afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: General_Surgery
A 35-year-old lady presented with a six months history of a painful breast lump. The pain was cyclical (premenstrual). She is para 4+0 and she breast fed all her children. The breast lump was in the left upper outer quadrant. It measured 2 X 2 cm, not tender, mobile, firm, no clear margins and not attached to the skin. Both breasts felt lumpy and granular. The ipsilateral axillary nodes were not palpable. Other systems were normal. Histological evaluation is negative for malignancy.

a)	What is your clinical diagnosis in this particular patient?
Rationale: Fibroadenosis (Fibrocystic disease).
Specialty: General_Surgery
For patients with lung cancer, state four treatment modalities and give an example.
Rationale: -	Surgery:  Pneumonectomy, Lobectomy, Video Assisted Thoracoscopic Surgery (VATS)
-	Radiotherapy: Inoperable stages, Hemoptysis, Spinal Cord Compression, Mediastinal, Intracranial
-	Endobronchial treatment: Laser, radiotherapy, photodynamic
-	Chemotherapy: Small cell carcinoma is more responsive
Specialty: General_Surgery
Name FIVE (5) symptoms and for each symptom indicate the associated mechanism(s) in patients with mediastinal tumors
Rationale: -	Cough:      Airway narrowing, Compression
-	Chest Pain:  Chest wall and nerve invasion
-	Dyspnea:   Airway compromise, pleural effusion, pericardial tamponade, pulmonary stenosis, heart   failure
-	Hemoptysis: Airway invasion, pulmonary stenosis, heart failure
-	Dysphagia:    Esophageal narrowing, obstruction, dysmotility
-	Hoarseness:  Vocal cord paralysis
-	Facial swelling:  SVC syndrome
Specialty: General_Surgery
A patient presents with pleural effusion. The following investigations have been done; complete blood count and chest x ray. 
What other investigations, laboratory(3) and imaging(3), would you request for in the evaluation of this patient?
Rationale: -	Pleural fluid -cytology, LDH, protein levels, sugar levels, CEA levels, ZN stain, Gene expert
-	Pleural biopsy
-	Thoracoscopy 
-	Video thoracoscopy 
-	Echocardiogram
-	Chest CT
Specialty: General_Surgery
End points of resuscitation 
Rationale: 
•	Vitals- pulse, blood pressure, mentation 
•	Urine output 
•	CVP 
•	Electrolytes 
•	Serum lactate 
•	Base deficit 
•	Passive leg raise test.SV > 10%. Pt is responsive 
Other: pulse pressure variation, mixed venous oxygen concentration
Specialty: General_Surgery
Indications of iv fluids
Rationale:   
•	Resuscitation 
•	Administration of medications 
•	Cleaning and dressing of wounds 
•	Flushing of IV access/maintain venous access 
•	Correct electrolyte disturbances/imbalance 
•	Correct metabolic alkalosis and acidosis 
•	NS can be used in underwater seal drainage 
•	Abdomen washout during surgery’s 
•	Correct patients’ nutritional status-D50, albumin
Specialty: General_Surgery
Classify IV fluids giving examples 
Rationale: 
Crystalloids-  
a.	Hypotonic-0.45% NS 
b.	isotonic -RL, 0.9% NS, D5 
c.	hypertonic-3% NS • Colloids  
Colloids contain larger molecules which stay in the circulation for longer.  
Increase oncotic pressure and can draw fluid back into the circulation. a. 	Plasma–derived (albumin, plasma, fresh frozen plasma) 
b. 	Synthetic (Gelatines (Hemaccel, Gelofusine), Dextran Hydroxyethyl starch (Hetastarch or HES) and Pentastarch) 
• 	Blood and blood products 
NB: colloids used in severe hemorrhage greater than 20% with hypotension not responsive to crystalloid therapy.
Specialty: General_Surgery
Investigations thyroid ca 
Rationale: 
•	TFTs-T3, T4, TSH. Done but does not rule out malignancy 
•	FNAC. difficult to differentiate follicular adenoma vs follicular ca 
•	Serum calcitonin-elevated in medullary ca 
•	Tumor markers- best for monitoring therapy rather than diagnosis-include 
a.	Thyroglobulin-FTC, PTC 
b.	Calcitonin-MTC 
c.	CEA-MTC 
•	Routine lab works. -FHG, UECs/LFTs 
 
