hllj/quesmed huggingface dataset:
What is the role of the baroreceptor reflex?

Options:
explanation: Baroreceptors respond to changes in blood pressure to ensure it remains at adequate levels. They do this by detecting stretch on the arterial wall.
name: Blood pressure regulation
label: a
answer: yes
explanation: This is managed by chemoreceptors in the brain and blood vessels which measure the carbon dioxide levels in the blood.
name: Controling rate of respiration
label: d
answer: no
explanation: This is mainly regulated by the kidneys through the renin-angiotensin-aldosterone system.
name: Sodium regulation
label: c
answer: no
explanation: This is regulated in a feedback loop with Vitamin D and parathyroid hormone.
name: Calcium regulation
label: b
answer: no
explanation: This is regulated by vasopressin secretion from the posterior pituitary gland.
name: Retention of water
label: e
answer: no

Correct answer: a
What is the primary mechanism of amiodarone?

Options:
explanation: This describes a class II anti-arrythmic such as bisoprolol.
name: Competitive antagonist that blocks adrenaline and noradrenaline at beta receptors
label: c
answer: no
explanation: This describes a class I anti-arrythmic such as flecainide.
name: Blocks sodium channels in cardiomyocytes to reduce velocity of action potentials
label: b
answer: no
explanation: This describes a class V anti-arrythmic.
name: Unknown mechanism
label: d
answer: no
explanation: Amiodarone is a class III anti-arrythmic and this is the mechanism of action.
name: Blocks potassium channels in atrioventricular cardiomyocytes
label: a
answer: yes
explanation: This describes a class IV anti-arrythmic such as verapamil. Amiodarone has some of these effects, but it is not the primary action.
name: Disrupts the movement of calcium through calcium channels
label: e
answer: no

Correct answer: a
Describe the physiological basis of P wave on an ECG

Options:
explanation: This describes the PR interval.
name: Time taken for conduction to pass through the AV node
label: d
answer: no
explanation: This describes the T wave.
name: Ventricular repolarisation
label: e
answer: no
explanation: This describes the QRS complex.
name: Ventricular depolarisation
label: b
answer: no
explanation: This describes the QT interval.
name: Time between ventricular depolarisation and repolarisation
label: c
answer: no
explanation: On an ECG, the p wave is representative of the electrical signal caused by depolarisation of the atria.
name: Atrial depolarisation
label: a
answer: yes

Correct answer: a
During the six to eight week newborn check, a baby is found to have a continuous murmur and is diagnosed with patent ductus arteriosus.

What is the role of the ductus arteriosus in foetal circulation?

Options:
explanation: This is the normal physiological movement of blood in an adult so does not require a duct in foetal life.
name: Move blood right atrium to right ventricle
label: c
answer: no
explanation: This describes the role of the foramen ovale.
name: Move blood from the right to left atrium
label: b
answer: no
explanation: This is the role of the ductus arteriosus. It should close functionally in the first 12-24 hours of life, and anatomically by the first two to three weeks of life.
name: Moves blood from the pulmonary artery to the aorta
label: a
answer: yes
explanation: This should not occur and, if seen, it is usually due to a ventricular-septal defect.
name: Move blood from right ventricle to left ventricle
label: e
answer: no
explanation: This describes the role of the ductus venosus.
name: Allows blood in the umbilical vein to bypass the liver
label: d
answer: no

Correct answer: a
Which embryological tissue forms the heart?

Options:
explanation: This contributes to the yolk sac, amnion and chorion.
name: Extra-embryonic mesoderm
label: c
answer: no
explanation: Along with the heart, the mesoderm also forms the bones and limbs.
name: Mesoderm
label: a
answer: yes
explanation: This forms the nervous system and sensory organs.
name: Neural ectoderm
label: b
answer: no
explanation: This contributes to the epidermis.
name: Surface ectoderm
label: d
answer: no
explanation: This forms the abdominal organs and lungs.
name: Endoderm
label: e
answer: no

Correct answer: a
Which artery mainly supplies the anterior region of the heart?

