afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: General_Surgery
A patient presents with gross swelling of the whole of right upper limb following a right modified radical mastectomy with level I and II axillary clearance. What is the most likely cause of the patient’s symptoms? 
Answer options: option1: injury to the cephalic vein
option2: axillary lymph node dissection
option3: failure to elevate the limb
option4: phlebitis
option5: n/a
Correct answer: option2
Specialty: Internal_Medicine
A 87 yrs old female who started smoking at the age of 19. Started coughing 6 months prior to presentation. Now presents with bloody productive cough. Has hoarse voice, drooping upper eyelid, partial ptosis. Where is the likely position of hr tumour? 
 
 
 
 

Answer options: option1: lung apices
option2: mediastinum
option3: lower lung zone
option4: vocal cords
option5: n/a
Correct answer: option1
Specialty: Internal_Medicine
A 36 years old man presents with sudden loss of function of his lower limbs associated with back pain. He is HIV non-reactive and was recently tested. There is no history of trauma. What are the likely neurological exam findings? 
 
 
 
 

Answer options: option1: Hyperreflexia
option2: Increased tone
option3: Loss of sensation
option4: Reduced tone
option5: n/a
Correct answer: option4
Specialty: Emergency_Medicine
A massive hemothorax is defined as: 
Answer options: option1: A hemothorax that is visible on ultrasound.
option2: A volume of blood > 3L in the pleural space in adults.
option3: A volume of blood >1500mL in the pleural space in adults.
option4: A hemothorax that is visible on chest radiograph.
option5: A volume of blood < 6L in the pleural space in adults.
Correct answer: option3
Specialty: Internal_Medicine
A 48 yrs. old man was brought by his daughter to the hospital. He is confused, agitated and has headache. Fundoscopy shows cottonwool, papiloedema. Vital signs; BP 230/150 mmhg, PR 130. What is the likely diagnosis? 





Answer options: option1: Hypertensive urgency
option2: Hypertensive emergency
option3: Glaucoma
option4: Hypertensive retinopathy
option5: n/a
Correct answer: option2
Specialty: Emergency_Medicine
A 33-year old unconscious female patient has sustained a trauma and presents to the emergencysetting. The mechanism of the trauma is unclear but there is no immediately obvious external signs of injury or bleeding. Which of the following is true of cervical spine immobilization? 
Answer options: option1: A c-collar is not necessary in this situation given that the patient is unconscious and not moving.
option2: A c-collar is not necessary in this situation given that the patient has no  external signs of trauma.
option3: A rigid c-spine collar should be applied.
option4: A rigid c-spine collar should be applied and the patient should be maintained on a hard spinal board
option5: A C- collar doesn’t work most of the times
Correct answer: option3
Specialty: Neurology
In the neurology clinic you see a 70 yr old man who has been referred from a primary health care facility with suspected CVA. He is a known Diabetic type two on oral medication and was diagnosed with hypertension two weeks prior to presentation. What are the risk factors for a stroke does he have ? 





Answer options: option1: Hypertension
option2: Diabetes
option3: Age
option4: All the above
option5: n/a
Correct answer: option5
Specialty: Internal_Medicine
An 18 yr lady with asthma presents with acute breathlessness and wheeze that started after running a marathon at school. Her last asthma exercabation was 6 months ago and she was admitted to hospital in the normal ward. She uses a salbutamol inhaler as needed. She has never smoked and has no significant biomass fuel exposure. She has a positive family history of atopy. What key findings in the physical exam will lead to a diagnosis of severe asthma exacerbation? 



 

Answer options: option1: Silent chest
option2: Unable to complete sentences when talking
option3: Diffuse wheezes in the chest
option4: Oxygen saturations of 90-92% on room air
option5: n/a
Correct answer: option1
Specialty: Emergency_Medicine
A 28-year-old male is involved in a motor vehicle collision. On arrival at the emergency setting, heis combative and agitated. He has severe facial trauma, with obvious facial fractures and soft tissue injury. He is bleeding heavily from his mouth and making "gurgling" noises. You determine he requires a secure airway. 
On attempted intubation, there is bleeding from the oral cavity that impairs visualization, evenwith suctioning. The patient's saturations are 84%. Your next course of action should be

