afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Oncology
Which of the following is a common complication of untreated African endemic schistosomiasis?
Answer options: option1: Cerebral malaria
option2: Bladder cancer
option3: Hepatic encephalopathy
option4: Acute respiratory distress syndrome (ARDS)
option5: None of the above
Correct answer: option2
Rationale: Untreated schistosomiasis in African populations can lead to the development of bladder cancer due to chronic inflammation and fibrosis of the bladder wall.
Specialty: Hematology
An 18-year-old previously healthy student who has just returned from a trip to East Africa presents with a cough and fever, particularly at night. He also has myalgia and headache. He had noticed an itchy rash in the preceding week. He admits that he has not taken his antimalarials conscientiously. His chest X-ray shows diffuse pulmonary infiltrates. FBC shows eosinophilia. The most likely diagnosis is:
Answer options: option1: Eosinophilic granulomatosis with polyangiitis
option2: Miliary tuberculosis
option3: Schistosomiasis
option4: Trypanosomiasis
option5: Malaria
Correct answer: option3
Rationale: The clinical manifestations are indicative of an allergic reaction to an acute schistosomal infection, wherein parasites penetrate the skin via contaminated water, resulting initially in a rash followed by subsequent migration of the parasites, leading to additional manifestations. This constellation of symptoms is recognized as Katayama fever or Katayama syndrome. In cases of febrile patients, a thorough travel history is imperative, necessitating inquiry into potential exposure to lakes and rivers.
Specialty: Nephrology
Which of the following is a common cause of acute glomerulonephritis in African children?
Answer options: option1: Streptococcus pneumoniae
option2: Neisseria meningitidis
option3: Plasmodium falciparum
option4: Human immunodeficiency virus (HIV)
option5: Group A Streptococcus
Correct answer: option5
Rationale: Acute poststreptococcal glomerulonephritis, caused by Group A Streptococcus infection, is a common cause of glomerulonephritis in African children.
Specialty: Allergy_and_Immunology
Which type of immunodeficiency is commonly associated with HIV/AIDS in Africa?
Answer options: option1: Transient immunodeficiency
option2: Congenital immunodeficiency
option3: Primary immunodeficiency
option4: Secondary immunodeficiency
option5: Autoimmune immunodeficiency
Correct answer: option4
Rationale: HIV/AIDS is the leading cause of secondary immunodeficiency in Africa. The virus targets and destroys CD4 T cells, weakening the immune system and increasing susceptibility to opportunistic infections. Effective management of HIV/AIDS with antiretroviral therapy (ART) is essential to maintain immune function.
Specialty: Psychiatry
In a rural African community, a patient presents with symptoms of persistent sadness, loss of interest in previously enjoyable activities, changes in appetite and sleep patterns, feelings of worthlessness, and recurrent thoughts of death. Which of the following is the most likely diagnosis?
Answer options: option1: Generalized anxiety disorder (GAD)
option2: Bipolar disorder
option3: Schizophrenia
option4: Major depressive disorder (MDD)
option5: Obsessive-compulsive disorder (OCD)
Correct answer: option4
Rationale: In African contexts where mental health resources may be limited, major depressive disorder remains a significant public health concern, often underdiagnosed and undertreated due to stigma and lack of access to care.
Specialty: Pulmonary_Medicine
Which of the following is the most common cause of chronic cough in Africa 
Answer options: option1: Gastroesophageal reflux disease (GERD)
option2: Asthma
option3: Pneumonia
option4: Chronic bronchitis
option5: Tuberculosis
Correct answer: option5
Rationale: The reason A) Tuberculosis is the most common cause of chronic cough in Africa is because tuberculosis is highly prevalent in many African countries, making it a leading cause of chronic respiratory symptoms such as coughing. Additionally, tuberculosis can remain latent for years before becoming active, contributing to its widespread prevalence and chronic nature in the region.
Specialty: Allergy_and_Immunology
A 30-year-old African patient presents with hives, angioedema, and wheezing shortly after consuming seafood. Which of the following immunoglobulins is most likely involved in this allergic reaction?
