afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Gastroenterology
On examination of the oral mucosa of a 35-year-old female who presented to the ER with recurrent hemoptysis, you notice strawberry gums. This finding is pathognomonic for 
Answer options: option1: Wegener’s granulomatosis
option2: Acute Lymphocytic leukemia
option3: Turners syndrome
option4: Pulmonary embolism
option5: Pulmonary Tuberculosis
Correct answer: option1
Specialty: Pediatrics
Non-edematous child with weight of 3.5 kg and MUAC 10.5. Which of the following will be appropriate to use at initiation phase?
Answer options: option1: A. F100
option2: B. F100 dilute
option3: F75
option4: RUTF
option5: n/a
Correct answer: option3
Rationale: N/a
Specialty: Pathology
Target cells are found in the following

Answer options: option1: Thalassemia
option2: Hemoglobin c disease
option3: Iron deficiency Anemia
option4: Liver disorders
option5: All of the above
Correct answer: option5
Rationale: Target cells , also known as Codocytes are red blood cells that have the appearance of a shooting target with a bullseye. They are found in the following conditions: thalassemia, hepatic disease with jaundice, hemoglobin C disorders, and the postsplenectomy state. Lesser numbers of target cells are found in sickle cell anemia, iron deficiency, and lead intoxication.
Specialty: Psychiatry
The following are incorrect about the psychiatric interview except 

 

Answer options: option1: The history is best taken from the relative of the patient in all cases
option2: The use of closed ended questions is preferred to open ended questions in the initial phase of the interaction
option3: It is important to show empathy towards the patient
option4: Leading questions are good because they help confirm the diagnosis
option5: It’s absolutely necessary to judge the actions of your patient as good or bad based on your religious belief system.
Correct answer: option3
Specialty: Infectious_Disease
Which is not true of treatment of sepsis

Answer options: option1: for every hour delay in giving antibiotics the mortality increases by 4%
option2: Lactate levels greater than 2mmol/L despite volume resuscitation indicates septic shock
option3: Noradrenaline has been shown to be a superior to adrenaline in vasopressor support
option4: Steroids are only recommended if in septic shock and/ or vasopressor therapy response is poor
option5: none of the above
Correct answer: option3
Specialty: Pediatrics
52. Which of the following can increase mortality in the management of a 10 year old who has head injury
Answer options: option1: A. Raise head 20-30degrees
option2: B.Give mannitol
option3: C.Rapid correction of fluid deficit
option4: D. Dexamethasone
option5: n/a
Correct answer: option3
Rationale: N/a
Specialty: Hematology
1. The earliest recognizable form of RBCs is:


Answer options: option1: Proerythroblast
option2: Early normoblast
option3: intermdiate normoblast
option4: late normoblast
option5: Reticulocyte
Correct answer: option1
Rationale: Proerythroblasts: These are earliest identifiable precursors of red blood cells.
Specialty: Pediatrics
A 7 year school age boy presented to the OPD with 4 months history of seizures and poor school performance. On examination he had hypopigmented macules and sebaceous adenoma. What is the mode of inheritance of the underlying pathology?

 
Answer options: option1: A. X-linked recessive
option2: autosomal dominant
option3: autosomal recessive
option4: x linked dominant
option5: n/a
Correct answer: option2
Specialty: Infectious_Disease
Regarding Gonorrhoea which is true

Answer options: option1: Rectal infections with discharge although common in homosexual men is rare in women
option2: Blood or joint aspiration and cultures are positive in about 75% of cases of disseminated gonorrhoea
option3: Gonococcal Arthritis twice as commonly affects women than men
option4: Co infections with chalmydia is uncommon
option5: None of the above
Correct answer: option3
Specialty: Infectious_Disease
Which is correct with respect to Epstein Barr Virus