Answer options: option1: . Emergency tracheostomy
option2: Attempt at blind endotracheal intubation
option3: Emergency cricothyrotomy (cricothyroidotomy)
option4: Attempt nasotracheal intubation
option5: None of the above
Correct answer: option3
Rationale: n/A
Specialty: Emergency_Medicine
You are part of a team at your hospital that receives several victims of a mass casualty event. You evaluate a patient who is not spontaneously breathing even after repositioning the airway. Which category is appropriate for this patient? 
Answer options: option1: Dead/dying - There is little chance forsurvival even with intervention.
option2: Delayed - The patient may have significant injuries, but they are not life threatening.
option3: Minor - The patient has no life-threatening injuries.
option4: Immediate - There is potential forsurvival with urgent intervention
option5: None of the above
Correct answer: option1
Specialty: Internal_Medicine
A 28 yr old man presents with two-week history of swelling of the lower extremities, face and body. He has no history of any infections and is not in any pain. Examination reveals anasarca. The nurse does a urine dipstick which reveals 3+ proteins and I+ blood. Serum albumin was low.

To confirm your diagnosis above you do a renal biopsy. What is the classical feature that would see to confirm your diagnosis HIV associated nephropathy? 
Answer options: option1: collapsing form of focal segmental glomerulosclerosis
option2: tubular atrophy
option3: interstitial fibrosis
option4: capillary wall thickening
option5: n/a
Correct answer: option1
Specialty: Emergency_Medicine
 Each of the following is appropriate to help determine the cause of hemorrhagic shock in a trauma patient EXCEPT: 
Answer options: option1: Focused Assessment with Sonography for Trauma (FAST)
option2: Abdominal computed tomography (CT)
option3: Pelvic radiograph
option4: Chestradiograph
option5: All of the above
Correct answer: option2
Specialty: Emergency_Medicine
A 34-year-old patient is injured by a cape buffalo and suffers blunt chest trauma. On arrival, the patient is tachypnic and tachycardic. His initial O 2 saturation is 84% on roomair, and his blood pressure is 83/40 mmHg. His airway is patent and protected, however, you note tracheal deviation to the patient's left. You hear no breath sounds on the right. What should you do at this time? 
Answer options: option1: Place him on nasal cannula oxygen, and begin to assess for sources of bleeding.
option2: Place him on nasal cannula oxygen, and prepare for a tube  thoracostomy.
option3: Place him on nasal cannula oxygen, and obtain a portable chest  radiograph.
option4: Place him on nasal cannula oxygen, and perform a needle  decompression in the 4th or5th intercostal space in the mid-axillary  line
option5: n/a
Correct answer: option4
Specialty: Internal_Medicine
A 28 yr old man presents with two-week history of swelling of the lower extremities, face and body. He has no history of any infections and is not in any pain. Examination reveals anasarca. The nurse does a urine dipstick which reveals 3+ proteins and I+ blood. Serum albumin was low.

After doing further tests you find that he is HIV positive. What would be the likely diagnosis in this case? 





Answer options: option1: Nephrotic syndrome
option2: Disseminated TB
option3: HIV associated nephropathy
option4: Acute kidney injury
option5: n/a
Correct answer: option3
Specialty: General_Surgery
Regarding open pneumothorax, which of the following is NOT true
Answer options: option1: It involves full thickness injury to the chest wall.
option2: For permanent management, the chest wall defect should be closed,and a tube thoracotomy placed remote from the wound.
option3: The wound should be temporarily covered with a sterile gauzetaped on all four sides.
option4: Symptoms may include hypoxia and tachypnea
option5: Do not put a chest drain
Correct answer: option3
Specialty: Oncology
. Which of the following represent synchronous metastases? 
A. A 55-year old male with biopsy-proven renal cell cancer has a screening CT that shows a single lung lesionconcerning for 
metastatic disease. 
B. A 43-year old woman undergoes modified radical mastectomy for breast cancer. One year later, she is found tohave a pleural effusion with cytology positive for metastatic breast carcinoma. 
C. A 64-year old male presents with perforated colon cancer and undergoes emergent resection of the tumor. Post-operatively, at his clinic follow up, he undergoes CT scan, which shows several liver lesions. 
D. A 23-year old woman presents with a skin lesion, and after punch biopsy, is diagnosed with melanoma. Herstaging workup reveals liver, brain, and lung metastases.

Answer options: option1: 1, 3 and 4
option2: 1 and 2
option3: 1 and 4
option4: 2
option5: All of the above
Correct answer: option1
Specialty: Internal_Medicine
A 28 yr old man presents with two-week history of swelling of the lower extremities, face and body. He has no history of any infections and is not in any pain. Examination reveals anasarca. The nurse does a urine dipstick which reveals 3+ proteins and I+ blood. Serum albumin was low. What is the likely diagnosis? 



