afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Obstetrics_and_Gynecology
List some obstetrics risk factors for anemia in pregnancy amongst Nigerian women 
Rationale: Obstetric risk factors for anemia in pregnancy amongst Nigerian women include:

1. _Multiple pregnancies_: Carrying twins or more increases the risk of anemia.
2. _High parity_: Having many children increases the risk of anemia.
3. _Short inter-pregnancy interval_: Less than two years between pregnancies increases the risk of anemia.
4. _Previous history of anemia_: Women who had anemia in previous pregnancies are at higher risk.
5. _Malaria_: Frequent malaria attacks increase the risk of anemia.
6. _HIV/AIDS_: Women with HIV/AIDS are more susceptible to anemia.
7. _Poor antenatal care_: Inadequate or infrequent prenatal check-ups increase the risk of anemia.
8. _Teenage pregnancy_: Adolescent pregnant women are at higher risk of anemia.
9. _Grand multiparity_: Women who have had many children (five or more) are at higher risk of anemia.
10. _History of postpartum hemorrhage_: Women who experienced excessive bleeding after previous deliveries are at higher risk of anemia.
11. _Chronic medical conditions_: Women with conditions like sickle cell disease, thalassemia, or chronic kidney disease are at higher risk of anemia.
12. _Poor nutrition and dietary habits_: Inadequate iron and folic acid intake increase the risk of anemia.
13. _Pregnancy-induced hypertension_: Women with high blood pressure during pregnancy are at higher risk of anemia.
14. _Placenta previa_: Women with placenta previa are at higher risk of anemia due to bleeding.
15. _Fetal growth restriction_: Women with fetal growth restriction are at higher risk of anemia.
Specialty: Obstetrics_and_Gynecology
What are the cardinal motions involved in the mechanism of labour 
Rationale: The cardinal motions involved in the mechanism of labor are:

1. *Engagement*: The fetal head enters the pelvis.
2. *Descent*: The fetal head moves downward through the pelvis.
3. *Flexion*: The fetal head flexes, or bends, as it moves through the pelvis.
4. *Internal Rotation*: The fetal head rotates to align with the mother's pelvis.
5. *Extension*: The fetal head extends, or straightens, as it crowns.
6. *External Rotation*: The fetal head rotates to align with the mother's pelvis after delivery.
7. *Expulsion*: The fetus is pushed out of the birth canal.

These cardinal motions help guide the fetus through the pelvis and birth canal during labor, ensuring a safe and successful delivery.
Specialty: Obstetrics_and_Gynecology
What are the medical and surgical treatment options for post partum hemorrhage 
Rationale: Medical treatment options for postpartum hemorrhage (PPH) include:

1. _Uterine massage_: Massaging the uterus to help control bleeding.
2. _Oxytocin_: Administering oxytocin to stimulate uterine contractions.
3. _Methylergometrine_: Using methylergometrine to induce uterine contractions.
4. _Prostaglandins_: Administering prostaglandins to stimulate uterine contractions.
5. _Tranexamic acid_: Using tranexamic acid to reduce bleeding.
6. _Fluid resuscitation_: Administering fluids and blood products to replace lost blood volume.
7. _Antibiotics_: Prescribing antibiotics to prevent infection.

Surgical treatment options for PPH include:

1. _Uterine artery ligation_: Ligating the uterine arteries to reduce blood flow.
2. _Internal iliac artery ligation_: Ligating the internal iliac arteries to reduce blood flow.
3. _B-Lynch suture_: Performing a B-Lynch suture to compress the uterus.
4. _Uterine tamponade_: Using a balloon or gauze to tamponade the uterus.
5. _Hysterectomy_: Performing a hysterectomy as a last resort to control bleeding.