Answer options: option1: EBV infection is considered teratogenic in pregnancy
option2: Acyclovir is effective at treating EBV
option3: corticosteroids can lessen symptom severity and should be routinely prescribed
option4: A negative Monospot test  effectively rulesout infectious mononucleosis
option5: all of the above
Correct answer: option1
Specialty: Infectious_Disease

 Regarding Herpes Ophtalmicus which sign is more likely to have ocular involvement

Answer options: option1: Presence of Ramsay Hunt Syndrome (facial paralysis)
option2: Presence of Hutchinson's sign
option3: concurrent involvement of cranial nerves V1 and V2
option4: rash that crosses midline
option5: none of the above
Correct answer: option2
Specialty: Infectious_Disease
Which is true of Herpes infection

Answer options: option1: HSV meningitis has a high morality rate greater than 70% without treatment
option2: Recurrent herpes labialis all need oral treatment to prevent systemic symptoms
option3: VZV is more contagious through contact with vesicle fluid than aerosolized droplets
option4: VZV pneumonitis is more common in pregnant women
option5: VZV is commoner in immunocompetent people than immunocompromised.
Correct answer: option4
Specialty: Infectious_Disease
 Regarding Tetanus which is correct?

Answer options: option1: spasm begins in the pripheris ans spread truncal then into facial musles
option2: Less than 1 % of tetanus can occur without a wound identified
option3: incubation periods can be from less than 24 hours to > 1month
option4: patients who have survived the disease confer a 10 year immunity to the disease.
option5: Does not respond to Metronidazole
Correct answer: option3
Specialty: Infectious_Disease
Regarding Malaria Life cycle which is true

Answer options: option1: clinical symptoms begin when the parasite sporozoites invade the hepatic parenchymal cells
option2: P. Faciparum can remain dormant in the intrahepatic cells for months and later activate to cause clinical relapse
option3: Pvivax and P Ovale infections can relapse due to new merozoites released uring the erythrocytic phase re-infecting the liver
option4: Only 52% of P. Vivax are evident within a month
option5: Quinine is the first-line drug of choice in uncomplicated p. falciparum malaria
Correct answer: option4
Specialty: Gastroenterology
20-year-old footballer presented to the emergency with bright red vomitus after an alcohol binge. Mallory-Weiss syndrome is suspected. This syndrome can be caused by? 
Answer options: option1: Vomiting
option2: Retching
option3: Vigorous coughing
option4: All of the above
option5: None of the above
Correct answer: option4
Specialty: Nephrology
In nephrotic syndrome, thyroxine-binding globulin, cholecalciferol-binding protein, transferrin, metal-binding proteins, antithrombin III, proteins S & C, fibrinogen and IgG are lost.
Hypercoagulable state in nephrotic syndrome is due to urinary loss of?






Answer options: option1: Antithrombin III
option2: Proteins S & C
option3: Fibrinogen
option4: All of the above
option5: None of the above
Correct answer: option4
Specialty: Nephrology
Almost two-thirds of filtered Na+ is reabsorbed in the proximal convoluted tubule. 25-30% occurs via apical Na+- K+- 2 Cl–co-transporter. 5% occurs in Distal convoluted tubule mediated by thiazide-sensitive Na+- Cl– co-transporter. Na+ reabsorption also occurs in cortical and medullary collecting ducts. Reabsorption of filtered sodium mediated by ‘Na+-K+-2 Cl cotransporter’ occurs in?






Answer options: option1: Proximal convoluted tubule
option2: Thick ascending limb of the loop of Henle
option3: Distal convoluted tubule
option4: Cortical collecting ducts
option5: Medullary collecting ducts
Correct answer: option2
Specialty: Nephrology
Central diabetes insipidus and nephrogenic diabetes insipidus can be distinguished by administering AVP analogue desmopressin (10 µg intranasally) after careful water restriction.
In central diabetes insipidus, urine osmolality after desmopressin should?




