afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Obstetrics_and_Gynecology
Which of the following is NOT true about twin pregnancy?



Answer options: option1: Pregnancy outcome is determined by the chorionicity.
option2: Early complications of monochorionic twins are caused by vascular anastomoses in thep lacenta
option3: Selective fetal growth restriction complicates 10% of monochorionic twins.
option4: Anaemia-polycythemia sequence is an early complication of monochorionic twins.
option5: Discordant fetal weight of over 25% is an independent predictor of poor pregnancy outcome in dichorionic twins.
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
Which of the following is/are true about timing of delivery in twins?

Answer options: option1: Maturity of singleton pregnancy at 40 weeks equates to that of twins at 38 weeks.
option2: Uncomplicated dichorionic twins should be delivered by 37 weeks.
option3: Monochorionic twins carry higher stillbirth rates than dichorionic twins.
option4: Uncomplicated monochorionic twins should be delivered at 34 weeks
option5: Frequent antenatal fetal monitoring is unnecessary in monochorionic twins.
Correct answer: option3
Specialty: Internal_Medicine
23. A 24-year-old boy was involved in a head-on collision road traffic accident as an unrestrained driver in a high-speed moving car. His car collided with an oncoming car which had veered off because the driver had apparently fallen asleep behind the wheel. The boy apparently sustained a compression injury to the abdomen. He was rushed to the ER, where he was found to be very pale with cold clammy extremities and delayed capillary refill. His BP was 77/45 with a high pulse rate of 125 bpm. He had a very tender abdomen and fractured left lower ribs. A FAST revealed a free fluid in the peritoneal cavity. What is the most appropriate diagnosis 
Answer options: option1: a.Haemorrhagic shock secondary to probable splenic rupture
option2: b.Septic shock secondary to infected fractured rib
option3: c.Spinal shock from spinal cord injury
option4: d.Cardiogenic shock sec trauma
option5: e.Hypovolaemic shock from dehydration
Correct answer: option1
Specialty: Cardiology
Which is incorrect about ECG: 

Answer options: option1: The T wave corresponds to atrial contraction
option2: If the S wave is greater than the R wave in lead I, there is right axis deviation
option3: If the S wave is greater than the R wave in lead II, there is left axis deviation
option4: ST segment depression may be a sign of cardiac ischaemia
option5: The P wave corresponds to atrial depolrisation
Correct answer: option1
Specialty: General_Surgery

21.45-year-old morbidly obese with tortuous dilated elongated veins along the lower limbs. The distended veins were associated with swelling of the legs and ankles. The patients noticed the distended vessels during her last pregnancy when she was 38 years old. She has noticed an ulcer just above the medial malleolus of the right leg with pruritic margins. What is most likely diagnosis 
Answer options: option1: a.Venous ulcer complicating varicose veins
option2: b.Decubitus ulcer
option3: c.Neurotrophic ulcer
option4: d.Diabetic ulcer
option5: e.Gestational ulcer
Correct answer: option1
Specialty: Cardiology
About endocarditis which is true? 

Answer options: option1: It is important to take blood cultures over at least 24 hour period to make the diagnosis
option2: Transthoracic echocardiography is a sensitive means of making or confirming the diagnosis
option3: Most patients with Staphylococcus aureus bacteraemia have endocarditis
option4: Viral endocarditis leads to valvular abnormality
option5: Diagnosis is based on the Duke’s criteria
Correct answer: option5
Specialty: Obstetrics_and_Gynecology
Which of the following is/are true about twin pregnancies with symptoms of preterm birth?
Answer options: option1: Most women will deliver within a week.
option2: Insufficient data are available to make evidence-based recommendations.
option3: The accuracy of cervical length measurement is higher than for asymptomatic women
option4: The accuracy of cervical length measurement is higher than for asymptomatic women
option5: Fetal fibronectin has high negative predictive value
Correct answer: option5
Specialty: Cardiology
A 60-year-old male patient on aspirin, an angiotensin-converting enzyme inhibitor, nitrates, and a beta blocker, who is being followed for chronic stable angina, presents to the ER with a history of two or three episodes of more severe and long-lasting anginal chest pain each day over the past 3 days. His ECG and cardiac enzymes are normal. Which of the following is the best course of action?