Thyroid imaging 
•	US-Dx and targeted sampling 
•	CT, MRI, PET scan- malignancy, extent of retrosternal goitre 
Radioisotope scanning
Specialty: General_Surgery
Pre-op preparation for thyrotoxicosis 
Rationale: 
Traditionally  
•	Patient is made euthyroid through use of antithyroids (carbimazole) for about more than 8-12 weeks 
Alternatively, 
•	Use of B blockers (propranolol) to abolish clinical manifestations of toxic state. Rapid response and surgery can be arranged within a week.  
Pre op investigations 
•	TFTs 
•	Laryngoscopy 
•	Serum ca2+ 
•	Isotope scan 
•	FBC 
•	GXM 
•	Airway assessment 
•	ASA scoring 
•	NPO 
•	Premedication 
•	Consent
Specialty: Endocrinology
Specific Management of thyrotoxicosis 
Rationale: 
• 	Medical 
a.	Antithyroid-carbimazole, propylthiouracil-to restore the patient to euthyroid. Milder cases 6 months duration, severe cases 2 yrs. Duration of Rx 
b.	B blockers-for sympathetic signs and symptoms. (Tremors, palpitations etc.) Propranolol, nadolol 
• 	Surgical 
a. 	thyroidectomy 
• 	radioiodine
Specialty: Endocrinology
Post-op notes after thyroidectomy 
Rationale: 
•	Monitor vitals PR & BP every 15 min till pt. awake 
•	Observe for bleeding at the site 
•	Keep stitch/clips removing tray @ bedside 
•	NPO till awake 
•	Iv fluids NS 500 mls 6 hourly till oral feeding starts
Specialty: Endocrinology
Complications of thyroidectomy 
Rationale: 
 
Immediate 
•	Hemorrhage 
•	Airway obstruction-tracheomalacia hematoma 
•	RLN injury 
•	Thyroid storm 
•	Injury to parathyroids 
 
Early 
•	Parathyroid insufficiency 
•	Infection 
•	Hypocalcemia 
Late 
•	Hypothyroidism 
•	Recurrent thyrotoxicosis 
•	Hypertrophic or keloid scar if incision overlies sternum 
•	Stitch granuloma
Specialty: Endocrinology
Indications for surgery on a goitre 
Rationale: 
•	Cosmesis 
•	Signs of compression- 
a.	distended neck veins 
b.	Difficulty in breathing 
c.	Dysphonia/voice hoarseness 
d.	Dysphagia 
•	Goitre refractory to medical treatment 
•	Malignant goitre 
•	Retrosternal goitre 
•	Pt’s preferences
Specialty: Endocrinology
Investigations for goitre/thyroid function 
Rationale: 
•	TFTs-T3, T4, TSH 
•	Thyroid auto antibodies 
•	FNAC  
Thyroid imaging 
•	Chest and thoracic inlet radiography-confirming retrosternal goitre and evidence of compression 
•	US-Dx and targeted sampling 
•	CT, MRI, PET scan- malignancy, extent of retrosternal goitre 
•	Radioisotope scanning
Specialty: Endocrinology
Classify goitres 
Rationale: 
Broadly into 
• 	Toxic-associated with a hyperthyroidism/thyrotoxicosis 
a.	Toxic nodular 
b.	Diffuse i.e., Grave’s disease 
c.	Multi nodular 
d.	Recurrent toxicosis 
 
• 	Non toxic 
a.	Endemic goitre (simple goitre)-iodine deficiency 
b.	Physiological goitre-puberty and pregnancy 
c.	Nodular goitre (Multinodular). 
d.	Solitary nontoxic nodule 
e.	Colloid goitre 
• 	Other goitres- inflammatory goitre, neoplastic
Specialty: General_Surgery
What is ANDI and examples 
Rationale: 
Aberration in the normal development and involution of the breast. Involves a wide spectrum of benign breast disease. 
 