Additional interventions may include:

1. _Intrauterine balloon tamponade_: Using a balloon to tamponade the uterus.
2. _Uterine packing_: Packing the uterus with gauze to control bleeding.
3. _Angiographic embolization_: Using angiographic embolization to occlude bleeding vessels.
Specialty: Obstetrics_and_Gynecology
What is the classical definition of post partum hemorrhage 
State why it is common in Nigeria 
Rationale: The classical definition of postpartum hemorrhage (PPH) is:

- Bleeding from the genital tract exceeding 500 mL within the first 24 hours after spontaneous vagina delivery or 1000 mL following caesarean section

PPH is common in Nigeria due to various factors, including:

1. _Poor access to quality healthcare_: Limited availability of skilled healthcare providers, especially in rural areas.
2. _High prevalence of anemia_: Widespread anemia among pregnant women increases the risk of PPH.
3. _Hypertension and preeclampsia_: Common conditions in Nigerian pregnant women, increasing the risk of PPH.
4. _Multiple pregnancies and high parity_: Higher risk of PPH in women with multiple pregnancies or high parity.
5. _Traditional birth practices_: Home deliveries without skilled attendants, increasing the risk of PPH.
6. _Limited availability of blood transfusion services_: Inadequate blood supply and lack of compatible blood types.
7. _Poor infrastructure and transportation_: Delays in accessing healthcare facilities, especially in emergency situations.
8. _Lack of adequate training and equipment_: Healthcare providers may not have the necessary skills or equipment to manage PPH effectively.
9. _Cultural and socioeconomic factors_: Limited awareness, education, and financial resources contribute to the high incidence of PPH.
10. _High maternal mortality rate_: PPH is a leading cause of maternal mortality in Nigeria, highlighting the need for improved healthcare services.

Addressing these factors is crucial to reducing the incidence of PPH in Nigeria and improving maternal health outcomes.
Specialty: Obstetrics_and_Gynecology
State the Amsel criteria for bacterial vaginosis
Rationale: The Amsel criteria for bacterial vaginosis (BV) include:

1. _Homogeneous, thin, white or gray discharge_ that coats the vaginal walls
2. _pH of vaginal fluid > 4.5_ (normal pH is < 4.5)
3. _Presence of clue cells_ (vaginal epithelial cells with adherent bacteria) on microscopic examination
4. _Positive whiff test_ (release of a strong fishy odor when vaginal discharge is mixed with potassium hydroxide)

To diagnose BV, at least three of the four Amsel criteria must be present.



- Clue cells are a key diagnostic feature, as they indicate the presence of Gardnerella vaginalis and other anaerobic bacteria.
- The whiff test is not always positive, but it can support the diagnosis.
- Vaginal pH testing can help rule out other conditions, such as trichomoniasis or yeast infections.
Specialty: Pathology
Apo-C 2 is associated with chylomicrons, HDL, VLDL and IDL where its function is






Answer options: option1: LCAT activation
option2: LDL receptor binding
option3: Lipoprotein lipase activation.
option4: Lipoprotein lipase inhibition
option5: LDL and remnant particle receptor binding
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
What are the leading causes of vaginal discharge in reproductive age African women seen in gynaecology practice
Rationale: The leading causes of vaginal discharge in reproductive age African women seen in gynecology practice include:

1. _Bacterial vaginosis_ (BV): Caused by an imbalance of vaginal bacteria.
2. _Trichomoniasis_: A sexually transmitted infection (STI) caused by Trichomonas vaginalis.
3. _Candidiasis_: A fungal infection caused by Candida albicans.
4. _Cervicitis_: Inflammation of the cervix, often caused by STIs like chlamydia or gonorrhea.
5. _Pelvic inflammatory disease_ (PID): Infection of the reproductive organs, often caused by STIs.
6. _Vaginal trichomoniasis_: An STI caused by Trichomonas vaginalis.
7. _Chlamydia_: An STI caused by Chlamydia trachomatis.
8. _Gonorrhea_: An STI caused by Neisseria gonorrhoeae.
9. _Vaginal atrophy_: Thinning and drying of vaginal tissues due to hormonal changes.
10. _Foreign body_: Presence of an object in the vagina, such as a forgotten tampon.
11. _Cervical ectopy_: A condition where the cervical cells grow outside the cervix.
12. _Vaginal infections_ caused by other microorganisms like E. coli, Staphylococcus aureus, and Haemophilus influenzae.
Specialty: Obstetrics_and_Gynecology
What are the types of placenta previa and what is the treatment option for each
Rationale: There are four types of placenta previa, classified based on the location and extent of placental coverage of the internal cervical os:

