afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Neurology
A 45-year-old male presents with a daily headache. He describes two attacks per day over the last 3 weeks. Each attack lasts about an hour and awakens the patient from sleep. The patient has noted associated tearing and reddening of the right eye as well as nasal stuffiness. The pain is deep, excruciating, and limited to the right side of the head. The neurologic examination is non-focal. The most likely diagnosis of this patient’s headache is?
Answer options: option1: Migraine headache
option2: Cluster headache
option3: Tension headache
option4: Brain tumor
option5: Giant cell arteritis
Correct answer: option2
Specialty: Urology
A 28-year-old female polytrauma patient presents to the accident and emergency department six hours following a road traffic accident with blunt abdominal injuries. She is hemodynamically stable. Which of the following is TRUE? 
Answer options: option1: Delayed presentation of ureteric injuries is rare.
option2: The best initial imaging modality to rule out ureteral injury in this patient is a CT scanwith IV contrast and delayed images
option3: . Gross or microscopic hematuria is nearly always present in patients with ureteric injuries.
option4: Ureteral injuries should not be repaired more than six hours’ post-injury.
option5: She doesn’t not need any investigations
Correct answer: option2
Specialty: Urology
A 42-year-old male has a ureteral transection below the pelvic brim with a 1-cm missing segment following a stab wound to the pelvis. He presents 3 hours post-injury. The following choices represent management options. Which option is most appropriate forthis scenario? 
Answer options: option1: Uretero-ureterostomy
option2: Directreimplantation into the bladder.
option3: Transuretero-ureterostomy
option4: Boari flap
option5: None of the above
Correct answer: option2
Specialty: Urology
A 32-year-old male patient presents to the emergency department with a suspected left renal trauma following a road traffic accident. Which of the following statements is true regarding his management? 
Answer options: option1: Most renal trauma will require operative management.
option2: Most grade III and IV injuries, including those with devitalized parenchymalfragments and urinary extravasation,can be managed non operatively
option3: Grade V injuries should never be managed non operatively. D.
option4: Blunt trauma is more likely than penetrating to require operative intervention.
option5: E. B and C
Correct answer: option2
Specialty: Urology
A 28-year-old male is brought to the emergency department following blunt trauma. He has a pelvic binder in place, and on secondary survey, you identify blood at the urethral meatus. Thenext best step is: 
Answer options: option1: You should perform a retrograde urethrogram as soon as it can be safely done and prior to anyattempts at catheter placement.
option2: You should go to the operating room for cystoscopy or suprapubic tube placement as soon asthis can be safely accomplished.
option3: You should perform a percutaneous suprapubic tube in the emergency department as soon asthis can be safely done.
option4: You should attempt placement of a Foley catheter once, and if it is not successful, you shouldperform a retrograde
option5: n/a
Correct answer: option1
Specialty: Oncology
A 30-year-old female consults you that her mother has been diagnosed with breast and ovarian cancer. Similarly, her maternal aunt was treated for breast cancer two years prior. She would like to be screened for breast cancer. Which screening approach IS NOT appropriate for her?
Answer options: option1: Clinical examination
option2: MRI scan
option3: Ultrasound
option4: Mammography
option5: Breast elastography
Correct answer: option5
Specialty: Hematology
Hemolytic disease of The newborn may be due to all of the following except:

