afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Neurology
Which of the following is not an absolute contraindication to the use of thrombolytic therapy in acute stroke
Answer options: option1: Pregnancy
option2: Blood pressure more than 185\110 mmHg
option3: Stroke in the last 3 months
option4: Platelet count less than 100000
option5: History of intracranial haemorrhage
Correct answer: option1
Specialty: Neurology
Which of the following statements on acute stroke is true?
Answer options: option1: Haemorrhagic stroke is the commonest form
option2: Acetylsalicylic acid can be given to patients with suspected stroke
option3: Sickle cell is commonly associated with haemorrhagic stroke
option4: Decompressive craniotomy has been shown to have benefit
option5: Low-dose statins have equal benefits to high-dose statins
Correct answer: option2
Specialty: Cardiology
Stable angina is described as?
Answer options: option1: Burning retrosternal pain associated with meals
option2: Stabbing chest pain worse with expiration
option3: Crushing central chest pain worsened with exercise and relieved by rest
option4: Left chest pain present at rest and radiating to the left arm
option5: Epigastric pain unrelated to meals
Correct answer: option3
Specialty: Nephrology
Jane was diagnosed with a gastric tumor three months ago. She has completed six cycles of chemotherapy. You realize that the estimated creatinine clearance is 40 ml/min/1.73. The diagnosis is?
Answer options: option1: Stage 1 chronic kidney disease
option2: Stage 2 chronic kidney disease
option3: Stage 3A chronic kidney disease
option4: Stage 3B chronic kidney disease
option5: Stage 4 chronic kidney disease
Correct answer: option4
Specialty: Nephrology
Peter has diabetes mellitus and would like to know whether his kidneys are at risk of diabetic nephropathy. Which test would pick renal disease at the earliest?
Answer options: option1: Dipstick test
option2: Urine microalbumin
option3: Fraction of excreted urine
option4: Renal ultrasound
option5: Blood in urine
Correct answer: option2
Specialty: Rheumatology
You are asked to see a 24 year old lady who has a symmetrical small joint polyarthritis.  Which of the following features would allow you to distinguish between a diagnosis of rheumatoid arthritis and SLE? 

Answer options: option1: Presence of small nodules over the extensor tendons at the MCP joints
option2: Bibasal fine crepitations
option3: Presence of rheumatoid factor
option4: Presence of anti-Sm antibodies
option5: n/a
Correct answer: option4
Specialty: Rheumatology
Concerning Raynaud phenomenon, choose the correct statement 

Answer options: option1: Is as a result of exaggerated response to hot temperature
option2: Primary Raynaud is associated with digital ischaemia
option3: Medications are indicated if there are signs of critical tissues ischaemia
option4: Nailfold capillary microscopy is not a useful investigation
option5: n/a
Correct answer: option3
Specialty: Rheumatology
The synovial fluid of a young man was examined under polarized microscopy. Needle shaped crystals were observed. 
The correct diagnosis of this man is

Answer options: option1: Pseudogout
option2: Monosodium urate crystal disease
option3: Psoriatic arthritis
option4: Calcium oxalate disease
option5: n/a
Correct answer: option2
Specialty: Rheumatology
A 7 year old boy was diagnosed with juvenile idiopathic arthritis. He has been on medications for almost 1 year. You will be careful with prescription of one of these drugs

Answer options: option1: Methotrexate
option2: Hydroxychloroquine
option3: Ibuprofen
option4: Prednisolone
option5: n/a
Correct answer: option4
Specialty: Psychiatry
Mr. Essien has had two different antipsychotics at the highest tolerable dose for 6 weeks without a change in his condition. His doctors suspect treatment resistance Schizophrenia. Which of the following should you prescribe?




 

Answer options: option1: Clozapine
option2: Amisulpride
option3: Quetiapine
option4: Risperidone
option5: Chlorpromazine
Correct answer: option1
Specialty: Psychiatry
Mr. Essien, a 32-year-old Diabetic with hypercholesterolemia, presents with delusions and hallucinations of over 3 months. Which of the following would you prescribe?




