afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Pathology
A 45-year-old woman has a lung biopsy because of a 1.0 cm lesion seen on a chest x-ray. Histologic examination reveals epithelioid macrophages and lymphocytes 	around a focus of caseous necrosis. What is the best explanation for this form necrosis?





Answer options: option1: Cell-mediated hypersensitivity
option2: Complement fixation
option3: Local histamine release
option4: Neutrophils release enzymes causing degradation
option5: n/a
Correct answer: option1
Specialty: Pathology
Which one of the following is correct in chronic passive congestion of the liver



Answer options: option1: The perivenular zone is supplied with adequately oxygenated blood
option2: The periportal hepatocytes are poorly oxygenated
option3: The central regions of the hepatic lobules are reddish brown and slightly depressed due to loss of cells
option4: The perivenular hepatocytes usually develop fatty change
option5: n/a
Correct answer: option3
Specialty: Pathology
One of these is correct about oedema




Answer options: option1: Anasarca is a severe and localized oedema with profound subcutaneous tissue swelling.
option2: Ascites is the accumulation of fluid in the plural cavity.
option3: Transudate has a high protein content and specific gravity> 1.020
option4: Exudate has a high protein content and specific gravity > 1.020
option5: n/a
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
Write on the impact of gestational diabetes on African women 
Rationale: Gestational diabetes is a type of diabetes that develops during pregnancy, usually in the second or third trimester. It is caused by hormonal changes and insulin resistance, which can lead to high blood sugar levels.

Risk factors:

- Obesity. Most africans live a sedentary life style and are mostly obesed

- Family history of diabetes,, commonly seen in Africa 

- Previous history of gestational diabetes

- Age over 35, African women mostly are seen to get married from the ages of 30 due to financial and traditional beliefs 

- Multiple pregnancy,, an average African family wants a home of least 5 children 

Symptoms:

- Increased thirst and urination
- Fatigue
- Blurred vision
- Slow healing of cuts and wounds

Complications:

- Macrosomia (large baby)
- Preterm labor
- Cesarean delivery
- Hypoglycemia (low blood sugar) in the baby
- Increased risk of type 2 diabetes after pregnancy

Management:

- Dietary changes (healthy eating)
- Exercise (regular physical activity)
- Blood sugar monitoring
- Insulin therapy (if necessary)

With proper management, most women with gestational diabetes can have a healthy pregnancy and delivery.
Specialty: Pathology
Concerning cell adhesion molecule, one of these is true
 


Answer options: option1: Integrin expressions by leukocytes is normally in a low affinity state
option2: The selectins mediate high-affinity interactions with a fast off rate
option3: L-selectin is normally stored intracellularly in Weibel-Palade bodies
option4: VCAM-1 is the corresponding ligand for β2 integrins
option5: n/a
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
Write briefly on pelvic inflammatory disease stating why it is common in African teenagers 
Rationale: Pelvic Inflammatory Disease (PID) is a bacterial infection that affects the female reproductive organs, including the uterus, fallopian tubes, and ovaries. It is often caused by untreated sexually transmitted infections (STIs) like chlamydia and gonorrhea.

Symptoms:

- Lower abdominal pain
- Abnormal vaginal discharge
- Fever
- Painful urination
- Painful sex
- Irregular menstrual bleeding

Complications:

- Infertility
- Ectopic pregnancy
- Chronic pelvic pain
- Abscesses
- Increased risk of HIV transmission

Treatment:

- Antibiotics to clear the infection
- Pain management
- Rest and avoiding strenuous activities
- Avoiding sexual intercourse until treatment is completed
- Partner treatment to prevent re-infection

Early diagnosis and treatment are crucial to prevent long-term complications and infertility. If you suspect PID, consult a healthcare provider promptly.

Reasons why it is common in teenage Africans include 
Poverty which in most cases lead teachers to prostitution hence having multiple sexual partners 
More reasons include negligence ignorance on the use of barrier contraceptives and safe sex practices
Specialty: Pathology
A man with black pigments on his skin visits the clinic. He reports that he has noticed that his unflushed urine in the toilet turns black if left for a certain duration of time. This is suspicious for:





Answer options: option1: Hemosiderosis
option2: Malignant melanoma
option3: Alkaptonuria
option4: Dehydration
option5: N/A
Correct answer: option3
Specialty: Pathology
A little boy presents at the clinic with hypopigmented skin spots described by the dermatologist as café- au-lait spots. Which of these may be the diagnosis?