Options:
explanation: This supplies the inferior region of the heart.
name: Right coronary artery
label: b
answer: no
explanation: This artery also supplies the septal region of the heart.
name: Left anterior descending artery
label: a
answer: yes
explanation: This is a branch of the left coronary artery.
name: Left marginal artery
label: e
answer: no
explanation: This supplies the lateral region of the heart.
name: Left circumflex artery
label: c
answer: no
explanation: This is a branch of the right coronary artery,, which supplies the inferior region of the heart.
name: Posterior interventricular artery
label: d
answer: no

Correct answer: a
Which of the following is NOT a type of cardiomyopathy>

Options:
explanation: This is one of the four main types of cardiomyopathy.
name: Hypertrophic
label: c
answer: no
explanation: This is not a type of cardiomyopathy, but in tako-tsubo cardiomyopathy, apical ballooning can be seen.
name: Apical
label: a
answer: yes
explanation: This is one of the four main types of cardiomyopathy.
name: Arrhythmogenic right ventricular cardiomyopathy
label: d
answer: no
explanation: This is one of the four main types of cardiomyopathy.
name: Dilated
label: e
answer: no
explanation: This is one of the four main types of cardiomyopathy.
name: Restrictive
label: b
answer: no

Correct answer: a
A 74-year-old patient presents to hospital with tibial fracture and is found to have anaemia and an eGFR of 43. You look back on their records and find they had another reduced eGFR four months ago.

What stage of chronic kidney disease does this patient have?

Options:
explanation: They have a reduced eGFR and evidence this has been ongoing for over three months.
name: This patient does not have chronic kidney disease
label: b
answer: no
explanation: In Stage 2, the eGFR would be between 60 and 89.
name: Stage 2
label: c
answer: no
explanation: In stage 3a, the eGFR would be between between 45 and 59.
name: Stage 3a
label: e
answer: no
explanation: In stage 4, the eGFR would be between between 15 and 29.
name: Stage 4
label: d
answer: no
explanation: Correct. The eGFR of this stage is between 30 and 44.
name: Stage 3b
label: a
answer: yes

Correct answer: a
Which of the following anatomical terms is the kidney classified as?

Options:
explanation: This describes an organ which was originally intraperitoneal but become retroperitoneal as the foetus develops.
name: Secondary retroperitoneal
label: b
answer: no
explanation: This is the area below the peritoneum, and includes the bladder and final part of the rectum.
name: Subperitoneal
label: d
answer: no
explanation: This can be used to describe a full bladder when it extends between the abdominal wall and peritoneum.
name: Preperitoneal
label: e
answer: no
explanation: This describes organs which are completely wrapped in visceral peritoneum.
name: Intraperitoneal
label: c
answer: no
explanation: This means the organ developed and remained outside the parietal peritoneum.
name: Primary retroperitoneal
label: a
answer: yes

Correct answer: a
Which ligament anchors the neck of the bladder to the pelvic floor in females?

Options:
explanation: This connects the spleen to the left kidney.
name: Splenorenal ligament
label: e
answer: no
explanation: This is the ligament connecting the bladder and pelvic floor in men, not women.
name: Puboprostatic ligament
label: b
answer: no
explanation: This ligaments connects the bony pelvis and vertebral column.
name: Sacrotuberous ligament
label: c
answer: no
explanation: The pubovesical ligament is a continuation of the detrusor muscle and adventitia which anchors the bladder to the pelvic floor.
name: Pubovesical ligament
label: a
answer: yes
explanation: This connects the liver and stomach.
name: Gastrohepatic ligament
label: d
answer: no

Correct answer: a
What is the layer found immediately outside the renal capsule?

Options:
explanation: This is a collection of fat in the posterior aspect of the kidney.
name: Paranephric fat
label: c
answer: no
explanation: This is a layer of extraperitoneal fat immediately surrounding the renal capsule.
name: Perinephric fat
label: a
answer: yes
explanation: This layer covers the perinephric fat and fuses with layers of the abdominal wall.
name: Renal fascia
label: b
answer: no
explanation: This is a structure found inside the kidney.
name: Renal papilla
label: e
answer: no
explanation: This covers the anterior and posterior surfaces of the kidney.
name: Fibrous capsule
label: d
answer: no

Correct answer: a
Which of the following is a function of the kidney?

Options:
explanation: This is not a function of the kidney. The functions can be remembered by the mnemonic A WET BED.

Acid-base balance
Water balance
Electrolyte balance
Toxin removal
Blood pressure control
Erythropoiesis
D- Vitamin D metabolism
name: Digestion of macromolecules
label: c
answer: no
explanation: This is not a function of the kidney. The functions can be remembered by the mnemonic A WET BED.

