hllj/quesmed huggingface dataset:
What is a class 1 mutation in cystic fibrosis?

Options:
explanation: This is a class 5 mutation
name: Splicing defect reducing quantity of correct mRNA leading to less CFTR at the cell surface
label: c
answer: no
explanation: This is a class 3 mutation
name: Reduced probability of the CFTR channel opening
label: d
answer: no
explanation: This is a class 6 mutation
name: Accelerated turnover of CFTR at cell surface
label: b
answer: no
explanation: This is a class 2 mutation
name: Defective post translational processing and transport reducing the quantity of functional CFTR delivered to the cell surface
label: e
answer: no
explanation: Cystic fibrosis is an inherited autosomal recessive condition caused by mutations of the cystic fibrosis transmembrane conductance regulator (CFTR) protein. There are different mutations of the CFTR that fall into different classes.
name: Defective synthesis of a full length cystic fibrosis transmembrane conductance regulator (CFTR) protein (e.g premature stop codon)
label: a
answer: yes

Correct answer: a
A consultant prescribes for a medication for hypertension and tells you it's an aldosterone antagonist.

Which of the following are they most likely to prescribe?

Options:
explanation: Losartan is an angiotensin receptor blocker used in the management of hypertension.
name: Losartan
label: e
answer: no
explanation: Ramipril is an ACE inhibitor used in the management of hypertension and heart failure
name: Ramipril
label: b
answer: no
explanation: Furosemide is a loop diuretic, that inhibits the luminal Na-K-Cl cotransporter in the thick ascending limb of the loop of Henle and is used in the management of hypertension.
name: Furosemide
label: d
answer: no
explanation: Amlodipine is a calcium channel blocker used in the management of hypertension.
name: Amlodipine
label: c
answer: no
explanation: Spironolactone is an aldosterone antagonist, it a mineralocorticoid steroid hormone and works at the late distal tubule and collecting duct. It is used in the management of hypertension and ascites.
name: Spironolactone
label: a
answer: yes

Correct answer: a
Which of the following conditions is an X-linked dominant condition?

Options:
explanation: Achondroplasia is an autosomal dominant condition
name: Achondroplasia
label: e
answer: no
explanation: Huntington's disease is an autosomal dominant condition
name: Huntington's disease
label: b
answer: no
explanation: Neurofibromatosis type 1 is an autosomal dominant condition
name: Neurofibromatosis type 1
label: d
answer: no
explanation: Marfan syndrome is an autosomal dominant condition
name: Marfan syndrome
label: c
answer: no
explanation: Alport syndrome affects the kidneys causing progressive loss of kidney function, hematuria and proteinuria. It also causes sensorineural hearing loss and problems with the retina.
name: Alport syndrome
label: a
answer: yes

Correct answer: a
Which of the following is a complication of cystic fibrosis?

Options:
explanation: Patients with cystic fibrosis may suffer from atopy, increased drug hypersensitivity reactions, premature skin wrinkles but not psoriasis
name: Psoriasis
label: c
answer: no
explanation: Patients with cystic fibrosis are more likely to have a low blood pressure
name: Hypertension
label: b
answer: no
explanation: Patients with cystic fibrosis may suffer from atopy, increased drug hypersensitivity reactions, premature skin wrinkles but not Ptyriasis versicolor
name: Ptyriasis versicolor
label: d
answer: no
explanation: Lambert-Eaton syndrome is typically associated with small cell lung cancer (SCLC) not cystic fibrosis
name: Lambert-Eaton syndrome
label: e
answer: no
explanation: Meconium Ileus occurs in 15-20% of babies with cystic fibrosis, it presents within 24-48 hours of life with abdominal distension and bilious vomiting.
name: Meconium Ileus
label: a
answer: yes

Correct answer: a
What proportion of people in the UK are carriers of a cystic fibrosis genetic mutation?