Answer options: option1: Peutz-Jegher’s syndrome
option2: Neurofibromatosis
option3: Melanosis coli
option4: Dermatopathic lymphadenopathy
option5: N/A
Correct answer: option2
Specialty: Pathology
A man was found to have collapsed at work and was brought in dead. On autopsy, the pathologist noticed a raindrop pattern of hyperpigmentation on the skin. This finding raises suspicion of:





Answer options: option1: Death by strangulation
option2: Chronic arsenic poisoning
option3: Addison’s disease
option4: Chloasma
option5: N/A
Correct answer: option2
Specialty: Pathology
 A woman with a six-month-old pregnancy begins to notice hyperpigmentation of her nipples and genitalia. This is likely due to





Answer options: option1: Oestrogen induced chloasma
option2: Fetus secreted melanin
option3: Progesterone induced skin changes
option4: Intrauterine fetal death
option5: N/A
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
What is placenta praevia,
causes/risk factors, Types,
Symptoms, 
Treatment 
And why is it common in Nigerian women
Rationale: Placenta praevia is a pregnancy complication where the placenta partially or completely covers the cervix, the lower part of the uterus that opens into the vagina. This can cause:

- Bleeding during pregnancy and delivery
- Premature birth
- Fetal distress
- Maternal hemorrhage

Types:

- Placenta praevia marginalis: Placenta is near but not covering the cervix
- Placenta praevia partialis: Placenta partially covers the cervix
- Placenta praevia totalis: Placenta completely covers the cervix

Causes and risk factors:

- Multiple pregnancy
- Previous uterine surgery or cesarean section
- Advanced maternal age
- Smoking

Symptoms:

- Painless vaginal bleeding
- Abdominal pain
- Fetal distress

Treatment:

- Bed rest and monitoring
- Corticosteroids to promote fetal lung maturity
- Cesarean delivery if necessary

Prompt medical attention is essential to ensure the health and safety of both mother and baby.

It is common in Nigerian women due to their poor hospital seeking behavior and local harmful traditional practices as well as ignorance and illiteracy
Specialty: Orthopedic_Surgery
 Commonest cause of failure of infernal fixation is:




.

Answer options: option1: Infection
option2: Corrosion
option3: Metal reaction
option4: Immune deficient patient
option5: Stress fracture of implant
Correct answer: option1
Rationale: 
Most common  is infection which will ultimately lead to implant becoming loose and
non-union. Immune deficient patient does not behave differently as regards
fracture healing. Corrosion, metal reaction and stress fracture of implant are
rare.
Specialty: Orthopedic_Surgery
Which of the following fracture does not usually need open
reduction and internal fixation:





Answer options: option1: Mid shaft fracture of femur
option2: Pathological fractures
option3: Trochanteric fracture in eldery
option4: Displaced intra-articular fractures
option5: Displaced fracture of both bones of forearm in adults.
Correct answer: option1
Rationale: 
Out of the fractures mentioned, femoral shaft fracture is least likely 
need operative treatment. In this fracture operation is done to get patient
of traction early. All other fractures mentioned will almost always need open 
reduction and internal fixation.
Specialty: Orthopedic_Surgery
Which of the following is incorrect about dislocation of sternoclavicular joint:






Answer options: option1: Anterior dislocation occurs due to indirect injury and is common type of dislocation
option2: Posterior dislocation is rare and occurs due to direct injuly Over medial end of clavicle
option3: Sternoclavicular dislocation is common compared to acromioclavicular dislocation
option4: Trachea can be compressed in posterior dislocation
option5: Manipulative reduction is often unstable and fixation with wiTe may be required. Dislocation of sternoclavicular joint is much less frequent than
Correct answer: option3
Rationale: 
acromioclavicular joint dislocation. All other statements are frue and briefly
describe the salient features of sternoclavicular
joint dislocation.
Specialty: Orthopedic_Surgery
What is the guideline to deltopectoral groove:






Answer options: option1: Axillary vein
option2: Ceplhalic vein
option3: Musculo-cutaneous nerve
option4: Median nerve
option5: None of above
Correct answer: option2
Rationale: Cephalic vein lies in deitopedoral groove and serves as landmark in
identification of plane between deltoid and pectaralis major during anterior
exposure of shoulder.
Specialty: Obstetrics_and_Gynecology
A 36 year-old woman presents with vaginal bleeding at 8 weeks 3 days’ gestation. She has never been pregnant before. The bright red ’spotting’ started 3 days ago with no abdominal pain. Vaginal examination revealed a closed cervix. Which of the following is helpful in the diagnosis of this condition?