Answer options: option1: IgA
option2: IgD
option3: IgE
option4: IgG
option5: IgM
Correct answer: option3
Rationale: IgE-mediated hypersensitivity reactions are common in allergic responses, particularly in immediate-type allergic reactions such as anaphylaxis to seafood.
Specialty: Psychiatry
 In African societies where communal living is common, a patient presents with symptoms of recurrent, intrusive thoughts, images, or impulses (obsessions) and repetitive behaviors or mental acts (compulsions) performed in response to these obsessions. Which of the following is the most likely diagnosis?
Answer options: option1: Panic disorder
option2: Generalized anxiety disorder (GAD)
option3: Post-traumatic stress disorder (PTSD)
option4: Social anxiety disorder
option5: Obsessive-compulsive disorder (OCD)
Correct answer: option5
Rationale: The communal living environment in African societies may exacerbate symptoms of obsessive-compulsive disorder, making it important to recognize and address in clinical practice.
Specialty: Gastroenterology
Which of the following is a common cause of chronic liver disease in African adults?
Answer options: option1: Alcoholic liver disease
option2: Non-alcoholic fatty liver disease (NAFLD)
option3: Hepatitis B virus (HBV) infection
option4: Hepatitis C virus (HCV) infection
option5: Autoimmune hepatitis
Correct answer: option3
Rationale: Chronic HBV infection is a major cause of chronic liver disease and hepatocellular carcinoma (HCC) in Africa.
Specialty: Orthopedic_Surgery
A 55-year-old African patient presents with chronic hip pain and stiffness, worse with weight-bearing and relieved by rest. Imaging reveals joint space narrowing, subchondral sclerosis, and osteophyte formation. Which of the following is the most likely diagnosis?
Answer options: option1: Osteoarthritis
option2: Rheumatoid arthritis
option3: Avascular necrosis
option4: Septic arthritis
option5: Ankylosing spondylitis
Correct answer: option1
Rationale: Osteoarthritis is characterized by joint degeneration, leading to symptoms such as pain, stiffness, and limited range of motion, particularly with weight-bearing.
Specialty: Infectious_Disease
Which of the following is a common presentation of African endemic cholera?
Answer options: option1: Bloody diarrhea
option2: Projectile vomiting
option3: Rice water stools
option4: Jaundice
option5: None of the above
Correct answer: option3
Rationale: African endemic cholera typically presents with profuse watery diarrhea, often described as "rice water stools."
Specialty: Infectious_Disease
A 27-year-old man presents to the clinic for follow-up. He has a history of HIV and is adherent to his antiretroviral therapy. He has no active complaints. He is traveling to Africa as part of an HIV awareness campaign. He is up to date with all his vaccinations, except for hepatitis A, which he last received when he was aged 2 years. Which of the following is the most appropriate recommendation regarding hepatitis A prophylaxis in this patient?
Answer options: option1: Reassurance that he does not need another dose
option2: Live-attenuated hepatitis A vaccine
option3: Inactivated hepatitis A vaccine
option4: Ribavirin prescription
option5: none
Correct answer: option3
Rationale: Hepatitis A vaccine effectively prevents the infection as effectiveness rates are reported between 82% and 95%.

However, their effectiveness falls off after 15 years. Vaccines with booster doses are estimated to be effective for 25 years.

In patients with a weak immune system (eg, HIV patients), it is advisable to use the inactivated form of the vaccine.

Live-attenuated vaccines have a risk of reactivation in patients with immunocompromise. Ribavirin has no role in hepatitis A prophylaxis or treatment.
Specialty: Obstetrics_and_Gynecology
What is the leading cause of maternal mortality in sub-saharan Africa?
Answer options: option1: malaria
option2: postpartum hemorrhage
option3: HIV/AIDS
option4: hypertensive disorders of pregnancy
option5: Cancer
Correct answer: option2
Rationale: Postpartum hemorrhage is the leading cause of maternal mortality in sub-saharan Africa, accounting for a significant number of maternal deaths. This is due to factors such as Limited access to Emergency obstetric care, poor infrastructures and delays in receiving appropriate treatment.
What is the primary method used for diagnosing hemolytic anemia associated with thrombotic thrombocytopenic purpura (TTP) in Africa? 
