afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Rheumatology
The clinical features of Felty syndrome include the following except

Answer options: option1: Peak prevalence in the age group 20-30 years
option2: Previous long-standing rheumatoid arthritis
option3: Positive rheumatoid factor test
option4: Lymphadenopathy and splenomegaly
option5: Recurrent infections and leg ulcers
Correct answer: option1
Specialty: General_Surgery
43. A 32-year-old woman who after an emergency laparotomy started exhibiting signs of depression and confusion after being kept NPO for more than 7 days. Which of the electrolyte disturbances is responsible for these new developments 
Answer options: option1: Hypomagnesaemia
option2: Hypokalaemia
option3: Hyponatraemia
option4: Hypo-phosphataemia
option5: Hyperkalaemia
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
The primary mechanism of a contraceptive implant is:
Answer options: option1: A. Suppression of ovulation
option2: B Thickening of cervical mucus
option3: C. Alteration of the endometrial lining
option4: D. Mechanically blocks implantation
option5: E Prevents fertilization
Correct answer: option1
Specialty: Rheumatology
Features associated with ankylosing spondylitis include the following except?

Answer options: option1: Peak onset in the second and third decades
option2: Subcutaneous nodules
option3: HLA-B27 in at least 90% of affected patients
option4: Faecal carriage of specific Klebsiella species
option5: Family history of psoriatic arthritis and Reiter's syndrome
Correct answer: option2
Specialty: Rheumatology
Features suggesting ankylosing spondylitis include the following except?

Answer options: option1: Early morning low back pain radiating to the buttocks
option2: Persistence of lumbar lordosis on spinal flexion
option3: Chest pain aggravated by breathing
option4: 'Squaring' of the lumbar vertebrae on radiograph
option5: The symphysis pubis is not affected
Correct answer: option5
Specialty: Obstetrics_and_Gynecology
Insertion of an IUD or an implant may occur at what point in the menstrual cycle
Answer options: option1: A Three days before the start of menstruation
option2: B. During menses
option3: C. Any time during the menstrual cycle
option4: D in the middle of the cycle
option5: E First week of the menstrual cycle
Correct answer: option3
Specialty: Rheumatology
The following are incorrect about Reiter's disease except?


Answer options: option1: Peripheral blood monocytosis is commonly found
option2: Sacroiliitis and spondylitis develop in most patients
option3: Salmonella or Shigella species can be cultured from joint aspirates
option4: Calcaneal spurs are not apparent radiologically
option5: Another name for Reiter’s syndrome is reactive arthritis
Correct answer: option5
Specialty: Obstetrics_and_Gynecology
The Copper IUD
Answer options: option1: A it is considered a hormonal contraception
option2: B Has similar contraception efficacy as sterilization
option3: C associated with atypical endometrial hyperplasia
option4: D. Frequent cause of ectopic pregnancy
option5: E Can be administered by any health cadre
Correct answer: option2
Specialty: Rheumatology
A 40-year-old female complains of 7 weeks of pain and swelling in both wrists and knees. The patient complained of fatigue and lethargy several weeks before noticing the joint pain. The patient notes that after a period of rest, resistance to movement is more striking. On exam, the metacarpophalangeal joints and wrists are warm and tender. There are no other joint abnormalities. There is no alopecia, photosensitivity, kidney disease, or rash. Which of the following is correct?

Answer options: option1: The clinical picture suggests early rheumatoid arthritis, and a rheumatoid factor should be obtained
option2: The prodrome of lethargy suggests chronic fatigue syndrome
option3: Lack of systemic symptoms suggests osteoarthritis
option4: X-rays of the hand are likely to show joint space narrowing and erosion
option5: An aggressive search for occult malignancy is indicate
Correct answer: option1
Specialty: Rheumatology
A 48-year-old black female complains of joint pain and morning stiffness over 4 months. Examination reveals swelling of the wrists and MCPs as well as tenderness and joint effusion in both knees. The rheumatoid factor is positive, antibodies to cyclic citrullinated protein are present, and subcutaneous nodules are noted on the extensor surfaces of the forearm.
Which of the following statements is correct?

