afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Endocrinology
A 30-year-old woman with bipolar disorder on lithium therapy presents with polyuria and polydipsia. Random blood sugar checked was 6.8 mmol/L . Which of the following is the most likely diagnosis?
Answer options: option1: Chronic interstitial nephritis
option2: Membranous glomerulonephritis
option3: Nephrogenic diabetes insipidus
option4: Psychogenic polydipsia
option5: Diabetes mellitus
Correct answer: option3
Specialty: Endocrinology
A 34-year-old woman presents with galactorrhoea, loss of libido and amenorrhoea for 4 months. MRI of the brain showed a macroadenoma with pressure on the optic chiasm. Which visual defect is likely to be found on examination?
Answer options: option1: Binasal hemianopia
option2: Bitemporal hemianopia
option3: Loss of colour vision
option4: Left homonymous hemianopia
option5: Central scotoma
Correct answer: option2
Specialty: Endocrinology
A 30-year-old man is seen in the Emergency Department following a collapse with severe headache and palpitations after chasing after a thief in the streets. On further questioning, he admits to a number of episodes over the past six months when he has suffered from palpitations and headaches. His blood pressure is 160/95 mmHg, and pulse is 98 bpm and regular. Heart sounds are normal and his chest is clear. His abdomen is soft and non-tender. Body mass index is 23 kg/m2. Which of the following is the most useful investigation?

Answer options: option1: 24-hour urine free cortisol
option2: 24-hour urine for 5-hydroxyindoleacetic acid
option3: Urine catecholamines
option4: Echocardiogram
option5: Abumin creatinine ratio
Correct answer: option3
Specialty: Endocrinology
A 32-year-old female is seen at the hospital a 6-month history of worsening lethargy and weight gain over the past six months. She has no known medical conditions and works as a librarian. There is no anterior neck swelling. Her blood pressure is 110/80 mmHg, and her pulse is 67 bpm and regular. Her body mass index is 32 kg/m2. Thyroid function tests showed a normal TSH of 1.5 m IU/L but low free T 4 of 7.8 pmol/L . Which of the following is most likely for this patient. 

Answer options: option1: Graves’ disease
option2: Hashimoto’s thyroiditis
option3: Subacute thyroiditis
option4: Secondary hypothyroidism
option5: Non toxic goiter
Correct answer: option4
Specialty: Endocrinology
All the following statements about growth hormone are true except
   
  
   
   
   

Answer options: option1: It exerts its effects through somatomedins.
option2: It is secreted by the anterior pituitary gland.
option3: It is a peptide hormone
option4: It stimulates the kidney to excrete more calcium
option5: Deficiency in adults results in abdominal obesity.
Correct answer: option4
Specialty: Endocrinology
Multiple endocrine neoplasia type 2 B includes the following except
   
   
   
   
   

Answer options: option1: Medullary thyroid carcinoma
option2: Parathyroid hyperplasia
option3: Phaechromocytoma
option4: Mucosal neuromas
option5: Marfanoid habitus
Correct answer: option2
Specialty: Pediatrics
Concerning Anorectal anormalies
Answer options: option1: High anormalies are treated by primary anoplasty
option2: The treatment of choice for low anormalies is colostomy and pull through procedure
option3: Anal dilatation is not necessary after pull through procedure
option4: Ano-cutaneous fistula should be treated by serial dilatation alone
option5: Pneumaturia is suggestive of recto-urethral or rectovesical fistula
Correct answer: option5
Specialty: Endocrinology
A 19-year-old woman presents to the clinic with primary amenorrhoea. She otherwise has no other complains and is well. Her blood pressure is 115/70 mmHg. She is 1.85 m in height and has normal breast development but has virtually no pubic or axillary hair. Karyotype tested is 46 XY. What is the most likely diagnosis?



Answer options: option1: Kallmann syndrome
option2: Androgen insensitivity syndrome
option3: Klinefelter syndrome
option4: Premature ovarian failure
option5: Turner syndrome
Correct answer: option2
Specialty: Pediatrics
Intussusception in children
Answer options: option1: Always present early in our environment
option2: The presence of penitonitis is an indication for non-operative ​​​​reduction
option3: The involved bowel segment should always be resected
option4: There is always a lead point in children
option5: The classical features are vomiting, colicky abdominal pain and ​​​​​passage of red currant jelly stool
Correct answer: option5
Specialty: Pediatrics
In gastrointestinal tract bleeding in children the following are true EXCEPT
Answer options: option1: Intestinal duplication is a common cause
option2: Intussusception is a cause
option3: Heamatemesis can result from swallowed blood in  a child with ​​​​pulmonary tuberculosis
option4: Biliary atresia can lead to bleeding from oesophageal varices
option5: Fissure-in-ano is a cause
Correct answer: option1
Specialty: Endocrinology
A 50-year-old woman presents to the hospital with a two-week history of malaise , anterior neck pain and has been experiencing symptoms of what feels like a severe flu-like illness. Her blood pressure is 130/78 mmHg, and pulse is 118 bpm and regular. She has moist palms and fine tremors of both hands. There is a slightly enlarged tender thyroid gland. Investigations reveal very low TSH and high thyroxine. What is the most likely diagnosis?
   