Rationale: Measurement of ADAMTS13 activity and presence of ADAMTS13 inhibitors is the primary method used for diagnosing hemolytic anemia associated with thrombotic thrombocytopenic purpura (TTP) in Africa. This can be done using enzyme-linked immunosorbent assays (ELISAs) or functional assays.
How do cultural beliefs and social norms influence the prevalence and management of chronic diseases such as diabetes and hypertension in Africa, and what strategies can be implemented to promote preventive behaviors and improve disease management?
Rationale: Cultural beliefs and social norms play a significant role in shaping perceptions of chronic diseases like diabetes and hypertension in Africa. Stigma, fear of diagnosis, and reliance on traditional healers may deter individuals from seeking early diagnosis and adhering to treatment regimens. Cultural dietary practices, physical activity patterns, and health-seeking behaviors also impact disease management outcomes. Strategies to promote preventive behaviors and improve disease management involve community engagement, culturally tailored health education programs, integration of traditional healing practices with modern healthcare services, training of community health workers, and decentralization of chronic disease management services to primary care settings. Empowering individuals and communities to make healthy lifestyle choices, addressing socio-economic inequalities, and strengthening healthcare systems are crucial for mitigating the burden of chronic diseases in Africa.
Explain the diagnostic approach and management of common gastrointestinal disorders, such as peptic ulcer disease and gastroenteritis, in Nigerian patients.
Rationale: Answer: Peptic ulcer disease is commonly caused by Helicobacter pylori infection or non-steroidal anti-inflammatory drugs (NSAIDs) in Nigeria. Diagnosis involves upper endoscopy and H. pylori testing. Management includes proton pump inhibitors, H. pylori eradication therapy, and avoidance of NSAIDs. Gastroenteritis is typically managed with rehydration therapy, antiemetics, and antibiotics in severe cases, with consideration of local antimicrobial resistance patterns.
Which condition is characterized by the presence of cystic dilatation of the Bartholin's gland duct and can cause pain and discomfort in the vulvar region of African women?

Rationale: Bartholin's gland cyst is characterized by the presence of cystic dilatation of the Bartholin's gland duct, leading to the formation of a painless or tender mass in the vulvar region. This condition can cause discomfort during intercourse and may require drainage or marsupialization for symptomatic relief.
What is the primary cause of acute pancreatitis in Africa?
Rationale: Gallstones is the primary cause of acute pancreatitis in Africa because gallstone disease is a major risk factor for the development of acute pancreatitis globally, including in Africa. Gallstones can obstruct the pancreatic duct, leading to inflammation and injury of the pancreas, which can result in acute pancreatitis. Gallstone-related acute pancreatitis is particularly common in regions where gallstone disease prevalence is high, such as Africa. Other causes of acute pancreatitis, such as alcohol consumption and hypertriglyceridemia, may also contribute to the burden of the disease, but gallstones are the most common etiology in Africa.
What is the name of the viral infection, transmitted through the saliva of infected animals, that causes acute encephalitis and is endemic in certain regions of Africa, posing a risk to humans through exposure to infected domestic and wild animals?
Rationale:  Rabies, a preventable viral disease caused by lyssaviruses. In Africa, dogs are the primary reservoir and source of transmission to humans, highlighting the importance of canine vaccination and post-exposure prophylaxis for individuals bitten by potentially rabid animals.
What are some common causes of acute kidney injury (AKI) in African settings?

Rationale: Common causes of acute kidney injury (AKI) in African settings include severe dehydration from diarrheal diseases such as cholera, infectious diseases such as malaria and HIV/AIDS, nephrotoxic medications, traditional herbal remedies containing potentially toxic substances, and obstetric complications such as postpartum hemorrhage and preeclampsia. Limited access to clean water, sanitation, and healthcare services further compound the risk of AKI in resource-limited settings.
What histopathological findings characterize African cases of endemic schistosomal appendicitis affecting the appendix?
Rationale: African cases of endemic schistosomal appendicitis often exhibit submucosal inflammation, granulomatous reaction to Schistosoma eggs, and eosinophilic infiltration within the appendiceal wall. Histopathological features may include mucosal ulceration, fibrosis, and the presence of calcified eggs within the appendiceal lumen or submucosa.