 

Answer options: option1: Clozapine
option2: Amisulpride
option3: Quetiapine
option4: Risperidone
option5: Chlorpromazine
Correct answer: option5
Specialty: Psychiatry
Sodium Valproate





Answer options: option1: ↑ GABA neurotransmission and ↓ NA effect
option2: ↑ GABA neurotransmission and ↑ NA effect
option3: ↓ GABA neurotransmission and ↓ NA effect
option4: ↑ GABA neurotransmission but no NA effect
option5: ↓ GABA neurotransmission but no NA effect
Correct answer: option1
Specialty: Neurology
In the analysis of gait which is incorrect?
Answer options: option1: Circumduction of a leg suggests pyramidal weakness
option2: A high-stepping gait suggests foot drop
option3: Inability to walk heel-to-toe suggests cerebellar disease
option4: Difficulty negotiating doorways suggests parkinsonism
option5: A waddling gait suggests distal muscle weakness
Correct answer: option5
Specialty: Psychiatry
For ladies taking carbamazepine, warn of use of other contraception apart from the pill because






Answer options: option1: Carbamazepine toxicity can occur
option2: There is no need for warning
option3: Carbamazepine induces metabolism of oral contraceptive pills
option4: Carbamazepine inhibits metabolism of oral contraceptive pills
option5: Oral contraceptive pills induce carbamazepine metabolism
Correct answer: option3
Specialty: Neurology
The following are incorrect in the evaluation of a patient with headache except?
Answer options: option1: Thunderclap headache is invariably associated with subarachnoid haemorrhage
option2: Patients with viral meningitis invariably display meningism
option3: The presence of concurrent focal limb weakness excludes migraine
option4: Improvement with simple analgesia suggests tension headache
option5: Headache on waking suggests raised intracranial pressure
Correct answer: option1
Specialty: Psychiatry
While on clozapine, patients suspected of having an infection





Answer options: option1: should have an immediate infection screen and red cell count performed.
option2: should have an immediate infection screen and platelet cell count performed.
option3: should have an immediate infection screen and white cell count performed.
option4: should have an immediate serum clozapine screen and white cell count performed.
option5: should have an immediate serum clozapine screen and red cell count performed.
Correct answer: option3
Specialty: Pediatrics
73)	Grace is a 4-year-old who attends A & E following profuse watery diarrhoea for 5 days and vomiting for 2 days. Her clinical findings are of lethargy, heart rate of 150 beats per minute, respiratory rate of 35/minute, capillary refill of 4 seconds and cold peripheries. What is the diagnosis?
Answer options: option1: b)	Gastroenteritis with moderate dehydration.
option2: b)	Gastroenteritis with moderate dehydration.
option3: c)	Gastroenteritis with hypovolaemic shock
option4: d)	Metabolic acidosis
option5: e)	Metabolic alkalosis
Correct answer: option3
Specialty: Psychiatry
The risperidone depot Risperdal must be administered every 2 weeks as



Answer options: option1: it has a much narrower pharmacokinetic profile than other depots.
option2: it has a much wider pharmacokinetic profile than other depots.
option3: it has a much narrower pharmacodynamic profile than other depots.
option4: it has a much wider pharmacodynamic profile than other depots.
option5: it has a much narrower pharmacologic profile than other depots.
Correct answer: option1
Specialty: Pediatrics
72)	A female child has just begun to sit on his own, cries when separated from his parents and laughs often. Developmentally, how old is he? 
Answer options: option1: b)	14months
option2: b)	14months
option3: c)	4 months
option4: d)	6 months
option5: e)	6 weeks
Correct answer: option4
Specialty: Psychiatry
Chlorpromazine should not be prescribed with sedatives because







