who was diagnosed of hypertension and started on Lisinopril 10 mg daily is referred to the Renal clinic due to hyperkalaemia and marked elevation in serum creatinine seen on on repeat kidney function test done after 2 weeks. What is the most useful investigation to identify the possible reason for this observation?

Answer options: option1: Renin and angiotensin levels
option2: Renal tract ultrasound
option3: Urinary electrolytes
option4: CT renal angiogram
option5: Short synacthen test
Correct answer: option3
Specialty: Nephrology
A 38-year-old male presents with hypertension and worsening renal function. An ultrasound done showed multiple cysts in both kidneys as well as cysts in the liver. A diagnosis of polycystic kidney disease is made. Which of the following is the most important association with the diagnosis?

Answer options: option1: Infertility
option2: Colon cancer
option3: Type 1 diabetes
option4: Cerebral aneurysms
option5: Mitral stenosis
Correct answer: option4
Specialty: Nephrology
A 32-year-old male with no medical conditions presents with generalized muscle aches and passage of progressively darkening urine one day after running the marathon. Physical examination is unremarkable aside mild tenderness over the quadriceps. Urine dipstick shows blood 3+ and leukocytes 1+. What is the most likely diagnosis?

Answer options: option1: Nephrolithiasis with haematuria
option2: Intravascular haemolysis
option3: Profound dehydration
option4: Rhabdomyolysis
option5: Multiple myeloma
Correct answer: option4
Specialty: Gastroenterology
A 62-year-old man is rushed to the Emergency Unit following a syncopal attack. He reports passing dark stools for the past five days. Which is the following is the most important marker for distinguishing upper from lower gastrointestinal bleeding?

Answer options: option1: Darkness of stool
option2: Elevated creatinine
option3: Elevated lactate dehydrogenase
option4: Elevated urea
option5: Elevated haematocrit
Correct answer: option4
Specialty: Gastroenterology
A 45-year-old woman presents to the clinic on account of easy fatigue and generalized pruritus for the past 5 months. She has a number of spider naevi over her chest and hepatomegaly 2 cm below subcostal margin. Liver function tests done were abnormal. Anti-mitochondrial antibody test is positive. What is the most likely diagnosis?

Answer options: option1: Autoimmune hepatitis
option2: Wilson’s disease
option3: Primary sclerosing cholangitis
option4: Alpha-1 antitrypsin deficiency
option5: Primary biliary cholangitis
Correct answer: option5
Specialty: Gastroenterology
A 60-year-old male with significant history of smoking presents with a 4 month history of epigastric pain with associated jaundice, weight loss and loss of appetite. His abdomen is soft but there is epigastric tenderness. An abdominal ultrasound showed a mass in the head of the pancreas. Which tumor marker is most likely to be elevated?

Answer options: option1: Alpha-fetoprotein
option2: Cancer antigen 15-3
option3: Cancer antigen 125
option4: Carcinoembryonic antigen
option5: Cancer antigen 19-9
Correct answer: option5
Specialty: Gastroenterology
A 52-year-old man who is known to have alcoholic cirrhosis is admitted at the Emergency Department with worsening ascites and abdominal pain. An ascitic tap is performed and the total fluid neutrophil count is 310 per mm3 A diagnosis of spontaneous bacterial peritonitis is made. What is the likely organism to be cultured?

Answer options: option1: Candida albicans
option2: Escherichia coli
option3: Proteus mirabilis
option4: Klebsiella pneumoniae
option5: Staphylococcus aureus
Correct answer: option2
Specialty: Gastroenterology
Which of the following is true of irritable bowel syndrome?

Answer options: option1: Constipation is rare in this condition
option2: The gold standard for diagnosis is upper GI endoscopy
option3: Biopsy reveals extensive colonic mucosal inflammation
option4: Abdominal pain or discomfort is a prerequisite clinical feature
option5: Nocturnal diarrhoea is a common feature
Correct answer: option4
Specialty: Gastroenterology
A patient being managed for coeliac disease complains of itchy blisters on the elbows, shoulders and ankles. Which of the following medications is most appropriate?




Answer options: option1: Acyclovir
option2: Dapsone
option3: Amoxicillin
option4: Terbinafine
option5: Calcipotriol
Correct answer: option2
Specialty: Gastroenterology
Which of the following is true concerning achalasia?

Answer options: option1: It is caused by Helicobacter pylori infection.
option2: It is caused by reflux of gastric acid into the oesophagus
option3: It is associated with Barrett’s oesophagus
option4: It is an oesophageal motility disorder
option5: It is caused by recurrent spasms of the lower oesophagus
Correct answer: option4
Specialty: Gastroenterology
A 22-year-old woman is suspected of having coeliac disease. What is the appropriate initial test?

Answer options: option1: Colonoscopy
option2: Anti-liver-kidney microsomal type 1 antibodies
option3: Abdominal CT scan
option4: Faecal calprotectin
option5: Anti-tissue transglutaminase antibodies
Correct answer: option5
Specialty: Gastroenterology
A 50-year-old woman who has been diagnosed with alcoholic steatohepatitis comes to the clinic for review. Over the past few months, she has begun to develop more abdominal swelling. She has no other complains. Examination reveals ascites. What is the most appropriate way to treat this ascites?