Answer options: option1: Admit the patient and begin intravenous digoxin
option2: Admit the patient and begin intravenous heparin
option3: Admit the patient and give prophylactic thrombolytic therapy
option4: Admit the patient for observation with no change in medication
option5: Increase the doses of current medications and follow closely as an outpatient
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
All of the following statements are true about multiple pregnancies after assisted reproductive technology (ART) treatment EXCEPT
Answer options: option1: Women carrying multiple pregnancies have a higher risk of complications than those who are pregnant with singletons
option2: Neonatal mortality is increased in multiple births
option3: Prematurity is the main cause of neonatal morbidity in twins.
option4: Three-quarters of triplets require neonatal admission.
option5: The mean gestational age for twin and high-order pregnancies is the same.
Correct answer: option5
Specialty: Infectious_Disease
20. Buruli ulcer is caused by …………………………………………………….
Answer options: option1: a.Mycobacterium tuberculosis
option2: b.Mycobacterium leprae
option3: c.Mycobacterium avian
option4: d.Mycobacterium ulcerans
option5: e.Myoclacton sp.
Correct answer: option4
Specialty: Cardiology
A 60-year-old white female presents with epigastric pain, nausea and vomiting, heart rate of 50, and pronounced first-degree AV block on ER cardiac monitor. Blood pressure is 130/80. Which of the following coronary arteries is most likely to be involved in this process?

Answer options: option1: Right coronary
option2: Left main
option3: Left anterior descending
option4: Circumflex
option5: Septal branches
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
A marked reduction occurs in multiple pregnancies after double embryo transfer (DET) compared with triple embryo transfer.
Answer options: option1: A marked reduction occurs in multiple pregnancies after double embryo transfer (DET) compared with triple embryo transfer.
option2: Pregnancy rates per fresh in-vitro fertilisation cycle after elective single-embryo transfer are lower compared with DET.
option3: Pregnancy rates per fresh in-vitro fertilisation cycle after elective single-embryo transfer are lower compared with DET.
option4: Multiple pregnancy rates are similar after single-embryo transfer and DET.
option5: An effective cryopreservation programme is essential for widespread use of single-embryo transfer
Correct answer: option4
Specialty: Cardiology
You are seeing in your office a patient with the chief complaint of relatively sudden onset of shortness of breath and weakness, but no chest pain. ECG shows nonspecific ST-T changes. You should be particularly attuned to the possibility of painless, or silent, myocardial infarction in which of the following patients?

Answer options: option1: Unstable angina patient on multiple medications
option2: Elderly diabetic
option3: Premenopausal female
option4: Inferior MI patient
option5: MI patient with PVCs
Correct answer: option2
Specialty: Obstetrics_and_Gynecology
Which of the following is/are true about serial ultrasound scanning in twin and triplet pregnancy?
I)	In screening for TTTS in monochorionic twins, it is recommended that scans are carried out
more often if membrane folding or liquor discordance occurs
II)	 In screening for fetal growth problems, scans should be carried out every 2 weeks from 20 weeks gestation.
III)	 No evidence supports screening for fetal growth problems using umbilical artery Doppler blood flow routinely.

Answer options: option1: I. II and III
option2: . I and III
option3: . II and III
option4: . II only
option5: I only
Correct answer: option2
Specialty: Cardiology
A 45-year-old white female smoker is admitted to the hospital for observation after presenting to the emergency department with vague chest pain. There is no past history of cardiac disease, diabetes, hypertension, or hyperlipidemia. Later that night while in bed she has a recurrence of pain, at which time cardiac monitoring shows a transient elevation of precordial ST segments. The pain is promptly relieved by sublingual nitroglycerin. Physical exam is unremarkable. Which of the following is the best follow up management plan?

Answer options: option1: Echocardiography and anti-inflammatory therapy
option2: EGD and proton pump inhibitor therapy
option3: Exercise stress testing; treatment depending on results
option4: Coronary angiography; likely treatment with nitrates and calcium channel blockers
option5: Chest CT scan; likely treatment with IV heparin
Correct answer: option4
Specialty: General_Surgery
19. A 48-year-old woman who sustained a 5% deep dermal burn of the right lower limb. She was managing it at home with some local remedies. About 3 years later the developed a Marjolijn’s ulcer. What is the characteristic edge of this type of ulcer 
Answer options: option1: a.Raised and everted
option2: b.Punched out ulcer
option3: c.Sloping edge
option4: d.Punched out edge
option5: e.Undermined edge
Correct answer: option1
Specialty: Cardiology
Two weeks after hospital discharge for documented myocardial infarction, a 65-year-old returns to your office very concerned about low grade fever and pleuritic chest pain. There is no associated shortness of breath. Lungs are clear to auscultation and heart exam is free of significant murmurs, gallops, or rubs. ECG is unchanged from the last one in the hospital. Which of the following therapies is likely to be most effective?

