afrimedqa/afrimedqa_v2 huggingface dataset:
Specialty: Pediatrics
About subarachnoid haemorrhage in the newborn:


 



Answer options: option1: It is associated with bulging anterior fontanelle
option2: It is a common cause of shock.
option3: It occurs most commonly among preterm infants
option4: Frequently complicates delivery by Caesarean section.
option5: There is usually an underlying skull fracture.
Correct answer: option1
Specialty: Pediatrics
A 6-day old infant delivered at 31 weeks who has been hospitalized from birth develops recurrent generalized seizures without fever. Lumbar puncture yields a uniformly bloody cerebrospinal fluid. The most likely aetiological factor is:





Answer options: option1: Perinatal asphyxia.
option2: Anencephaly.
option3: Subarachnoid haemorrhage
option4: Febrile seizure
option5: Intraventricular haemorrhage
Correct answer: option5
Specialty: Pediatrics
Concerning Hepatitis B vaccine:



 

Answer options: option1: It is recommended at 4 weeks, 8 weeks, 12 weeks in Nigeria.
option2: It is live attenuated.
option3: Route of administration is intravenous.
option4: It is indicated in babies of HBsAg positive mothers.
option5: It is contraindicated in HIV-exposed children.
Correct answer: option4
Specialty: Pediatrics
Which of the following is the requirement for a newborn infant delivered at 32 nd week of gestation?

Answer options: option1: 160-180 ml/kg of intravenous fluid on the first day of life
option2: 4 – 6 mmol/kg/day of sodium.
option3: 3 – 5 mmol/kg/day of potassium.
option4: 110 – 120 kcal/day of calories.
option5: 10 – 20 mg/kg/day of calcium.
Correct answer: option4
Specialty: Pediatrics
A 9-year old boy presented with fever, vomiting, abdominal pain and passage of dark urine. He took a hypodermic injection for a foot injury in the preceding month. Physical examination revealed axillary temperature of 38.1⁰C, heart rate of 80/minute, moderate pallor and 6 cm tender hepatomegaly. The most likely diagnosis in the patient is: 

Answer options: option1: Septicaemia.
option2: Congestive cardiac failure.
option3: Severe malaria.
option4: Viral hepatitis
option5: Peptic Ulcer Disease.
Correct answer: option4
Specialty: Pediatrics
A 3-year old child presented with catarrh of four days duration, progressively  worsening cough and difficulty with breathing. Physical examination revealed an acutely ill child with axillary temperature of 37.8⁰C, loud inspiratory stridor, chest wall retraction but the breath sounds were normal. The likely diagnosis is:
Answer options: option1: Acute epiglottitis
option2: Acute laryngotracheobronchitis.
option3: Foreign body aspiration.
option4: Bronchopneumonia.
option5: Coryza.
Correct answer: option1
Specialty: Pediatrics
Indications for double volume Exchange Blood Transfusion among term infants include:

Answer options: option1: Serum Total Bilirubin up to 10mg/dL on the first day of life
option2: Serum Total Bilirubin greater than 18mg/dL with coexisting hypoglycaemia
option3: Venous haematocrit greater than 70% in the first week of life
option4: Venous haematocrit less than 30% in the first week of life
option5: Cord blood Total Bilirubin greater than 5% with haematocrit less than 36%
Correct answer: option1,option2,option5
Specialty: Pediatrics
Which of the following is valid concerning pyogenic meningitis?






Answer options: option1: Haematogenous spread is the only source of infection known
option2: Staphylococcus specie is the commonest aetiology
option3: Chronic otalgia is a risk factor
option4: There is reduced CSF production.
option5: Elevated protein is due to destruction of organisms.
Correct answer: option3
Specialty: Pediatrics
A 7-day old infant presents with inability to move the left upper limb. Examination shows the limb is adducted at the shoulder with pronation at the elbow and flexion at the wrist joint. The likely diagnosis is: 





Answer options: option1: Klumpke’s palsy
option2: Phrenic nerve injury
option3: Erb’s palsy
option4: Fracture of clavicle.
option5: Spinal nerve injury.
Correct answer: option3
Specialty: Pediatrics
A 15-year old adolescent female was rushed into the emergency room. He was said to have collapsed after complaining of headache. Which of these is most desirable investigation?



 


Answer options: option1: Lumbar puncture
option2: Serum electrolyte, urea, and creatinine estimation
option3: Computerized tomographic scan
option4: Serum lipid profile
option5: Fasting Blood Glucose
Correct answer: option3
Specialty: Pediatrics
A baby delivered at 39 weeks of gestation weighs 1.55 kg, which plots on the 5 th centile of the weigh for gestational age chart. Which of the following clinical problems is the infant unlikely to encounter?  