Answer options: option1: Rh incompatibility mostly anti-C
option2: ABO incompatibility
option3: Minor group incompatibility
option4: All of the above
option5: None of the above
Correct answer: option1
Rationale: HDN may develop when a mother and her unborn baby have different blood types. The types are based on small substances (antigens) on the surface of the blood cells.
There is more than one way in which the unborn baby's blood type may not match the mother's.
A, B, AB, and O are the 4 major blood group antigens or types. This is the most common form of a mismatch. In most cases, this is not very severe.
Rh is short for the "rhesus" antigen or blood type. People are either positive or negative for this antigen. If the mother is Rh-negative and the baby in the womb has Rh-positive cells, her antibodies to the Rh antigen can cross the placenta and cause very severe anemia in the baby. It can be prevented in most cases.Anti-c, clinically the most important Rh antibody after anti-D, may cause severe HDN. Anti-C, anti-E, and anti-e do not often cause HDN, and when they do, it is usually mild.
There are other, much less common, types of mismatch between minor blood group antigens. Some of these can also cause severe problems.
Specialty: Orthopedic_Surgery
A mechanically unstable pelvic fracture is: 
Answer options: option1: n/a
option2: A fracture pattern where there is an open fracture
option3: Any fracture pattern where there is bony displacement.
option4: A fracture pattern that disrupts the pelvic ring in two places withbony  displacement
option5: If the ligaments are involved
Correct answer: option4
Specialty: Oncology
A 70-year-old female, diagnosed with sigmoid colon adenocarcinoma with metastasis to the liver, is receiving her 6 th cycle of chemotherapy. Which of the following is the best blood test to indicate her response to chemotherapy?
Answer options: option1: Carbohydrate Antigen (CA) 19-9 level
option2: Carcinoembryonic antigen (CEA) level
option3: Alpha fetoprotein level
option4: Beta human chorionic gonadotropin (B -HCG) level
option5: CA-125 levels
Correct answer: option2
Specialty: Orthopedic_Surgery
Which of the following is TRUE regarding pelvic binders? 
Answer options: option1: Pelvic binders should be removed as soon as possible to reduce the potential for skin ulceration.
option2: Pelvic binding is contraindicated in pregnant patients and theelderly
option3: The binder or sheet should be positioned at the level of the iliaccrest
option4: Pelvic binding not indicated in unstable pelvic ring fractures
option5: New studies do not recommend pelvic binders
Correct answer: option1
Specialty: Emergency_Medicine
Which of the following is true of the diagnosis and management of pneumothoraces?
Answer options: option1: All pneumothoraces require chest tube placement if a  patient requires positivepressure ventilation
option2: If a patient has a persistent air leak on post-injury day 3, a video assisted thoracoscopy(VATS) may reduce chest tube time, hospital  length-of-stay, and empyema risk.
option3: Pneumothoraces cannot be detected by ultrasound but require a chest radiograph orchest CT for imaging confirmation.
option4: occult pneumothorax is one that is visible on a chest radiograph but missed by theinterpreting provider
option5: None of the above
Correct answer: option2
Specialty: General_Surgery
Which of the following strategies for control of bleeding from the liver wilnot control bleeding from the hepatic veins? 
Answer options: option1: . Pringle maneuver (compression of the porta hepatis).
option2: Manual compression of the liver.
option3: Packing of the liver.
option4: Suture repair of liver bleeding.
option5: None of the above
Correct answer: option1
Specialty: General_Surgery
Which of the following prohibits the possibility of non-operative 
management of a splenic injury? 

Answer options: option1: Requirement of transfusion on presentation
option2: Initial hypotension on presentation.
option3: Grade IV or V splenic injury.
option4: Lack of a monitored setting where the patient's vital signs arefrequently  checked
option5: None of the above
Correct answer: option4
Specialty: Family_Medicine
You are requested to give an educational talk to parents of teens regarding the prevention of cervical cancer. According to the currently available data, when should HPV vaccination be performed?

Answer options: option1: In young girls, if possible before their first sexual intercourse
option2: HPV vaccination should be performed at any age
option3: Young girls and boys should be vaccinated against HPV after their first intercourse
option4: According to the currently available data, HPV vaccination should not be performed at the present time
option5: In young men only
Correct answer: option1
Specialty: Neurosurgery
Which of the following is true regarding sodium in patients with head trauma? 
Answer options: option1: Hypotonic fluids are often used to reduce brain edema.
option2: Sodium equally distributes throughout the intracellular andextracellular compartments.
option3: Increased serum sodium can help to decrease intracranial pressure.
option4: Ideal serum sodium in a patient with traumatic brain injury is 135 -145 mEq/L.
option5: Sodium has not any effect
Correct answer: option3
Specialty: Internal_Medicine
You see a 65 yr old man in clinic complaints of erectile dysfunction. He is a known diabetic and dilated cardiomyopathy patient with history of CVA in 2012 but regained function after under going physiotherapy. Which of his diseases is likely related to his complaints? 