 

Answer options: option1: Decrease
option2: Increase
option3: Remain unchanged
option4: Any of the above
option5: None of the above
Correct answer: option2
Specialty: Nephrology
Cortisol is converted to cortisone by 11 beta-hydroxysteroid dehydrogenase (11 b-HSDH). 11 b-HSDHn deficiency or suppression allows cortisol to bind to the aldosterone receptor. This is known as?






Answer options: option1: Barters syndrome
option2: Gordons syndrome
option3: Liddle’s syndrome
option4: Giltemans syndrome
option5: Syndrome of apparent mineralocorticoid excess
Correct answer: option5
Specialty: Nephrology
ECG changes of hypokalemia are due to delayed ventricular repolarization and do not correlate well with the plasma K+ concentration. Which of the following is false regarding ECG changes of hypokalemia?






Answer options: option1: Prominent U wave
option2: Inversion of T wave
option3: Shortened QU interval
option4: Prolonged QU interval
option5: ST-segment depression
Correct answer: option3
Specialty: Nephrology
ACE inhibitors block conversion of angiotensin I to II. Angiotensin receptor antagonists directly inhibit actions of angiotensin II on AT 1 angiotensin II receptors and result in impaired aldosterone release.
Patients at increased risk of ACE inhibitor induced hyperkalemia includes all except?






Answer options: option1: Diabetes mellitus
option2: Decreased effective circulating arterial volume
option3: Concurrent use of NSAIDs
option4: All of the above
option5: None of the above
Correct answer: option5
Specialty: Nephrology
In severe hyperkalemia, IV Calcium gluconate decreases membrane excitability. Usual dose is 10 m L of a 10% solution infused over 2-3 minutes. Its effect is short-lived (30-60 min). Dose can be repeated if no change in ECG is seen after 5-10 minutes.
Which of the following is used for lowering potassium levels in severe hyperkalemia?






Answer options: option1: Insulin-glucose infusion
option2: Alkali therapy with IV NaHCO3
option3: Beta 2 adrenergic agonists
option4: All of the above
option5: None of the above
Correct answer: option4
Specialty: Nephrology
Some lymphomas secrete the active form of vitamin D, 1,25-dihydroxyvitamin D (1,25(OH) 2 D), causing hypercalcemia as a result of the combination of enhanced osteoclastic bone resorption and enhanced intestinal absorption of calcium. Enhanced conversion of 25(OH) D to 1,25(OH) 2 D leading to hypercalcemia is usually related to?






Answer options: option1: Hypercalcemia of solid tumors
option2: Milk-alkali syndrome
option3: Familial hypocalciuric hypercalcemia (FHH)
option4: Sarcoidosis
option5: Primary hyperparathyroidism
Correct answer: option4
Specialty: Nephrology
Chvostek’s sign which is the twitching of circumoral muscles in response to tapping of facial nerve just anterior to the ear is present in what percentage of normal individuals?






Answer options: option1: ~ 4 %
option2: ~ 6 %
option3: ~ 8 %
option4: ~ 10 %
option5: < 1 %
Correct answer: option4
Specialty: Nephrology
Anionic gap (AG) represents unmeasured anions in plasma (normally 10 to 12 mmol/L ) and is calculated as AG =Na+ – (Cl– + HCO 3–). AG represents “unmeasured” anions below except?






Answer options: option1: Anionic proteins (Albumin)
option2: Phosphate
option3: Sulfate
option4: All of the above
option5: None of the above
Correct answer: option5
Specialty: Nephrology
Bartter’s syndrome is an inherited disorder of thick ascending limb. It leads to a salt-wasting renal disease with hypokalemia and metabolic alkalosis. Loss-of-function mutations in which of the following can cause Bartter’s syndrome?