Options:
explanation: 1/25 of people in the UK are carriers of a cystic fibrosis genetic mutation
name: 1/50
label: e
answer: no
explanation: 1/25 of people in the UK are carriers of a cystic fibrosis genetic mutation
name: 1/20
label: c
answer: no
explanation: 1/25 of people in the UK are carriers of a cystic fibrosis genetic mutation
name: 1/100
label: b
answer: no
explanation: 1/25 of people in the UK are carriers of a cystic fibrosis genetic mutation
name: 1/250
label: d
answer: no
explanation: 1/25 of people in the UK are carriers of a cystic fibrosis genetic mutation
name: 1/25
label: a
answer: yes

Correct answer: a
Which of the following is an example of a Direct oral anticoagulant?

Options:
explanation: Warfarin is a vitamin K antagonist and is an anticoagulant
name: Warfarin
label: c
answer: no
explanation: Unfractionated Heparin is Antithrombin III-dependent and binds to it causing a conformational change that results in its activation through an increase in the flexibility of its reactive site loop.
name: Unfractionated Heparin
label: b
answer: no
explanation: This is the name for Vitamin K which is the reversal agent for warfarin
name: Phytomenadione
label: d
answer: no
explanation: Sertraline is a selective serotonin re-uptake inhibitor used in the management of depression and anxiety
name: Sertraline
label: e
answer: no
explanation: Rivaroxaban is an anticoagulant which binds directly to factor Xa, this means the coagulation cascade cannot propagate so a thrombus cannot form.
name: Rivaroxaban
label: a
answer: yes

Correct answer: a
What medication should be avoided in asthmatic patients?

Options:
explanation: Amlodipine is a calcium channel blocker used in hypertension and is not contraindicated in asthma
name: Amlodipine
label: e
answer: no
explanation: Ramipril is an ACE inhibitor used in hypertension and is not contraindicated in asthma
name: Ramipril
label: d
answer: no
explanation: Ciprofloxacin is a antibiotic which inhibits topoisomerase II (DNA gyrase) and topoisomerase IV (both Type II topoisomerases), which are required for bacterial DNA replication, transcription, repair, and recombination
name: Ciprofloxacin
label: b
answer: no
explanation: Montelukast is a leukotriene receptor antagonist that can be used in the management of asthma
name: Montelukast
label: c
answer: no
explanation: Ibuprofen is an NSAID and so should be avoided in asthmatic patients as it can induce bronchospasm
name: Ibuprofen
label: a
answer: yes

Correct answer: a
Which of the following genetic mutations predisposes a patient to developing Chronic obstructive pulmonary disease (COPD)?

Options:
explanation: This genetic mutation means patients are likely to have a myeloproliferative neoplasm, not COPD
name: JAK2
label: b
answer: no
explanation: Alpha 1 anti trypsin deficiency is due to a mutation in the SERPINA1 gene that results in not enough alpha-1 antitrypsin. Alpha-1 antitrypsin is an enzyme inhibitor and protects tissues from enzymes of inflammatory cells such as neutrophil elastase. If it is not present, then neutrophil elastase can breakdown the lung tissue.
name: Alpha 1 anti trypsin deficiency
label: a
answer: yes
explanation: This is one of the mutations that can lead to maple syrup urine disease, a rare autosomal recessive metabolic disorder that doesn't cause COPD
name: BCKDHA
label: d
answer: no
explanation: This is a mutation that causes autosomal dominant polycystic kidney disease type 1, not COPD
name: PKD1
label: e
answer: no
explanation: This genetic mutation puts patients at an increased risk of developing breast cancer, not COPD
name: BRCA1
label: c
answer: no

Correct answer: a
Which of the following diseases would lead to this set of pulmonary function tests:

FEV1 - reduced (0.7, normal = >0.7)

FVC - significantly reduced (0.4, normal = >0.8)

FEV1% (FEV1/FVC) - increased (1.75, normal = 0.7) ?