Answer options: option1: Hyaline membrane disease.
option2: Hyperglycaemia
option3: Polycythaemia
option4: Hypothermia.
option5: Hypocalcaemia.
Correct answer: option3
Specialty: Pediatrics
Which of the following is not a diagnostic feature of heart failure in a 4-year old child? 






Answer options: option1: Bilateral basal crepitation.
option2: Heart rate 125beats/minute.
option3: Respiratory rate 54cycles/minute.
option4: Tender hepatomegaly of 3cm.
option5: Oxygen saturation of 84%.
Correct answer: option5
Specialty: Pediatrics
The characteristic features of classic Haemorrhagic Disease of the Newborn include:





Answer options: option1: It manifests in the second week of life.
option2: It is due to deficiency of Factors II, V, IX and XIII.
option3: It is due to deficiency of Factors II, VII, IX and X.
option4: It commonly causes haemathrosis.
option5: It can be prevented with Vitamin E administered at birth.
Correct answer: option3
Specialty: Pediatrics
A 2-year old child presents with two-day history of passage of blood-streaked loose stool. There was no associated vomiting but there was history of excessive crying prior to bowel opening. The most likely aetiology is:






Answer options: option1: Enterohaemorrhagic Escherichia coli.
option2: Entamoeba coli
option3: Shigella flexneri
option4: Shigella dysenteriae
option5: Helicobacter pylori
Correct answer: option4
Specialty: Pediatrics
A 5-year old child presents with passage of dark urine following the ingestion of some over-the-counter medications. Which of the following medications is unlikely to be involved?






Answer options: option1: Acetylsalicylate
option2: Ferrous sulphate
option3: Acetaminophen
option4: Nitrofurantion
option5: Nalidixic acid
Correct answer: option2
Specialty: Pediatrics
A resident doctor, after examining the chest of a 4-year old child who presents with fever and breathlessness declares that the baby has pleural rubs. What does that statement imply?





Answer options: option1: There is massive pleural effusion
option2: There is minimal pleural effusion
option3: There is massive pneumothorax
option4: There is multi-segmental consolidation
option5: There is congestive heart failure
Correct answer: option2
Specialty: Pediatrics
A 38-hour old female infant presents with axillary temperature of 35.2⁰C. The most likely aetiological factor is: 




Answer options: option1: Perinatal asphyxia
option2: Intracranial haemorrhage
option3: Early-Onset Sepsis
option4: Acute Bilirubin Encephalopathy
option5: Prematurity
Correct answer: option3
Specialty: Pediatrics
A 35-year old woman presents in labour at 38 weeks of gestation and tests positive to Hepatitis B surface Antigen and HIV. Which of the following management steps is not recommended for the baby? 






Answer options: option1: Immediate commencement of breastfeeding at birth
option2: Commencement of prophylactic phototherapy
option3: Administration of Hepatitis B Immune Globulin within 12 hours of birth
option4: Administration of Hepatitis B vaccine at birth
option5: Administration of Nevirapine
Correct answer: option2
Specialty: Pediatrics
A 20-month old presents with passage of loose stools. His weight-for-length Z-Score plots on-3.5 SD. Which of the following features should be aggressively requested at presentation? 





Answer options: option1: Chest radiograph
option2: Mantoux reaction
option3: Urine culture
option4: Serum lipid profile
option5: Random Blood Glucose
Correct answer: option5
Specialty: Pediatrics
A 5-year-old child presents with recurrent afebrile generalized seizures. Examination reveals head circumference of 46 cm. Other findings are apparently normal. Which of the following is not useful in the evaluation of the child’s condition? 






Answer options: option1: History of previous blood transfusion
option2: History of perinatal asphyxia
option3: History of severe hyperbilirubinaemia
option4: Intelligence Quotient of 65
option5: History of delayed speech
Correct answer: option1
Specialty: Pediatrics
A 7-year old presents with neck stiffness and fever of a day duration and convulsed an hour prior to presentation. Examination also reveals right sided oculomotor nerve palsy with right-sided hypertonia, hyper-reflexia and muscle weakness. What is the most likely diagnosis? 