Answer options: option1: Nephrotic syndrome
option2: Cushing’s syndrome
option3: Chronic renal failure
option4: Kaposi sarcoma
option5: n/a
Correct answer: option1
Specialty: General_Surgery
A patient present to you for concerns of anemia and a change in stool habits. You suspect he may have colorectal cancer. Of the following, which should be your first step in working him up? 
Answer options: option1: Computed tomography (CT) scan of the abdomen and pelvis to assess for metastatic disease and evidence of tumor spread
option2: . Obtain a CEA level to screen for cancer
option3: Colonoscopy with biopsy of any polyps or masses
option4: Surgical exploration with examination of the entire colon for suspiciousmasses and resection of any identified lesions
option5: Give Iv fluids for resuscitation
Correct answer: option3
Specialty: Internal_Medicine
A 32 yr old woman comes with acute on chronic history of fatigue, shortness of breath and general body pains. Her full blood count is done which shows WBC of 1.3, HB of 2 mg/dL and platelets of 110. What term is given to the findings above? 

 



Answer options: option1: Leukocytosis
option2: Thrombocytopenia
option3: Pancytopenia
option4: Bicytopenia
option5: n/a
Correct answer: option3
Specialty: Oncology
Which is TRUE regarding tumor markers? 
Answer options: option1: Many have low sensitivities and specificities.
option2: The utility of prostate-specific antigen (PSA) in prostate cancer screening is now well-established
option3: The utility of alpha-fetoprotein (AFP) in hepatocellular carcinoma screening is now well-established.
option4: They are not elevated in benign disease, making them more usefulin cancer detection
option5: All of the above
Correct answer: option1
Specialty: Internal_Medicine
An 85 years old man comes with an inability to move the right side of his body, he cannot speak and has homonymous hemianopia. He was previously treated for angina years ago and is currently fine. His blood pressure is 180/100. Of note is that he is a known hypertensive patient on medication but has established poor adherence. Which artery in the brain is involved? 
 

 

Answer options: option1: Posterior cerebral artery
option2: Middle cerebral artery
option3: Anterior cerebral artery
option4: Basilar artery
option5: n/a
Correct answer: option2
Specialty: Oncology
Which of the following medications is correctly matched with its description? 
Answer options: option1: Vincristine: an antimetabolite agent used as a chemotherapeutic agent
option2: Imatinib: targeted therapy for the tyrosine kinase receptor c-KIT
option3: Tamoxifen: monoclonal antibody for the HER2 receptor that is usedin breast cancer therapy
option4: . Doxorubicin: an alkylating used as a chemotherapeutic agent
option5: None of the above
Correct answer: option2
Specialty: Internal_Medicine
A 23-year-old university female student was brought to the emergency department after she had ingested an unknown poison because he had a break up with her boyfriend. On examination she had excess salivation, pin point pupils, pulse rate was 55 beats per minute, blood pressure was 100/75 mmHg.
In the above case what is the likely diagnosis? 





Answer options: option1: Cyanide poisoning
option2: Organophosphate poisoning
option3: Lead poisoning
option4: Mercury poisoning
option5: n/a
Correct answer: option2
Specialty: Oncology
Which is TRUE regarding surgical therapy for cancer? 
Answer options: option1: Sentinel lymph node biopsy avoids the morbidity of lymph node dissections in patients with negative nodes.
option2: In general, more radical surgeries lead to better oncologic cure rates.
option3: An R2 resection indicates that there is microscopic residual tumorbut no gross disease.
option4: Surgery should only be performed if oncologic cure is expected tobe the outcome
option5: Sentinel lymph node is not necessary
Correct answer: option1
Specialty: Internal_Medicine
A 23-year-old university female student was brought to the emergency department after she had ingested an unknown poison because he had a break up with her boyfriend. On examination she had excess salivation, pin point pupils, pulse rate was 55 beats per minute, blood pressure was 100/75 mmHg. What is the first line drug for this condition? 