1. *Type 1: Low-lying placenta*
    - Placenta is located near the internal os, but does not cover it.
    - Treatment: Expectant management, vaginal delivery possible.
2. *Type 2: Marginal placenta previa*
    - Placenta covers the internal os partially.
    - Treatment: Expectant management, vaginal delivery possible, but may require cesarean section.
3. *Type 3: Partial placenta previa*
    - Placenta covers the internal os partially, but extends into the cervical canal.
    - Treatment: Cesarean section recommended, as vaginal delivery may cause severe bleeding.
4. *Type 4: Complete placenta previa*
    - Placenta completely covers the internal os and extends into the cervical canal.
    - Treatment: Cesarean section necessary, as vaginal delivery is not possible.

Additional treatment options may include:

- *Corticosteroids*: To promote fetal lung maturity in case of preterm delivery.
- *Tocolytics*: To delay delivery in case of preterm labor.
- *Blood transfusions*: To manage excessive bleeding.
- *Bed rest*: To reduce bleeding and promote fetal growth.
- *Pelvic rest*: Avoiding intercourse, tampons, and vaginal exams to reduce bleeding risk.
Specialty: Obstetrics_and_Gynecology
Define antepartum Hemorrhage and state why it is common amongst Africans
Rationale: Antepartum hemorrhage (APH) is defined as vaginal bleeding that occurs after the 28th week of gestation, but before labor begins. It is a serious complication of pregnancy that can threaten the life of both the mother and the fetus.

APH is common amongst Africans due to various factors, including:

1. _High prevalence of hypertension and preeclampsia_: These conditions increase the risk of placental abruption, a leading cause of APH.
2. _Poor access to prenatal care_: Inadequate monitoring and delayed diagnosis of pregnancy complications contribute to APH.
3. _High incidence of malaria and anemia_: These conditions can lead to placental insufficiency and increase the risk of APH.
4. _Genetic predisposition_: Women of African descent are more likely to have inherited bleeding disorders, such as sickle cell disease.
5. _Limited access to blood transfusion services_: Inadequate blood supply and lack of compatible blood types can worsen APH outcomes.
6. _Poor nutritional status_: Inadequate nutrition can contribute to anemia and poor pregnancy outcomes.
7. _High parity and short inter-pregnancy intervals_: These factors increase the risk of placental abruption and APH.
8. _Limited availability of emergency obstetric care_: Delays in receiving timely and appropriate care can worsen APH outcomes.

These factors contribute to the higher incidence of APH amongst African women, highlighting the need for improved prenatal care, access to emergency obstetric services, and addressing underlying health conditions.
Specialty: Pathology
Familial hypertriglyceridaemia (Type IV)
 



Answer options: option1: It is associated with defects in the production or catabolism of VLDL
option2: HDL-cholesterol is often increased with normal total cholesterol.
option3: In diabetic patients high VLDL may be associated also with high chylomicrons
option4: The patient is in increased risk of attacks of acute pancreatitis
option5: Also, they are in increased risk of CVD due to decreased HDL levels.
Correct answer: option2
Specialty: Pathology
Which of the following is incorrect?


