hllj/quesmed huggingface dataset:
Identify the vessel indicated by the blue arrow in the image below.
[lightgallery]

Options:
explanation: The image shows a representation of the basal view of the brain with the arteries in situ. The frontal lobe is at the top of the image, while the cerebellum is at the bottom of the image. The posterior inferior cerebellar artery is a branch of the vertebral artery on each side, which supplies the inferior aspect of the cerebellar lobes. However, the blue arrow indicates the basilar artery, the main blood vessel which contributes to the posterior circulation of the brain.
name: Posterior inferior cerebellar artery
label: c
answer: no
explanation: The image shows a representation of the basal view of the brain with the arteries in situ. The frontal lobe is at the top of the image, while the cerebellum is at the bottom of the image. The superior cerebellar artery, a vessel supplying the superior aspect of the cerebellar lobes, is a branch of the artery indicated by the blue arrow, which is the basilar artery. The basilar artery is the main blood vessel which contributes to the posterior circulation of the brain.
name: Superior cerebellar artery
label: d
answer: no
explanation: The image shows a representation of the basal view of the brain with the arteries in situ. The frontal lobe is at the top of the image, while the cerebellum is at the bottom of the image. The blue arrow indicates the basilar artery, the main blood vessel, which contributes to the posterior circulation of the brain. It arises from the union of the right and left vertebral arteries located inferior to it. It bifurcates into the paired posterior cerebral arteries.
name: Basilar artery
label: a
answer: yes
explanation: The image shows a representation of the basal view of the brain with the arteries in situ. The frontal lobe is at the top of the image, while the cerebellum is at the bottom of the image. The vertebral arteries are paired arteries, right and left, which arise from the corresponding subclavian arteries and ascend into the neck through the transverse foramina of the cervical vertebrae to reach the skull where they unite to form the artery indicated by the blue arrow, which is the basilar artery. The basilar artery is the main blood vessel, which contributes to the posterior circulation of the brain.
name: Vertebral artery
label: b
answer: no
explanation: The image shows a representation of the basal view of the brain with the arteries in situ. The frontal lobe is at the top of the image, while the cerebellum is at the bottom of the image. The posterior cerebral arteries are paired arteries arising at the top of the basilar artery, contributing to the formation of the circle of Willis. However, the blue arrow indicates the basilar artery, the main blood vessel which contributes to the posterior circulation of the brain.
name: Posterior cerebral artery
label: e
answer: no

Correct answer: a
Identify the structure indicated by the arrow in the image below:
[lightgallery]

Options:
explanation: The image shows a close view of the inside of the bony orbit on the left side. The inferior orbital fissure is an irregularly shaped foramen found between the sphenoid bone and the maxilla, on the floor of the orbit. It allows the passage of the maxillary nerve, the inferior ophthalmic vein and the sympathetic nerves into the orbit. It is located more lateral (to the right of the image) compared to the structure indicated by the blue arrow which is the optic canal. The optic canal is an opening in the sphenoid bone, which allows the passage of the optic nerve out of, and the ophthalmic artery into the orbit.
name: Inferior orbital fissure
label: c
answer: no
explanation: The image shows a close view of the inside of the bony orbit on the left side. The blue arrow indicates the optic canal, which is the opening in the sphenoid bone allowing the passage of the optic nerve out of, and the ophthalmic artery into the orbit. The fact that this is the left orbit can be determined by the presence of the optic canal medial to the superior orbital fissure.
name: Optic canal
label: a
answer: yes
explanation: The image shows a close view of the inside of the bony orbit on the left side. The foramen ovale is an opening in the base of the greater wing of the sphenoid bone, which allows the passage of the mandibular branch of the trigeminal (CN V) nerve out of the skull at the level of the middle cranial fossa. However, the blue arrow indicates the optic canal, which is an opening in the sphenoid bone, which allows the passage of the optic nerve out of, and the ophthalmic artery into the orbit.
name: Foramen ovale
label: d
answer: no
explanation: The image shows a close view of the inside of the bony orbit on the left side. The foramen rotundum is an opening in the base of the greater wing of the sphenoid bone, located inferior to the superior orbital fissure (visible in the image), and which allows the passage of the maxillary branch of the trigeminal (CN V) nerve out of the skull at the level of the middle cranial fossa. However, the blue arrow indicates the optic canal, an opening in the sphenoid bone, which allows the passage of the optic nerve out of, and the ophthalmic artery into the orbit.
name: Foramen rotundum
label: e
answer: no
explanation: The image shows a close view of the inside of the bony orbit on the left side. The superior orbital fissure is an irregularly shaped foramen found between the lesser and the greater wings of the sphenoid bone, which allows the passage of the CN III, CN IV and CN VI into the orbit from the skull. It is located more lateral (to the right of the image) compared to the structure indicated by the blue arrow, which is the optic canal. The optic canal is an opening in the sphenoid bone, which allows the passage of the optic nerve out of, and the ophthalmic artery into the orbit.
name: Superior orbital fissure
label: b
answer: no