Some examples of ANDI 
•	Polymastia and polythelia 
•	Accessory axillary breast tissue 
•	Cyclical nodularity and mastalgia 
•	Cysts 
•	Fibroadenoma 
•	Duct ectasia 
•	Fibrocystic change 
•	Galactocele 
•	Puerperal abscess
Specialty: General_Surgery
Prevention of breast ca 
Rationale: 
•	Avoid avoidable risk factors 
•	Encourage breastfeeding 
•	Health Education 
•	Population screening- 
•	history-risk factors 
•	CBE-clinical breast exam 
•	BSE-breast self-exam 
•	Prophylactic anti-estrogens 
•	Early diagnosis and early treatment 
•	Prophylactic mastectomy in high-risk patients
Specialty: General_Surgery
Surgical procedures for breast diseases 
Rationale: 
1. 	Breast conservation surgery 
•	lumpectomy 
•	Partial mastectomy 
•	Quadrantectomy 
2.	Simple mastectomy 
3.      Modified Radical mastectomy-simple mastectomy + ALND (axillary lymph node dissection) 
4.	Toilet mastectomy for inoperable breast ca to reduce infection, pain, and bleeding 
5.	Sentinel lymph node Biopsy-in patients with clinically negative node disease 
6.	Mammoplasty : Reduction, Augmentation -implants, Muscles flaps
Specialty: General_Surgery
BREAST CANCER: Staging (TNM and Manchester staging) 
Rationale: 
•	T1-<2cm 
•	T2-2-5cm 
•	T3->5cm 
•	T4-tumor extends to the skin or chest wall 
•	N1-mobile axillary nodes 
•	N2-firm/fixed axillary nodes 
•	N3-supraclavicular lymph nodes 
•	M1-Metastasis
Specialty: General_Surgery
BREAST: CANCER Investigations 
Rationale: Laboratory 
•	CBC 
•	UECs 
•	LFTs 
•	FNAC 
•	Core biopsy samples for histology 
•	GXM 
  
Imaging 
  
•	CXR 
•	US 
•	MRI 
•	Mammography 
•	Ct scan chest abdomen 
•	Isotope bone scan
Specialty: General_Surgery
What’s a positive DPL 
Rationale: 
•	At least 10mls of gross blood 
•	RBC count at least 100000/ml 
•	WBC count at least 500 cells/ml 
•	Amylase >19 iu/l 
•	Food, bile or bacteria 
•	ALP > 2IU/l 
•	Bilirubin > 0.01mg/dl
Specialty: General_Surgery
Thoracotomy indications 
Rationale: 
•	Resuscitation thoracotomy:  To do open cardiac massage. 
•	Emergency thoracotomy:  
For massive hemothorax, cardiac tamponade, major air leak, great vessel injury, intrathoracic foreign body and chest wall defect. 
•	Elective thoracotomy: (done in after investigations): 
For diaphragmatic injuries, esophageal injuries, intracardiac injuries, aortic rupture with false aneurysm, clotted hemothorax and empyema. 
 
After chest tube insertion 
•	Drainage of > 1500mls of blood in 24 hours 
•	Continuous bubbling after 24 hours 
•	Drainage of blood > 300mls/h for 3 consecutive hours
Specialty: General_Surgery
 Complications of herniorrhaphy 
Rationale: 
•	Hemorrhage 
•	Hematoma 
•	Infection 
•	Haematocoele 
•	Hyperesthesia over the medial side of the inguinal canal due to ilioinguinal nerve damage 
•	Recurrence of hernia 
•	Osteitis pubis 
•	Injury to urinary bladder, bowel; 
•	Testicular atrophy
Specialty: General_Surgery
Surgical management of inguinal hernia
Rationale: 
• 	Surgery can be open or laparoscopic 
a. 	Open surgery 
b. 	Herniotomy- in children done alone. Excision of the hernial sac.  
• 	Adults : involve herniotomy plus, 
ii.	Herniorrhaphy and Posterior wall repair 
iii.	Hernioplasty and Reinforcement of the posterior wall with a synthetic mesh 
 