Answer options: option1: Graves’ disease
option2: Toxic adenoma
option3: Subacute thyroidits
option4: Toxic multinodular goiter
option5: Medullary thyroid carcinoma
Correct answer: option3
Specialty: Endocrinology
. A 23-year-old woman with history of previously well controlled Type 1 diabetes reports with having multiple recent episodes of hypoglycaemia. Her blood pressure is 100/60 mmHg with a postural drop of 10 mmHg. Initial investigations done were significant for a normocytic anaemia with haemoglobin of 10 g/dL and sodium of 130 mmol/L . Which of the following is most likely to determine the underlying diagnosis?
   
   
   
   
   

Answer options: option1: Serum iron studies
option2: Paired serum and urine osmolality
option3: Continuous glucose monitoring
option4: Short Synacthen test
option5: Low dose dexamethasone suppression test
Correct answer: option4
Specialty: Endocrinology
A 17-year-old woman, who is obese, reports to the hospital with a three-month history of amenorrhoea. She is noticed to have facial hair. Her blood pressure is 126/80 mmHg and body mass index is 32 kg/m2. What is the next most appropriate investigation?
Answer options: option1: Pituitary MRI
option2: Serum testosterone levels
option3: Serum 17-hydroxy-progesterone levels
option4: Serum FSH and LH levels
option5: Pregnancy test
Correct answer: option5
Specialty: Endocrinology
A 22-year-old female presents with palpitations, anxiety, and heat intolerance. 
A small smooth goitre is palpated. She has fine tremors and sweaty palms. Her blood pressure is 126/72 mmHg, and pulse is 98 bpm and regular. Thyroid-stimulating hormone (TSH) level is < 0.01 m IU/L , and both her T 4 and T 3 are elevated. Thyroid scanning reveals a uniformly increased uptake of technetium. What diagnosis best fits with this clinical picture?
Answer options: option1: Graves’ disease
option2: Subacute thyroiditis
option3: Toxic adenoma
option4: Toxic multinodular goiter
option5: Hashimoto’s thryroiditis
Correct answer: option1
Specialty: Endocrinology
A 68-year-old man is admitted to hospital with pneumonia and hyponatraemia with a sodium of 116 mmol/l. He was treated with antibiotics and rapid infusions of 3% hypertonic soline. Despite initial improvement, he started having seizures and went into a coma the next day. What is the possible cause of his deterioration?
   
   
   
  

Answer options: option1: Central pontine myelinosis
option2: Acute stroke
option3: Syndrome of inappropriate antidiuretic hormone secretion
option4: Meningitis
option5: Normal pressure hydrocephalus
Correct answer: option1
Specialty: Urology
Of urethral stricture disease
Answer options: option1: Post traumatic stricture develop about 20years after the incident trauma
option2: Post inflammatory stricture follows the infection within days
option3: Dilatation and curettage is Treatment of choice in multiple strictures
option4: Excision and end to end anastomosis is used in stricture longer than 2cm
option5: Substitution Urethroplasty  is used for penile urethral stricture
Correct answer: option5
Specialty: Otolaryngology
A 29-year old sawyer presented with bilateral nasal obstruction and epitaxis, further history shows that he is a smoker and takes alcohol occasionally, the likely diagnosis is.
Answer options: option1: Adenoid enlargement
option2: Silicosis
option3: Squamous cell carcinoma
option4: Angiofibroma
option5: Nasal polyp
Correct answer: option3
Specialty: Cardiology
A 65-year-old male presents with a 6-month history of chest pain and difficulty breathing on physical activity. An echocardiogram done reveals severe aortic stenosis. Which of the following is likely to be found during physical examination?

Answer options: option1: Corrigan sign
option2: Slow rising pulse
option3: Bounding pulse
option4: Quincke sign
option5: Finger clubbing
Correct answer: option2
Specialty: Cardiology
A 72-year-old man who had a myocardial infarction three days ago for which percutaneous coronary intervention was done experiences sudden difficulty breathing. His blood pressure is 90/65 mmHg and pulse is 102 bpm and regular. Oxygen saturation is 94% on 4 liters of oxygen. He has bibasal crackles and a pansystolic murmur radiating to the axilla is heard. What is the most likely cause of these clinical findings?