Answer options: option1: It destroys the sedative effect of sedative drugs
option2: It potentiates the sedative effects of sedative drugs
option3: It has no effect on sedative drugs
option4: It loses its antipsychotic effect when given with sedative drugs
option5: Sedative drugs potentiate the antipsychotic effects of Chlorpromazine
Correct answer: option2
Specialty: Pediatrics
69)	A Healthy term new-born baby, with normal development would be expected to:
Answer options: option1: a)	Lie supine in a frog leg posture
option2: b)	Fix and follow a face through 180 degrees
option3: c)	Have head lag when pulled up from lying
option4: d)	Make sounds like “ah” and “eh”
option5: e)	Turn their head towards a voice
Correct answer: option3
Specialty: Pediatrics
68)	BCG vaccine is given to new-borns in Malawi as part of the routine immunization schedule. Which of the following is an effect of BCG which leads to its recommendation by WHO? 
Answer options: option1: d)	It reduces TB meningitis
option2: d)	It reduces TB meningitis
option3: d)	It reduces TB meningitis
option4: d)	It reduces TB meningitis
option5: e)	It reduces TB adenitis
Correct answer: option4
Specialty: Pediatrics
67)	Which of the following vaccines on the Malawi infant vaccination schedule is a live vaccine? 
Answer options: option1: a)	Diphtheria
option2: b)	Haemophilus influenza type b
option3: c)	Hepatitis B
option4: d)	Bacillus Calmette-Guerin (BCG)
option5: e)	Tetanus
Correct answer: option4
Specialty: Psychiatry
Carbamazepine 




Answer options: option1: Induces CYP 450 liver enzymes, accelerating its own and many other drugs’ metabolism
option2: Induces CYP 3A liver enzymes, accelerating its own and many other drugs’ metabolism
option3: Induces CYP 350 liver enzymes, accelerating its own and many other drugs’ metabolism
option4: Induces CYP 4A liver enzymes, accelerating its own and many other drugs’ metabolism
option5: Induces CYP 1A liver enzymes, accelerating its own and many other drugs’ metabolism
Correct answer: option2
Specialty: Pulmonary_Medicine
A patient presents with dyspnea and right-sided pleuritic chest pain. The percussion note is stony dull. Which of the following is the most likely finding on chest imaging?
Answer options: option1: Pleural effusion
option2: Pneumothorax
option3: Lung abscess
option4: Aspergilloma
option5: Lung cancer
Correct answer: option1
Specialty: Pediatrics
65)	The Blantyre Coma Score of a child who localizes to pain, produces an inappropriate cry and has wide open eyes but does not follow an object is
Answer options: option1: b)	1/5
option2: b)	1/5
option3: c)	2/5
option4: d)	3/5
option5: e)	4/5
Correct answer: option4
Specialty: Pediatrics
64)	A four-year-old HIV uninfected boy presents with seizures and headache. He has a Blantyre coma score of 4/5 on presentation. A lumbar puncture is taken and the CSF is cloudy. The CSF subsequently grows Streptococcus Pneumoniae. Which of the following long-term complications is most likely to occur? 
Answer options: option1: a)	Hydrocephalus
option2: b)	Cerebral palsy
option3: c)	Hearing impairment
option4: d)	Visual impairment
option5: e)	Epilepsy
Correct answer: option3
Specialty: Pediatrics
63)	A ten-year-old boy with Sickle Cell disease is described as having upper motor neurone signs following a stroke affecting the right side of his body. He has a right sided facial weakness. Which of the following would help you distinguish a facial weakness caused by an upper motor neurone lesion rather than a lower motor neurone lesion? 
Answer options: option1: a)	Decreased tear production
option2: b)	Mouth deviating to normal side
option3: c)	Loss of taste sensation to anterior two thirds of the tongue
option4: d)	Loss of corneal reflex
option5: e)	Bilateral forehead wrinkling when asked to raise eye brows
Correct answer: option5
Specialty: Infectious_Disease
Concerning infections by cestodes, which statement is false?
Answer options: option1: Humans are both the definitive and intermediate host for Taenia solium
option2: Eosinophilia and elevated Ig E are expected findings
option3: Praziquantel is the drug of choice
option4: Neurocysticercosis develops after ingestion of eggs of Taenia saginatum
option5: Patients with Echinococcosis can present with respiratory symptoms
Correct answer: option4
Specialty: Pediatrics
62)	You auscultate the heart of a one-year-old boy. You hear a normal first and second heart sound. The first heart sound is caused by
Answer options: option1: a)	Closing of the Tricuspid and Mitral Valve
option2: b)	Opening of the Tricuspid and Mitral Valve
option3: c)	Closing of the Aortic and Mitral valve
option4: d)	Opening of the Pulmonary and Aortic Valve
option5: e)	Closing of the Pulmonary and Aortic Valve
Correct answer: option1
Specialty: Pediatrics
61)	A four-year-old boy presents to the paediatric accident and emergency with a two-year history of cough and shortness of breath on exertion. On examination he has finger clubbing and cyanosis. He is not in respiratory distress. His apex beat is in the fifth left intercostal space, mid clavicular line. There are no heaves or thrills. He has normal 1 st and 2 nd heart sounds with a grade 3/5 ejection systolic murmur heard loudest at the left upper sternal edge, which radiates to the back. What is the most likely explanation for these physical findings? 
Answer options: option1: a)	Ventriculo-septal defect
option2: b)	Rheumatic Heart Disease
option3: c)	Transposition of the great arteries
option4: d)	Tetralogy of Fallot
option5: e)	Patent Ductus Arteriosus
Correct answer: option4
Specialty: Pediatrics
60)	An eleven-year-old girl is known to have rheumatic heart disease with mitral regurgitation. Where would you expect the murmur to be heard loudest? 
Answer options: option1: a)	At the back
option2: b)	Cardiac apex
option3: d)	Left upper sternal edge
option4: d)	Left upper sternal edge
option5: e)	Right upper sternal edge
Correct answer: option2
Specialty: Pediatrics
58)	A 4-year-old girl presents with severe vomiting of non-bilious in nature for 2 days. Which of the following blood gas findings is consistent with this clinical presentation? 
Answer options: option1: a)	Hypochloremic, hypokalemic metabolic alkalosis
option2: b)	Hypochloremic, hyperkalemic metabolic alkalosis
option3: c)	Hypochloremic, hypokalemic metabolic acidosis
option4: d)	Hypochloremic, hyperkalemic metabolic acidosis
option5: e)	Hyperchloremic, hyperkalemic metabolic alkalosis
Correct answer: option1
Specialty: Psychiatry
Risperidone is generally not prescribed above