Answer options: option1: Transvaginal ultrasound scan
option2: Full blood count
option3: Urine pregnancy test
option4: Blood pregnancy test
option5: Chromosomal studies
Correct answer: option1
Specialty: Orthopedic_Surgery
6. Arthroscope was invented and first used by:





Answer options: option1: Takagi
option2: Watanabe
option3: Dandy
option4: Jackson
option5: Patel
Correct answer: option1
Rationale:  First prototype of arthroscope was made and used by Takagi in 1918.
Modern day arthroscope was made by Takagi and Watanabe. Dandy, Jackson
and Patcl are some of the leaders of arthroscopic surgery nowadays
Specialty: Obstetrics_and_Gynecology
The combined oral contraceptive pill: Which is false


Answer options: option1: Inhibits ovulation.
option2: Improves cycle control.
option3: Can be used in a breastfeeding mother immediate postpartum.
option4: Is Absolutely contraindicated in patients with acute/severe liver disease.
option5: Can be used in the management of PCOS
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
Use of the intrauterine contraceptive device (IUCD): which is true?
 
Answer options: option1: The intrauterine system (IUS) contains norethisterone.
option2: The intrauterine system (Mirena) is licensed for ten years.
option3: Heavy bleeding is the most common side effect with the Mirena.
option4: The risk of pelvic inflammatory disease is increased with IUCD use.
option5: There is an increased risk of ectopic pregnancy with IUCD use.
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
The obstetric doctor on call is asked to review a cardiotocograph performed prior to induction of labour in a 39 weeks old multigravida. Which of the following features should help to reassure the doctor that this is a normal trace?


Answer options: option1: The baseline heart rate is 100 beats per minute.
option2: The baseline variability is <5 beats per minute
option3: 2 accelerations of 15 beats per minute above the baseline for 15 seconds in a 20 minutes trace.
option4: are no significant accelerations of the fetal heart on the 30-minute recording.
option5: The tocograph is picking up regular contractions.
Correct answer: option3
Specialty: Orthopedic_Surgery
Commonest cause of failure of arthrography is:





Answer options: option1: Extra-articular injection of contrast
option2: Bubbling of air in the joint
option3: False positive interpretation
option4: False negative interpretation
option5: Allergic reaction
Correct answer: option1
Rationale: Extra-articular injection of contrast medium is the commonest
cause of failure of arthrography especially in smaller and deep situated joints.
Allergic reaction to contrast medium is rare but when it happens examination
will have to be discontinued. Other factors also make this procedure futile.
Specialty: Obstetrics_and_Gynecology
Management of an 89-year old woman with ischaemic heart disease who is not sexually active but presents with a procidentia of the uterus is:






Answer options: option1: Shelf pessary.
option2: Pelvic floor exercises.
option3: Vaginal hysterectomy.
option4: Hysteroscopy.
option5: Total vaginal mesh procedure.
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
A patient presents with vulval itching, sore vagina and a profuse, white, curdy discharge with erythema and redness at the introitus. The likely diagnosis is:

Answer options: option1: Bacterial vaginosis.
option2: Trichomonas vaginalis.
option3: Candida.
option4: Chlamydia.
option5: HPV.
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
As the obstetric SHO on call, you are preparing to perform a ventouse delivery. Which of the following is contraindication to ensure? 
 

Answer options: option1: Gestation more than 35 weeks.
option2: The cervix is fully dilated.
option3: Adequate maternal analgesia.
option4: Empty bladder.
option5: Fetal membranes are ruptured.
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
Which of the following is the main advantage to performing a medio-lateral episiotomy? 
 