Options:
explanation: Asthma is an obstructive lung diseases and so would have the following pulmonary function test results:

FEV1 - significantly reduced

FVC - reduced or normal

FEV1% (FEV1/FVC) - reduced
name: Asthma
label: b
answer: no
explanation: Pulmonary fibrosis is right answer as it is a restrictive lung disease, so the pulmonary function tests will show a restrictive lung picture. In a restrictive disease patients cannot fully fill their lungs with air as the damage to the lungs means they cannot fully expand leading to a reduced FVC.
name: Pulmonary fibrosis
label: a
answer: yes
explanation: Bronchiectasis is an obstructive lung diseases and so would have the following pulmonary function test results:

FEV1 - significantly reduced

FVC - reduced or normal

FEV1% (FEV1/FVC) - reduced
name: Bronchiectasis
label: d
answer: no
explanation: Bronchiolitis obliterans is an obstructive lung diseases and so would have the following pulmonary function test results:

FEV1 - significantly reduced

FVC - reduced or normal

FEV1% (FEV1/FVC) - reduced
name: Bronchiolitis obliterans
label: e
answer: no
explanation: COPD is an obstructive lung diseases and so would have the following pulmonary function test results:

FEV1 - significantly reduced

FVC - reduced or normal

FEV1% (FEV1/FVC) - reduced
name: COPD
label: c
answer: no

Correct answer: a
What peptide chains make up haemoglobin?

Options:
explanation: These are the peptide chains present in foetal haemoglobin
name: 2 alpha chains and 2 gamma chains
label: b
answer: no
explanation: A hemoglobin molecule is made up of four polypeptide chains, two alpha chains of 141 amino acid residues each and two beta chains of 146 amino acid residues each.
name: 4 alpha chains
label: c
answer: no
explanation: Hemoglobin transports oxygen from the lungs to the tissues and carbon dioxide back to the lungs. A hemoglobin molecule is made up of four polypeptide chains, two alpha chains of 141 amino acid residues each and two beta chains of 146 amino acid residues each.
name: 2 alpha chains and 2 beta chains
label: a
answer: yes
explanation: Hemoglobin S (Hgb S) is an abnormal type of hemoglobin that causes sickle cell anaemia. A hemoglobin molecule is made up of four polypeptide chains, two alpha chains of 141 amino acid residues each and two beta chains of 146 amino acid residues each.
name: 4 Haemoglobin S chains
label: d
answer: no
explanation: A hemoglobin molecule is made up of four polypeptide chains, two alpha chains of 141 amino acid residues each and two beta chains of 146 amino acid residues each.
name: 2 beta chains and 2 gamma chains
label: e
answer: no

Correct answer: a
Where is the hilum of the spleen located?

Options:
explanation: This a lobe of the liver, the spleen is not split into lobes
name: In the caudate lobe
label: c
answer: no
explanation: The hilum of the spleen is found on the visceral surface of the spleen, not the diaphragmatic
name: On the diaphragmatic surface
label: b
answer: no
explanation: The spleen is an intraperitoneal lymphoid organ found on the left side of the abdomen. The hilum of the spleen is where the the splenic artery and vein pass through, and is the only part of the spleen not covered by peritoneum
name: On the visceral surface
label: a
answer: yes
explanation: This a lobe of the liver, the spleen is not split into lobes
name: In the right lobe
label: e
answer: no
explanation: This a lobe of the liver, the spleen is not split into lobes
name: In the quadrate lobe
label: d
answer: no

Correct answer: a
What is the function of the foramen ovale?