Pure tissue repair techniques 
Shouldice 
Mac vay 
Modified bassini  
 
Prosthetic tissue repair (mesh repair) 
• 	Lichtenstein 
 
b. 	Laparoscopic 
•	total extraperitoneal (TEP) or  
•	transabdominal pre-peritoneal (TAPP)).
Specialty: General_Surgery
What is an incarcerated hernia vs a strangulated hernia? 
Rationale: •	Incarcerated hernia is an irreducible hernia. Unable to return to its normal cavity. Blood supply intact. 
•	Strangulated hernia. Blood supply is compromised leading to bowel ischemia. Surgical emergency 
•	Incarcerated hernia can easily become strangulated.
Specialty: General_Surgery
Components of the spermatic cord 
Rationale: 
• 	3 arteries 
a.	Cremasteric artery 
b.	Testicular artery 
c.	Artery to the vas deferens 
• 	2 nerves 
a.	Genital branch of the genitofemoral nerve 
b.	Sympathetic plexus around the artery to the vas 
• 	Veins 
a.	Pampiniform plexus • Other structures 
b.	Vas deferens 
c.	Lymphatics 
d.	Spermatic fascia 
e.	Cremasteric fascia 
f.	Remnants of processus vaginalis
Specialty: Obstetrics_and_Gynecology
56 years old woman has come to you with the complaints of hot flushes irritability, joint pains with lack of sleep. Most appropriate treatment would be: 

Answer options: option1: Hysterectomy.
option2: Vitamins.
option3: Combined oestrogen, progesterone preparations.
option4: Phytooestrogens.
option5: Selective estrogen receptor modulators (SERMS).
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
A newly married girl comes to gynae OPD with history of dysuria, burning, micturition and sore perineum. What is your likely diagnosis: 

Answer options: option1: Trichomonas vaginalis.
option2: Candida infection.
option3: Trauma due to coitus.
option4: Honey moon cystitis.
option5: Genital herpes.
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
28 years old woman with previous history of having baby with Down's 
Syndrome is now 12 weeks pregnant. Which of the following would you suggest to her: 
Amniocentesis. 

Answer options: option1: Obstetric ultrasound.
option2: Chorionic villus sampling.
option3: Fetal blood sampling.
option4: Wait till eighteen weeks for detailed ultrasound and amniocentesis.
option5: Obstetric ultrasound.
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
A 20-year-old medical student presents with five years history of weight gain, irregular periods and worsening fascial hair. What is the most likely diagnosis? 

Answer options: option1: Polycystic ovarian disease.
option2: Hypothyroidism.
option3: Obesity.
option4: Cushing's Syndrome.
option5: Nephrotic Syndrome.
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
A large cystic ovarian tumour is detected in a woman on routine antenatal check-up. The most common complication she can encounter is: 

Answer options: option1: Torsion.
option2: Rupture. .
option3: Haemorrhage
option4: Degeneration.
option5: Infection.
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
A 28-year-old patient complains of amenorrhea after having dilatation and curettage. The most likely diagnosis is: 

Answer options: option1: Kallman's Syndrome.
option2: Turner's Syndrome.
option3: Asherman's Syndrome.
option4: Pelvic inflammatory disease.
option5: Anorexia nervosa.
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
28 years old G 3 P 2 has presented with complaints of brownish vaginal discharge, passage of vesicles and excessive vomiting. Ultrasound scan shows snowstorm appearance in uterus with no fetus. The most likely diagnosis is: 

Answer options: option1: Septic induced abortion.
option2: Twin pregnancy.
option3: Gestational trophoblastic disease.
option4: Ectopic pregnancy.
option5: Fibroid uterus.
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
A 40 years old multiparous woman complains of involuntary loss of urine associated with coughing, or standing. The history is most laughing, lifting suggestive of: 

Answer options: option1: Fistula.
option2: Stress incontinence.
option3: Urge incontinence.
option4: Urethral diverticulum.
option5: Urinary tract infection.
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
A 28 years old woman has 14 weeks size irregular uterus. She does not complain of abdominal pain or menorrhagia. Her pap smear is normal. The best next step in her management would be: 