Answer options: option1: Prednisone 60 mg per day should be started
option2: The patient has RA and should be evaluated for disease-modifying antirheumatic therapy
option3: A nonsteroidal anti-inflammatory drug should be added to aspirin
option4: The patient’s prognosis is highly favorable
option5: The patient should receive a 3-month trial of full-dose nonsteroidal antiinflammatory agent before determining whether and/or what additional therapy is indicate
Correct answer: option2
Specialty: General_Surgery
40. the management of a 65-year-old woman with Gastric Outlet Obstruction secondary to Gastric Adenocarcinoma, what is the fluid of choice for resuscitation is 
Answer options: option1: a.Ringers lactate
option2: ORS
option3: c.Normal saline
option4: Dextrose-normal saline
option5: e.Darrow’s solution
Correct answer: option3
Specialty: Rheumatology
A 60-year-old female complains of dry mouth and a gritty sensation in her eyes. She states it is sometimes difficult to speak for more than a few minutes. There is no history of diabetes mellitus or neurologic disease. The patient is on no medications. On exam, the buccal mucosa appears dry and the salivary glands are enlarged bilaterally. Which of the following is the best next step in evaluation?

Answer options: option1: Lip biopsy
option2: Schirmer test and measurement of autoantibodies
option3: IgG antibody to mumps virus
option4: Use of corticosteroids
option5: Administration of a benzodiazepine
Correct answer: option2
Specialty: Cardiology
A 40-year-old male complains of exquisite pain and tenderness in the left ankle. There is no history of trauma. The patient is taking a mild diuretic for hypertension. On exam, the ankle is very swollen and tender. There are no other physical exam abnormalities. Which of the following is the best next step in management?

Answer options: option1: Begin colchicine and broad-spectrum antibiotics
option2: Perform arthrocentesis
option3: Begin allopurinol if uric acid level is elevated
option4: Obtain ankle x-ray to rule out fracture
option5: Apply a splint or removable cast
Correct answer: option2
Specialty: Cardiology
A 70-year-old non–sexually active male complains of fever and pain in his left knee. Several days previously, the patient skinned his knee while working in his garage. The knee is red, warm, and swollen. An arthocentesis is performed, which shows 200,000 leukocytes/µL and a glucose of 20 mg/dl. No crystals are noted. Which of the following is the most important next step?

Answer options: option1: Gram stain and culture of joint fluid
option2: Urethral culture
option3: Uric acid level
option4: Antinuclear antibody
option5: Antineutrophil cytoplasmic antibody
Correct answer: option1
Specialty: General_Surgery
	……………………………. is the commonest cause of large bowel obstruction in the Africa
Answer options: option1: a.	Colonic carcinomas
option2: b.	Bands and adhesions
option3: c.	Sigmoid volvulus
option4: d.	Strangulated inguinal hernia
option5: e.	Schistosomiasis
Correct answer: option3
Specialty: Cardiology
A 45-year-old woman with long-standing, well-controlled rheumatoid arthritis develops severe pain and swelling in the left elbow over 2 days. She is not sexually active. You suspect septic arthritis. If you are correct, which of the following is the most likely organism to cause septic arthritis in this case?

Answer options: option1: Streptococcus pneumoniae
option2: Neisseria gonorrhoeae
option3: Escherichia coli
option4: Staphylococcus aureus
option5: Clostridium spp
Correct answer: option4
Specialty: Cardiology
A 45-year-old woman has pain in her fingers on exposure to cold, arthralgias, and difficulty swallowing solid food. Of the following tests, which, if positive, would be most supportive of a definitive diagnosis?


Answer options: option1: Rheumatoid factor
option2: Antinucleolar antibody
option3: ECG
option4: BUN and creatinine
option5: Reproduction of symptoms and findings by immersion of hands in cold water
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
Regarding surrogacy

Answer options: option1: a the fetus and surrogate must have the same blood group
option2: b. traditional surrogacy is a common practice in ghana
option3: c the surrogate and the fetus are not genetically related
option4: d is ilegal in ghana
option5: e delivery is through ceasarean section
Correct answer: option1
Specialty: General_Surgery
………………………… is the commonest cause of small bowel obstruction in Ghana 
Answer options: option1: a.	Strangulated inguinal hernia
option2: b.	Intussusception
option3: c.	Band and adhesions
option4: d.	Adenocarcinoma of the small bowel
option5: e.	Volvulus
Correct answer: option1
Specialty: Cardiology
A 20-year-old male complains of arthritis and eye irritation. He has a history of burning on urination. On exam, there is a joint effusion of the right knee and a dermatitis of the glans penis. Which of the following is correct?