Answer options: option1: Ascitic tap
option2: Bendroflumethiazide
option3: Carvedilol
option4: Furosemide
option5: Spironolactone
Correct answer: option5
Specialty: Gastroenterology
A 72-year-old man presents with intermittent dysphagia to both solids and liquids over the past 8 months. He experiences retrosternal pain which is relieved by regurgitating food. He has had one episode of pneumonia over the past year. There is mild epigastric tenderness on palpation. A barium swallow done showed dilated oesophagus with a bird’s beak appearance. What is the most likely diagnosis?


Answer options: option1: Oesophageal spasms
option2: Achalasia
option3: Oesophageal carcinoma
option4: Zenker’s diverticulum
option5: Eosinophilic oesophagitis
Correct answer: option2
Specialty: Gastroenterology
A 50-year-old farmer presents with diarrhoea, flatulence, joint pains and gradual weight loss over the past 6 months. A small bowel biopsy shows villous atrophy and periodic acid-Schiff positive macrophages. What is the most likely diagnosis?


Answer options: option1: Whipple’s disease
option2: Small bowel lymphoma
option3: Coeliac disease
option4: Ulcerative colitis
option5: Lactose intolerance
Correct answer: option1
Specialty: Gastroenterology
A 48-year-old bartender is suspected of having exocrine pancreatic insufficiency. What is the most useful investigation?

Answer options: option1: Anti-tissue transglutaminase antibodies
option2: Faecal calprotectin
option3: Hydrogen breath test
option4: Faecal elastase
option5: Faecal helicobacter antigen test
Correct answer: option4
Specialty: Gastroenterology
Which of the following statements is false about ascites?

Answer options: option1: It is a complication of liver cirrhosis
option2: It may cause respiratory embarrassment
option3: Spontaneous bacterial peritonitis is a complication
option4: It is as a result of portal hypertension when the serum ascitic albumin gradient is low.
option5: It is a recognized feature of constrictive pericarditis.
Correct answer: option4
Specialty: Gastroenterology
Which of these statements about Hepatitis B infection is true?

Answer options: option1: Presence of envelope antigen is a good prognostic sign.
option2: Presence of envelope antibodies following infection indicates recovery and immunity.
option3: Presence of core IgM antibodies indicates chronic infection.
option4: Approximately 90 percent of children under 5 years will clear the virus spontaneously
option5: Surface antigen is detectable within one month of exposure.
Correct answer: option5
Specialty: Gastroenterology
A 70-year-old woman is diagnosed of Zollinger-Ellison syndrome and undergoes a gastrectomy. She is informed of the need to take intramuscular vitamin B 12 shots for the rest of her life. Absence of which of the following cell types is responsible for this vitamin replacement requirement?

Answer options: option1: Chief cells
option2: G cells
option3: Goblet cells
option4: Mucous neck cells
option5: Parietal cell
Correct answer: option5
Specialty: Gastroenterology
An 18-year-old man presents with chronic diarrhoea and a diagnosis of pancreatic insufficiency is made. Supplementation of which of the following vitamins is most appropriate.

Answer options: option1: Vitamins A, D, E and K
option2: Vitamins A, B12, C and D
option3: Vitamins B12, C, E and K
option4: Vitamins B, C and K
option5: Vitamins B12, D, E and K
Correct answer: option1
Specialty: Endocrinology
A 32-year-old woman is seen at the Endocrine Clinic on account of recurring headaches and episodes of diaphoresis. She was diagnosed of hypertension 6 months which have worsened over the last few months despite starting lisinopril 10 mg daily. Blood pressure checked is 160/94 mmHg. It is also noticed that she had a large tongue and prominent lower jaw. Her body mass index is 24 kg/m2. What is the likely cause of the hypertension?

Answer options: option1: Cushing disease
option2: Primary hypertension
option3: Acromegaly
option4: Phaechromocytoma
option5: Carcinoid syndrome
Correct answer: option3
Specialty: Endocrinology
An 18-year-old man complains of a lack of sex drive and having no sense of smell. He is of normal height and weight. He has absence of facial, axillary and pubic hair. His penis and testes are small in size. What is the most likely diagnosis?
Answer options: option1: Conn syndrome
option2: Klinefelter syndrome
option3: Kallmann syndrome
option4: Turner syndrome
option5: Gitelmann syndrome
Correct answer: option3
Specialty: Endocrinology
A 52-year-old woman presents with worsening tiredness and weight gain over the past six months. She also feels short of breath, particularly when she lies flat at night. Her blood pressure is 138/100 mmHg and her heart rate is 65 bpm and regular. She has a smooth goiter. Her body mass index is 31 kg/m2. Blood tests shows a markedly elevated thyroid stimulating hormone. What is the most likely diagnosis?
Answer options: option1: Graves’ disease
option2: Hashimoto’s thyroiditis
option3: Secondary hypothyroidism
option4: Non-toxic goiter
option5: Subacute thyroiditis
Correct answer: option2
Specialty: Endocrinology
A 43-year-old man presents with complains of weight gain of 6 kg over the past four months, development of diabetes mellitus and poorly controlled blood pressure. His blood pressure is 155/95 mmHg, his body mass index is 37 kg/m2 and he has obvious
abdominal striae. What is the next most useful investigation?
Answer options: option1: Random cortisol
option2: Random growth hormone
option3: 24-hour urinary free cortisol
option4: 24-hour urinary 5-hydroxyindoleacetic acid
option5: Thyroid function test
Correct answer: option3