 

Answer options: option1: Adrenaline
option2: Gastric lavage
option3: Atropine
option4: 20mls/kg IV bolus of fluids
option5: n/a
Correct answer: option3
Specialty: Oncology
. Which of the following is TRUE of systemic cancer therapy? 
Answer options: option1: Chemotherapy is the primary modality of therapy in  distantmetastatic disease.
option2: Appropriate chemotherapy commonly achieves cure in the settingof distant metastatic disease.
option3: Most single-agent chemotherapies are as effective as combination treatment and decrease toxicity
option4: Hormonal therapy is not tumor-specific
option5: None of the above
Correct answer: option1
Specialty: Internal_Medicine
A 25 years old female, HIV reactive on TDF/3TC/DTG , cotrimoxazole preventive therapy. Two 
weeks ago, was started on isoniazid preventive therapy. She presents with history of diarrhoea, confusion and a rash on the skin. What is the likely diagnosis? 



 

Answer options: option1: Pellagra
option2: ART failure
option3: IRIS
option4: advanced HIV disease
option5: n/a
Correct answer: option1
Specialty: Oncology
. Which of the following malignancies is most likely to benefit from a screening program? 
Answer options: option1: A highly aggressive malignancy that has no curative surgical or  chemotherapeuticoptions and with a high prevalence in a   population.
option2: A common malignancy that requires highly specialized  training and equipment fordetection.
option3: A malignancy that is likely to progress to death over a period of 5-10 years and is rarein the population.
option4: A malignancy with a moderately high prevalence in the population that progresses tosymptoms over a period of 5-10 years and rapidly causes death once symptoms begin.
option5: None of the above
Correct answer: option4
Specialty: Internal_Medicine
You are in the emergency department and you meet one of your patients from hypertensive clinic coming in with complaints of shortness of breath at rest, lower limb swelling and a cough. You immediately think it could be heart failure and you decide to do a chest Xray. Which one of the following would be suggestive of heart failure? 


Answer options: option1: Kerley B lines
option2: Dilated prominent upper lobe vessels
option3: Dilated cardiac shadow
option4: Pleural effusion
option5: All the above
Correct answer: option5
Specialty: General_Surgery
A breastfeeding mother presents with a painful localized swelling of the right breast associated with fever and general malaise. The right breast was shiny, warm to touch, tender, and fluctuant over a localized area. Treatment of this patient will include the following except 
Answer options: option1: neo-adjuvant chemotherapy
option2: Antibiotics
option3: surgical drainage
option4: Analgesia
option5: n/a
Correct answer: option3
Specialty: Internal_Medicine
An 18 yr old female presents with two-week history of lower limb swelling associated with shortness of breath on exertion and a cough. On further probing you find out that she recently gave birth two weeks ago and has a strong beautiful baby. What is the likely diagnosis? 
 

 


Answer options: option1: Hypertensive heart disease
option2: Dilated cardiomyopathy
option3: Community acquired pneumonia
option4: Peripartum cardiomyopathy
option5: n/a
Correct answer: option4
Specialty: Oncology
. Which statement on cancer staging (Stage It) is TRUE? 
Answer options: option1: Tumor grade and cancer stage are similar in that both describe  how extensive thecancer is within the body.
option2: TNM staging can be applied to situations in which cancer is  suspected based on physical exam or imaging and situations in  which tumors have been pathologicallyconfirmed to be  malignant
option3: Staging of the lymph node basin is not considered a standard part of primary surgicaltherapy.
option4: Accurate staging is essential to facilitate exchange of information  among treatmentcenters or practitioners
option5: ll of the above
Correct answer: option4
Specialty: Oncology
Regarding tissue diagnosis of cancers (Name It), which statement is TRUE? 
Answer options: option1: . Sampling errors are seen fine needle aspiration but not in coreneedle biopsies.
option2: Excisional biopsies should be performed with curative intent.
option3: . Biopsy findings cannot determine tumor grade.
option4: Fine needle aspiration gives information on cells within the tissue  architecture.
option5: n/a
Correct answer: option2
Specialty: Oncology
Which of the following scenarios describes metachronous metastases? 
Answer options: option1: A 55-year old male with biopsy-proven renal cell cancer has a screening CT that shows a singlelung lesion concerning for metastatic disease.
option2: A 43-year old woman undergoes modified radical mastectomy for breast cancer. One year later,she is found to have a pleural effusion with  cytology positive for metastatic breast carcinoma.
option3: A 69-year old woman has a rectal tumor identified on digital rectal  exam. She undergoes colonoscopy which identifies two other malignant lesions within her ascending and transversecolon.
option4: A 64-year old male presents with perforated gastric cancer and  undergoes emergent resectionof the tumor. Post-operatively, at his   clinic follow up, he undergoes CT scan, which shows several liver  lesions.
option5: n/A
Correct answer: option2
Specialty: Internal_Medicine
A 45 yr old male known hypertensive patient but not on any medications for the past five years presents with an acute history of left sided chest pain radiating to the arm. He describes it as that feels like an elephant is sitting on his chest. From the short history what is your first differential diagnosis? 