 

Answer options: option1: Hypertension
option2: Diabetes
option3: History of CVA
option4: Dilated cardiomyopathy
option5: n/a
Correct answer: option2
Specialty: Oncology
A 60-year-old male with known head and neck squamous cell carcinoma with metastasis to the ribs and pelvis is admitted for her 4 th cycle of palliative chemotherapy. Since her last cycle of chemotherapy, she has been very lethargic and constipated. You conduct various investigations and discover her corrected calcium is 2.95 mmol/L . Which of the following is the next most appropriate treatment?
Answer options: option1: Continue with the chemotherapy
option2: Withhold the chemotherapy and wait for calcium levels to normalize through reduced intake
option3: Administer intravenous saline rehydration and zoledronate
option4: Administer intravenous saline alone
option5: Administer Calcitonin
Correct answer: option3
Specialty: Internal_Medicine
A 52 yr old man on antihypertensives presents with history of a cough that started when he was imitated on his anti-hypertensives and is not going away. What drug could likely be causing this? 

 



Answer options: option1: Enalapril
option2: Nifedipine
option3: Hydrochlorothiazide
option4: Atenolol
option5: n/a
Correct answer: option1
Specialty: Neurosurgery
A 25-year-old man involved in a motor vehicle collision opens his eyesto painful stimuli, does not form words but mumbles, and withdraws to pain. The patient's Glasgow Coma Scale (GCS) score is: 
Answer options: option1: 7
option2: 9
option3: 8
option4: 10
option5: n/a
Correct answer: option3
Specialty: Neurosurgery
All of the following are concerning in a patient with a traumatic braininjury EXCEPT: 
Answer options: option1: Increased intracranial pressure (ICP)
option2: Increased serum sodium level.
option3: Decreased cerebral perfusion pressure (CPP)
option4: Decreased cerebral perfusion pressure (CPP)
option5: None of the above
Correct answer: option2
Specialty: Hematology
A 67-year-old female patient complains of fatigue, dizziness, and abdominal distention. On examination, she is pale and an enlarged spleen is palpated. Her full blood count shows an elevated white cell count of 600 x 109/L . Her bone marrow shows the full spectrum of myeloid maturation. Her BCR-ABL 1 is positive. Which one of the following is true about her treatment?
Answer options: option1: She should be initiated on hydroxyurea and allopurinol
option2: She is eligible for a tyrosine kinase inhibitor
option3: She should start chemotherapy with a cytarabine-based protocol
option4: She should undergo white cell apharesis
option5: She should undergo a stem cell transplant
Correct answer: option2
Specialty: Internal_Medicine
Concerning HIV which one of the following is true or false? 
 
Answer options: option1: Most of the HIV infected people are found in thsub Saharan Africa
option2: All HIV positive patients with a CD4 count of less than 50 should be screen for opportunistic infections
option3: Tenofavir is contraindicated in kidney disease
option4: n/a
option5: n/a
Correct answer: option1,option2,option3
Specialty: General_Surgery
A 14-year-old boy presents with generalized abdominal pain following a week’s history of a febrile illness. He also had a history of passage of blood stain loose stools. During surgery it was noticed a perforation on the ante-mesenteric border of the ileum. What is the likely cause of the perforation? 
Answer options: option1: TB
option2: Trauma
option3: gall stones
option4: salmonella typhi
option5: n/a
Correct answer: option4
Specialty: Neurosurgery
A 32-year-old woman sustained a significant head injury in a motor vehicle collision, with a CT scan showing multiple subarachnoid hemorrhages and fractures of the right petrous temporal bone. Which of the following should be performed on this patient? 
Answer options: option1: Ultrasound of the neck
option2: Bronchoscopy
option3: CT angiogram of the head and neck
option4: Esophagostomy
option5: All of the above
Correct answer: option3
Specialty: Neurology
The Monroe-Kellie Doctrine describes which of the following? 
Answer options: option1: Increased intracranial pressure may result in a physiologic response that involves bradycardia, hypertension with widening pulse pressure, and irregular respirations
option2: The different mechanisms by which primary and secondary brain injury result.
option3: The skull contains a fixed volume of brain tissue, blood, and  CSF. Anything that increases the volume of one component  must result in a decreased volume of theother two or will cause increased intracranial pressure.
option4: The formula from which cerebral perfusion pressure is derived, which explains how meanarterial pressure and intracranial pressure impact cerebral perfusion.
option5: None of the above
Correct answer: option3
Specialty: Neurosurgery
Which of the following situations necessitates drainage of the CSF in apatient with traumatic brain injury? 
Answer options: option1: A decrease in the patient's GCS from 12 to 8
option2: Measured intracranial pressure (ICP) of 22 mmHg
option3: Clinical findings of tachycardia and hypertension
option4: A pupil that is unilaterally dilated and does not react to light
option5: All of the above
Correct answer: option2
Specialty: Hematology
A 16-year-old male presents with easy fatigability, exercise intolerance, bleeding gums, gum hypertrophy and fevers. His complete blood count is significant for pancytopenia. Which of the following diagnostic tests are NOT necessary in the work-up of such a patient?
Answer options: option1: Morphology of blood and bone marrow smears
option2: CT scan of liver and spleen
option3: Cytogenetic analysis of the bone marrow cells
option4: Molecular genetic analysis of the bone marrow cells
option5: Flow cytometry or cytochemistry of the bone marrow cells
Correct answer: option2
Specialty: Cardiology
Which of these drugs’ side effects is not attributed to its paired drug?