Answer options: option1: Less blood loss.
option2: Reduced incidence of dyspareunia.
option3: Less anal sphincter damage.
option4: Less pain in the postpartum period.
option5: It is easier to repair.
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
Choose the best option with regard to a non-immune pregnant woman with an exposure to chickenpox: 

Answer options: option1: Should be given the varicella zoster vaccine as soon as possible after exposure.
option2: Should be given varicella zoster immunoglobulin as soon as possible after exposure.
option3: Does not need intervention unless symptoms of chickenpox occur.
option4: Should not be treated with acyclovir in the third trimester.
option5: Has a 15 per cent risk of having a baby with fetal varicella syndrome.
Correct answer: option3
Specialty: Orthopedic_Surgery
 Radionucleide bone scanning is Mostly useful in:





Answer options: option1: Avascular necrosis
option2: Malignancy
option3: Rheumatoid arthritis
option4: Stress fractures
option5: Acute osteomvelitis
Correct answer: option2
Rationale:  Radionucleide bone scanning is most useful in defining extent of
primary tumour, locating unsuspected metastasis and primary maligant
tumour. In all other conditiOns mentioned its use is more of academic interest
Specialty: Obstetrics_and_Gynecology
You are counselling a pregnant woman in the antenatal clinic who has known hepatitis with regard to fetal risk. Which form of hepatitis has the highest rate of fetal transmission? 
 

Answer options: option1: Hepatitis A.
option2: Hepatitis B.
option3: Hepatitis C.
option4: Hepatitis B+D.
option5: Hepatitis E.
Correct answer: option2
Specialty: Orthopedic_Surgery
 Which part of quadriceps muscle is most frequently fibrosed in post
injection quadriceps contracture:






Answer options: option1: Rectus femoris
option2: Vastus medialis
option3: Vastus intermedius
option4: Vastus lateralis
option5: All of above
Correct answer: option4
Rationale:  Vastus lateralis is most frequently affected probably because
injections are usually given in this area of thigh.
Specialty: Obstetrics_and_Gynecology
Which of the following is least accurate regarding adrenal disease in pregnancy?
 

Answer options: option1: Cushing’s syndrome may resemble the features of normal pregnancy.
option2: Addison’s disease may be difficult to diagnose in pregnancy due to changes in steroid profiles.
option3: Phaeochromocytoma may be diagnosed using 24-hour urine catecholamine testing.
option4: Steroid replacement therapy should be reduced to allow normal delivery.
option5: Phaeochromocytoma may mimic the features of pre-eclampsia.
Correct answer: option4
Specialty: Orthopedic_Surgery
1. Which is the strongest ligament:










Answer options: option1: ilio-femoral ligament
option2: Ischio-femoral ligament
option3: Pubo-femoral ligament
option4: Transverse acetabular ligament
option5: Ligamentum teres.
Correct answer: option1
Rationale: Ilio-femoral ligament blends with anterior part of hip joint capsule
and is the strongest ligament at hip joint.
Specialty: Obstetrics_and_Gynecology
Which statement is most accurate regarding cervical cerclage? 


Answer options: option1: In a high-risk patient it should be performed as soon as practical after confirmation of intrauterine pregnancy.
option2: Is a suitable procedure in any woman with a history of delivery between 20 and 26 weeks.
option3: Should be performed using an absorbable suture material.
option4: May be placed using a transvaginal approach.
option5: Requires a second anaesthetic procedure for removal when delivery is imminent.
Correct answer: option4
Specialty: Family_Medicine
WRITE A SHORT NOTE ON THE WAYS OF PREVENTING ACUTE DIARRHEA DISEASE IN MOTHERS AND CHILDREN IN LAGOS STATE NIGERIA 
Answer options: option1: N/A
option2: N/A
option3: N/A
option4: N/A
option5: N/A
Correct answer: option1,option2,option3,option4,option5
Rationale: PREVENTION OF DIARRHOEA

Prevention is always a lot more effective than treatment and in most cases diarhea is easily
preventable.

 measures and precautions include 
- Make sure that you wash your hands thoroughly before eating or handling any foods. 
- Always wash
your hands after using the bathroom or if you have been travelling and just returned from the
outdoors.

-Instruct and teach CHILDREN not to put objects in their mouth

If vou are on any antibiotic medications then make sure that you consume foods with active
cultures of lactobacilli a healthy bacteria that helps prevent the flourishing of other harmful bacteria.

Yogurt with active culture is the best source of such healthy bacteria

Diarrhea is a risk of particular concern when you are traveling It is therefore important that you
take these added hygiene precautions when travelling to such areas:
Make sure to drink only clean or bottled mineral water.

Avoid consuming any fresh and uncooked fruits and vegetables that have no peels.

Do not eat any type of shellfish Although you may like your stake rare it is best to avoid
consuming any undercooked meats

•Avoid the consumption of any dary products!
Breast feed your children exclusIvelv for at least6 months
•Ensure your children are adequately immunized for age
Specialty: Obstetrics_and_Gynecology
A thirty-seven-year-old woman attends for a routine dating scan. She asks you in detail what information will be obtained from the scan. Which of the following will not be possible? 
 