 

Answer options: option1: Myocardial Infarction
option2: Pneumonia
option3: Hypertensive heart disease
option4: Pulmonary Embolism
option5: n/a
Correct answer: option1
Specialty: Internal_Medicine
A 19 yr old man comes with three-day history of fevers and vomiting. He reports to have vomited about ten episodes in the last 24 hrs and has now noted a reduced urine output and lower limb swelling. What is the first bedside test you will do during investigations? 
Answer options: option1: Random blood glucose
option2: Urine dipstick
option3: Arterial blood gas
option4: Full blood count
option5: n/a
Correct answer: option2
Specialty: Oncology
Regarding oncogenes and tumor-suppressor genes: 
Answer options: option1: Oncogenes are normal cellular genes.
option2: Tumor-suppressor genes play no role in normal cellular function.
option3: Oncogenes are mutated genes that give cells a growth or survivaladvantage
option4: Oncogenes mutate into proto-oncogenes.
option5: Oncogenes help cells to die
Correct answer: option3
Specialty: Oncology
Which statement is TRUE regarding apoptosis? 
Answer options: option1: p53 is a tumor suppressor gene that helps to regulate apoptosis
option2: p53 expression is increased in malignancy, resulting in lower ratesof apoptosis
option3: Apoptosis does not occur as a normal part of cellular behavior
option4: Apoptosis occurs by the same causal factors as necrosis
option5: None of the above
Correct answer: option1
Specialty: Oncology
Which viral carcinogen is correctly properly matched with the tumorit causes
Answer options: option1: Human herpesvirus-8 - nasopharyngeal cancer
option2: Human papilloma virus - anal cancer
option3: . Epstein-Barr virus - hepatocellular carcinoma
option4: Hepatitis B virus - Hodgkin's lymphoma
option5: All of the above
Correct answer: option2
Specialty: Cardiology
When considering Starlings Law, which of these is incorrect?
Answer options: option1: Cardiac output is determined by the volume and pressure of blood in the ventricles at the end of diastole, the volume and pressure of blood in the ventricles during systole and myocardial contractility.
option2: Ventricular performance is related to the degree of myocardial stretching.
option3: A reduction in preload increases cardiac output
option4: The physiological importance of the mechanism expressed by Starlings Law is to ensure that changes in preload directly result in changes in stroke volume.
option5: Increases in myocardial contractility or reductions in cardiac afterload enhance cardiac output
Correct answer: option3
Specialty: Cardiology
In a normal ECG, with a standard recording speed of 25 mm/sec, which of these statements is FALSE?
Answer options: option1: The PR interval is less than 0.2s
option2: The P wave represents atrial repolarisation
option3: The QT interval represents the duration of ventricular depolarization and repolarisation
option4: If the R-R interval is 20 small squares, then the heart rate is 75 beats/min
option5: The QRS duration is dependent on the conduction of the electrical impulse through the ventricles
Correct answer: option2
Specialty: General_Surgery
A 54-year-old female known with a right breast cancer presents with difficulty breathing. On assessment of the chest, she had stony dull percussion notes. A blood tap was obtained from the pleural space. What is the stage of breast cancer? 
Answer options: option1: stave IV
option2: stage I
option3: early breast cancer
option4: stage III
option5: n/a
Correct answer: option1
Specialty: Oncology
Which of the following is TRUE of somatic but not germline mutations? 
Answer options: option1: Every cell in the affected individual's body will carry the mutation.
option2: The mutation affects only tissue of a particular cell line or cell type.
option3: Half of the affected individual's gametes will carry the mutation
option4: Mutations are inherited from one or the other parent.
option5: None of the above
Correct answer: option2
Specialty: Oncology
 Which of the following is true regarding cancer invasion? 
Answer options: option1: An increase in calcium-adhesion molecules are important in  malignantinvasion.
option2: Cancer invasion and metastasis rely on the same underlying processes  of changesin adhesion, increased motility, and breakdown of the  extracellularmatrix.
option3: Matrix metalloproteinase (MMPs) are down-regulated in invasive cancers.
option4: In-situ cancers breach the basement membrane
option5: All of the above
Correct answer: option2