Answer options: option1: 8 mg/day (2–6 mg said to be optimal) due to occurrence of EPS.
option2: 18 mg/day (12–16 mg said to be optimal) due to occurrence of EPS.
option3: 16 mg/day (4–12 mg said to be optimal) due to occurrence of EPS.
option4: 6 mg/day (1–6 mg said to be optimal) due to occurrence of EPS.
option5: 6 mg/day (0.5–6 mg said to be optimal) due to occurrence of EPS.
Correct answer: option1
Specialty: Pediatrics
57)	The typical clinical signs (on percussion & auscultation) of a pleural effusion are
Answer options: option1: a)	Dullness to percussion, bronchial breathing, increased vocal resonance
option2: b)	Dullness to percussion, loud crepitations, reduced vocal resonance
option3: c)	Dullness to percussion, reduced or absent breath sounds, reduced vocal resonance
option4: d)	Hyper-resonance on percussion, absent breath sounds, reduced vocal resonance
option5: e)	Hyper-resonance on percussion, vesicular breath sounds, normal vocal resonance
Correct answer: option3
Specialty: Pediatrics
56)	According to the WHO guidelines, the most appropriate first-line antibiotic for the treatment of severe pneumonia in children is
Answer options: option1: a)	Amoxycillin
option2: b)	Benzyl penicillin
option3: c)	Ampicillin and gentamicin
option4: d)	Chloramphenicol
option5: e)	Ceftriaxone
Correct answer: option3
Specialty: Pediatrics
55)	According to WHO guidelines, the upper limit of normal for the respiratory rate of a child who is 3 months old is: 
Answer options: option1: a)	80 breaths per minute (BPM)
option2: b)	60 BPM
option3: c)	50 BPM
option4: d)	40 BPM
option5: e)	30 BPM
Correct answer: option3
Specialty: Pediatrics
53)	A 10-month-old baby presents to hospital with respiratory distress. She has had an upper respiratory tract infection for 2 days. On examination there is intercostal recession, tachypnoea, an audible wheeze and fine crackles throughout the lung fields. The organism most likely to cause this illness is: 
Answer options: option1: a)	Bordetella pertussis
option2: c)	Respiratory syncytial virus
option3: c)	Respiratory syncytial virus
option4: d)	Rhinovirus
option5: e)	Streptococcus pneumonia
Correct answer: option3
Specialty: Psychiatry
A 60 yr old man suddenly becomes convinced that he has cancer. 
He has a weight loss of 6 kgs, and his physical investigations have 
been normal.
 