Answer options: option1: Accurate dating of the pregnancy.
option2: The detection of placenta praevia.
option3: The early detection of twin pregnancies.
option4: The detection of a failed pregnancy.
option5: The detection of uterine abnormalities.
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
 A woman contacts her midwife with concerns regarding fetal well-being at 32/40 in a previously normal pregnancy. Which is the best management?
 


Answer options: option1: Auscultation of the fetal heart at home by midwife.
option2: Encourage the patient to record a 24-hour kick chart.
option3: Book a growth scan within 2 days.
option4: Attend hospital if fetal movements are decreased.
option5: Advise repeat nuchal translucency scan.
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
An infant is delivered at 27/40 and taken to the neonatal unit. Which problem is most likely to be experienced?
 

Answer options: option1: Incomplete formation of the epidermis from the mesoderm.
option2: Excessive vernix formation
option3: Lanugo shedding.
option4: Thermoregulation due to thin skin.
option5: Lack of hair follicle development.
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
A woman is found to have oligohydramnios at 30/40. Which of the following is the most likely cause? 


Answer options: option1: Duodenal atresia.
option2: Placental chorioangioma.
option3: Diabetes.
option4: Oesophageal atresia.
option5: Renal agenesis.
Correct answer: option5
Specialty: Obstetrics_and_Gynecology
Which statement is correct regarding general examination in pregnancy?
 a) 
b) 
 c) 
 d) 
e) 
Answer options: option1: The abdomen should always be palpated lying flat.
option2: Breast examination should be conducted as part of routine antenatal care.
option3: Approximately 80 per cent of women have an audible murmur at 12/40.
option4: A symphysis–fundal height measurement should be plotted at every visit after 16/40.
option5: Nipple examination can predict women who will need help in breastfeeding.
Correct answer: option5
Specialty: Obstetrics_and_Gynecology
Obstetric history taking and examination
 Which statement is correct regarding calculating expected date of delivery (EDD)? 

Answer options: option1: Pregnancy is dated from conception.
option2: The last menstrual period (LMP) is reliable if the cycles are irregular.
option3: The average length of pregnancy is 280 days.
option4: LMP defined dates are more accurate than those calculated from USS.
option5: Head circumference may be used to date a pregnancy until 25 weeks.
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
Management of an eighty nine-year-old woman with ischaemic heart disease who is not sexually active but presents with a procidentia of the uterus is: 

Answer options: option1: Shelf pessary.
option2: Pelvic floor exercises.
option3: Vaginal hysterectomy.
option4: Hysteroscopy
option5: Total vaginal mesh procedure.
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
The most appropriate treatment option for an eighty-year-old woman with a BMI of 25 presenting with post-menopausal bleeding and found to have Stage 1 a endometrial adenocarcinoma on MRI and hysteroscopy is: 


Answer options: option1: Polypectomy and Mirena.
option2: TAH/BSO in a local centre.
option3: TAH/BSO in a cancer centre.
option4: TAH/BSO and radiotherapy.
option5: Radiotherapy alone.
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
A seventeen-year-old girl who is not sexually active presents with left iliac fossa pain. An ultrasound scan shows a 5 cm cyst on the left ovary which is complex in nature, with solid, calcified elements and fatty deposits noted on MRI. The likely diagnosis is: 


Answer options: option1: Thecal luteal cyst.
option2: Tubo-ovarian abscess.
option3: Serous cystadenoma.
option4: Fibroma.
option5: Dermoid cyst.
Correct answer: option5
Specialty: Obstetrics_and_Gynecology
The most suitable treatment for a thirty four-year-old woman with minimal endometriosis on laparoscopy, who has been trying to conceive for two years and has pelvic pain, is:


Answer options: option1: Laser ablation to endometriosis/excision of the endometriosis.
option2: GnRH analogues.
option3: Danazol.
option4: Progesterone.
option5: Combined oral contraceptive pill.
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
A twenty five-year-old girl presents with mid-cycle pain on a regular monthly basis. She is sexually active and does not take any contraception. The pain quickly resolves after 24 hours. She has a regular 28-day cycle. The likely cause of the pain is: 


Answer options: option1: PID.
option2: Endometriosis.
option3: Mittelschmertz syndrome.
option4: Adenomyosis.
option5: Polycystic ovaries.
Correct answer: option3