afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Neurology
You are asked to consult on a 14-year-old boy who was hospitalized overnight with a fever of 39 C. He is toxic appearing and has been sick for six days. He had a bad upper respiratory infection two weeks ago, but over the last few days has had increasing headaches, pain in his right eye, and increasing nasal discharge. Two days ago, he was noted to have swelling and redness around his right eye, but this spread to his left one day ago. He now has proptosis and chemosis in the right eye with some limitation of eye motion and redness, as well as swelling and chemosis of the left eye. Which diagnosis is most concerning for this patient? 
Answer options: option1: A cavernous sinus thrombosis
option2: A right orbital cellulitis
option3: A right periorbital abscess
option4: Bilateral acute bacterial ethmoiditis
option5: Aortic Aneurysm
Correct answer: option1
Specialty: Cardiology
Which of the following is not a feature of pericarditis?
A.	
B.	
C.	
D.

Answer options: option1: Dysphagia due to irritation of oesophagus.
option2: Sharp chest pain worse on lying supine.
option3: Pericardial friction rub
option4: Tachypnoea
option5: n/a
Correct answer: option1
Specialty: Otolaryngology
A 50-year-old male comes to the clinic complaining of pain in the area of his right parotidgland and a one-month history of weakness around his right eye and mouth. On examination, you note weakness when he closes his right eye and a weak right smile. On palpation of the parotid gland, there is a vague
mass deep in the parotid, 3 cm anterior to the tragus. The most likely diagnosis would be: 

Answer options: option1: Facial neuroma
option2: Benign adenoma of the parotid gland
option3: Malignant tumor of the parotid gland
option4: Malignant tumor of the mandible
option5: None of the above
Correct answer: option3
Specialty: General_Surgery
Patient was seen at the emergency department and diagnosed with a strangulated para-umbilical hernia. During surgery, it was noticed that only part of the circumference of the bowel involved was gangrenous. What type of hernia is this? 
Answer options: option1: a sliding hernia
option2: Berger’s hernia
option3: Richter’s hernia
option4: Maydl’s hernia
option5: n/a
Correct answer: option2
Specialty: Cardiology
A 28-year-old man presents with fever, CHF and an episode of SVT. You suspect myocarditis. Which is true regarding the investigation of this man?

Answer options: option1: Global wall motion abnormalities on ECHO are characteristic of myocarditis.
option2: A positive Trop I rules out myocarditis.
option3: The ESR is always elevated in myocarditis.
option4: The gold standard for diagnosis of myocarditis is endomyocardial biopsy.
option5: n/a
Correct answer: option4
Specialty: Otolaryngology
epistaxis from the left nostril. The epistaxis started yesterday and was intermittent; however, it has become severe today. The blood is coming from his nose, and he is also coughing up blood. 
On examination, he is leaning forward, has bright red blood draining from the left nostril, and is coughing bright redblood into an emesis basin. You estimate that there is about 250 m L of blood. His wife says that he has soaked three large cloths with blood today. On nasal speculum exam, you can clear the clots and note spurting blood in themiddle meatus of the nose. The most likely blood vessel involved would be the: 

Answer options: option1: Sphenopalatine artery
option2: Posterior ethmoid artery
option3: Vascular plexus in Kiesselbach's area
option4: Anterior ethmoid artery
option5: None of the above
Correct answer: option1
Specialty: Pathology
Irreversible cell injury is characterised by
Answer options: option1: dispersion of ribosomes
option2: cell swelling
option3: nuclear chromatin dumping
option4: cell membrane defects
option5: lysosomal rupture
Correct answer: option4
Rationale: There are two main consequences that characterize irreversible cell injury. The first consequence is the inability to reverse mitochondrial dysfunction even once oxygen has been restored. The second main consequence is the occurrence of extreme disturbances in overall membrane function.
Specialty: Otolaryngology
. You are asked to see a 55-year-old female who has a history of diabetes for the past fiveyears and drainage from her left ear for more than 20 years. About three months ago, the ear became quite painful. On 
examination of the ear canal, you see irregular raised skin with a small ulcer and exposed bone in the center. Your next step should be to: 