Answer options: option1: Continued observation.
option2: Endometrial biopsy. .
option3: Hysterectomy
option4: Pelvic ultrasonography. .
option5: Laparoscopy
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
A 39 years old women Para 6 has presented with complaint of post coital bleeding for the past three months. Your first investigation should be: 

Answer options: option1: Dilatation & Curettage.
option2: Cone biopsy of cervix.
option3: Pap smear.
option4: Colposcopy.
option5: Laparoscopy.
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
A 43-year-old, lecturer has come to you with complaints of heavy but regular menstrual bleeding with flooding and clots. There is no anatomical reason for heavy flow. The most effective remedy for reducing her menstrual flow is: 


Answer options: option1: Tranexemic acid.
option2: Dilatation and Curettage.
option3: Depomedroxy progesterone acetate.
option4: Misoprostol.
option5: Ergometrine maleate.
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
A young medical student has come to you to you with complaints of oligomenorrrhea, hirsuitism and weight gain, ultrasound reveals bulky ovaries with sub-capsular cysts. Most likely diagnosis is: 

Answer options: option1: Ovarian cancer.
option2: Cushing's syndrome.
option3: Polycystic ovarian disease.
option4: Diabetes mellitus.
option5: Pelvic inflammatory disease.
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
A 25 years old school teacher Para 1 wants to use oral contraceptive pills for contraception. She is asking about the mode of action of oral contraceptive pills. The mechanism of action of oral contraceptive pills is: 

Answer options: option1: Inhibiting ovulation by suppression of serum FSH.
option2: Inducing endometrial atrophy.
option3: Increasing cervical mucous hostility.
option4: Inducing endometritis.
option5: Inhibiting prolactin.
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
A young girl, 23 years old is presented with complaint of abdominal pain, menorrhagia and 18 weeks size mass arising from hypogastrium. The most likely diagnosis is: 

Answer options: option1: Endometriosis.
option2: Pelvic inflammatory disease.
option3: Ovarian cyst.
option4: Fibroid uterus.
option5: Mesenteric cyst.
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
A 63 years old lady presents with abdominal mass and weight loss, was diagnosed as having an ovarian tumour. The most common ovarian tumour in this woman would be: 

Answer options: option1: Epithelial tumour.
option2: Germ cell tumour.
option3: Stromal tumour.
option4: Sex cord tumour.
option5: Trophoblastic tumour
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
23 years old primigravida presents with abdominal pain, syncope and vaginal spotting. Assessment reveals that she has an ectopic pregnancy. The most common site of pregnancy is: . 

Answer options: option1: Ampulla
option2: Isthmus.
option3: Fimbrial end.
option4: Abdomin.
option5: Cervix.
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
A couple presented in OPD with H/0 infertility since last 2 years. Husbands’ semen analysis was advised. What is WHO criterion for minimum sperm counts in normal semen? 

Answer options: option1: 10 million.
option2: 20 million.
option3: 30 million.
option4: 40 million.
option5: 70 million.
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
Which of the following is NOT one of the criteria needed for lactational amenorrhea (LAM) to be used as a contraceptive option? 

Answer options: option1: Menstrual period not returned after delivery.
option2: Exclusive breastfeeding on demand, day and night.
option3: Baby less than 6 months old.
option4: Lactational amenorrhea up to 1 year.
option5: No supplementary feeding.
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
About human chorionic gonadotropin (h CG), choose the correct statement 

Answer options: option1: Detectable rise in maternal serum and urine 6 hours after ovulatiton.
option2: Is responsible for programmed corpus luteum demise.
option3: Concentration in serum double every 2 to 3 weeks in early pregnancy.
option4: Has structural similarities to Luteinizing Hormone.
option5: Is not useful in assisted reproductive techniques
Correct answer: option4
Specialty: General_Surgery
A 34-year-old patient presents to the emergency department with a history of rectal bleeding that is bright red and only noticed on wiping. The patient was complaining of constipation with no history of weight loss. The patient is hemodynamically stable with normal blood results. 
Outline measures to manage constipation in this patient. 
Rationale: To increase their fiber intake and ensure good oral hydration.
Oral laxatives or stool softeners.
Specialty: Obstetrics_and_Gynecology
As regards fertilization and capacitation, which statement is false 