Clinical Scenario: A 35-year-old woman presents with fever, headache, and joint pain after returning from a trip to a rural area in Nigeria. On examination, she has hepatomegaly and splenomegaly. A blood smear reveals the presence of Plasmodium parasites.
Question: What is the most likely diagnosis, and what is the recommended treatment for this patient?
Rationale: Answer: The most likely diagnosis is malaria, specifically Plasmodium falciparum malaria, given the patient's symptoms and travel history to a malaria-endemic area in Nigeria. The recommended treatment for uncomplicated P. falciparum malaria in Nigeria is Artemisinin-based combination therapy (ACT), such as Artemether-Lumefantrine (AL). ACTs are preferred due to their high efficacy, rapid parasite clearance, and reduced risk of drug resistance development compared to monotherapy. Additionally, prompt treatment is essential to prevent progression to severe malaria, especially in areas with high transmission rates like Nigeria.
Reason: Malaria, particularly caused by P. falciparum, is endemic in Nigeria, and individuals returning from malaria-endemic areas are at risk of infection. The patient's symptoms of fever, headache, joint pain, and findings of hepatomegaly and splenomegaly are consistent with malaria infection. Prompt diagnosis and treatment with an effective antimalarial drug such as ACT are crucial to prevent complications and reduce morbidity and mortality associated with malaria.
A 30-year-old woman presents with fever, headache, and joint pain for the past week. She reports recent travel to Nigeria, where she participated in outdoor activities. On examination, there are multiple erythematous papules and nodules on her lower extremities, some of which have a target-like appearance. What is the most likely diagnosis, and what is the recommended next step in management for this patient?
Rationale: Answer: The most likely diagnosis is Lyme disease, likely acquired during outdoor activities in Nigeria. The recommended next step in management is to perform serological testing, such as enzyme immunoassay (EIA) or western blot, to confirm the diagnosis of Lyme disease. Additionally, the patient should be started on antibiotic therapy with doxycycline, amoxicillin, or cefuroxime for appropriate treatment of the infection.
Clinical Scenario: A 35-year-old man presents with a history of fever, headache, and muscle pain for the past week. He reports recent travel to Nigeria, where he spent time in rural areas. On examination, there are multiple erythematous papules and nodules on the skin, particularly on the lower extremities. Some of the lesions are ulcerated and tender to touch.
Question: What is the most likely diagnosis, and what is the recommended next step in management for this patient?
Rationale: Answer: The most likely diagnosis is cutaneous leishmaniasis, likely acquired during travel to Nigeria. The recommended next step in management is to perform a skin biopsy of one of the lesions to confirm the diagnosis. Additionally, the patient should be started on treatment with antimonial drugs, such as sodium stibogluconate or meglumine antimoniate, to eliminate the parasite and resolve the skin lesions.
Reason: Cutaneous leishmaniasis is a parasitic infection caused by protozoa of the Leishmania species, transmitted through the bite of infected sandflies. The patient's symptoms of fever, headache, and muscle pain, along with the presence of multiple erythematous papules and nodules on the skin, are consistent with cutaneous leishmaniasis. Travel to Nigeria, particularly rural areas where the disease is endemic, increases the likelihood of acquiring the infection. Confirmation of the diagnosis is essential through skin biopsy, which demonstrates the presence of Leishmania parasites in the tissue. Treatment with antimonial drugs is effective in eliminating the parasite and resolving the skin lesions, preventing further complications and promoting healing.
What is the primary method used for diagnosing hemolytic anemia associated with paroxysmal nocturnal hemoglobinuria (PNH) in Africa? 
Rationale: Flow cytometry is the primary method used for diagnosing hemolytic anemia associated with paroxysmal nocturnal hemoglobinuria (PNH) in Africa. This test detects the absence or deficiency of glycosylphosphatidylinositol (GPI)-anchored proteins on the surface of red blood cells, a characteristic feature of PNH.
What is the primary cause of chronic kidney disease (CKD) in Africa?