Answer options: option1: Send the patient for a CT scan of the temporal bone
option2: Culture the ear canal, by taking a scraping from the exposed bone
option3: Use aminoglycoside or fluoroquinolone ear drops three times daily for 2 weeks
option4: Take a biopsy at the edge of the ulce
option5: . None of the above
Correct answer: option4
Specialty: Hematology
A 26-year-old male comes to the surgical clinic with a history of intermittent bleeding from the right nostril for the past two days. The amounts are small but keep recurring. Hehas never had anything like this before, has no other health problems, and takes no medications. He also noted that he had some minor trauma yesterday with a small cut that has been oozing small amounts of blood from that time and continues today. The most likely diagnosis would be:
Answer options: option1: An acquired bleeding disorder, possibly associated with acute lymphoblastic lymphoma
option2: Epistaxis secondary to chronic digital trauma to the nasal septum
option3: A hereditary bleeding disorder, such as hemophilia
option4: A mucocele in the ethmoid sinus
option5: None of the above
Correct answer: option1
Specialty: Neurology
65-year-old woman presents to the emergency department complaining ofa facial droop and dribbling from the left corner of her mouth. On examination, you note that she can wrinkle her forehead and close her eye, but she is unable to smile. Which of the following is most likely to cause these physical examination findings? 
Answer options: option1: N/A
option2: Glomus jugulare tumor at the left jugular foramen
option3: Ramsay-Huntsyndrome (Herpes zoster) with facial nerve paralysis.
option4: Idiopathic facial nerve paralysis.
option5: Acute stroke affecting her right motor cortex
Correct answer: option5
Specialty: Cardiology
Which is INCORRECT of hypertrophic cardiomyopathy?

Answer options: option1: 50% is familial with autosomal dominant inheritance.
option2: Younger patients tend to have more severe symptoms.
option3: The characteristic systolic murmur decreases with passive leg raising.
option4: Chest pain and shortness of breath worse especially at rest
option5: n/a
Correct answer: option4
Specialty: Pathology
Hypertrophy
Answer options: option1: occurs after partial hepatectomy
option2: increases function of an organ exponentially
option3: is triggeredby mechanical and trophic chemicals
option4: occurs after dennervation
option5: is usually pathological
Correct answer: option3
Rationale: Hypertrophy is the increase in the volume of an organ or tissue due to the enlargement of its component cells. It is distinguished from hyperplasia, in which the cells remain approximately the same size but increase in number. Although hypertrophy and hyperplasia are two distinct processes, they frequently occur together, such as in the case of the hormonally induced proliferation and enlargement of the cells of the uterus during pregnancy.
Specialty: Cardiology
A 46-year-old male presents to the emergency room with complaints of acute-onset chest and back pain, which he describes as "shearing." He is visibly uncomfortable. His heart rate is 92 bpm, blood pressure 187/94, respiratory rate 24, and O 2 saturation is 98% on 2 L nasal cannula oxygen. What is the most appropriate imaging for this patient? 
Answer options: option1: Plain chest radiograph
option2: Transesophageal echocardiography
option3: Angiography
option4: CT Angiography of the chest
option5: None of the above
Correct answer: option4
Specialty: General_Surgery
Patient is noticed to have produced 100 ml of urine in the recovery ward over the last 8 hours after undergoing surgery for bowel obstruction. What is the normal urine production of an adult? 
Answer options: option1: 2ml/Kg/min
option2: 0.5-1ml/kg/min
option3: 1L/Kg/hr
option4: 10 ml/Kg/hr
option5: n/a
Correct answer: option2
Specialty: Emergency_Medicine
A 56-year-old male presents with abdominal pain and is found to have a 6.2-cm infrarenal abdominal aortic aneurysm (AAA). Which of the following is TRUE of this condition
Answer options: option1: The decision to operate is based on the size of the aneurysm.
option2: The decision to operate is based on the risk of rupture compared to the riskof complications of the operation
option3: The decision to operate is based on the age and comorbidities of the patient.
option4: All of the above are true.
option5: None of the above are true
Correct answer: option4
Specialty: Cardiology
Concerning Dilated Cardiomyopathy, which is true?

