afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Obstetrics_and_Gynecology
A 29-year-old woman presents to her GP at 27 weeks' gestation with a rash on her trunk. She had developed this rash 10 hours previously and thought that she had developed a food allergy. On questioning she gives a history of coming in close contact, 3 days earlier, with her niece, who had developed chickenpox rash. General examination reveals rash typical of varicella or chickenpox. She is otherwise well. What is her next initial management following diagnosis of chickenpox 

Answer options: option1: Intravenous acyclovir
option2: Oral gancyclovir for 7 days
option3: Oral acyclovir for 7 days
option4: Elective caesarean section at 39 weeks' gestation
option5: Ultrasound scan for structural abnormalities in 5 weeks’ time
Correct answer: option3
Specialty: General_Surgery
A 30-year-old male, weighing 70 kg, develops a high output anastomotic leak 5 days after undergoing resection and anastomosis for adhesive small bowel obstruction. Total parenteral nutrition is planned. 
Estimate the caloric requirements of this patient.
Rationale: 25(20-30) kcal/kg/day – 1400-2100kcalories
Specialty: Obstetrics_and_Gynecology
A 28-year-old Asian woman presents to her GP as she had come in close contact, 3 days previously, with her nephew, who had chickenpox. She is currently 32 weeks' pregnant and feels feverish. Examination does not reveal any rash on the body. The GP prescribes her paracetamol and warns her not to come in contact with other pregnant women. Her booking bloods are negative for varicella IgG antibodies. What should be her next step of management? 


Answer options: option1: Oral acyclovir
option2: Intravenous acyclovir
option3: Intravenous varicella Immunoglobulin (IVIG)
option4: Emergency caesarean section
option5: Oral vanciclovir
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
A 32-year-old woman presented with painful vulva at 36 weeks' gestation. Clinical examination revealed multiple painful vesicles suggestive of genital herpes infection. She had a sexual health screening and was given oral acyclovir for 5 days. She was booked for elective caesarean section at 39 weeks' gestation. However, she presents at 38 weeks in second stage and delivered vaginally within half an hour of admission to labour ward. The newborn baby develops neonatal herpes Infection. What was the most likely mode of viral transmission to the fetus?

Answer options: option1: Blood borne
option2: Direct contact with genital secretions
option3: Transplacental
option4: Postnatal transmission
option5: Contact with maternal urine
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
A 36-year-old HIV-positive woman on highly active anti-retroviral therapy (HAART) comes to see you after a positive pregnancy test. Which one of the following statements is not true with regard to her management? 

Answer options: option1: Advise her to continue to take HAART throughout the pregnancy and postpartum.
option2: Vaginal delivery is not recommended for women on HAART.
option3: Screening for genital infections at booking and at 28 weeks' gestation.
option4: Screening for Hepatitis C should be performed at booking.
option5: Avoidance of breastfeeding reduces the risk of mother to child transmission.
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
A 29-year-old woman presents to the emergency department by ambulance with a history of a severe headache for 3 days and focal seizures. Two months prior to this, she presented to her GP with menorrhagia of 10 months' duration. She was offered LNG-IUS but she declined. She was prescribed tranexamic acid to be taken during her periods. Her medications box reveals that she has taken tranexamic acid for the whole previous month. There is no history of any viral illness recently. 
What is the likely diagnosis in her case? 

Answer options: option1: Subarachnoid haemorrhage
option2: Intracerebral haemorrhage
option3: Cerebral sinus thrombosis
option4: Drug-induced psychosis
option5: Intracranial tumour
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
A 39-year-old African Caribbean woman presents to her GP with menorrhagia of 10 months' duration. She does not give any history of intermenstrual or postcoital bleeding. All her previous smears have been normal. Vaginal examination reveals an essentially normal pelvis. She suffers from Crohn's disease and is taking oral sulphasalazine. She is fed up and is asking for a hysterectomy. What is her first line of management for menorrhagia? 