Acid-base balance
Water balance
Electrolyte balance
Toxin removal
Blood pressure control
Erythropoiesis
D- Vitamin D metabolism
name: Production of sex hormones
label: e
answer: no
explanation: This is not a function of the kidney. The functions can be remembered by the mnemonic A WET BED.

Acid-base balance
Water balance
Electrolyte balance
Toxin removal
Blood pressure control
Erythropoiesis
D- Vitamin D metabolism
name: Produce and store bile
label: d
answer: no
explanation: This is not a function of the kidney. Clotting factors are produced by the liver. The functions can be remembered by the mnemonic A WET BED.

Acid-base balance
Water balance
Electrolyte balance
Toxin removal
Blood pressure control
Erythropoiesis
D- Vitamin D metabolism
name: Regulate blood clotting
label: b
answer: no
explanation: Correct. This is a function of the kidney. The functions can be remembered by the mnemonic A WET BED.

Acid-base balance
Water balance
Electrolyte balance
Toxin removal
Blood pressure control
Erythropoiesis
D- Vitamin D metabolism
name: Blood pressure control
label: a
answer: yes

Correct answer: a
Which part of the microanatomy of the kidney does the vasa recta supply?

Options:
explanation: Capillaries in this area come together to form the efferent arteriole and is where the filtrate is formed.
name: Glomerulus
label: c
answer: no
explanation: This is the outer layer enclosing the kidney.
name: Renal fascia
label: e
answer: no
explanation: The vasa recta are long arteries branching from efferent arterioles.
name: Inner 1/3 of cortex and medulla
label: a
answer: yes
explanation: This is supplied by interlobar arteries.
name: Renal capsule
label: d
answer: no
explanation: This is supplied by interlobular/peritubular capillaries.
name: Outer 2/3 of renal cortex
label: b
answer: no

Correct answer: a
Which of the following is true regarding atrial natriuretic peptide (ANP)?

Options:
explanation: It causes dilation of afferent arterioles and constriction of efferent arterioles.
name: It causes dilation of efferent arterioles within the kidney
label: d
answer: no
explanation: ANP is released from atrial cells in response to stretching of the right atrium.
name: ANP is released in response to an increased venous pressure
label: a
answer: yes
explanation: ANP increases glomerular filtration rate by dilating the afferent arterioles and constricting the efferent arterioles.
name: ANP decreases glomerular filtration rate within the kidney
label: b
answer: no
explanation: Increased ANP leads to decreased renin.
name: Increased ANP leads to increased renin
label: e
answer: no
explanation: ANP is released from heart muscle cells in response to stretching of the right atrium.
name: Cells in the adrenal medulla release ANP
label: c
answer: no

Correct answer: a
A 19-year-old non-pregnant woman presents to the GP with dysuria. After further history taking, they are diagnosed with a lower urinary tract infection (UTI).

What would be the most appropriate antibiotic regime to give to this patient?

Options:
explanation: This is the first-line treatment for a non-pregnant woman over the age of 16.
name: Nitrofurantoin for three days
label: a
answer: yes
explanation: This is the correct first-line drug, but the length of use would apply to pregnant women or males. Non-pregnant women can have a shorter course of three days.
name: Nitrofurantoin for seven days
label: b
answer: no
explanation: This would be suitable for a lower UTI in children.
name: Cefalexin for three days
label: e
answer: no
explanation: This would be suitable for a catheter-associated UTI.
name: Amoxicillin for seven days
label: d
answer: no
explanation: This is a second-line option if the first line treatment does not show improvement in symptoms
name: Fosfomycin 3g single dose sachet
label: c
answer: no

Correct answer: a
A 250-year-old pregnant woman presents to the GP with fever, urgency and dysuria. It is suspected that they have pyelonephritis and they are admitted to hospital.

Which of the following would make you most suspicious of pyelonephritis instead of a lower urinary tract infection?

Options:
explanation: This is a symptom you would expect to see in an uncomplicated lower urinary tract infection.
name: Foul smelling urine
label: d
answer: no
explanation: This is a symptom you would expect to see in an uncomplicated lower urinary tract infection.
name: Increased urinary frequency
label: b
answer: no
explanation: Whilst this is seen in pyelonephritis, it is also seen in uncomplicated lower urinary tract infection.
name: Urine dipstick is positive for leucocytes and nitrites
label: c
answer: no
explanation: This is suggestive of pyelonephritis as a lower urinary tract infection is more likely to cause just suprapubic pain.
name: Loin pain
label: a
answer: yes
explanation: This is a symptom you would expect to see in an uncomplicated lower urinary tract infection.
name: Suprapubic tenderness
label: e
answer: no

Correct answer: a
Which of these best describes anaphase?