Answer options: option1: Mostly due to infective causes
option2: The ECG is almost always abnormal with LV hypertrophy, & Left atrial enlargement being the most common abnormalities.
option3: Use of digoxin has been shown to improve survival rates.
option4: Chest pain in these patients is usually due to atherosclerosis of coronary arteries.
option5: n/a
Correct answer: option2
Specialty: Rheumatology
A 34-year-old heavy smoker is found to have an inflammatory vasculitis of the small vessels of the lower extremities. This is mostlikely which of the following
Answer options: option1: N/A
option2: Giant cell arteritis
option3: Takayasu's arteritis
option4: Kawasaki's disease
option5: Buerger's disease
Correct answer: option5
Specialty: Emergency_Medicine
47-year-old man is found to have an acute thoracic aortic dissection as shown below 
(purple arrow). All of the following are true of this condition EXCEPT
Answer options: option1: The false lumen may compress the true lumen and impair perfusion.
option2: The false lumen is typically smaller than the true lumen
option3: Pressures in the false lumen may create a re-entry tear, allowing   perfusion through both the false and the true
option4: The false lumen does not fill as quickly with contrast and   therefore
option5: None of the above
Correct answer: option2
Specialty: Cardiology
A 52-year-old otherwise healthy man presents to the emergency room with complaints of acute-onset pain and heaviness in his right leg. He has no pulsesin the right lower extremity. His heart rate is 153 and irregular. What is the most likely cause of this presentation? 
Answer options: option1: Aortic dissection that has progressed to the iliofemoral level
option2: Thrombotic complication of atherosclerotic plaque of the femoral artery
option3: Embolism to the femoral artery
option4: Leriche syndrome
option5: Diabetes
Correct answer: option3
Specialty: Neurology
Which of the following is true concerning idiopathic Parkinson's disease?

Answer options: option1: There is degeneration primarily of the cells of the globus pallidus
option2: The classical features include tremor, bradykinesia, and spasticity
option3: There is an associated vertical gaze palsy
option4: Anticholinergic drugs are most effective in relieving tremor
option5: Treatment is aimed at reducing dopamine levels
Correct answer: option4
Specialty: Gastroenterology
A 74-year-old woman presents to the emergency room with sudden onset abdominal pain and vomiting. Her abdominal exam is soft withmild tenderness to deep palpation, but she is writhing on the bed in pain. The next most appropriate step in management is: 
Answer options: option1: Initiation of intravenous fluids, antibiotics, and heparin
option2: CT scan of the abdomen and pelvis
option3: Echocardiography of the heart
option4: Emergent laparotomy
option5: Abdominal USS
Correct answer: option1
Specialty: Cardiology
A 67-year-old man presents to the outpatient clinic with a CT angiogram, which shows occlusion of the distal aorta and proximal common iliac arteries. Which of the following symptoms is this patient LEAST likely to experience as a result of this finding? 
Answer options: option1: . Constipation
option2: Buttock claudication
option3: Erectile dysfunction
option4: Thigh claudication
option5: A and C
Correct answer: option1
Specialty: Neurology
When WBCs count are increased in CSF, it is known as....?
Answer options: option1: Thrombocytosis
option2: Leukcopenia
option3: Erythrocytosis
option4: Pleocytosis
option5: none of the above
Correct answer: option4
Rationale: Pleocytosis, a marker of CNS inflammation, is defined as the appearance of leukocytes in the CSF to a level exceeding normal
Specialty: Cardiology
A 62-year-old diabetic male with a history of claudication now presents withrest pain, and you begin a workup in preparation for surgery. Which of the following is TRUE of the workup? 
Answer options: option1: Segmental pressure changes of > 20 mmHg between levels in the lowerextremity indicate a hemodynamically significant  occlusive lesion.
option2: . An ankle-brachial of > 1 indicates that his pain is non-ischemic
option3: Angiography is necessary for operative planning
option4: CT angiography is unlikely to be beneficial in this patient.
option5: B and D
Correct answer: option1
Specialty: Cardiology
A 55-year-old male presents with a history of cramping pain in his calf muscles with exertion. He states that this occurs predictably when hehas walked about 50 meters. It resolves when he stops to rest. Whichof the following is TRUE of this condition? 
Answer options: option1: It typically occurs with an ankle-brachial index (ABI) of 0.6-0.8.
option2: It is a form of limb-threatening ischemia.
option3: The treatment of choice is surgical bypass.
option4: There are no medical therapies available for this condition.
option5: None of the above
Correct answer: option1
Specialty: Psychiatry
A 20-year-old man with an identical twin is diagnosed with major depressive disorder. His twin brother asks you to comment on the chance that he will develop a depressive disorder. Which of the following is the correct response to his twin brother?
Answer options: option1: ‘Major depressive disorder is strongly heritable. You will definitely develop it as well.’
option2: ‘The likelihood of you developing depressive disorder is higher than your other siblings’
option3: ‘There is only a slightly increased risk that you will become depressed as compared to the general population’
option4: ‘The likelihood of you developing depressive disorder is the same as if you were non-identical twins.’
option5: ‘You need not worry because environmental factor is an important thing to determine whether you will develop a depressive disorder.’
Correct answer: option2
Specialty: Cardiology
Which is false about Valvular Heart disease?