Answer options: option1: Hysterectomy
option2: Subtotal hysterectomy
option3: Levonorgestrel-releasing intrauterine system (LNG-IUS)
option4: Injectable long-acting progestogens
option5: Progesterone-only pill (POP)
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
A 22-year-old Caucasian para 0 woman attends maternal medicine clinic at 13 weeks' gestation following her normal dating scan. Her booking bloods are normal. She gives a history of deep venous thrombosis following a pelvic fracture after a trip over the stairs 2 years ago. Her recent thrombophilia screen is negative. Choose the most appropriate management option for this woman with regards to thrombopropylaxis. 

Answer options: option1: TEDS only during pregnancy
option2: TEDs and low molecular weight heparin (LMWH) during antenatal period
option3: Aspirin during antenatal period
option4: Aspirin and TED stockings during antenatal period
option5: 6 weeks of postpartum LMWH
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
Which one of the following statements is true with respect to perineal tears? 

Answer options: option1: Fourth-degree tear involves injury to the anal sphincter complex, but not anal mucosa.
option2: Third-degree tear involves injury to the perineal muscle complex
option3: Intact perineal skin excludes the possibility of damage to the anal sphincter complex.
option4: First-degree tear involves the skin and superficial perineal muscles.
option5: The degree of trauma in a right mediolateral episiotomy is equivalent to a second-degree tear.
Correct answer: option5
Specialty: Obstetrics_and_Gynecology
With regard to treatment of CIN, which one of the following statements is false? 

Answer options: option1: Treatment of CIN 2 and 3 can be treated at first colposcopic assessment.
option2: The standard treatment for CIN 2 and 3 is excisional treatment of the cervix.
option3: When CIN 2 and 3 are treated at first colposcopic assessment, it should be by excisional treatment to provide specimen for histological examination.
option4: CIN 1 can be treated with ablative techniques.
option5: CIN 2 and 3 can be treated with cervical biopsy only.
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
A 29-year-old woman comes to see her GP for advice as her mother, aunt and grandmother have all had ovarian cancers. Which of the following would reduce her risk of developing ovarian cancer? 

Answer options: option1: Prophylactic bilateral salpingo oophorectomy once family complete
option2: Having knowledge about BRCA1 familial cancer
option3: Monthly colour doppler ultrasound examination
option4: Use of clomiphene citrate
option5: Monthly measurement of Ca-125
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
A 29-year-old woman presents to her GP with small lumps on her vulva. 
Examination reveals warty lesions. Subsequently she is referred to the vulval clinic. The biopsy of the lesions reveals benign genital warts. The following drugs can be used in the treatment of her condition except which one of the following? 

Answer options: option1: Trichloracetic acid
option2: Podophyllin
option3: Podophyllotoxin
option4: Dactinomycin
option5: Imiquimod
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
With regard to the management of pregnant women with obesity (BMI 30), which one of the following statements is false? 

Answer options: option1: Glucose tolerance test should be offered during pregnancy.
option2: Folic acid 5 mg daily supplementation prior to and during pregnancy to minimize the risk of neural tube defects.
option3: Induction of labour at 39 weeks is recommended.
option4: They should have continuous electronic monitoring of the fetal heart during labour.
option5: Active management of the third stage is recommended to minimize the risk of postpartum haemorrhage
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
A 38-year-old nulliparous woman with type 1 diabetes attends the antenatal clinic at 6 weeks' gestation. Which of the following is not an increased risk in her pregnancy? 

Answer options: option1: Neural tube defects
option2: Macrosomia
option3: Congenital heart disease
option4: Oligohydramnios
option5: Pre-eclampsia
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
A 30-year-old para 2 woman with a BMI of 45 attends the antenatal clinic at 10 weeks gestation. One of the following is incorrect with respect to the associated risks and counselling? 

Answer options: option1: lncreased risk of venous thromboembolism
option2: Increased risk of pre-eclampsia
option3: Folic acid 5 mg once a day supplementation
option4: Vitamin D 100 micrograms daily supplementation during pregnancy
option5: Increased risk of gestational diabetes
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
A 28-year-old para 1 woman with a dichorionic diamniotic (DCDA) twin pregnancy attends her antenatal appointment at 20 weeks' gestation. She is at risk of developing the following complications with the exception of which of the following? 

Answer options: option1: Twin-to-twin transfusion syndrome
option2: Pre-eclampsia
option3: Postpartum haemorrhage
option4: Fetal growth restriction
option5: Preterm labour
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
Which one of the following statements is false with respect to the risks of advanced maternal age? 