Answer options: option1: he cannot  have cancer
option2: he may have hypochondriasis
option3: he is likely to respond to authoritative reassurance
option4: the most likely diagnosis is an illness phobia
option5: he most likely has Dementia
Correct answer: option2
Specialty: Pediatrics
51)	Which of the following is the best definition of bronchial breathing?
Answer options: option1: a)	Equal length inspiratory and expiratory phase separated by a short gap; whispered words heard clearly over lung fields
option2: b)	Inspiratory phase longer than expiratory phase, no gap between them. No added sounds
option3: c)	Inspiratory phase longer than expiratory phase, no gap between them. No added sounds.
option4: d)	Prolonged expiratory phase, no gap between inspiration and expiration, high pitched noise in expiration
option5: e)	Prolonged inspiratory phase, short gap between inspiration and expiration; harsh noise during inspiration
Correct answer: option4
Specialty: Pediatrics
50)	Two weeks after a viral syndrome, a 2-year-old child develops bruising and generalized petechiae, more prominent over the legs. No hepatosplenomegaly or lymph node enlargement is noted. The examination is otherwise unremarkable. Laboratory testing shows the patient to have a normal hemoglobin, hematocrit, and white blood cell (WBC) count and differential. The platelet count is 15,000/μL. Which of the following is the most likely diagnosis?
Answer options: option1: Von Willebrand disease (vWD)
option2: Acute leukemia
option3: Idiopathic (immune) thrombocytopenic purpura (ITP)
option4: Aplastic anemia
option5: Thrombotic thrombocytopenic purpura
Correct answer: option3
Specialty: Pediatrics
49)	You are working in a refugee camp when a mother brings in her 8-day-old boy. The mother states he started becoming irritable 2 days ago, and now any loud noise appears to cause him pain, as evidenced by muscle tightening and back arching causing his head to nearly touch his feet. Physical examination reveals only a dried packing on his umbilical cord, as is the local custom. He appears normal until he is stimulated by touch or a loud noise, and then he begins to cry, stiffens, and arches his back. The stiffness continues until he calms down. Of the following, the MOST likely diagnosis is
Answer options: option1: bacterial meningitis
option2: botulism
option3: generalized seizure
option4: tetanus
option5: viral encephalitis
Correct answer: option4
Specialty: Pediatrics
48)	A 6-year-old girl presents with a 1-year history of periumbilical, nonradiating abdominal pain. The pain occurs at least three times per week and lasts up to 30 minutes. There is no history of heartburn, constipation, or diarrhea. Physical examination, complete blood count, erythrocyte sedimentation rate, and urinalysis yield normal results. A Helicobacter pylori serology (immunoglobulin G antibody) is positive. Of the following, a TRUE statement regarding this patient is that
Answer options: option1: the H pylori antibody test is more sensitive in younger children than older children
option2: the H pylori antibody test is more sensitive in younger children than older children
option3: he positive serology should be confirmed by another diagnostic test
option4: the prevalence of H pylori increases with higher socioeconomic status
option5: this patient most likely has a gastric ulcer
Correct answer: option3
Specialty: Pediatrics
47)	A 15-month-old infant has been breastfed since birth. He eats finger foods (eg, peas, carrots) and occasionally some cereal. His mother adheres to a vegan diet and plans the same for her child. A complete blood count documents anemia. Of the following, the MOST likely cause of this infant's anemia is a deficiency of