Answer options: option1: Antibiotics
option2: Anticoagulation with warfarin (Coumadin)
option3: An anti-inflammatory agent
option4: An increase in antianginal medication
option5: An antianxiety agent
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
Which ONE of the following best describes a fetal distress in labour?
Answer options: option1: Reduced variability on CTG tracing
option2: Recurrent variable deceleration on CTG tracing
option3: Bradycardia on CTG tracing
option4: Absent variability and recurrent late decelerations on CTG tracing
option5: Absent accelerations on CTG tracing
Correct answer: option4
Specialty: Cardiology
A 72-year-old male presents to the ER with the chief complaint of shortness of breath that awakens him at night. Physical exam findings include bilateral basilar rales, an S 3 gallop, and evidence of cardiomegaly, all major criteria for the diagnosis of congestive heart failure under the Framingham system. While patients with CHF may display a wide range of symptoms and signs, which of the following are also considered among the major criteria (i., more specific to CHF)?

Answer options: option1: Dyspnea on exertion and night cough
option2: Right-sided pleural effusion plus hepatomegaly
option3: Tachycardia (rate 120 or greater) with new onset or increase in ectopy
option4: Neck vein distention and positive hepatojugular reflux
option5: Extremity edema and weight gain greater than 2 kg over 1 week
Correct answer: option4
Specialty: Cardiology
Yesterday you admitted a 55-year-old white male to the hospital for an episode of chest pain, and you are seeking to rule out MI plus assess for any underlying coronary artery disease. The patient tends to be anxious about his health. On admission, his lungs were clear, but his heart revealed a grade 1/6 early systolic murmur at the upper left sternal border without radiation. Blood pressure readings have consistently been in the 140/90 to 150/100 range. Serial cardiac enzymes are normal, and resting ECGs have shown no change from the initial finding of left ventricular hypertrophy with secondary ST-T changes (“LVH with strain”). The thought of performing a routine Bruce protocol treadmill exercise test (stress test) comes to mind, but is rejected, primarily due to which of the following?

Answer options: option1: Anticipated difficulty with the patient’s anxiety (i., he might falsely claim chest pain during the test)
option2: The increased risk associated with these high blood pressure readings
option3: Concern about the heart murmur, a relative contraindication to stress testing
option4: The presence of LVH with ST-T changes on baseline ECG
option5: Concern that this represents the onset of unstable angina with unacceptable risk of MI with stress testing
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
Select the CORRECT statement regarding abnormal labour:
Answer options: option1: A primary arrest is when labour does not progress past the latent phase over 8 hours
option2: A primary arrest is when labour does not progress past the latent phase over 8 hours
option3: Primary arrest is commonly due to fetal malposition
option4: Secondary arrest is typically from uterine dysfunction
option5: In secondary arrest, it is impossible for the baby to be born vaginally
Correct answer: option1
Specialty: Cardiology
A 75-year-old patient presents to the ER after a sudden syncopal episode. He is again alert and in retrospect describes occasional substernal chest pressure and shortness of breath on exertion. His lungs have a few bibasilar rales, and his blood pressure is 110/80. Which of the following classic findings should you expect to hear on cardiac auscultation?

Answer options: option1: A harsh systolic crescendo-decrescendo murmur heard best at the upper right sternal border
option2: A diastolic decrescendo murmur heard at the mid-left sternal border
option3: A holosystolic murmur heard best at the apex
option4: A midsystolic click
option5: Pansystolic murmur
Correct answer: option1
Specialty: Cardiology
A 72-year-old male comes to the office with intermittent symptoms of dyspnea on exertion, palpitations, and cough occasionally productive of blood. On cardiac auscultation, a low-pitched diastolic rumbling murmur is faintly heard toward the apex. The origin of the patient’s problem probably relates to which of the following?