Answer options: option1: Accuracy is the closeness of a measured value to a standard or known or true value
option2: Precision is the closeness of two or more measurements to each other
option3: Diagnostic Sensitivity is the ability of a test to detect a given disease or condition
option4: Diagnostic Specificity is the ability of a test to correctly identify the absence of a given disease or condition.
option5: Positive Predictive Value is the Chance an individual does not have a given disease or condition if the test is within the reference interval.
Correct answer: option5
Specialty: Pathology
Which is true of Urinary albumin excretion 

Answer options: option1: microalbuminuria is <30mg/g creatinine
option2: microalbuminuria is between 30 to 300 mg/g creatinine
option3: microalbuminuria is 20-30 mg/g creatinine
option4: microalbuminuria is between 20 to 200 mg/g creatinine
option5: none of the above.
Correct answer: option2
Specialty: Pathology
A woman is being treated for congestive cardiac failure in the coronary care unit. After several days of treatment, the following results are returned:
p H 7.49, PO 2 11.6 k Pa, Pa CO 2 5.8 k Pa, HCO 3-42 mmol/L , Na+ 142 mmol/L , K+ 3.0 mmol/L , Cl-85 mmol/L , Total CO 2 44 mmol/L , Urea 9.3 mmol/L , Creatinine 84 μmol/L , e GFR >60 m L/min/1.73 m 2
Question: What is the anion gap? .



Answer options: option1: The anion gap is 14 mmol/L.
option2: The anion gap is 15 mmol/L.
option3: The anion gap is 16 mmol/L.
option4: The anion gap is 17 mmol/L.
option5: The anion gap is 18 mmol/L.
Correct answer: option5
Specialty: Pathology
Which of the following statements is wrong concerning Day-21 progesterone?
	 
	



Answer options: option1: Low concentration (<30nmol/L) may suggest ovulatory failure
option2: Levels are elevated in impaired luteal function
option3: Levels greater 100nmol/L suggests pregnancy
option4: Most common cause of low levels (<30nmol/L) is inaccurate sampling time
option5: Levels are low (<30nmol/L) in impaired luteal function.
Correct answer: option2
Specialty: Pathology
 A useful dynamic test for differentiating between Nephrogenic and Neurogenic Diabetes insipidus is:

	




Answer options: option1: Water deprivation test
option2: Desmopressin stimulation test
option3: Clonidine stimulation test
option4: Dexamethasone suppression test
option5: Synacthen stimulation test.
Correct answer: option2
Specialty: Pathology
Which of the following is the best indicator of ovulation?
  

Answer options: option1: Day 21 serum progesterone level.
option2: Basal body temperature charts.
option3: Measurement of the luteinizing hormone surge.
option4: Measurement of Follicle stimulating hormone levels.
option5: Day 21 serum oestrogen level.
Correct answer: option1
Specialty: Pathology
Calculated osmolality in mmol/L =





Answer options: option1: 2(Na+) + (Glucose) + (Urea).
option2: 2(K+) + (Glucose) + (Urea).
option3: (Ca2+) + (Glucose) + (Urea).
option4: (Na+) + (Glucose) + (Urea).
option5: (K+) + (Glucose) + (Urea).
Correct answer: option1
Specialty: Pathology
An elderly woman who had pin-rolling tremor, stooped posture and festinating gait has passed away. Histology reports from her brain tissue reveal pallor of the substantia nigra. This may indicate





Answer options: option1: Parkinsons disease
option2: Hungtington disease.
option3: Alzheimer disease
option4: Frontotemporal lobar degeneration
option5: n/a
Correct answer: option1
Specialty: Pathology
The correct opinion about inheritance of sickle cell disease (SCD) is? 
 