Options:
explanation: The role of the foramen ovale is to shunt blood from the right atrium to the left atrium of the heart
name: To shunt blood from the right ventricle to the left ventricle of the heart
label: e
answer: no
explanation: This is the function of the ductus venosus
name: To shunt blood to bypass the liver to the inferior vena
label: c
answer: no
explanation: This is the function of the ductus arteriosus
name: To shunt blood from the pulmonary artery to the aorta
label: b
answer: no
explanation: During pregnancy, the fetal circulatory system works differently. This is because oxygenated blood is received from the mother via the placenta and thus the lungs need to be bypassed. The foramen ovale moves blood from the right atrium to the left, therefore bypassing the pulmonary circulation.
name: To shunt blood from the right atrium to the left atrium of the heart
label: a
answer: yes
explanation: This is the function of the umbilical cord
name: To connect the foetus cord to the placenta
label: d
answer: no

Correct answer: a
What is the mechanism of action of warfarin?

Options:
explanation: Warfarin is a blood thinning medication that blocks the function of the vitamin K epoxide reductase complex in the liver, leading to less vitamin K that serves as a cofactor for gamma carboxylation of vitamin K-dependent coagulation factors
name: Blocks the function of the vitamin K epoxide reductase complex in the liver
label: a
answer: yes
explanation: This is the mechanism of action of calcium channel blockers such as amlodipine
name: Dihydropyridine calcium antagonist
label: e
answer: no
explanation: This is the mechanism of action of aspirin
name: Irreversibly inhibits cyclooxygenase (COX) 1 and COX-2
label: c
answer: no
explanation: This is the mechanism of action of heparin
name: Binds reversibly to ATIII and leads to inactivation of factors IIa, Xa, IX, XI, XII and plasmin
label: b
answer: no
explanation: This is the mechanism of action of direct oral anticoagulants e.g. rivaroxaban
name: Inhibit prothrombinase complex-bound and clot-associated factor Xa, leading to reduced thrombin
label: d
answer: no

Correct answer: a
Which of the following findings may be seen on a chest radiograph in a patient with stable Chronic obstructive pulmonary disease (COPD)?

Options:
explanation: This is the main chest radiograph finding in pneumothorax. Whilst COPD may lead to a secondary pneumothorax, this is not a finding of the condition itself.
name: Presence of gas in the pleural space
label: b
answer: no
explanation: This is a chest radiograph finding in pleural effusion
name: Bluntting of the costo-phrenic angles
label: d
answer: no
explanation: COPD can lead to hyperexpansion of the lungs leading to the flattening of the hemidiaphragms. This is one of the most sensitive indicators of hyperinflation and is best seen on a lateral chest X-ray. You may also identify hyperinflation by the ‘counting ribs’; hyperinflation is suspected when >6 anterior ribs or >10 posterior ribs are visible above the diaphragm on the midclavicular line. [Radiopaedia]( https://radiopaedia.org/articles/lung-hyperinflation-1?lang=gb) has some great example chest radiographs that demonstrat these findings.
name: Flattened hemidiaphragms
label: a
answer: yes
explanation: This is the chest radiograph finding in a tension pneumothorax. Whilst COPD may lead to a secondary pneumothorax, this is not a finding of the condition itself.
name: Deviated trachea
label: c
answer: no
explanation: This is the chest radiograph finding in aspergilloma
name: Upper lobe cavitary lesion
label: e
answer: no

Correct answer: a
Which of the following is a cause of microcytic anaemia?

Options:
explanation: There are 2 types of thalassaemia, alpha and beta. If there are 3+ defective haemoglobin chains, patients will have hypochromic microcytic anaemia with splenomegaly
name: Thalassaemia
label: a
answer: yes
explanation: Vitamin B12 deficiency is a cause of megaloblastic macrocytic anaemia
name: Vitamin B12 deficiency
label: d
answer: no
explanation: Haemolytic anaemia is a cause of normocytic anaemia (where the mean corpuscular volume is within the normal range)
name: Haemolytic anaemia
label: b
answer: no
explanation: Aplastic anaemia is a cause of normocytic anaemia (where the mean corpuscular volume is within the normal range)
name: Aplastic anaemia
label: c
answer: no
explanation: Folate deficiency is a cause of megaloblastic macrocytic anaemia
name: Folate deficiency
label: e
answer: no

Correct answer: a
Which of the following is a side effect of spironolactone?