Answer options: option1: Ventricular free wall rupture
option2: New myocardial infarction
option3: Acute pericarditis
option4: Ventricular septal defect
option5: Acute mitral regurgitation
Correct answer: option5
Specialty: Otolaryngology
A sixteen year old male student presented at the ENT clinic with recurrent nasal bleeding. Anterior and posterior rhinoscopy revealed a unilateral nasal mass, which extended into the nasopharynx. What is the likely diagnosis?

Answer options: option1: Nasal polyposis.
option2: Antro-choanal polyp
option3: Inverted papilloma
option4: Juvenile nasopharyngeal angiofibroma
option5: Squamous cell carcinoma
Correct answer: option4
Specialty: Cardiology
A 55-year-old woman with a 10 year history of hypertension reports to the Emergency Unit on account of sudden central chest pain which radiates to her back for the past hour. Blood pressure checked was 160/94 mmHg in the right arm and 130/82 in the left arm. Pulse is 102 bpm and regular. There are no crackles on examination but an early diastolic murmur is heard at the left sternal border. What is the most likely diagnosis?

Answer options: option1: Acute myocardial infarction
option2: Pulmonary embolism
option3: Infective endocarditis
option4: Acute heart failure
option5: Aortic dissection
Correct answer: option5
Specialty: Cardiology
A 62-year-old man who had prosthetic aortic valve replacement 6 weeks earlier presented with weight loss, night sweats and intermittent palpitations over the
past month. His heart rate is 88 bpm and regular. Blood pressure checked was 140/86 mmHg. He has a prosthetic valve murmur and splinter haemorrhages are found on examination of his fingernails. Echocardiogram done showed vegetations on the aortic valve. What is the most likely causative organism?

Answer options: option1: Staphylococcus epidermidis
option2: Streptococcus viridans
option3: Haemphilus ducreyi
option4: Candida albicans
option5: Cardiobacterium hominis
Correct answer: option1
Specialty: Cardiology
A 66-year-old man being managed for heart failure is found unresponsive on the medical ward after suffering a cardiac arrest. The ward defibrillator shows ventricular tachycardia and one direct current shock is delivered but there is no sinus rhythm. What is the next appropriate action?

Answer options: option1: Give another direct current shock
option2: Give adrenaline 1 mg
option3: Give atropine
option4: Resume cardiopulmonary resuscitation for two minutes
option5: Give amiodarone 300 mg
Correct answer: option4
Specialty: Cardiology
A 69-year-old man presents to the Emergency Department after a syncopal attack while shopping at the market. She has recently completed a two-week course of amoxicillin, omeprazole and clarithromycin for eradication of Helicobacter pylori. His wife also mentioned he has had diarrhoea for the past few days. Blood pressure is 90/66 mmHg and heart rate is regular at 98 bpm. Electrocardiogram done showed a prolonged corrected QT interval of 540 ms. While being monitored, a short run of polymorphic ventricular tachycardia is seen on the cardiac monitor. What is the best intervention for this patient’s arrhythmia?

Answer options: option1: Lidocaine
option2: Calcium gluconate
option3: Amiodarone
option4: Magnesium sulphate
option5: DC synchronized cardioversion
Correct answer: option4
Specialty: Cardiology
A 50 year old male with type 2 diabetes mellitus was recently diagnosed with hypertension and started on Lisinopril. His blood pressure is however not controlled. Which of the following is the most appropriate antihypertensive to add on?

Answer options: option1: Valsartan
option2: Atenolol
option3: Amlodipine
option4: Bendoflumethiazide
option5: Verapamil
Correct answer: option3
Specialty: Cardiology
A 58-year-old man has been found to persistent have systolic blood pressure readings between 145 and 155 mmHg and diastolic pressures between 80 and 95 mmHg when checked at routine visits at the hospital. His blood pressure today is 130/85 mmHg. What is the next most appropriate step in his management?

Answer options: option1: Start him on a beta blocker
option2: Reassure and discharge from follow-up
option3: Start him on a calcium channel blocker
option4: 24 hour ambulatory BP monitoring
option5: Arrange for more office BP checks
Correct answer: option4
Specialty: Cardiology
A 56-year-old man presents to the Emergency Unit with central chest pain which lasted for 15 minutes while playing tennis. He has two similar episodes over the past three months. The first episode was while he was taking a walk and the second episode while he was on the treadmill in the gym. He is a hypertensive with well controlled blood pressures and has a past history of smoking. ECG done showed left ventricular hypertrophy and T wave inversion in leads V 5 and V 6. Troponins done were normal. What diagnosis best fits with the clinical scenario?