Answer options: option1: Neisseria gonorrhoeae is likely to be cultured from the glans penis
option2: The patient is likely to be rheumatoid factor–positive
option3: An infectious process of the GI tract may precipitate this disease
option4: An ANA is very likely to be positive
option5: This is not likely to be reactive arthritis
Correct answer: option3
Specialty: General_Surgery

36. In the management of fluid therapy for a 3-year-old toddler, moderate dehydration corresponds to
Answer options: option1: 2% loss of body weight
option2: b.4% loss of body weight
option3: c.6% loss of body weight
option4: d.10% loss of body weight.
option5: e.5% loss of body weight.
Correct answer: option4
Specialty: General_Surgery
A 30-year-old woman who is 18 weeks pregnant reported with right sided abdominal pain and tenderness. She had a low-grade fever, anorexia and one episode of bilious vomiting. Which of the following is the most likely diagnosis 
Answer options: option1: a.	Acute cholecystitis
option2: b.	Acute pancreatitis
option3: c.	Acute gastritis
option4: d.	Acute appendicitis
option5: e.	Diverticulitis
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
Semen analysis
Answer options: option1: A coitus interruptus is the prefered method of specimen collection
option2: B morphology of 6% is normal
option3: C volume of 2ml is normal
option4: D abstinence of 4weeks is recommended
option5: E pH of 4 is normal
Correct answer: option3
Rationale:  N/A
Specialty: Cardiology
A 65-year-old male develops the onset of severe knee pain over 24 hours. The knee is red, swollen, and tender. He has a history of diabetes mellitus and cardiomyopathy. An x-ray of the knee shows linear calcification. Definitive diagnosis is best made by which of the following?

Answer options: option1: Serum uric acid
option2: Serum calcium
option3: Arthrocentesis and identification of positively birefringent rhomboid crystals
option4: Rheumatoid factor
option5: Serum alkaline phosphatase
Correct answer: option2
Specialty: General_Surgery
35. In the management of fluid therapy for an adult woman, moderate dehydration corresponds to 
Answer options: option1: a.2% loss of body weight
option2: b.4% loss of body weight
option3: c.6% loss of body weight
option4: d.10 – 15% loss of body weight.
option5: e.5% loss of body weight.
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
Induction of labour between 41 and 42 weeks for prolonged pregnancy:


Answer options: option1: Prevents approximately one perinatal death for every 500 women Induced
option2: B) Increases the caesarean section rate
option3: C) Increases the rates of meconium aspiration syndrome
option4: D) Increases the rates of instrumental delivery
option5: (E) Should be offered at 41 weeks +5 days
Correct answer: option1
Specialty: General_Surgery
In tuberculous cervical lymphadenitis with abscess formation
Answer options: option1: there is indication for incision and drainage
option2: HIV screening test is usually positive
option3: wide excision of the abscess and lymph nodes under cover of anti-tuberculous therapy is the usual mode of treatment
option4: Directly Observed Therapy and aspiration of pus may be the mode of treatment
option5: prognosis is poor
Correct answer: option4
Specialty: Cardiology
A 50-year-old drug abuser presents with fever and weight loss. Exam shows hypertension, nodular skin rash, and peripheral neuropathy. ESR is 100 mm/L , and RBC casts are seen on urinalysis. What is the likely diagnosis?