Answer options: option1: Rheumatic heart disease is the most common cause of Mitral Valve disease
option2: Mitral Regurgitation could be from  functional and Organic cause
option3: Newer oral anticoagulants are best choice of therapy.
option4: Anticoagulants are important to prevent Cardioembic stroke
option5: n/a
Correct answer: option3
Specialty: Cardiology
A 63-year-old woman presents with sudden-onset severe abdominal pain. Thepain has been present for the past 6 hours and has increased in intensity. Shehas an irregular heart rate, which is confirmed on EKG to be atrial fibrillation. You suspect mesenteric ischemia. What is the definitive treatment for this patient's condition? 
Answer options: option1: Intravenous fluids and antibiotics with observation.
option2: Anticoagulation with unfractionated or low-molecular-weight heparin.
option3: Endovascularthrombolytic therapy.
option4: Open embolectomy.
option5: A and B
Correct answer: option4
Specialty: Internal_Medicine
A 22-year-old patient with known rheumatic disease of the mitral
valve presents to thehospital with acute-onset pain in her right lower extremity. The limb is cool, and she describes a sensation of numbness and tingling. You are unable to appreciate pulses in the limb. Which of the following is TRUE of her management? 

Answer options: option1: CTA should be performed following the initiation of a  heparin drip to confirm thediagnosis and guide the surgical  approach
option2: This condition is treated with anticoagulation and observation.
option3: The patient should undergo amputation of the limb following the initiation of a heparindrip
option4: Emergent embolectomy is indicated following the initiation of a heparin drip
option5: A and D
Correct answer: option4
Specialty: Nephrology
A 57-year-old man presents to the hospital with blurred vision. He is found to have a systolic blood pressure of 174 mmHg. He has a history of hypertension and is already taking three antihypertensive medications, which he says he regularly uses as instructed. You are concerned about renovascular hypertension. Which of the following diagnostic modalities has the highest risk of complications? 
Answer options: option1: Duplex ultrasound
option2: CT angiogram
option3: Angiography
option4: Captopril scanning
option5: MRI
Correct answer: option3
Specialty: Internal_Medicine
The appearance of this 35-year-old woman's internal carotid artery (circled) is most likely due to which of the following? 
Answer options: option1: Fibromuscular dysplasia (FMD)
option2: Vasospasm
option3: Atherosclerotic stenosis
option4: Carotid dissection
option5: None of the above
Correct answer: option1
Specialty: Neurology
CSF is produced in the 
Answer options: option1: Pia matter
option2: Choroid plexus
option3: Ventricles of the Brain
option4: pineal gland
option5: pituitary galnd
Correct answer: option2
Rationale: The CSF is produced by the choroid plexus which covers two lateral ventricles, and the roof of the third and fourth ventricles. Around 500 ml of CSF is produced each day, with around 150 ml being present in the body at any given time
Specialty: Cardiology
A 74-year-old man with poorly controlled diabetes and a long smoking history presents with right leg pain that wakes him up at night. He says that the pain is relieved by dangling his leg over the bed or by standing. He has an ankle-brachial index (ABI) of 1.5 in theaffected limb. Which of the following is
true of this finding

Answer options: option1: His ABI confirms the diagnosis of moderate occlusion causing rest pain
option2: His ABI is normal, and his pain is likely non-vascular in etiology
option3: He likely has calcified arteries that are affecting the ABI; ABI is not useful in this patient
option4: . His ABI was likely miscalculated
option5: None of the above
Correct answer: option3
Specialty: Neurology
CSF is formed from 
Answer options: option1: Blood plasma
option2: water
option3: electrolytes
option4: metabollic end-products
option5: serum
Correct answer: option1
Rationale: The CSF is produced by the choroid plexus which covers two lateral ventricles, and the roof of the third and fourth ventricles. Around 500 ml of CSF is produced each day, with around 150 ml being present in the body at any given time
Specialty: Ophthalmology
A female patient 18 years old, who is contact lens wearer since two years, is complaining of redness, lacrimation and foreign body sensation of both eyes. On examination, visual acuity was 6/6 with negative fluorescein test. The expected diagnosis can be: 
Answer options: option1: Acute anterior uveitis
option2: Giant papillary conjunctivitis.
option3: Bacterial corneal ulcer.
option4: Acute congestive glaucoma
option5: n/a
Correct answer: option2
Specialty: Neurology
The following are true about headaches except?