Options:
explanation: Skin thinning is a common side effect of steroids, not spironolactone
name: Skin thinning
label: e
answer: no
explanation: Spironolactone is an aldosterone receptor antagonist that can be used in the management of hypertension. Hyperkalaemia is another side effect of spironolactone
name: Gynaecomastia
label: a
answer: yes
explanation: Galactorrhoea is not a side effect of spironolactone, but gynaecomastia is. Galactorrhoea is a side effect of anti-psychotics such as risperidone
name: Galactorrhoea
label: c
answer: no
explanation: Hyperkalaemia is a side effect of spironolactone, not hypokalaemia
name: Hypokalaemia
label: b
answer: no
explanation: Dry cough is a side effect of rampiril, an angiotensin converting enzyme inhibitor used in hypertension and heart failure
name: Dry cough
label: d
answer: no

Correct answer: a
What chromosome contains the mutation for alpha thalassaemia?

Options:
explanation: Alpha thalassemia involves the genes HBA1 and HBA2.  In alpha-thalassemia, there are less alpha chains, resulting in fewer normal hemoglobin molecules. Additionally, unstable beta globin molecules are produced which lead to increased red blood cell destruction.
name: Chromosome 16
label: a
answer: yes
explanation: Chromosome 15 is not involved in thalassaemia, this chromosome is involved in Prader-Willi syndrome
name: Chromosome 15
label: e
answer: no
explanation: Chromosome 21 is not involved in thalassaemia, the presence of three 21 chromosomes leads to Down's syndrome, or trisomy 21
name: Chromosome 21
label: c
answer: no
explanation: Beta-thalassemia, not alpha thalassaemia is caused by mutations in the beta globin gene on chromosome 11
name: Chromosome 11
label: b
answer: no
explanation: The X chromosome is not involved in thalassaemia, the absence of an x chromosome e.g. 45XO leads to Turner's syndrome
name: X Chromosome
label: d
answer: no

Correct answer: a
Which of the following describes a scoring of 4 on the New York Heart Association (NYHA)?

Options:
explanation: The New York Heart Association (NYHA) classification is used to classify the severity of heart failure. It ranges from I wherein the patient has no symptoms to IV which describes patients with severe symptoms who are unable to carry out any physicial activity without discomfort and symptoms are present at rest.
name: Severe limitations in activity and the experience symptoms of heart failure at rest
label: a
answer: yes
explanation: This is NYHA II
name: Mild symptoms with a slight limitation of physical activity as ordinary activity results in fatigue, palpitations or dyspnoea
label: c
answer: no
explanation: This is NYHA III
name: Moderate symptoms with  marked limitation of physical activity with less than ordinary activity resulting in symptoms
label: d
answer: no
explanation: This is the definition for the American Society of Anaesthesiologists (ASA) classification ASA V. This classification is used for anaesthetic patients in preparation for theatre
name: A moribund patient who is not expected to survive without the operation
label: e
answer: no
explanation: This is NYHA I
name: No symptoms and ordinary physical exercise does not cause undue fatigue, dyspnoea or palpitations
label: b
answer: no

Correct answer: a
Which of the following is a cause of mitral stenosis?

Options:
explanation: HOCM is linked to subvalvular aortic stenosis, not mitral stenosis
name: Hypertrophic Obstructve Cardiomyopathy (HOCM)
label: e
answer: no
explanation: William's syndrome is linked to supravalvular aortic stenosis, not mitral stenosis
name: William's syndrome
label: d
answer: no
explanation: Marfan's Syndrome is a collagen disorder that increases the risk of mitral regurgitation, not mitral stenosis
name: Marfan's Syndrome
label: b
answer: no
explanation: Rheumatic fever develops due to an immunological reaction to a recent Streptococcus pyogenes infection. Other causes of mitral stenosis are carcinoid and endocardial fibroelastosis.
name: Rheumatic fever
label: a
answer: yes
explanation: Ehlers-Danlos syndrome is a collagen disorder that increases the risk of mitral regurgitation, not mitral stenosis
name: Ehlers-Danlos syndrome
label: c
answer: no

Correct answer: a
What does residual volume in spirometry refer to?