Answer options: option1: Non ST elevation myocardial infarction
option2: Unstable angina
option3: Non cardiac chest pain
option4: Stable angina
option5: ST elevation myocardial infarction
Correct answer: option4
Specialty: Cardiology
A 40-year-old man presents to the Emergency Unit with retrosternal chest pain which occurred while jogging. He reports a similar previous episode while playing football 2 weeks prior. His father died suddenly at 42 years and his brother died at the age of 21. Examination reveals a fourth heart sound and a systolic murmur loudest at the left sternal border. What diagnosis fits best with the clinical findings?

Answer options: option1: Primary dilated cardiomyopathy
option2: Aortic stenosis
option3: Coronary artery disease
option4: Hypertrophic cardiomyopathy
option5: Restrictive cardiomyopathy
Correct answer: option4
Specialty: Cardiology
A 22-year-old man is admitted to the Emergency Department with history of sudden onset palpitations. Blood pressure on arrival is 85/50 mmHg. ECG done shows atrial fibrillation with heart rate of 140 bpm and he is electrically cardioverted. Repeat ECG shows sinus rhythm but a short PR interval and delta waves. What is the most likely diagnosis?

Answer options: option1: Brugada syndrome
option2: Hypertrophic cardiomyopathy
option3: Long QT syndrome
option4: Wolff-Parkinson-White syndrome
option5: Hyperthyroidism
Correct answer: option4
Specialty: Cardiology
A 24 year old man who has suffered from recurrent shoulder dislocation is found to have an early diastolic murmur best heard at left third intercostal space. He is tall and thin with a long arm span. What is the likely cause of the murmur?

Answer options: option1: Aortic regurgitation
option2: Aortic stenosis
option3: Pulmonary stenosis
option4: Tricuspid regurgitation
option5: Mitral stenosis
Correct answer: option1
Specialty: Neurosurgery
Which of the following statements is true regarding Spinal injury?
Answer options: option1: It  results  in a permanent spinal cord injury
option2: It results in  quadriplegia when the injury involves the lumbar vertebrae
option3: Methylprednisolone is sometimes given in the acute stage
option4: Surgery is always indicated in the management
option5: Physiotherapy is not a  part of the  management modalities
Correct answer: option3
Specialty: Cardiology
A 19-year-old man is seen after collapsing during an argument with his roommate. He has been experiencing palpitations and once fainted while playing basketball. He is otherwise fit and well. His blood pressure is 120/76 mmHg and heart rate is 70 bpm and regular. ECG done shows sinus rhythm and a prolonged corrected QT interval. What is the most likely cause of his symptoms?

Answer options: option1: Brugada syndrome
option2: Romano-Ward syndrome
option3: Hypertrophic cardiomyopathy
option4: Wolff-Parkinson-White syndrome
option5: Atrial myxoma
Correct answer: option2
Specialty: Cardiology
A 28-year-old woman is found to have primary pulmonary hypertension and started on sildenafil. What is most likely to be found on cardiovascular assessment?

Answer options: option1: Left ventricular hypertrophy
option2: Mitral regurgitation
option3: Pulmonary stenosis
option4: Tricuspid regurgitation
option5: Left atrial dilatation
Correct answer: option4
Specialty: Neurosurgery
A 21-year-old girl presented with 3 weeks history of fever, headache and drowsiness. There was an antecedent history of right ear discharge and convulsion a day prior to presentation before lapsing into unconsciousness. What is the most likely diagnosis?
Answer options: option1: Epilepsy
option2: Cerebral malaria
option3: Cerebral Abscess
option4: Intracranial hemorrhage
option5: Intracranial tumor
Correct answer: option3
Specialty: Cardiology
A 50-year-old with dyspnoea is found to have mitral stenosis on echocardiography. Which of the following clinical findings will be consistent with her echocardiography diagnosis?

Answer options: option1: Tapping apex beat
option2: Pansystolic murmur
option3: Early diastolic murmur
option4: Late systolic murmur
option5: Slow rising pulse
Correct answer: option1
Specialty: Cardiology
A 34-year-old male presents to the Emergency Department with sudden onset paplpitations, difficulty breathing and chest pain. Heart rate is 180 bpm and regular. Blood pressure is 85/40 mmHg. ECG done shows a supraventricular tachycardia. What is the next appropriate step in his management?