Answer options: option1: Increased risk of pre-eclampsia
option2: No increase or decrease in the stillbirth rate
option3: Increased rate of instrumental delivery
option4: Increased risk of gestational diabetes
option5: Increased rate of caesarean section
Correct answer: option3
Specialty: Obstetrics_and_Gynecology

In relation to the treatment of BV, which one of the following statements is true? 

Answer options: option1: Routine treatment of male partners is recommended.
option2: Vaginal douching is beneficial for symptomatic improvement.
option3: Metronidazole is not safe during the first trimester of pregnancy.
option4: Clindamycin 2% Intravaginal cream is not effective.
option5: Recurrent BV is difficult to manage as it can recur in up to 70% of females within 3 months of treatment
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
Which one of the following statements is not true with respect to bacterial vaginosis (BV)? 

Answer options: option1: Isolation of Gardnerella vaginalis on high vaginal swab culture is diagnostic of BV.
option2: Vaginal pH is increased and is typically more than 4.5.
option3: Presence of 'clue cells on microscopy is diagnostic of bacterial vaginosis.
option4: It is associated with preterm labour or miscarriage.
option5: It is the commonest cause of abnormal vaginal discharge in women of reproductive age.
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
A 22-year-old Asian woman is admitted to the hospital with an incomplete miscarriage at 11 weeks' gestation. She subsequently has surgical evacuation of the uterus. The histology reveals focal hydropic placental villi interspersed with normal villi and presence of fetal tissue. Which of the following is the most likely karyotype and parental chromosomal origin? 

Answer options: option1: 46 XX, maternal
option2: 46 XX, paternal
option3: 46 XY, paternal
option4: 69 XXY, paternal
option5: 69 XXY, paternal and maternal
Correct answer: option5
Specialty: Obstetrics_and_Gynecology
A 22-year-old Asian woman is admitted to the hospital with an incomplete miscarriage at 11 weeks' gestation. She subsequently has surgical evacuation of the uterus. The histology reveals a large mass with hydropic changes in all the placental villi with no fetal tissue. Which of the following is the most likely karyotype and parental chromosomal origin? 

Answer options: option1: 46 XX, maternal
option2: 46 XX, paternal
option3: 46 XY, paternal
option4: 69 XXY, paternal
option5: 69 XXY, paternal and maternal
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
A 30-year-old woman presents to the early pregnancy unit with mild vaginal bleeding. An ultrasound is performed, which reports a complete molar pregnancy. What would be the parental origin and genetic complement of the complete molar pregnancy? 

Answer options: option1: 2 paternal sets: diploid
option2: 2 paternal sets: haploid
option3: 1 paternal set: haploid
option4: 2 paternal and 2 maternal sets: tetraploid
option5: 1 maternal and 1 paternal set: diploid
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
A 22-year-old Asian woman is admitted to the hospital with an incomplete miscarriage at 11 weeks' gestation. An ultrasound shows a 'snowstorm appearance. She passes grape-like vesicles through the vagina. She subsequently has a surgical evacuation of the uterus. The histology reveals a large mass with hydropic changes in all the placental villi and no fetal tissue. She is followed up with serum beta human chorionic gonadotrophin (beta h CG) levels. There was an initial fall but it started to rise gradually (10,000 units/m L) at 3 months' follow-up. Her CT scan chest, abdomen and pelvis are normal except localized thickened vascular area in the posterior wall of uterus. What is the likely diagnosis? 

Answer options: option1: Gestational choriocarcinoma
option2: Persistent trophoblastic disease
option3: Non-invasive mole
option4: Non-gestational choriocarcinoma
option5: Placental site trophoblastic disease
Correct answer: option5
Specialty: Obstetrics_and_Gynecology
All the following statements are correct except; 

Answer options: option1: Condition for vacuum extraction are fetal head at least 0 station or not more than 2/5 above the symphysis pubis and a fully dilated cervix
option2: Ahead that is felt in the flank on abdominal examination indicates a shoulder presentation or transverse lie
option3: If labour is prolonged in the case of a breach presentation, a cesarean section should be performed
option4: Manual vacuum aspiration (MVA) is an effective method for treatment of incomplete abortion if the uterine size is not greater than 8 weeks
option5: Breast pain and tenderness 3 to 5 days after childbirth is usually due to breast enlargement.
Correct answer: option5
Specialty: Obstetrics_and_Gynecology
A woman is admitted in first stage of active labour, with cervical dilatation at 5 cm. 
You plot a cervical dilatation on which part of partograph 