Answer options: option1: Ventriculitis
option2: Intracerebral haemorrhage
option3: Viral encephalitis
option4: Cerebral abscess
option5: n/a
Correct answer: option4
Specialty: Pediatrics
A 9-year-old boy presents with fever, vomiting, upper abdominal pain and passage of dark urine of three days duration. He had taken a hypodermic injection for a foot injury in the preceding month. Physical examination reveals moderate pallor, heart rate of 80/minute, and 6 cm tender hepatomegaly. The most likely diagnosis in the patient is: 



Answer options: option1: Septicaemia
option2: Congestive cardiac failure
option3: Severe malaria
option4: Viral hepatitis
option5: Peptic Ulcer Disease
Correct answer: option4
Specialty: Pediatrics
A 36-hour old infant presents with repeated blinking and lip smacking. There was no fever or jaundice. The serum calcium measures 1.2 mmol/l. What of the following is not a likely aetiological factor?







Answer options: option1: Perinatal asphyxia
option2: Maternal diabetes
option3: Hypoglycaemia
option4: Early-Onset Sepsis
option5: Artificial milk feeding
Correct answer: option5
Specialty: Pediatrics
A 10-year-old presents with inability to open the mouth of 12 hours duration and generalized body stiffness. Which of the following findings will not be useful in the evaluation of the child? 






Answer options: option1: History of lack of immunization
option2: Board-like abdominal rigidity
option3: Mask-like expressionless face
option4: Suppurative ear discharge
option5: Glasgow Coma Score of 4/15
Correct answer: option5
Specialty: Pediatrics
A 7-year old child presents with fever of four days duration and a massive swelling of the left thigh of a day duration. Examination reveals a well circumscribed, diffuse, fluctuant and tender swelling over the left inner thigh area. There was a history of a fall over the left thigh a week prior to the illness. Which of the following is the most likely diagnosis? 
Pathological fracture





Answer options: option1: Cellulitis
option2: Septicaemia
option3: Pyomyositis
option4: Osteoarthirits of the hip joint
option5: Osteosarcoma
Correct answer: option3
Specialty: Pediatrics
A five-month old female infant whose parents are both bankers is brought into the emergency room with two-day history of passage of loose watery stool and two hours of irritability. She is exclusively fed on artificial milk. Physical examination reveals an infant weighing 7.5 kg with doughy skin and dry mucous membrane. The diagnosis is: 



Answer options: option1: Severe acute malnutrition
option2: Hyponatraemic dehydration
option3: Hypernatremic dehydration
option4: Encephalitis
option5: Acute gastritis
Correct answer: option3
Specialty: Pediatrics
A 23-day old male infant presents with jaundice which was noticed shortly after birth. The serum bilirubin values are 22.7 mg/dl (total) and 17.5 mg/dl (conjugated). The most likely aetiology is: 



Answer options: option1: Hypothyroidism
option2: Haemolytic disease of the newborn
option3: Septicaemia
option4: Galactosaemia
option5: G6PD deficiency
Correct answer: option4
Specialty: Pediatrics
A 3-year old child presents with fever, progressively worsening cough and difficulty with breathing. Chest Xray shows homogenous radiolucency over the right middle and lower lobe areas. Which of the following physical examination findings will be commensurate with the radiological features? 






Answer options: option1: Tracheal shift to the right
option2: Stony dullness to percussion on the right
option3: Increased vocal resonance on the right
option4: Increased tactile fremitus on the right
option5: Decreased chest excursion on the right
Correct answer: option5
Specialty: Pediatrics
The most appropriate step in the management of a 4-year old known sickle cell disease patient with a 3-day history of fever, jaundice and intense pain over both shoulders is:

 



Answer options: option1: Intravenous Normal Saline 100ml/kg over three hours
option2: Transfusion with 20ml/kg of whole blood over 1 hour
option3: Intranasal oxygen at 4-5l/minute
option4: Intravenous Half-Strength Darrow’s solution 2000ml/m2 over 24 hours
option5: Intravenous Ceftriaxone 100mg/kg/day
Correct answer: option4
Specialty: Pediatrics
A previously healthy 8-week old infant presents with four-week history of vomiting soon after each episode of breastfeeding. Abdominal examination reveals a non-tender epigastric mass. Which of the following dyselectrolytaemia is typical? 






Answer options: option1: Hyperglycaemia
option2: Hypoglycaemia
option3: Hypokalaemia
option4: Hypernatraemia
option5: Hyperkalaemia
Correct answer: option3
Specialty: Pediatrics
A 9-month old presents with axillary temperature of 40.8ºC with demonstrable asexual forms of Plasmodium falciparum on blood film. Which of the complications is least likely to be present in the child? 