 

Answer options: option1: NKCC2
option2: KCNJ1
option3: CLCNKB
option4: Any of the above
option5: None of the above
Correct answer: option4
Specialty: Nephrology
A 40-year-old man underwent a second kidney transplant, some 8 years after his first, but unfortunately the donor kidney never functioned. A biopsy revealed pathological features consistent with acute rejection associated with anti HLA antibodies.
Which type of Immunoglobulin is expected to account for this process?






Answer options: option1: IgD
option2: IgA
option3: IgG
option4: IgM
option5: IgE
Correct answer: option3
Specialty: Nephrology
A 17-year-old boy presents to the GP. Most recently he has suffered a respiratory tract infection and he is very distressed that on going to the bathroom he is urinating
frank blood. The only history of note is microscopic hematuria diagnosed in childhood.
Renal biopsy with histological staining is consistent with a diagnosis of Alport’s syndrome.
Which of the following other features is likely to be present?






Answer options: option1: Red-green color blindness
option2: Otosclerosis
option3: Sensorineural deafness
option4: Multiple lipomas
option5: Cataracts
Correct answer: option3
Specialty: Nephrology
A 40-year-old man is referred to the clinic with refractory hypertension and a slow deterioration in his creatinine. On further questioning it transpires that his brother now
requires renal replacement therapy. He has an ultrasound scan of the abdomen which is highly suggestive of polycystic kidney disease (ADPKD).
Which of the following proteins is associated with the development of the condition?






Answer options: option1: Type-1 collagen
option2: Elastin
option3: Matrix metalloproteinase
option4: Polycystin
option5: Anticystin
Correct answer: option4
Specialty: Nephrology
A 32-year-old man is referred to the renal clinic by his GP after a second episode of gross hematuria. Past history of note includes coeliac disease. On both occasions the hematuria appears to have been closely associated with an upper respiratory tract infection. Blood pressure is 125/80 mmHg. Light microscopy of a renal biopsy specimen reveals diffuse mesangial proliferation and extracellular matrix expansion. Ig A deposits are seen on
immunofluorescence. Which of the following diagnoses fits best with this clinical picture?






Answer options: option1: Alport’s syndrome
option2: Lupus nephritis
option3: IgA nephropathy
option4: Goodpasture’s syndrome
option5: Wegener’s granulomatosis
Correct answer: option3
Specialty: Nephrology
You are called to a cardiac arrest in the Emergency Department where a patient who is known to the dialysis unit has been brought by ambulance. On reviewing her drugs, you note that she is taking a statin, three antihypertensive agents, aspirin and has been receiving
erythropoietin injections. Unfortunately, resuscitation is unsuccessful.
Which of the following is the commonest cause of death in renal dialysis patients?






Answer options: option1: Gastrointestinal hemorrhage
option2: Occult malignancy
option3: Pulmonary embolus
option4: Cardiovascular disease
option5: Overwhelming sepsis
Correct answer: option4
Specialty: Nephrology
A 75-year-old patient has a history of squamous cell carcinoma of the lung that was resected some years ago. He presents with pedal edema. Urinary dipstick showed protein 2+. What is the most likely diagnosis?






Answer options: option1: Membranous nephropathy
option2: Membranoproliferative glomerulonephritis
option3: Minimal change nephropathy
option4: IgA nephropathy
option5: Focal segmental glomerulosclerosis
Correct answer: option1
Specialty: Nephrology
A patient has been diagnosed with renal carcinoma. His brother was diagnosed with the same condition three years ago. What is the most likely inherited condition?






Answer options: option1: Alport’s syndrome
option2: Gaucher’s disease
option3: Von Hippel–Lindau disease
option4: Tay–Sachs disease
option5: Thrombotic thrombocytopenic purpura
Correct answer: option3
Specialty: Nephrology
A 33-year-old man presents with rapid progressive glomerulonephritis and nephrotic syndrome. A renal biopsy shows granulomas. What is the most likely diagnosis?