Answer options: option1: Alert line
option2: Action line
option3: Between alert and action
option4: Left to the alert line
option5: Right to the action line
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
Respective care at birth includes these except: 


Answer options: option1: Speaking kindly to the woman
option2: Do not let the laboring woman drink or eat in case she vomits
option3: Allowing the laboring woman to drink or eat
option4: Allowing the laboring woman to deliver in any position she wants
option5: Allow the laboring woman a companion of her choice.
Correct answer: option2
Specialty: General_Surgery
A 65-year-old female, weighing 100 kg, with a history of hypertension underwent surgery for cancer of the right colon. The estimated blood loss was 800 m L and intra-operative urine output was 150 ml. A central venous catheter was inserted. The patient received 1,000 m L of normal saline and 1 unit of packed red blood cells during surgery. Admission to the ICU was requested because the patient was slow to awaken from anesthesia. He arrived in the ICU on mechanical ventilation. Vital signs in the first hour included BP 110/50, HR 120, urine output of 25 m L for the hour, and a temperature of 35.4°C. 
What is the next step in the management of this patient? 
Rationale: Continuous hemodynamic monitoring
Pain management/sedation
A fluid and diuretic challenge. At least 0.5 to 1 mL/kg of urine per hour 
Restoring a normal temperature - external warming, devices, warm IV fluids, humidified air delivered by the ventilator, and raising the temperature of the patient’s room
Residual neuromuscular blockade evaluation 
Anticoagulation/stockings
Specialty: General_Surgery
A 65-year-old female, weighing 100 kg, with a history of hypertension underwent surgery for cancer of the right colon. The estimated blood loss was 800 m L and intra-operative urine output was 150 ml. A central venous catheter was inserted. The patient received 1,000 m L of normal saline and 1 unit of packed red blood cells during surgery. Admission to the ICU was requested because the patient was slow to awaken from anesthesia. He arrived in the ICU on mechanical ventilation. Vital signs in the first hour included BP 110/50, HR 120, urine output of 25 m L for the hour, and a temperature of 35.4°C. 
List the investigation you would request in this patient? 
Rationale: Chest X-ray is needed to evaluate the placement of the central venous catheter (CVC) and endotracheal tube (ETT)
An arterial blood gas (ABG) to assess ventilation/oxygenation
A complete blood count 
Urea and electrolytes
Specialty: General_Surgery
How do one reverse the following medication(aspirin, clopidegrol, warfarin and heparin) to prevent coagulation abnormalities in patients undergoing elective surgery? 
Rationale: Aspirin – stop for 7-10days
Clopidegrol – stop for 10-14 days
Warfarin- vitamin K, prothrombin complex concentrates, FFP 
Heparin – protamine sulfate
Specialty: Obstetrics_and_Gynecology
Which of the following statements are true; 

Answer options: option1: The bethseda classification has 4 categories
option2: The squamous zone is prone to dysplasia
option3: The screening by pap smear is not useful in developing countries
option4: HPV type 16 is the most common HPV in woman with abnormal cervical smear
option5: Exposed lesions are associated with increased chance of failure of cryotherapy in the treatment of abnormal cervical smear
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
Regarding chronic pelvic pain 

Answer options: option1: Colposcopy has a great role in evaluation
option2: Is best managed with opioids
option3: Avoidance/conflict related to sex and intimacy is a common co- symptom
option4: These patients should be sent for psychotherapy while awaiting investigations
option5: Identification of pelvic pathology excludes a psychogenic cause
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
Concerning maternal mortality 

Answer options: option1: Kenya has almost attained the MDG target
option2: Death from HIV in pregnancy is a direct maternal death
option3: The big five causes of direct maternal deaths in Kenya are haemorrhage sepsis hypertensive disease abortion and obstructed labour
option4: Maternal mortality fate and ratio are the same
option5: The target of MDGS is to reduce maternal mortality ratio by 50% by 2015
Correct answer: option3
Specialty: General_Surgery
A 27-year-old female with accidentally lacerates her hand while cutting onions. What sequence of events results in hemostasis in this healthy individual? 