Rationale: Hypertension is the primary cause of chronic kidney disease (CKD) in Africa, contributing to renal parenchymal damage, glomerular sclerosis, and progressive loss of kidney function. Factors such as uncontrolled hypertension, genetic predisposition, and limited access to healthcare contribute to the high burden of CKD in the region.
What histopathological findings characterize African cases of endemic Dracunculiasis (Guinea worm disease) affecting the skin and subcutaneous tissues?
Rationale: African cases of endemic Dracunculiasis affecting the skin and subcutaneous tissues often exhibit inflammatory infiltrates, fibrosis, and the presence of Dracunculus medinensis larvae within subcutaneous nodules or ulcers. Histopathological examination may reveal granulomatous inflammation, necrosis, and varying degrees of tissue destruction in affected areas.
How does the prevalence of cervical cancer in Africa correlate with access to screening and vaccination programs, and what challenges exist in implementing comprehensive cervical cancer prevention strategies?
Rationale: Cervical cancer is a leading cause of cancer-related deaths among women in Africa, largely due to limited access to screening and vaccination programs. Disparities in healthcare infrastructure, resources, and awareness contribute to low screening rates and late-stage diagnosis. Challenges in implementing comprehensive prevention strategies include limited funding, infrastructure constraints, shortage of trained healthcare personnel, cultural barriers, and vaccine hesitancy. Efforts to address these challenges require multi-sectoral collaboration, investment in screening and vaccination programs, community outreach, and advocacy for policy reforms to prioritize cervical cancer prevention and control.
What is the primary cause of chronic liver disease in adults with hepatitis B virus (HBV) infection in Africa?

Rationale: Chronic hepatitis B virus (HBV) infection is the primary cause of chronic liver disease in adults in Africa, leading to progressive liver inflammation, fibrosis, and cirrhosis. Factors such as vertical transmission, unsafe medical injections, and limited access to HBV vaccination contribute to the high prevalence of chronic HBV infection and its sequelae in the region.
How do cultural beliefs and social norms influence perceptions of disability in Africa, and what challenges do individuals with disabilities face in accessing healthcare, education, and employment opportunities?
Rationale: Cultural beliefs and social norms play a significant role in shaping perceptions of disability in Africa, with attitudes ranging from acceptance and inclusion to stigma and discrimination. Traditional beliefs about the causes of disability, such as spiritual or supernatural factors, may lead to social isolation and marginalization of individuals with disabilities. Inaccessible infrastructure, limited educational opportunities, and discriminatory practices in healthcare and employment sectors further exacerbate the challenges faced by people with disabilities. Lack of awareness, inadequate funding, and policy gaps contribute to barriers in accessing essential services and participating fully in society. Efforts to address these challenges require a rights-based approach that promotes disability rights, inclusive policies, accessibility standards, inclusive education, vocational training, and economic empowerment initiatives for people with disabilities. Changing societal attitudes, promoting diversity and inclusion, and ensuring the full participation of people with disabilities in decision-making processes are essential for achieving disability-inclusive development in Africa.
Describe the histopathological changes seen in African cases of hepatosplenic schistosomiasis.
Rationale: Hepatosplenic schistosomiasis in Africa is characterized by periportal fibrosis, portal vein hypertension, and splenomegaly. Histologically, it presents with a "pipestem" fibrosis pattern surrounding portal tracts, along with congestion, fibroblastic proliferation, and occasional granulomatous inflammation.
What are the socio-economic determinants influencing access to education and healthcare for children with disabilities in East Africa, and how can inclusive policies and programs promote their rights and well-being?
Rationale: Socio-economic determinants such as poverty, discrimination, and lack of accessibility hinder access to education and healthcare for children with disabilities in East Africa. Inclusive policies and programs, including inclusive education, community-based rehabilitation, and disability-inclusive healthcare services, can promote their rights and well-being by addressing barriers to participation and fostering social inclusion.
What histopathological findings are associated with African cases of endemic cutaneous diphtheria affecting the skin?
Rationale: African cases of endemic cutaneous diphtheria affecting the skin typically exhibit pseudomembrane formation, dermal inflammation, and the presence of Corynebacterium diphtheriae within affected tissues. Histopathological examination may reveal epidermal necrosis, neutrophilic infiltrates, and varying degrees of tissue destruction in affected areas.