Answer options: option1: Sickle cell disease is inherited in autosomal dominant pattern
option2: Both copies of the genes in each cell have mutation.
option3: Most common variant of sickle cell disease is due to nonsense mutation.
option4: It is a sex-linked disorder.
option5: n/a
Correct answer: option2
Specialty: Pathology
The Waterhouse-Friderichsen syndrome 



Answer options: option1: Is a very common life threatening disorder
option2: There is haemorrhagic infarction of the spleen
option3: There is haemorrhagic infarction of the adrenal gland.
option4: It occurs most often with meningococcal and pneumococcal meningitis
option5: n/a
Correct answer: option3
Specialty: Pathology
In the earliest phase of mycobacterial infection, the organisms proliferate continuously within the macrophages. Immunity to curtail this process is mediated by;




Answer options: option1: TH2 mediated response producing interleukin 10
option2: TH1 mediated response producing interferon gamma
option3: TH3 mediated response producing tumour necrosis beta
option4: TH17 mediated response producing transforming growth factor alpha
option5: n/a
Correct answer: option2
Specialty: Pathology
Plasmodium can cause several complications, including membranous glomerulopathy which can present as nephrotic syndrome, which of the specie is commonly associated with this complication?





Answer options: option1: Plasmodium malaria
option2: Plasmodium vivax
option3: Plasmodium Lowensi
option4: Plasmodium falciparum
option5: n/a
Correct answer: option1
Specialty: Pathology
A woman presents to the gynaecology clinic following an ultrasound scan which revealed multiple uterine leiomyomata. She also complained about multiple nodules on her skin. Further tests revealed an aggressive variant of papillary renal cell carcinoma. She may likely have which of the following gene mutations?





Answer options: option1: MET gene
option2: FH gene
option3: FLCN gene
option4: VHL gene
option5: n/a
Correct answer: option2
Specialty: Pathology
A young man with a mutation in Von Hippel Lindau (VHL) develops a bilateral renal tumour. Histologically, it is more likely to be:





Answer options: option1: Papillary renal cell carcinoma
option2: Clear cell carcinoma
option3: Medullary carcinoma
option4: Oncocytoma
option5: n/a
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
Mention the techniques used to reduce blood loss during myomectomy
Rationale: Techniques used to reduce blood loss during myomectomy include:

1. _Preoperative GnRH agonists_: To shrink fibroids and reduce bleeding.
2. _Intraoperative vasopressin_: To constrict blood vessels and reduce bleeding.
3. _Tourniquet or rubber band_: To occlude blood flow to the uterus.
4. _Uterine artery ligation_: To reduce blood flow to the uterus.
5. _Temporary clipping of uterine arteries_: To control bleeding.
6. _Electrosurgical coagulation_: To cauterize bleeding vessels.
7. _Suture ligation_: To ligate bleeding vessels.
8. _Hemostatic agents_: To promote clotting and reduce bleeding.
9. _Uterine compression sutures_: To compress the uterus and reduce bleeding.
10. _Intraoperative cell salvage_: To recover and reinfuse blood lost during surgery.
11. _Preoperative autologous blood donation_: To have patient's own blood available for transfusion.
12. _Intraoperative tranexamic acid_: To reduce fibrinolysis and promote clotting.

These techniques can be used alone or in combination to minimize blood loss during myomectomy.
Specialty: Pathology
A young lady presents with hematuria and flank pain. Ultrasound reveals a renal mass as well as multiple leiomyomata in the uterus. Which of these familial syndromes may be responsible?





Answer options: option1: Von Hippel Lindau
option2: Hereditary papillary carcinoma
option3: Hereditary leiomyomatosis and renal cancer syndrome (HLRCC)
option4: Birt-Hogg-Dube syndrome
option5: n/a
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
List the suture lines of the fetal skull and their corresponding bordering bones
Rationale: the suture lines of the fetal skull and their corresponding bordering bones:

1. _Metopic suture_: Frontal bone (interfrontal suture)
2. _Coronal suture_: Frontal bone and parietal bone
3. _Sagittal suture_: Parietal bones (interparietal suture)
4. _Lambdoid suture_: Parietal bone and occipital bone
5. _Occipitomastoid suture_: Occipital bone and mastoid part of temporal bone
6. _Sphenofrontal suture_: Sphenoid bone and frontal bone
7. _Sphenoparietal suture_: Sphenoid bone and parietal bone
8. _Sphenotemporal suture_: Sphenoid bone and temporal bone
9. _Sphenosquamosal suture_: Sphenoid bone and squamous part of temporal bone
10. _Petrosquamosal suture_: Petrous part of temporal bone and squamous part of temporal bone
11. _Intermaxillary suture_: Maxilla bones (intermaxillary suture)
12. _Internasal suture_: Nasal bones (internasal suture)
13. _Nasofrontal suture_: Nasal bone and frontal bone
14. _Zygomaticofrontal suture_: Zygomatic bone and frontal bone
15. _Zygomaticotemporal suture_: Zygomatic bone and temporal bone
16. _Zygomaticomaxillary suture_: Zygomatic bone and maxilla bone
17. _Frontonasal suture_: Frontal bone and nasal bone
18. _Parietomastoid suture_: Parietal bone and mastoid part of temporal bone
Specialty: Pathology
Autopsy findings in a 20 year old female who was HBs Ag positive includes severe pallor, male hair distribution and pedal swelling on general examination. Internal organ finding include macronodularity of the liver. Which of these is probably found at autopsy and likely cause of death?



Answer options: option1: Pulmonary haemorrhages with cavitatory lesion
option2: Massive intracranial haemorrhages with cerebral oedema
option3: Prominent lower oesophageal vascular markings and haemorrhages within the stomach
option4: Huge ascending colon annular mass with extensive haemorrhages within colon and rectum
option5: n/a
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
What are the causes of primary amenorrhea and the causes of secondary amenorrhea 
Rationale: *Primary Amenorrhea:*

Primary amenorrhea is the absence of menstruation in a woman by the age of 16, or by 14 if there are no secondary sexual characteristics. Causes include:

1. *Genetic disorders*: Turner syndrome, Klinefelter syndrome, and androgen insensitivity syndrome.
2. *Hormonal imbalances*: Hypothalamic or pituitary gland problems, thyroid disorders, or adrenal gland disorders.
3. *Reproductive system abnormalities*: Uterine or vaginal agenesis, imperforate hymen, or cervical stenosis.
4. *Developmental disorders*: Müllerian agenesis or Mayer-Rokitansky-Küster-Hauser syndrome.
5. *Chromosomal abnormalities*: 46,XY gonadal dysgenesis or Swyer syndrome.

*Secondary Amenorrhea:*

Secondary amenorrhea is the absence of menstruation for 3-6 months in a woman who has previously menstruated. Causes include:

1. *Hormonal imbalances*: Polycystic ovary syndrome (PCOS), thyroid disorders, or hyperprolactinemia.
2. *Pregnancy or breastfeeding*: Amenorrhea can occur during pregnancy or breastfeeding.
3. *Weight changes*: Significant weight gain or loss, or eating disorders.
4. *Stress or emotional factors*: Stress, anxiety, or depression.
5. *Medications*: Birth control pills, antidepressants, or antipsychotics.
6. *Reproductive system disorders*: Asherman's syndrome, endometrial scarring, or cervical stenosis.
7. *Pituitary gland problems*: Tumors or inflammation.
8. *Hypothalamic disorders*: Tumors, inflammation, or congenital conditions.
9. *Ovarian failure*: Premature ovarian failure or menopause.
10. *Other medical conditions*: Diabetes, celiac disease, or autoimmune disorders.
Specialty: Pathology
A 35 year old woman develops jaundice with occasional abdominal pain for more than 6 months period. The total bilirubin is elevated. The alpha -- feto protein was not elevated. In her laboratory work up towards diagnosis, the liver biopsy shows ground-glass hepatocytes. Which of these aetiological agents is most probably responsible for this clinical condition?



Answer options: option1: Herpes zoster virus
option2: Hepatitis D virus
option3: Epstein Barr virus
option4: Hepatitis B virus
option5: n/a
Correct answer: option4