Answer options: option1: Rheumatic fever as a youth
option2: Long-standing hypertension
option3: A silent MI within the past year
option4: A congenital condition
option5: Diabetes
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
The following are true about the management of pre-eclampsia.
Answer options: option1: Oral antihypertensive are indicated to all mild pre-eclamptic patients.
option2: Patient with severe pre-eclampsia should be induced as soon as hypertension has been controlled
option3: Patient with severe pre-eclampsia should be induced as soon as hypertension has been controlled
option4: Patient with severe pre-eclampsia should be induced as soon as hypertension has been controlled
option5: None of the above
Correct answer: option5
Specialty: Cardiology
You are helping with school sports physicals and see a 13-year-old boy who has had some trouble keeping up with his peers. He has a cardiac murmur, which you correctly diagnose as a ventricular septal defect based on which of the following auscultatory findings?
 

Answer options: option1: A systolic crescendo-decrescendo murmur heard best at the upper right sternal border with radiation to the carotids; the murmur is augmented with transient exercise
option2: A systolic murmur at the pulmonic area and a diastolic rumble along the left sternal border
option3: A holosystolic murmur at the mid-left sternal border
option4: A diastolic decrescendo murmur at the mid-left sternal border
option5: A continuous murmur through systole and diastole at the upper left sternal border
Correct answer: option3
Specialty: General_Surgery
15. In a discussion between the anaesthetist and house officer concerning a patient being sent for thyroidectomy, the house pointed out that the patient did not require antibiotics because the surgery was a ………………………………………..
Answer options: option1: a.Clean operation
option2: b.Clean contaminated wound
option3: c.Contaminated wound
option4: d.Contaminated-dirty wound
option5: e.Dirty wound wound
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
. Hydralazine use in pre-eclampsia
Answer options: option1: The hypotensive response to intravenous hydralazine is as predictable as with labetalol
option2: Oral hydralazine is very useful
option3: Cannot be used in acute hypertension once labetalol is ineffective
option4: All of the above
option5: None of the above
Correct answer: option5
Specialty: Cardiology
A 30-year-old female presents with a chief complaint of palpitations. A 24-h Holter monitor is obtained and shows occasional unifocal PVCs and premature atrial contractions. Which of the following is the best antiarrhythmic management in this patient?