Answer options: option1: Osteopenia - Thiazide diuretics
option2: Hyperkaliemia - Angiotensin-converting enzyme inhibitors
option3: Impaired glucose tolerance – Beta-blockers
option4: Peripheral oedema - Calcium channel antagonists
option5: Gynecomastia - Spironolactone
Correct answer: option1
Specialty: Pulmonary_Medicine
73. Which of the following is NOT part of the definition (Berlin definition) for ARDS? 
Answer options: option1: Acute in onset, within 1 week of injury or insult
option2: Bilateral opacities or fluffy infiltrates on CT or CXR
option3: Improved PaO2/FiO2 ratio when placed on PEEP
option4: Pulmonary edema not explained by cardiac failure or fluid overload
option5: None of the above
Correct answer: option3
Specialty: Internal_Medicine
A 52-year-old female presents with a 2-day history of severe chest pain. He has a history of hypertension and hypercholesterolemia. What is the most likely diagnosis? 
 
 



Answer options: option1: Myocardial infarction
option2: Pneumonia
option3: Pulmonary embolism
option4: Tension pneumothorax
option5: n/a
Correct answer: option1
Specialty: Emergency_Medicine
Which of the following is true regarding tension pneumothorax? 
Answer options: option1: It causes cardiogenic shock.
option2: v Current recommendations involve needle decompression in the 4thor 5th intercostal space in the mid-axillary line.
option3: It should be diagnosed by chest x-ray as an adjunct of the primarysurvey
option4: If needle decompression completely evacuates the pneumothorax,tube thoracostomy is unnecessary
option5: n/a
Correct answer: option2
Specialty: Cardiology
With regards to secondary hypertension, which of these statements is FALSE?

Answer options: option1: Hyperkalaemia suggests Conn’s syndrome
option2: A pulse with radio-femoral delay suggests coarctation of the aorta
option3: It should be considered in a patient who presents with hypertension before the age of 30 years
option4: Paroxysmal blood pressure elevation associated with headaches, diaphoresis and tachycardia should be evaluated with measurements of urinary catecholamines and metanephrines
option5: It should be sought in all patients with severe and resistant hypertension
Correct answer: option1
Specialty: Internal_Medicine
Concerning diabetic complications which one is true or false? 
Answer options: option1: Diabetic retinopathy is Irreversible
option2: Glaucoma is a common complication
option3: Renal function tests are necessary if there are no signs of AK
option4: Half of all diabetic patients end up getting amputated due to diabetic gangrenous foot
option5: E) Silent chest MI is a complication
Correct answer: option1,option2,option5
Specialty: Internal_Medicine
A 20 yr old man was sent to clinic after being noted to have persistent high blood pressures. He plays sports and is HIV negative. In this the list below which one test would be significant to rule in or out a differential diagnosis? 
 
 

 

Answer options: option1: Full blood count
option2: Thyroid function test
option3: Liver function tests
option4: Random blood glucose
option5: n/a
Correct answer: option2
Specialty: Pulmonary_Medicine
Which of the following is most likely to improve outcomes in acute respiratory distress syndrome (ARDS)? 
Answer options: option1: Maintaining higher than normal levels of oxygen (high pO2 and oxygen saturation
option2: The use of high positive end-expiratory pressure.
option3: The use of low tidal volumes.
option4: . Maintaining a normal blood gas (normal pH, pO2, and pCO2
option5: None of the above
Correct answer: option3
Specialty: Cardiology
Which of these matches is incorrect?
Answer options: option1: Paradoxical splitting of second heart sound – Aortic stenosis
option2: Left parasternal heave- Left ventricular hypertrophy
option3: Pansystolic murmur best heard over apex and radiating to axilla – Mitral regurgitation
option4: Third heart sound – Pregnancy
option5: Early diastolic murmur along left sternal border – Aortic regurgitation
Correct answer: option2
Specialty: General_Surgery
A two-day born is brought in with vomiting and yet to pass meconium, plain abdominal radiographs showed a double bubble sign, what is the diagnosis?
Answer options: option1: oesophageal atresia
option2: gastric web
option3: Jejunal atresia
option4: duodenal atresia
option5: n/a
Correct answer: option4
Specialty: Pulmonary_Medicine
Which of the following is the most important determinant of risk for
ventilator-associated pneumonia (VAP) in trauma patients? 