Options:
explanation: This is the Tidal Volume
name: The amount of air that can be inhaled or exhaled during one respiratory cycle
label: c
answer: no
explanation: This is the Total Lung Capacity and the normal value for adults is about 4‐6 L
name: The maximum volume of air the lungs can accommodate
label: e
answer: no
explanation: Residual volume is the amount of air left in lungs after expiration. It is indirectly measured using the  Function Residual Capacity and Expiratory Reserve Volume and cannot be measured by spirometry.
name: The amount of air left in the lungs after maximal expiration
label: a
answer: yes
explanation: This is the Expiratory Reserve Volume. The normal adult value is 700-1200ml, this can be reduced in obesity.
name: The volume of air that can be exhaled forcibly after exhalation of normal tidal volume
label: b
answer: no
explanation: This is the Inspiratory Reserve Volume and is used in deep breathing
name: The amount of air that can be forcibly inhaled after a normal tidal volume
label: d
answer: no

Correct answer: a
What is the function of the ductus arteriosus?

Options:
explanation: The blood needs to bypass the foetal pulmonary circulation, as the lungs are filled with fluid, and thus gas exchange cannot take place here. Usually, the ductus arteriosus closes with the baby's first breaths.
name: To shunt blood from the pulmonary trunk to aorta
label: a
answer: yes
explanation: This is the function of the umbilical cord
name: To connect the foetus cord to the placenta
label: d
answer: no
explanation: The ductus venosus shunts blood from the pulmonary trunk to the aorta, not the other way round
name: To shunt blood from the aorta to the pulmonary trunk
label: e
answer: no
explanation: This is the function of the foramen ovale
name: To shunt blood from the right atrium to the left atrium of the heart
label: b
answer: no
explanation: This is the function of the ductus venosus
name: To shunt blood to bypass the liver to the inferior vena
label: c
answer: no

Correct answer: a
What is the life span of red blood cells in sickle cell anaemia?

Options:
explanation: Red blood cells have a much shorter life span in sickle cell disease compared to normal blood cells.  This is because the sickle hemoglobin is abnormally shaped and binds with other haemoglobin molecules  causing the red blood cells to become stiff and  sickle shaped. This makes them more fragile and means they can also be filtered out by the spleen
name: 10-20 days
label: a
answer: yes
explanation: This is the normal life span of platelets
name: 9-12 days
label: d
answer: no
explanation: This is the normal life span of red blood cells in newborns
name: 70-80 days
label: e
answer: no
explanation: This is the life span of normal red blood cells
name: 120 days
label: b
answer: no
explanation: Although the life span of red blood cells is reduced in sickle cell disease, it is normally higher than this, at 10-20 days
name: 0-5 days
label: c
answer: no

Correct answer: a
What is the mechanism of action of montelukast?

Options:
explanation: This is the mechanism of action of salbutamol, used in the management of asthma and COPD
name: Short-acting beta agonist
label: b
answer: no
explanation: This is the mechanism of action of aspirin
name: Irreversibly inhibits cyclooxygenase (COX) 1 and COX-2
label: e
answer: no
explanation: This is the mechanism of action of tiotropium, used in the management of asthma and COPD
name: Long-acting muscarinic receptor antagonist
label: d
answer: no
explanation: Montelukast is a leukotriene receptor antagonist that can be used in the management of asthma, not 1st line but can be trailled 3rd line and continued dependent on patient response
name: Antagonist at cysteine-leukotriene receptors on bronchiole smooth muscle cells
label: a
answer: yes
explanation: This is the mechanism of action of salmeterol, used in the management of asthma and COPD
name: Long-acting beta agonist
label: c
answer: no

Correct answer: a