Options:
explanation: This describes what occurs during S phase.
name: DNA duplicates for 4 to 6 hours
label: e
answer: no
explanation: This describes what happens during prophase.
name: The chromosomes within the cell condense
label: d
answer: no
explanation: This describes what occurs during anaphase.
name: Contraction of spindle fibres pull chromatids to opposite poles
label: a
answer: yes
explanation: This describes what occurs during prometaphase.
name: Nuclear membrane breaks down
label: c
answer: no
explanation: This describes what occurs during telophase.
name: A membrane forms around the chromosomes
label: b
answer: no

Correct answer: a
In the UK, at what age is breast cancer screening routinely offered?

Options:
explanation: This is the correct frequency, but incorrect age group for routine screening in the UK.
name: Women aged between 30 and 70 every 3 years
label: d
answer: no
explanation: This is the correct age group, but incorrect frequency of routine screening in the UK. Screening should occur every three years.
name: Women aged between 50 and 70 years, every 5 years
label: c
answer: no
explanation: Women in this group can request screening but it will not be routinely offered.
name: Women over 70, every 3 years
label: b
answer: no
explanation: This is not correct. Routine screening is offered to women aged 50-70 years every three years.
name: No screening is offered routinely in the UK
label: e
answer: no
explanation: This is the age group and frequency women are offered routine breast screening in the UK. Women will be invited to have a mammogram of their breasts.
name: Women aged between 50 and 70 years, every 3 years
label: a
answer: yes

Correct answer: a
A 25-year-old female patient presents with tiredness. Following blood tests, she is diagnosed with iron deficiency anaemia. She is prescribed ferrous sulphate as treatment for this.

Which of the following is the most likely side effect of ferrous sulphate?

Options:
explanation: This is not a common side effect of ferrous sulphate.
name: Headache
label: b
answer: no
explanation: This is a common side effect of ferrous sulphate. Patients may also report that their stools look black.
name: Constipation
label: a
answer: yes
explanation: This is not a common side effect of ferrous sulphate.
name: Palpitations
label: e
answer: no
explanation: This is not a common side effect of ferrous sulphate.
name: Postural hypotension
label: c
answer: no
explanation: This is not a common side effect of ferrous sulphate.
name: Hyperglycaemia
label: d
answer: no

Correct answer: a
A 56-year-old male is diagnosed colon cancer and TNM staging is used for classification. It is found that they have T3, N1, M0 colon cancer.

Which of the following is true?

Options:
explanation: M0 indicates they have no distant metastasis.
name: They may have a lung metastasis
label: e
answer: no
explanation: T1 is the smallest size and T4 is significantly bigger. Hence, T1 has a better prognosis than T4.
name: T4 has a better prognosis than T1
label: c
answer: no
explanation: This is indicated by T3. The T refers to the size and extent of the tumour.
name: The tumour has extended into subserosa of colon
label: a
answer: yes
explanation: It indicates the size of the tumour and how far it has invaded the bowel wall. N represents nodes whilst M represents metastases.
name: T describes the shape of the tumour
label: b
answer: no
explanation: N1 indicates they have at four or more regional lymph nodes affected.
name: At least six region lymph nodes have evidence of spread
label: d
answer: no

Correct answer: a
Which of the following describes a sarcoma?

Options:
explanation: This is the definition of a sarcoma.
name: Malignant tumour arising in connective or other non-epithelial tumour
label: a
answer: yes
explanation: This describes an adenocarcinoma.
name: Malignant tumour arising in glandular tissue
label: b
answer: no
explanation: This describes the process of dysplasia.
name: Pre-cancerous area with abnormal cells and increased cell division
label: c
answer: no
explanation: This describes a papilloma.
name: Benign epithelial tumour growing exophytically
label: e
answer: no
explanation: This describes an adenoma.
name: Benign tumour arising in glandular tissue
label: d
answer: no

Correct answer: a
An unborn baby undergoes genetic testing for alpha thalassaemia as they have a family history of the condition. They are found to have three copies of the defective gene.

What is the most likely phenotype of this patient?