Answer options: option1: Ankylosing spondylitis
option2: Polymyalgia rheumatica
option3: Reiter’s syndrome
option4: Drug-induced lupus erythematosus
option5: Polyarteritis nodosa
Correct answer: option5
Specialty: General_Surgery
Which of the following is not a routine component of the first 24-hour 
Answer options: option1: Vital signs including heart rate, blood pressure, oxygen saturation
option2: Wound evaluation including assessment of drain output and content
option3: Wound evaluation including assessment of drain output and content
option4: Plan for removal of the nasogastric tube, Foley catheter, and initiation of liquid diets
option5: None of the above
Correct answer: option4
Specialty: General_Surgery
32. An 70 kg 28-year-old body builder reported to the ER with a 3-day history of intermittent colicky abdominal pain, total constipation, abdominal distension and 5 episodes of bilious vomiting. He also has a right groin swelling which had always been reducible until 3 days ago. He appears to be moderately dehydrated on examination. An NG passed yielded about a litre of bilious gastric fluid. Patient is being kept NPO as part of treatment, what is most appropriate fluid to use in the resuscitation of this patient.
Answer options: option1: Normal saline
option2: b.Dextrose and normal saline
option3: c.Ringers lactate
option4: Badoe’s solution
option5: e.Dextrose-Normal Saline
Correct answer: option3
Specialty: Plastic_Surgery
In chemical burns
Answer options: option1: Initial treatment is dilution with acid or alkaline solutions
option2: degree of tissue destruction is indirectly proportionate to the chemical concentration
option3: overall treatment is targeted at the cancellation of the biochemical reactions in the body
option4: wound management is by topical antibiotics only
option5: appropriate initial treatment is dilution with water to minimize tissue destruction
Correct answer: option5
Specialty: General_Surgery
31. A 19-year-old teenager had an emergency laparotomy with an appendicectomy on account of typhoid ileal perforation. Today is POD 2 and the NG tube drained about 1 L of bilious aspirate. His urine output was however adequate, and he does not appear to be dehydrated. What is the fluid requirement of this patient
Answer options: option1: 2L of NS; 1L of 5% Dextrose and 1L of 10% Dextrose
option2: b.2L of RL and 2L of 5% Dextrose
option3: 1L of ORS, 1L of 5% Dextrose and 3L of Badoe’s solution
option4: d.1L of RL, 1L of NS, 1L of 10% Dextrose
option5: e.1L of Gastrointestinal replacement fluid and 3L of 5% Dextrose
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
Regarding induction of labour
Answer options: option1: A) An intravenous oxytocin infusion is recommended as the preferred method of induction of labour
option2: B) Women with one previous caesarean section have overall approximately a five per cent risk of uterine rupture if they are induced
option3: C) uterine hyperstimulation occurs during an oxytocin infusion delivery by caesarean section is indicated immediately
option4: D) Women receiving an oxytocin infusion are at risk of developing hypernatraemia
option5: E) A Bishop's score greater than 5 is predictive of a successful induction
Correct answer: option5
Specialty: Cardiology
The following are true concerning pulse except?

Answer options: option1: In pulsus paradoxus the rate slows during inspiration
option2: Pulsus alternans indicates a poorly functioning left ventricle
option3: A tachycardia of 150 beats per minute in a resting patient usually implies an underlying cardiac arrhythmia
option4: A collapsing pulse may be noticed in thyrotoxicosis
option5: Corrigan's sign supports a diagnosis of aortic regurgitation
Correct answer: option1
Specialty: Cardiology
Concerning heart murmurs which is false?

Answer options: option1: A low rumbling diastolic murmur with presystolic accentuation may be heard in mitral stenosis accompanied by atrial fibrillation.
option2: Causes of a pansystolic murmur include mitral regurgitation and ventricular septal defect
option3: A systolic murmur heard over the whole praecordium associated with a thrill usually indicates aortic stenosis
option4: Left heart murmurs are best heard during expiration
option5: An early blowing diastolic murmur at the left sternal edge indicates aortic incompetence
Correct answer: option1
Specialty: Cardiology
The following are true concerning pulsus paradoxus except?

Answer options: option1: The volume of the pulse increases in inspiration
option2: Can be confirmed by detecting >10 mmHg difference in systolic pressure during the breathing cycle
option3: Is a sign of severe asthma
option4: It is seen in tension pneumothorax
option5: Can occur in cardiac tamponade
Correct answer: option1
Specialty: General_Surgery
30. A 48-year-old man living in Liberia had an elective left hemicolectomy on account of adenocarcinoma of the caecum. Today is POD 2 following the surgery. The patient is stable and well hydrated. Bowel function has not resumed. Patient is being kept nil per os. What is the fluid requirement of this patient?
Answer options: option1: a.1L of RL and 2L of 5% Dextrose.
option2: b.2L of RL and 1L of 5% Dextrose
option3: 2L of NS and 1L of RL
option4: d.1L of RL, 1L of NS and 2L
option5: e.Liberal oral fluids
Correct answer: option1
Specialty: Cardiology
The jugulovenous pressure	

Answer options: option1: Is raised if it is 2 cm from the sternal angle with the patient seated at 45°
option2: Tall 'a' waves may be seen in pulmonary hypertension
option3: Irregular cannon waves indicate complete heart block
option4: Regular cannon waves may indicate a nodal rhythm
option5: Giant 'v' waves and a pulsatile liver indicate tricuspid regurgitation
Correct answer: option1
Specialty: Cardiology
The physical signs of an uncomplicated large pneumothorax is associated with one of these except?