Answer options: option1: Synchronized DC Cardioversion
option2: Valsalva maneuver
option3: Intravenous adenosine
option4: Intravenous verapamil
option5: Intravenous amiodarone
Correct answer: option1
Specialty: Cardiology
Blood pressure measurement for a 26-year-old man is 120/84 mmHg. What are the Korotkoff sounds used usually to measure the blood pressure.

Answer options: option1: 2 and 5
option2: 1 and 4
option3: 1 and 3
option4: 2 and 4
option5: 1 and 5
Correct answer: option5
Specialty: Oncology
Concerning Hepatocellular carcinoma, which of the following statements is NOT True?
Answer options: option1: It is more common in men
option2: It is associated with intake of Aflatoxin
option3: It usually presents with weight loss, right hypochondrial pain and hepatomegaly
option4: It is radiosensitive
option5: The progress of the disease can be monitored by serial measurement of the tumor marker Alpha-fetoprotein
Correct answer: option4
Specialty: Cardiology
A 65-year-old being managed for heart failure with reduced ejection fraction has a NYHA class of III despite being on optimal doses of bisoprolol, sacubitril/valsartan, dapagliflozin, eplerenone and furosemide. ECG done shows a left bundle branch block and QRS duration of 182 ms. What is the appropriate next step in her management?

Answer options: option1: Add Ivabradine
option2: Add Spironolactone
option3: Cardiac resynchronization therapy
option4: Implantable cardioverter-defibrillator
option5: Add Lisinopril
Correct answer: option3
Specialty: Dermatology
Concerning Melanoma, which of the following statements is True?
Answer options: option1: Ulceration of the primary lesion is associated with worsening of prognosis
option2: A brisk tumor infiltrating lymphocyte response is associated with worse prognosis
option3: Clark’s level III implies invasion of the reticular dermis
option4: Suspicious lesions should be evaluated by initial incision biopsy
option5: Sentinel lymph node mapping should be considered for lesions of intermediate depth
Correct answer: option3
Specialty: Pathology
Which of the following statements is True in normal wound healing?
Answer options: option1: Partial thickness wounds are painless
option2: Fetal wounds heal by regeneration without fibrosis so do not result in scars
option3: Haemostasis creates a protective wound scab beneath which cell migration and movement of the wound edges can occur
option4: Partial thickness wounds regenerate much more rapidly than full thickness wounds of the same surface area
option5: In adults, full thickness wounds are repaired by fibrosis (scar tissue)
Correct answer: option3
Specialty: Neurology
 A 56-year-old woman presents with facial asymmetry. Whilst brushing her teeth this morning she noted that the right hand corner of her mouth was drooping. She is generally well but noted some pain behind her right ear yesterday and says her right eye is becoming dry. 
On examination she has a complete paralysis of the facial nerve on the right side, extending from the forehead to the mouth. Ear, nose and throat examination is normal. Clinical examination of the peripheral nervous system is normal. 
What is the most likely diagnosis? 

Answer options: option1: Ramsey-Hunt syndrome
option2: Bell's palsy
option3: Stroke
option4: Multiple sclerosis
option5: NONE OF THE ABOVE
Correct answer: option1
Specialty: Neurology
A 76-year-old man is admitted with a right hemiparesis. He first noticed weakness on his right side around six hours ago. A CT scan shows an ischaemic stroke and aspirin 300 mg is commenced. terms of further management in the acute phase, 
which one of the following values should not be corrected? 

Answer options: option1: A.	BP 170/110
option2: B.	Blood glucose 11.2 mmol/l
option3: C.	Oxygen saturation 93%
option4: D.	Temp 38.3ºC
option5: NONE OF THE ABOVE
Correct answer: option2
Specialty: Rheumatology
All except one are true about Paget’s disease of bone (PDB) 

Answer options: option1: Paget disease of bone, also known historically as osteitis deformans
option2: It is characterized by an accelerated rate of bone remodeling
option3: Uncommonly affect the skull and long bones of the lower extremity
option4: Osteoclasts from patients with PDB show a hypersensitivity to vitamin D
option5: n/a
Correct answer: option3
Specialty: Neurology
A 27-year-old man presents to the Emergency Department with 2 day history of severe headache and pyrexia (38.2ºC). A CT scan is reported as Petechial haemorrhages in the temporal and inferior frontal lobes. No mass effect. Brain parenchyma otherwise normal
What is the most likely diagnosis? 

Answer options: option1: A.	Brain abscess
option2: B.	Meningococcal meningitis
option3: C.	Cerebral malaria
option4: D.	Herpes simplex encephalitis
option5: NONE OF THE ABOVE
Correct answer: option4