Options:
explanation: Three copies of the defective gene leads to symptomatic haemoglobin H disease.
name: Microcytic anaemia, haemolysis and splenomegaly
label: a
answer: yes
explanation: This would be more likely with only two defective copies of the gene.
name: Mild asymptomatic anaemia
label: c
answer: no
explanation: This describe what happens in sickle cell disease.
name: Frequent vaso-occlusive crises
label: e
answer: no
explanation: This would be more likely with four copies of the gene, as this is the most serious phenotype.
name: Hydrops fetalis
label: b
answer: no
explanation: Thalassaemia causes microcytic anaemia, not macrocytic anaemia.
name: Macrocytic anaemia with iron deficiency
label: d
answer: no

Correct answer: a
Which of the following is true?

Options:
explanation: ABO antigens develop around 16 weeks after birth, meaning neonates do not express these antigens.
name: If blood is taken from a neonate at the time of birth, the ABO group cannot be determined
label: a
answer: yes
explanation: The O group undergoes autosomal recessive inheritance.
name: The O group undergoes autosomal dominant inheritance
label: b
answer: no
explanation: There are actually over 400 blood groups.
name: The only blood groups are ABO and Rhesus
label: c
answer: no
explanation: They are expressed on the surface of red blood cells.
name: Blood group antigens are found within the nucleus of red blood cells
label: d
answer: no
explanation: They can recieve blood from A and O.
name: People with blood group A can recieve blood from A and AB
label: e
answer: no

Correct answer: a
Which ligament contains the splenic vessels?

Options:
explanation: This ligament connects the left colic flexure to the diaphragm and supports the spleen.
name: Phrenocolic ligament
label: c
answer: no
explanation: This contains the short gastric and gastro-omental vessels.
name: Gastrosplenic ligament
label: b
answer: no
explanation: This ligament connects the splenic capsule to the transverse colon.
name: Colicosplenic ligament
label: d
answer: no
explanation: This divides the liver into left and right lobes.
name: Falciform ligament
label: e
answer: no
explanation: The splenic vessels (splenic artery and vein) pass through the splenorenal ligament.
name: Splenorenal ligament
label: a
answer: yes

Correct answer: a
Which of the following is an example of a rapid-acting insulin?

Options:
explanation: Also known as insulin determir, this is a long-acting insulin.
name: Levemir
label: d
answer: no
explanation: Also known as insulin lispro, this is a rapid-acting insulin.
name: Humalog
label: a
answer: yes
explanation: This is a short-acting insulin.
name: Actrapid
label: b
answer: no
explanation: Also known as insulin glargine, this is a long-acting insulin.
name: Lantus
label: e
answer: no
explanation: This is an intermediate-acting insulin.
name: Isophane
label: c
answer: no

Correct answer: a
Which of the following statements describes the mechanism of dapagliflozin?

Options:
explanation: This describes the mechanism of metformin - a biguanide.
name: Increases insulin sensitivity and decreases liver production of glucose
label: b
answer: no
explanation: This describes the mechanism of a dipeptidyl peptidase IV (DPP-4) inhibitor such as sitagliptin.
name: Prevents breakdown of endogenous incretin
label: c
answer: no
explanation: Dapagliflozin is a sodium-glucose co-transporter-2 (SGLT-2) inhibitor.
name: Reduces glucose reabsorption and increase urinary glucose excretion
label: a
answer: yes
explanation: This is the role of injectable insulins.
name: Replaces endogenous insulin supply
label: e
answer: no
explanation: This describes the mechanism of a gliclazide such as sulfonylurea
name: Stimulates insulin release from pancreas
label: d
answer: no

Correct answer: a
Which of the following statements about amino acids is true?

Options:
explanation: This is a non-essential amino acid.
name: Asparagine is an essential amino acid
label: e
answer: no
explanation: The R group is specific to each amino acid.
name: The R group is the same in each amino acid
label: b
answer: no
explanation: There are 20 amino acids used to form proteins.
name: There are 15 amino acids used to make proteins within the body
label: c
answer: no
explanation: Some amino acids do have positively charged side chains, but some have negatively charged, or uncharged side chains.
name: All amino acids have positively charged side chains
label: d
answer: no
explanation: Of the 20 standard amino acids, nine are referred to as the "essential" amino acids. This means that they must be obtained through the diet.
name: Essential amino acids must be obtained through the diet
label: a
answer: yes

Correct answer: a