Answer options: option1: Anxiolytic therapy
option2: Beta blocker therapy
option3: Digoxin
option4: Quinidine
option5: Reassurance, no medication
Correct answer: option5
Specialty: Obstetrics_and_Gynecology
You have just examined a 28-year-old primigravida in spontaneous labour. Examination findings are 0/5 palpable per abdomen, cervix is 7 cm dilated, cephalic presentation,-1 station, anterior fontanelle palpable with orbital ridges and nasal bridge felt anteriorly. What is the presenting diameter of the fetus?
Answer options: option1: Mentovertical
option2: Occipitofrontal
option3: Suboccipitobregmatic
option4: Suboccipitobregmatic
option5: Suboccipitofrontal
Correct answer: option1
Specialty: Infectious_Disease
14. The following are major risk factors for health workers for occupationally acquiring HIV except
Answer options: option1: a.Deep puncture from a hypodermic needle used earlier on a HIV patient
option2: b.Visible blood on the inuring device
option3: Receiving a hug from an HIV patient
option4: d.Patient has a late-stage HIV infection
option5: e.Injury from a large bore needle
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
Which of the following is correct about premalignant lesions of the cervix?
Answer options: option1: They are intraepithelial lesions of the cervix
option2: They are intraepithelial lesions of the cervix
option3: They are intraepithelial lesions of the cervix
option4: They are intraepithelial lesions of the cervix
option5: They are intraepithelial lesions of the cervix
Correct answer: option4
Specialty: Infectious_Disease
12. Which of the following vaccines is used to prevent rabies in a patient bitten by an unprovoked dog 
Answer options: option1: Human diploid cell vaccine (HDCV
option2: b.Anti-tetanus serum (ATS)
option3: c.Tetanus toxoid (TT)
option4: d.Penicillin G
option5: e.BCG vaccine
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
Which of the following statements is true about conception?
Answer options: option1: The blastocyst implants on day 4
option2: Conception is established after fertilization
option3: The site of conception is the fallopian tube
option4: Contraceptives are abortifacients after fertilization
option5: The fertilized ovum enters the endometrial cavity from day 5 to 7
Correct answer: option5
Specialty: Infectious_Disease
11. A 45-year-old man who works on a cattle farm sustained an open injury of the foot after stepping on a nail that pierced through the boot. He was nursing the wound at home with an antiseptic solution. 2 weeks later she started having trouble moving his jaw. His back and neck became stiff and painful. He had worsening dysphagia and hesitancy on urination. He was rushed to the emergency of a local hospital after experiencing a seizure. What is the most like diagnosis of this patient
Answer options: option1: Meningitis
option2: Encephalitis
option3: Rabies
option4: Tetanus
option5: e.Bovine spongiform encephalopathy
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
The following is a relative contraindication to the use of the combined hormonal contraceptive
Answer options: option1: a History of vascular disease (thromboembolism)
option2: Systemic diseases e.g. SLE, DM with retinopathy or nephropathy
option3: Smoking female less than 35 years
option4: Undiagnosed uterine bleeding
option5: Severe Hyperlipidemia bleeding is caused by:
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
The following are true of Red degeneration of fibroids EXCEPT:
Answer options: option1: Occur due to hemorrhage within the centre of the fibroid.
option2: Can lead to mid-trimester miscarriages
option3: Is treated conservatively.
option4: Occur due to the fibroid outgrowing its blood supply due to rapid growth.
option5: Occur recurrently during the pregnancy.
Correct answer: option2
Specialty: General_Surgery
9. To achieve adequate control of the source of infection, which of the following measures is the most appropriate?
Answer options: option1: Debridement of the wound
option2: b.Starting empirical antibiotics
option3: c.Administering more IV fluids
option4: d.Starting paracetamol and morphine for adequate analgesia
option5: e.Reducing the blood sugar by starting insulin therapy.
Correct answer: option1
Specialty: Obstetrics_and_Gynecology
Madam LP is seen at the antenatal at 32 weeks with a BP of 150/80 mmHg and complains of 2 hour history of blurred vision. Protein on urine dipstick was trace. Her BP on previous visits have been normal. What is your diagnosis?
Answer options: option1: A.	Gestational hypertension
option2: B.	White coat hypertension
option3: C.	Chronic hypertension with superimposed preeclampsia
option4: D.	Preeclampsia with severe features
option5: E.	Eclampsia
Correct answer: option4
Specialty: Obstetrics_and_Gynecology
In obstetric haemorrhage
I. colloids are preferred to crystalloids in fluid replacement
II. Anti-D prophylaxis is required when an Rh Negative woman receives Rh Positive FFP
III Whole blood is superior to blood components in preventing acute kidney Injury 

Answer options: option1: . I only
option2: . II only
option3: III Only
option4: . II and III
option5: . I, II and III
Correct answer: option3
Specialty: General_Surgery
8. Which of the following parameters is not part of the SIRS criteria
Answer options: option1: a.High temperature of 38.7
option2: b.Pulse rate of 106bpm
option3: c.Respiratory rate of 28cpm
option4: d.BP reading of 85/55
option5: e.Elevated WBC of 18 x 109 /L
Correct answer: option4
Specialty: Internal_Medicine
A 53-year-old diabetic who weighs 65 kg sustained an open injury on his leg when a log of wood fell on his left leg. He was managing the wound at home with local remedies. Over the subsequent week he noticed that the left leg had become warm reddened and very painful to touch. He also observed a yellowish purulent discharge from the open wound. He was rushed to the hospitals where he was found to confused and weak. His temperature on examination was 38.7 o C. His pulse and respiratory rates were 106 and 28 respectively. The BP was 74/46 mmHg which did not improve after 2 L of normal saline was administered by the medical officer on duty. A full blood count revealed a WBC of 18 x 109/L . The RBS on arrival at the emergency was 28 mmol/L . 
Use the above information to answer questions 7 to 10

7. From the above scenario, what is the most appropriate diagnosis for the patient

Answer options: option1: a.Sepsis
option2: b.Septicaemia
option3: c.Septic shock
option4: d.Gas gangrene
option5: Bacteraemia
Correct answer: option3
Specialty: Obstetrics_and_Gynecology
A 52-year-old woman has been recently diagnosed with HSIL. A LLETZ specimen showed CIN 3 incompletely excised specimen at the endocervical margin. What is the appropriate next step in her management?
Answer options: option1: Colposcopy and Pap smear in 6 months
option2: . Loop excision immediately
option3: Loop excision in 6 months
option4: Pap smear and HPV - DNA testing in 6 months
option5: Pap smear and HPV - DNA testing in 6 months
Correct answer: option2