Answer options: option1: folic acid
option2: niacin
option3: riboflavin
option4: Thiamine
option5: vitamin B12
Correct answer: option5
Specialty: Pediatrics
46)	A previously healthy 8-year-old boy has a 3-week history of low-grade fever of unknown source, fatigue, weight loss, myalgia, and headaches. On repeated examinations during this time, he is found to have developed a heart murmur, petechiae, and mild splenomegaly. Which of the following is the most likely diagnosis?
Answer options: option1: Rheumatic fever
option2: Kawasaki disease
option3: Scarlet fever
option4: Endocarditis
option5: Tuberculosis
Correct answer: option4
Specialty: Pediatrics
45)	An 18-month-old child has been brought to your clinic for evaluation. He and his mother are in town visiting his grandmother. His mother tells you that she found him playing with an open bottle of his grandmother's medication. On physical examination, he is sleepy but arousable, pale, mildly diaphoretic, and afebrile. His respiratory rate is 20 breaths/min, heart rate is 60 beats/min, and blood pressure is 65/40 mmHg. His lungs are clear, there are no murmurs, and his pulses are weak. Of the following, the MOST likely cause for this patient's presentation is ingestion of
Answer options: option1: beta blocker
option2: . captopril
option3: pseudoephedrine
option4: pseudoephedrine
option5: tricyclic antidepressant
Correct answer: option1
Specialty: Pediatrics
44)	A 16-day-old infant presents with fever, irritability, poor feeding, and a bulging fontanelle. Spinal fluid demonstrates gram-positive cocci. Which of the following is the most likely diagnosis?
Answer options: option1: Listeria monocytogenes
option2: Group A streptococci
option3: Group B streptococci
option4: Streptococcus pneumoniae
option5: Staphylococcus aureus
Correct answer: option3
Specialty: Pulmonary_Medicine
Which of the following is true regarding tuberculosis?
Answer options: option1: Tuberculin skin test is diagnostic
option2: First-line therapy in adults consists of 4 drugs
option3: A vaccine is not available
option4: MDR-TB refers to TB that is resistant to Pyrazinamide and Ethambutol
option5: It does not affect cattle
Correct answer: option2
Rationale: N /A
Specialty: Pediatrics
43)	In a patient with newly presenting type 1 diabetes
Answer options: option1: A blood pH < 7.30 indicates severe ketoacidosis
option2: Blood ketones are low when insulin levels are low in ketoacidosis
option3: Blood ketones are low when insulin levels are low in ketoacidosis
option4: A random blood glucose >7 mmol/L is diagnostic of type 1 diabetes
option5: Autoantibodies to islet cells are seen in all patients with type 1 diabetes
Correct answer: option2
Specialty: Rheumatology
A 29 year old Caucasian was diagnosed as having ankylosing spondylitis. He has both spinal and peripheral joint pain. Which of the following will benefit his spinal pain

Answer options: option1: Etanercept
option2: Methotrexate
option3: Azathioprine
option4: Sulphasalazine
option5: n/a
Correct answer: option1
Specialty: Pediatrics
42)	A 6-year-old child is hospitalized for observation because of a short period of unconsciousness after a fall from a playground swing. He has developed unilateral pupillary dilatation, focal seizures, recurrence of depressed consciousness, and hemiplegia. Which of the following is the most appropriate management at this time?
Answer options: option1: Spinal tap
option2: CT scan
option3: Rapid fluid hydration
option4: Naloxone
option5: Gastric decontamination with charcoal
Correct answer: option2