Answer options: option1: A finding of lung contusions on chest X-ray
option2: The duration of intubation and mechanical ventilation
option3: The ventilator settings used.
option4: The patient's level of consciousness at intubation
option5: Use of IV antibiotics prior to intubation
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.

What syndrome has the woman above developed as a complication of her actual diagnosis? 




 

Answer options: option1: Cushing’s syndrome
option2: Horner’s syndrome
option3: Paraneoplastic syndrome
option4: Lambat-Eaton syndrome
option5: n/a
Correct answer: option2
Specialty: Emergency_Medicine
A 30-year-old male is involved in a major motor vehicle crash. During the primary survey in the emergency department, he is intubated for airway protection. He has equal breath sounds. He hasreceived one liter of intravenous crystalloid fluid. 
On repeat assessment, he has a blood pressure of 80/50 mmHg and pulse of 120 bpm. What is the best next step in management? 

Answer options: option1: A. Proceed immediately to theatre for laparotomy
option2: B. Start inotropic support and titrate to MAP > 65 mm Hg.
option3: Immediately transfuse blood products, either whole blood or a 1:1:1 transfusion of red bloodcells, platelets, and plasma as soon as  available.
option4: Continue ongoing crystalloid resuscitation while drawing blood samples to assess hemoglobinlevel and determine the need for blood transfusion.
option5: A and D
Correct answer: option3
Specialty: Emergency_Medicine
lethal triad" of trauma includes: 
Answer options: option1: Hypothermia, coagulopathy, and hemorrhage
option2: Hypothermia, acidosis, and coagulopathy
option3: Coagulopathy, shock, and hemorrhage
option4: Acidosis, shock, and hemorrhage
option5: Hypothermia, shock and acidosis
Correct answer: option2
Specialty: Hematology
A 23-year-old man is brought to casualty following a motorcycle collision. His airway and breathing was noted to be intact, but he is bleeding heavily from his left lower extremity, which has suffered a traumatic amputation. While attempting to obtain intravenous access, he is noted to be hypotensive. Which of the following is true? 
Answer options: option1: He will be coagulopathic due to dilution of clotting factors.
option2: . He will be hypercoagulable due to consumption of clotting factors.
option3: He will be coagulopathic due to loss of clotting factors.
option4: He will be hypercoagulable due to increased hepatic production of clotting factors.
option5: He will be hypercoagulable due to high platelet production
Correct answer: option3
Specialty: General_Surgery
A 26-year-old female comes to the emergency setting following a high-impact blunt trauma. She ishypotensive with large-volume intraperitoneal fluid on ultrasound (FAST). She has received 2 unitsof whole blood but remains hypotensive. Which of the following is true regarding a damage control treatment strategy? 
Answer options: option1: Damage control surgery aims to perform the definitive operation that the patient requires asquickly as possible.
option2: The patient should remain in the emergency or casualty area until she has been stabilized, asthis is the best place for resuscitation.
option3: Damage control resuscitation attempts to prevent or minimize the progression of the lethaltriad and the systemic response to injury
option4: Damage control resuscitation requires that the patient be  hemodynamically stable beforesurgery is undertaken.
option5: Damaged control surgery is always performed by an experienced  surgeon
Correct answer: option3
Specialty: Pulmonary_Medicine
Which of the following interventions is LEAST likely to be a 
recommended intervention to decrease the risk of ventilator-associated pneumonia (VAP)? 

Answer options: option1: The use of non-invasive positive pressure ventilation (NIPPV) when possibleto avoid intubation.
option2: Avoiding a supine position by elevating the head of the bed 30-45 degrees
option3: Oral decontamination with antisepticslike chlorhexidine or povidone
option4: The use of oral antibiotics with or without intravenous antibioticsfor oral,respiratory, and GI tract decontamination.
option5: None of the above
Correct answer: option4