Answer options: option1: Severe anaemia
option2: Hypoglycaemia
option3: Acute renal insufficiency
option4: Haemoglobinuria
option5: Hyperbilirubinaemia
Correct answer: option5
Specialty: Pediatrics
A 4-hour old baby delivered at 29 weeks of gestation has a loud grunt, respiratory rate of 96/minute, SPO 2 of 57%, flaring of alae nasi and mild chest wall retraction at the sixth hours of life. The most likely diagnosis is:





Answer options: option1: Congenital diaphragmatic hernia
option2: Transient Tachypnea of the Newborn
option3: Congenital pneumonia
option4: Respiratory distress syndrome
option5: Congenital Laryngeal Stridor
Correct answer: option4
Specialty: Pediatrics
A newborn baby delivered at term appears uniformly blue, has a heart rate of 30/minute, no grimace, a partial flexion of the limbs and irregular respiration at the fifth minute of life. The most important immediate resuscitative measure at that moment is: 






Answer options: option1: Wrap in a warm towel
option2: Set up Normal Saline infusion
option3: Start bag and mask ventilation
option4: Start endotracheal intubation
option5: Administer intra-cardiac hydrocortisone injection
Correct answer: option4
Specialty: Pediatrics
A 6-year old child known diabetic presents with severe vomiting and abdominal pain. Examination reveals severe dehydration and fast thready pulse. Which of the following conditions is the likely precipitant? 

Answer options: option1: Urinary Tract Infection
option2: Hypertension
option3: Addison’s disease
option4: Severe anaemia
option5: Hypocalcaemia
Correct answer: option1
Specialty: Pediatrics
A 15-month old unimmunized child presents with persistent cough of a week duration. It is associated with occasional loud inspiratory noise and vomiting after episodes of cough. Which of the following additional features should be searched for?

Answer options: option1: Loud stridor
option2: Subconjunctival haemorrhage
option3: Severe conjunctivitis
option4: Morbilliform rash
option5: Encephalitis
Correct answer: option2
Specialty: Pediatrics
A 5-year old child who is receiving treatment for Burkitt’s Lymphoma presents with serum potassium of 5.6 mmol/l and serum calcium 6.7 mg/dl. Which of the following clinical features will match the condition?






Answer options: option1: Bleeding gums
option2: Oliguria
option3: Inability to stand erect
option4: Severe pallor
option5: Ptosis
Correct answer: option2
Specialty: Ophthalmology
Identify the best management option for a suspected corneal laceration


 


Answer options: option1: Prescribe topical and oral antibiotics and have the patient return for follow-up in 48hours
option2: To improve exposure, apply 4 rectus sutures in the operating room, usually with general anesthesia
option3: Perform a thorough, gentle exploration and repair in the operating room, usually under general anesthesia
option4: Irrigate the fornixes to ensure that no particles are left behind
option5: Masterly inactivity
Correct answer: option3
Specialty: Ophthalmology
A healthy 30-year old woman presents with red eyes of 2 days duration. There was associated watering, stinging sensation and mild photophobia. Her vision was 6/9 in each eye. The most likely cause of her red eye is:


 


Answer options: option1: Angle-closure glaucoma
option2: Viral conjunctivitis
option3: Diabetic retinopathy
option4: Preseptal cellulitis
option5: Hypopyon keratitis
Correct answer: option2
Specialty: Ophthalmology
A 12-year-old child presented with right periorbital oedema, ophthalmoplegia and proptosis. Which of the following is incorrect about the management?


Answer options: option1: Dental caries may be an inciting condition
option2: Most likely diagnosis is preseptal cellulitis
option3: Most likely diagnosis is orbital cellulitis
option4: It may result in a life-threatening condition
option5: Urgent admission into the hospital is required
Correct answer: option2
Specialty: Ophthalmology
In the management of ophthalmia neonatorum which of the following will NOT be helpful
 



Answer options: option1: Time of appearance of first symptom
option2: History of vaginal discharge in the mother
option3: Gestational age of pregnancy before delivery
option4: Use of Crede’s prophylaxis
option5: Microscopy, culture and sensitivity of eye discharge
Correct answer: option4
Specialty: Neurosurgery
A 35-year old man was involved in a road traffic accident about 4 months ago, he presented now with history of persistent headache. The differential diagnosis include
	

Answer options: option1: Perforated typhoid
option2: Subdural hematoma
option3: Benign intracranial hypertension
option4: Pontine haemorrhage
option5: Pituitary adenoma
Correct answer: option2
Specialty: Pediatrics
The following blood film features and childhood conditions are well matched:

Answer options: option1: Heinz bodies – Asplenia
option2: Reticulocytisis – Haemolytic anaemia
option3: Macrocytosis – Folate deficiency
option4: Toxic granulations – Septicaemia
option5: Target cells – Haemoglobinopathies
Correct answer: option1,option2,option3,option4,option5
Specialty: Pediatrics
List the major complications seen in bronchopneumonia commonly seen in Africa 
Rationale: Major complications of bronchopneumonia in Africa include:

1. _Respiratory failure_: Need for mechanical ventilation.
2. _Septicemia_: Bloodstream infection, leading to sepsis or septic shock.
3. _Meningitis_: Infection spreading to the central nervous system.
4. _Pleural effusion_: Fluid accumulation in the pleural space.
5. _Empyema_: Pus collection in the pleural space.
6. _Pneumothorax_: Air leakage into the pleural space.
7. _Bronchiectasis_: Permanent bronchial damage, leading to chronic disease.
8. _Chronic lung disease_: Long-term lung damage, affecting lung function.
9. _Malnutrition_: Prolonged illness leading to malnutrition and weight loss.
10. _Death_: High mortality rates, especially in children under five and adults with underlying conditions.
11. _Acute respiratory distress syndrome (ARDS)_.
12. _Cardiac complications_: Myocarditis, pericarditis, or arrhythmias.
13. _Neurological complications_: Seizures, encephalopathy, or stroke.
14. _Hemolytic anemia_: Red blood cell destruction, often seen in G6PD deficiency.
15. _Co-infections_: Concurrent infections like malaria, HIV, or tuberculosis.
Specialty: Pediatrics
How is bronchopneumonia managed in Nigeria tertiary hospitals
Rationale: Management of bronchopneumonia in Nigerian tertiary hospitals typically involves:

1. _Oxygen therapy_: Supplemental oxygen to maintain adequate oxygen saturation.

2. _Antibiotics_: Broad-spectrum antibiotics, such as ceftriaxone, cefotaxime, or ampicillin, to cover common bacterial pathogens.

3. _Fluid management_: Intravenous fluids to prevent dehydration and maintain electrolyte balance.

4. _Chest physiotherapy_: Techniques like percussion, vibration, and suctioning to help loosen and clear mucus.

5. _Pain management_: Analgesics like acetaminophen or ibuprofen to control chest pain and discomfort.

6. _Monitoring_: Close observation of vital signs, oxygen saturation, and chest X-ray findings.

7. _Supportive care_: Nutritional support, rest, and isolation to prevent transmission.

8. _Mechanical ventilation_: In severe cases, mechanical ventilation may be necessary to support breathing.

9. _Bronchodilators_: Medications like salbutamol or ipratropium bromide to help open airways.

10. _Corticosteroids_: In some cases, corticosteroids like prednisolone may be used to reduce inflammation.
Specialty: Pediatrics
What are the signs and symptoms of bronchopneumonia seen in children 
Rationale: Bronchopneumonia in children can present with the following signs and symptoms:

*Common symptoms:*

1. _Cough_: Usually dry and persistent, may be accompanied by mucus production
2. _Fever_: High temperature, usually above 102°F (39°C)
3. _Rapid breathing_: Increased respiratory rate
4. _Chest retractions_: Inward movement of the chest wall during breathing
5. _Wheezing_: High-pitched sound while breathing out
6. _Chest pain_: May be present, especially in older children
7. _Fatigue_: Child may appear tired or lethargic
8. _Loss of appetite_: Decreased interest in feeding or eating
9. _Vomiting_: May occur, especially in infants
10. _Diarrhea_: May be present in some cases

*Physical examination findings:*

1. _Crackles_: Abnormal sounds heard through a stethoscope during breathing
2. _Wheezes_: High-pitched sounds heard through a stethoscope during breathing
3. _Rhonchi_: Coarse sounds heard through a stethoscope during breathing
4. _Tachycardia_: Rapid heart rate
5. _Tachypnea_: Rapid breathing rate
6. _Nasal flaring_: Nostrils flare during breathing
7. _Grunting_: Child makes a grunting sound while breathing out

*Severe symptoms (seek immediate medical attention):*

1. _Difficulty breathing_
2. _Cyanosis_ (blue discoloration of lips and fingers)
3. _Severe chest pain_
4. _Confusion or altered mental status_
5. _Severe vomiting or diarrhea_
6. _Refusal to feed or showing signs of dehydration_
Specialty: Pediatrics
A two-year old child presents at the emergency unit with a 2-day history of fever, cough and sialorrhoea. Examination shows enlarged jugulodigastric lymph nodes. Which of the following is the most likely diagnosis?






Answer options: option1: Coryza
option2: Pneumonia
option3: Pertussis
option4: Tonsillopharyngitis
option5: Severe bronchiolitis
Correct answer: option4