Answer options: option1: The headache of raised intracranial pressure is worst at the end of the day
option2: The sensitivity of subarachnoid haemorrhage on CT scan decreases with time
option3: Amaurosis fugax may be caused by temporal arteritis
option4: Neurological signs on examination does not rule out migraine as a diagnosis
option5: Cluster headaches are more common in men than in women
Correct answer: option1
Specialty: Pathology
The primary factor in the development of peripheral arterial disease (PAD) is the presence of atherosclerosis, which accumulates over years and decades. Which of the following stages is LEAST likely to cause symptoms? 
Answer options: option1: . Complicated lesion
option2: . Fatty streak
option3: Fibroatheroma
option4: Atheroma
option5: None of the above
Correct answer: option2
Specialty: Neurology
A 73-year-old man presents to the hospital with hemiparesis and is found to have stenosis of the left carotid bifurcation with 80% stenosis of the internal carotid artery. The cause of his stroke is mostlikely: 
Answer options: option1: Thromboembolism from the carotid bifurcation.
option2: Embolism from a cardiac source
option3: . Dissection of the internal carotid artery
option4: Hemorrhage of the intracerebral vessels.
option5: All of the above
Correct answer: option1
Specialty: Gastroenterology
Ulcerative colitis typically affects the rectum and extends proximally to involve the colon in continuity. Rarely it may extend about 1-2 cm into the terminal ileum. This is called backwash ileitis. Which part of the colon is involved when this is seen?


Answer options: option1: Rectum
option2: Ascending colon
option3: Transverse colon
option4: Descending colon
option5: Whole colon
Correct answer: option5
Specialty: Gastroenterology
Obstructive jaundic is accompanied by:
Answer options: option1: increased excretion of conjugated biliruin in urine
option2: Increased excrtion of unconjugated bilirubin in urine
option3: increased serum unconjugated bilirubin
option4: increased urinary urobilinogen
option5: none of the above
Correct answer: option1
Rationale: Urine bilirubin normally is absent. When it is present, only conjugated bilirubin is passed into the urine. This may be evidenced by dark-colored urine seen in patients with obstructive jaundice or jaundice due to hepatocellular injury
Specialty: Ophthalmology
A patient complains of maceration of skin of the lids and conjunctiva redness at the inner and outer canthi. Conjunctival swab is expected to show: 

Answer options: option1: Slaphylococcus aureus
option2: Streptococcus viridans
option3: Streptococcus pneumonae
option4: Morax- Axenfeld diplobacilli
option5: n/a
Correct answer: option4
Specialty: Neurology
A 50-year-old woman presents with facial weakness and slurred speech, which resolve shortly after her arrival to the 
hospital. A CT angiogram shows the finding below of a 
"beaded" appearance of the internal carotid artery. Which of 
the following is TRUE of this condition? 

Answer options: option1: Treatment involves surgical resection of the affected   region of the artery
option2: It most commonly in men in the 4th and 5th decades of   life.
option3: It only affects the carotid arteries
option4: It only affects the carotid arteries
option5: C and E
Correct answer: option3
Specialty: Internal_Medicine
A 64-year-old, otherwise healthy male is found on physical exam to have a carotid bruit. An ultrasound shows luminal stenosis in the left 
internal carotid artery (ICA) of approximately 90%. He is asymptomatic. Which of the following is true of treatment for his condition? 
A. He 
Answer options: option1: He should probably be treated with endovascular placement of a carotid stent and best medicalmanagement (daily antiplatelet therapy, SBP<130  mmHg, blood glucose well controlled, and LDL cholesterol<100).
option2: He should probably be treated with best medical management  (daily antiplatelet therapy,SBP<130 mmHg, blood glucose  well controlled, and LDL cholesterol<100).
option3: He should probably be reassured that treatment is unnecessary at this time.
option4: He should probably be treated with surgical endarterectomy and best medical management(daily antiplatelet therapy, SBP<130  mmHg, blood glucose well controlled, and LDL cholesterol<100).
option5: N/
Correct answer: option4
Specialty: Ophthalmology
In viral epidemic kerato-conjunctlvitis characteristically there is usually: 
a. 
c. 
d. 

Answer options: option1: Copious purulent discharge  b.
option2: Copious muco-purulent discharge
option3: Excessive watery lacrimation
option4: Mucoid ropy white discharge
option5: n/a
Correct answer: option3