Answer options: option1: Capacitation lasts about 7 hours
option2: A glycoprotein coat is removed from the surface of the sperm’s acrosome
option3: Capacitation occurs in the cervix
option4: Capacitated sperms are more active
option5: The acrosomal reaction cannot occur until capacitation has occurred
Correct answer: option3
Specialty: General_Surgery
A 34-year-old patient presents to the emergency department with a history of rectal bleeding that is bright red and only noticed on wiping. The patient was complaining of constipation with no history of weight loss. The patient is hemodynamically stable with normal blood results. 
List TWO investigations/procedures that will confirm the diagnosis. 
Rationale: Proctoscopy 
Sigmoidoscopy. 
Colonoscopy
Specialty: Obstetrics_and_Gynecology
You have attempted to perform a direct entry for your laparoscopy and opted to undertake a Palmer's point entry. When would you find Palmer’s point? 


Answer options: option1: 1cm below the left costal margin in the mid-clavicular line
option2: 1cm below the right costal margin in the mid-clavicular line
option3: 3cm below the left costal margin in the mid-axilla
option4: 3cm below the left costal margin in the mid-clavicular line
option5: 3cm inferior to the right intercostal margin
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
A 19-year-old woman is to undergo a laparoscopy for pelvic pain. How would you describe the correct technique or entry with the veress needle? 

Answer options: option1: Enter below the umbilicus horizontally and then pass the needle at 45° to the skin
option2: Enter below the umbilicus transverse plane and then pass the needle at 45° to the skin
option3: Enter below the umbilicus vertical to the skin
option4: Enter at the base of the umbilicus and pass the needle at 60° to the skin
option5: Enter the base of the umbilicus vertical to the skin
Correct answer: option2
Specialty: General_Surgery
A 34-year-old patient presents to the emergency department with a history of rectal bleeding that is bright red and only noticed on wiping. The patient was complaining of constipation with no history of weight loss. The patient is hemodynamically stable with normal blood results. List FOUR possible causes of the bleeding? 

Rationale: Bleeding hemorrhoids. 
Anal fissure
Rectal polyp
Rectal/anal carcinoma
Ulcerative colitis
Diverticular disease
Specialty: Obstetrics_and_Gynecology
With respect to instrumentation of the uterus, which operation has the highest risk of perforation? 

Answer options: option1: Division of intrauterine adhesions
option2: Outpatient hysteroscopy
option3: Postpartum suction evacuation for haemorrhage
option4: Second generation endometrial ablation
option5: Surgical termination of pregnancy
Correct answer: option5
Specialty: Obstetrics_and_Gynecology
A 32-year-old is due to undergo a laparoscopic operation for investigation and management of an ovarian cyst detected on scan. What is the expected serious complication rate following a laparoscopy? 

Answer options: option1: 1:500
option2: 1:1000
option3: 1:2500
option4: 1:5000
option5: 1:10,000
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
A 43-year-old lady with a history of heavy menstrual bleeding and a scan suggesting a polyp is due to undergo an outpatient hysteroscopy. Which distension medium is routinely recommended due to its improved quality of image and speed of the procedure? 

Answer options: option1: Carbon dioxide
option2: Gelofusin
option3: Normal saline 0.9%
option4: Purosol
option5: 5% glucose
Correct answer: option3
Specialty: General_Surgery
Enumerate FOUR (4) predisposing factors to the patient’s condition. 
Rationale: A long sigmoid loop with a narrow mesentery.
A loop fixed at its apex by adhesions, around which it rotates; 
Chronic constipation 
A high-fibre diet  
Systemic neurological disease(e.g. Pseudobulbar Palsy) 
In South America, there is an association with Chagas disease
Specialty: Obstetrics_and_Gynecology
A 62-year-old is due to undergo a hysteroscopy due to a thickened endometrium detected as part of her investigations for postmenopausal bleeding. 
Which medication should be used to 'prime' the cervix prior to the hysteroscopy? 

Answer options: option1: Mifepristone
option2: Misoprostol
option3: No medication required
option4: Non-steroidal anti-inflammatory
option5: Vaginal oestrogen
Correct answer: option2