Rationale: Vasoconstriction
Platelet stimulation, adhesion, and aggregation (primary hemostasis)
Activation and binding of coagulation factors forming thrombin (secondary hemostasis)
Fibrin deposition to strengthen the platelet plug
Specialty: Obstetrics_and_Gynecology
During the repair of a type 1 vesicovaginal fistula; 

Answer options: option1: The bladder is closed in 2 layers
option2: The vaginal mucosa is closed in 3 layers
option3: The bladder is closed in 3 layers
option4: The bladder is closed in 1 layer
option5: The vaginal mucosa is closed in 2 layers
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
The following is not true of endometriosis 

Answer options: option1: Infertility is a common association
option2: Haematuria or haematochezia may occur
option3: It is in multiparous women
option4: May occur in distant organs like the lungs.
option5: The commonest sites are visceral peritoneal surfaces of pelvic organ
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
One day after unprotected casual sex encounter with a man recently diagnosed as HIV infected, a young lady undergoes an antibody-based HIV test that returns negative. What is the earliest time to reschedule a repeat HIV antibody test; 

Answer options: option1: Two weeks
option2: Six weeks
option3: Three weeks
option4: Nine weeks
option5: Twelve weeks
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
The indicators of infective process in reproductive health practice includes the following except; 

Answer options: option1: ESR of more than 30mm/hr. (winthrobe)
option2: C-reactive protein >15mg/all
option3: Basophilia of more than 3% in differential count
option4: Lymphocytes consisting 45% in the differential count
option5: Total white blood cell counts of 17* 10/91
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
The following are the correct actions to take when a woman is in shock except; 

Answer options: option1: Give first bolus of 1.V fluids over 15-20 minutes
option2: Keep airway open
option3: If haemorrhage run bedside clotting test
option4: Give first bolus of I.V fluids over 1 hour
option5: Continue I.V fluids
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
Which of the following is the best definition of evidence-based medicine (practice) 

Answer options: option1: Making medical decisions only when there is adequate evidence to support them
option2: Adhering strictly to the scientific evidence, despite patients’ preference
option3: The conscientious, explicit and judicious best evidence in making decisions about the care of the individual patient
option4: Making medical decisions that are consistent with grade A evidence
option5: a and b
Correct answer: option3
Specialty: General_Surgery
Give four indications for surgery in a patient with a bleeding peptic ulcer

Rationale: Severe, life-threatening hemorrhage not responsive to resuscitative efforts
Failure of medical therapy and endoscopic hemostasis with persistent recurrent bleeding
A coexisting reason for surgery (eg, perforation, obstruction, malignancy)
Prolonged bleeding, with loss of 50% or more of the patient's blood volume
A second hospitalization for peptic ulcer hemorrhage
Specialty: Obstetrics_and_Gynecology
High risk choriocarcinoma is treated by: 

Answer options: option1: Methotrexate plus external beam pelvic radiation
option2: EMACO combination chemotherapy
option3: Methotrexate single agent therapy
option4: Methotrexate plus radical hysterectomy plus external beam pelvic radiation
option5: External hysterectomy
Correct answer: option2
Specialty: General_Surgery
Apart from peptic ulcer disease, Give four (4) possible causes for an upper gastrointestinal bleed. 
Rationale: Severe or erosive esophagitis, Esophagogastric varices, Mallory-Weiss syndrome, Portal hypertensive gastropathy, Angiodysplasia (vascular ectasia), dieulafoy lesion, Mass lesions (polyps/cancers); Hemobilia; Hemosuccus pancreaticus; Aortoenteric fistula; Cameron lesions; Ectopic varices; Iatrogenic bleeding after endoscopic interventions
Specialty: Obstetrics_and_Gynecology
The following are true of placenta praevia except; 

Answer options: option1: The first haemorrhage is often less severe than subsequent haemorrhages.
option2: Blood is often fresh and bright red
option3: Type II anterior, spontaneous vaginal delivery is anticipated
option4: Type Il posterior, spontaneous vaginal anticipated
option5: Pain is not common feature
Correct answer: option4