Answer options: option1: Systemic lupus erythematosus
option2: Wegener’s disease
option3: Rheumatoid arthritis
option4: Hepatitis C infection
option5: HIV
Correct answer: option2
Specialty: Nephrology
A patient has been complaining of a facial rash and arthralgia for the last six months. She is hypertensive and has proteinuria. What is the most likely diagnosis?






Answer options: option1: IgA nephropathy
option2: Minimal change disease
option3: Lupus nephritis
option4: Rapid progressive glomerulonephritis
option5: Proliferative glomerulonephritis
Correct answer: option3
Specialty: Endocrinology
. Features of Kallmann syndrome include anosmia or hyposmia, color blindness, optic atrophy, nerve deafness, cleft palate, renal abnormalities, cryptorchidism & neurologic abnormalities (mirror movements). Kallmann syndrome is due congenital synthesis defect of?






Answer options: option1: LH
option2: FSH
option3: Testosterone
option4: GnRH
option5: TSH
Correct answer: option4
Specialty: Endocrinology
IGF-I is a potent growth & differentiation factor. Peripheral tissue IGF-I exerts local paracrine actions that appear to be both dependent and independent of GH. The major source of circulating IGF-I is from?






Answer options: option1: Pancreas
option2: Liver
option3: Heart
option4: Muscle
option5: Kidney
Correct answer: option2
Specialty: Endocrinology
Due to the pulsatility of GH secretion, measurement of a single random GH level is not useful for the diagnosis or exclusion of acromegaly and does not correlate with disease severity. For the diagnosis of acromegaly, measurement of which of the following is most useful?






Answer options: option1: GH
option2: GHRH
option3: IGF-I
option4: IGF-II
option5: IGF-III
Correct answer: option3
Specialty: Endocrinology
TSH is a 31-k Da hormone composed of alpha & beta subunits. The beta subunit of thyroid-stimulating hormone is common to which of the following hormones?






Answer options: option1: Luteinizing hormone
option2: Follicle-stimulating hormone
option3: Human chorionic gonadotropin (hCG)
option4: All of the above
option5: None of the above
Correct answer: option5
Specialty: Endocrinology
Symptoms of hypothyroidism such as fatigue, cold intolerance, weight gain, constipation and hair loss become more readily apparent at TSH levels of?






Answer options: option1: > 7 mU/L
option2: > 8 mU/L
option3: > 9 mU/L
option4: > 10 mU/L
option5: 5 mU/L
Correct answer: option4
Specialty: Endocrinology
Adrenal glands are located above the kidneys and have their own blood supply. Arterial blood supply is from outside to inside. Initially to subcapsular region then to other areas. 
Which of the following is located outermost in adrenal gland? 






Answer options: option1: Zona glomerulosa
option2: Zona fasciculata
option3: Zona reticularis
option4: Adrenal medulla
option5: All of the above
Correct answer: option1
Specialty: Endocrinology
ACTH, lipotropins, endorphins & melanocyte-stimulating hormones are processed from a larger precursor molecule proopiomelanocortin (POMC). POMC (Pro-opiomelanocortin) is made in?






Answer options: option1: Anterior pituitary
option2: Posterior pituitary
option3: Lymphocytes
option4: All of the above
option5: None of the above
Correct answer: option4
Specialty: Endocrinology
Hypercortisolism promotes deposition of adipose tissue in upper face (moon facies), interscapular area (buffalo hump), supraclavicular fat pads & mesenteric bed (truncal obesity). Rarely, episternal fatty tumors and mediastinal widening secondary to fat accumulation occur.
Most common cause of Cushing’s syndrome is?




 

Answer options: option1: Iatrogenic administration of steroids
option2: Adrenal macronodular hyperplasia
option3: Adrenal micronodular dysplasia
option4: Adrenal neoplasia
option5: Lung malignancy
Correct answer: option1
Specialty: Endocrinology
21-hydroxylase gene is located on chromosome 6 p 21·3 within HLA histocompatibility complex. The highest rates of classic CAH occur in two geographically isolated populations-Yupic Eskimos of Alaska (one in 280) & French island of La Réunion (one in 2100). High rates have also been reported in Brazil (one in 7500) and the Philippines (one in 7000). CAH is characterized by?