Answer options: option1: The trachea deviated to the opposite side
option2: A clicking sound asynchronous with the heart beat
option3: Symmetrical expansion of the chest
option4: Increased breath sounds over the pneumothorax
option5: Increased percussion note over the pneumothorax
Correct answer: option5
Specialty: Cardiology
Which is true about electrocardiogram

Answer options: option1: The PR interval is measured from the peak of the P wave to the start of the QRS complex
option2: Right axis deviation is indicated by a QRS axis of -35°
option3: Q waves in S-II, S-III and aVf indicate a transmural inferior myocardial infarction.
option4: Left bundle branch block is suggested by broadening of the QRS complex to 0.10 seconds (two and a half little squares), and positive RSR' waves in V4-V6.
option5: P mitrale is suggested by a P wave taller than 2.5 mm
Correct answer: option3
Specialty: Cardiology
About heart failure which is false?

Answer options: option1: The clinical features of left heart failure include: tachycardia, basal crepitations and pulsus alternans
option2: Congestion of the pulmonary veins alone does not result in orthopnoea
option3: Chronic congestive heart failure leads to secondary hyperaldosteronism
option4: Causes of heart failure include ischaemic heart disease, hypertension, and thiamine deficiency
option5: Clinical features of right heart failure include a raised JVP, ankle oedema, and hepatomegaly
Correct answer: option2
Specialty: General_Surgery
29. The main aim of the Ebb phase of the metabolic response to trauma is 
Answer options: option1: a.Conservation of blood volume and energy store
option2: b.Breakdown of tissues to produce raw materials for wound healing
option3: c.Building up of lost body tissues
option4: d.Mobilization of amino acids and glucose
option5: e.Increase the production of acute phase reactants
Correct answer: option1
Specialty: Cardiology
Concerning hypertension which is true

Answer options: option1: An average diastolic blood pressure of >90 mmHg over prolonged observation is an indication for drug treatment in uncomplicated hypertension
option2: Thiazide diuretics are the least effective antihypertensive drugs
option3: Thiazide diuretics work on the loop of Henle in the kidney
option4: Resistant hypertension is defined as a failure to control the blood pressure adequately with a good three-drug regimen
option5: Thiazide diuretics are not contraindicated in gout and diabetes
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
Late deceleration during labour


Answer options: option1: a) Umbilical cord compression is the cause
option2: Atosiban should not be given
option3: The duration from the onset of the deceleration to the nadir is > 30 seconds
option4: Oxytocin should be given
option5: Deliver within 30 minutes by Caesarean section
Correct answer: option3
Specialty: General_Surgery
28. The metabolic response that starts immediately after an injury and last for about 24 to 48 hours is called
Answer options: option1: a.Flow phase of metabolic response
option2: b.The catabolic metabolic response
option3: c.Anabolic metabolic response
option4: d.Ebb phase of metabolic response
option5: e.Septic phase of the response
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
The following features of a normal or reactive antepartum CTG includes all the following except;




Answer options: option1: a) At least two fetal movements within 20 minute
option2: At least 2 accelerations of more than 15 beats per minute over the baseline rate and lasting at least 15 seconds within 20 minutes
option3: Normal baseline variability of 6-25 beats per minute
option4: Normal baseline rate of 110-160 beats per minute
option5: No late or variable decelerations
Correct answer: option1
Specialty: Cardiology
The following are true of ventricular tachycardia except?

Answer options: option1: It is a life-threatening condition
option2: It may be caused by myocardial ischaemia
option3: It may be caused by hypokalaemia
option4: Amiodarone may be used to prevent recurrent episodes of ventricular tachycardia
option5: Acute ongoing ventricular tachycardia should be treated initially with drugs
Correct answer: option5
Specialty: Internal_Medicine

25. In the early stages of shock which of the following response does not occur
Answer options: option1: a.Constriction of veins
option2: b.Increased heart rate
option3: c.Constriction of arterioles
option4: d.More forceful contraction of the heart
option5: e.Increased venous vasodilation to increase venous return to the heart
Correct answer: option5
Specialty: Cardiology
The following statements are true of the apex beat except

Answer options: option1: It is the lowest and most lateral point at which the cardiac impulse can be felt
option2: It is displaced downwards and laterally if the left ventricle is enlarged
option3: It is thrusting in mitral stenosis
option4: It is thrusting in aortic regurgitation
option5: It is heaving in aortic stenosis
Correct answer: option3