Answer options: option1: Cortisol deficiency
option2: With or without aldosterone deficiency
option3: Androgen excess
option4: All of the above
option5: None of the above
Correct answer: option4
Specialty: Endocrinology
Type 2 DM is a heterogeneous group of disorders characterized by variable degrees of abnormalities of glucose metabolism as per the ominous octet except?






Answer options: option1: Insulin resistance
option2: Impaired insulin secretion
option3: Increased glucose production
option4: Increased renal glucose excretion threshold
option5: Increased hepatic insulin sensitivity
Correct answer: option5
Specialty: Endocrinology
The diagnosis of Diabetes is based on fasting blood sugar, random, HBA 1 C and OGTT. In the ADA criteria for diagnosis of DM, what is meant by “fasting state”?






Answer options: option1: No oral intake since last 8 hours
option2: No oral intake for last 12 hours
option3: No caloric intake for last 8 hours
option4: No caloric intake for last 12 hours
option5: All the above
Correct answer: option3
Specialty: Endocrinology
In hyperosmolar hyperglycemic state (HHS), nausea, vomiting, abdominal pain and Kussmaul respirations characteristic of DKA are notably absent. Which of the following statements is false?






Answer options: option1: Dehydration in HHS > DKA
option2: HHS patient is usually young
option3: Mortality higher in HHS than DKA
option4: None of the above
option5: All of the above
Correct answer: option2
Specialty: Endocrinology
In patients who have achieved glycemic goal, ADA recommends Hb A 1 C estimation twice a year. Depending on the assay methodology, Which disease may interfere with the Hb A 1 C result?




 

Answer options: option1: Hemoglobinopathies
option2: Hemolytic anemia
option3: Uremia
option4: All of the above
option5: None of the above
Correct answer: option4
Specialty: Endocrinology
Group of glucose transporters (GLUT) consists of five homologous trans-membrane proteins, GLUT-1, 2, 3, 4, and 5 that are encoded by distinct genes.
Which of the following GLUT is an insulin-responsive glucose transporter?






Answer options: option1: GLUT-1
option2: GLUT-2
option3: GLUT-3
option4: GLUT-4
option5: GLUT-5
Correct answer: option4
Specialty: Endocrinology
Testicular volume is best assessed by Prader orchidometer. Normal adult testicular volume is about?






Answer options: option1: 5 to 12 mL
option2: 12 to 25 mL
option3: 25 to 40 mL
option4: 40 to 65 mL
option5: 5 to 10 ml
Correct answer: option2
Specialty: Endocrinology
Perimenopause refers to the time period preceding menopause, when fertility wanes and menstrual cycle irregularity increases. Onset of perimenopause precedes the final menses by 2-8 years, with mean duration of 4 years. Menopause is diagnosed retrospectively after how many months of amenorrhea?
Answer options: option1: 3
option2: 6
option3: 9
option4: 12
option5: 15
Correct answer: option4
Specialty: Endocrinology
Iron released from enterocytes basolateral membrane binds to free sites on the plasma iron transport protein transferrin. Normal transferrin saturation is ~30%. Systemic regulation of iron absorption is mediated by?






Answer options: option1: Hepcidin
option2: Ferroportin
option3: Ferritin
option4: DMT1
option5: Serum iron
Correct answer: option1
Specialty: Pulmonary_Medicine
Sp 02 is a measure of oxygen saturation using the pulse oximeter. Hemoglobin is almost fully (~90%) saturated at a PO 2 of?






Answer options: option1: 60 mmHg
option2: 70 mmHg
option3: 80 mmHg
option4: 90 mmHg
option5: 50mmHg
Correct answer: option1