Correct answer: a
Which of the following best describes the cerebellar structure indicated by the arrow in the image below?
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Options:
explanation: The image shows a prosection of the cerebellum of a brain in a basal view, with the cerebellar hemispheres on each side of the image and the brainstem at the top of the image. The blue arrow indicates the tonsil of the cerebellum, which is a round lobule on each side, located on the underside of the cerebellar hemispheres. It is continuous with the vermis in the midline.
name: Tonsil
label: a
answer: yes
explanation: The image shows a prosection of the cerebellum of a brain in a basal view, with the cerebellar hemispheres on each side of the image and the brainstem at the top of the image. The flocculonodular lobe is the smallest lobe of the cerebellum, located on the anteroinferior aspect of it. It is found deeper to the structure indicated by the blue arrow which is the tonsil of the cerebellum, a round lobule on each side, located on the underside of the cerebellar hemispheres. The tonsil is continuous with the vermis in the midline.
name: Flocculonodular lobe
label: b
answer: no
explanation: The image shows a prosection of the cerebellum of a brain in a basal view, with the cerebellar hemispheres on each side of the image and the brainstem at the top of the image. The vermis is the midline structure of the cerebellum, forming a connection between the left and the right cerebellar hemispheres. However, the blue arrow indicates the tonsil of the cerebellum, which is a round lobule on each side, located on the underside of the cerebellar hemispheres. The tonsil is continuous with the vermis in the midline.
name: Vermis
label: c
answer: no
explanation: The image shows a prosection of the cerebellum of a brain in a basal view, with the cerebellar hemispheres on each side of the image and the brainstem at the top of the image. The posterior lobe is the largest of the three cerebellar lobes, found on the posterolateral aspect. However, the blue arrow indicates the tonsil of the cerebellum, which is a round lobule on each side, located on the underside of the cerebellar hemispheres. The tonsil is continuous with the vermis in the midline.
name: Posterior lobe
label: e
answer: no
explanation: The image shows a prosection of the cerebellum of a brain in a basal view, with the cerebellar hemispheres on each side of the image and the brainstem at the top of the image. The anterior lobe is found on the anterosuperior aspect of the cerebellum and is connected to the pons through the superior cerebellar peduncles. However, the blue arrow indicates the tonsil of the cerebellum, which is a round lobule on each side, located on the underside of the cerebellar hemispheres. The tonsil is continuous with the vermis in the midline.
name: Anterior lobe
label: d
answer: no

Correct answer: a
Identify the anatomical structure indicated by the arrow in the image below:
[lightgallery]

Options:
explanation: The image shows an anatomical model displaying a mid-sagittal view of the head and brain, with the nose and front of the head to the left of the image and the spine and back of the head to the right. The mandible is the largest bone of the face, forming the jaw and the origin of the lower teeth. It articulates with the temporal bone of the skull at the temporomandibular joint and consists of a horizontal body and two vertical rami. However, the blue arrow points to the hyoid bone, a U-shaped bone found in the anterior aspect of the neck inferior to the mandible.
name: Mandible
label: b
answer: no
explanation: The image shows an anatomical model displaying a mid-sagittal view of the head and brain, with the nose and front of the head to the left of the image and the spine and back of the head to the right. The blue arrow points to the hyoid bone, a U-shaped bone found in the anterior aspect of the neck inferior to the mandible. This bone does not articulate with any other bone in the body and serves as an attachment point for a number of anterior neck muscles.
name: Hyoid bone
label: a
answer: yes
explanation: The image shows an anatomical model displaying a mid-sagittal view of the head and brain, with the nose and front of the head to the left of the image and the spine and back of the head to the right. The thyroid cartilage is a large structure found on the anterior surface of the neck, particularly prominent in adult males. However, the blue arrow points to the hyoid bone, a U-shaped bone found in the anterior aspect of the neck inferior to the mandible.
name: Thyroid cartilage
label: d
answer: no
explanation: The image shows an anatomical model displaying a mid-sagittal view of the head and brain, with the nose and front of the head to the left of the image and the spine and back of the head to the right. The cricoid cartilage is a ring-shaped hyaline cartilage at the top of the trachea, but inferior to the thyroid cartilage, forming the inferior border of the larynx at the level of the C6 vertebra. However, the blue arrow points to the hyoid bone, a U-shaped bone found in the anterior aspect of the neck inferior to the mandible.
name: Cricoid cartilage
label: c
answer: no
explanation: The image shows an anatomical model displaying a mid-sagittal view of the head and brain, with the nose and front of the head to the left of the image and the spine and back of the head to the right. The epiglottis is a leaf-shaped elastic cartilage found at the superior border of the larynx and attached to the anterior aspect of the thyroid cartilage. It flattens and is displaced posteriorly during swallowing to prevent aspiration of food contents into the larynx and the airway. However, the blue arrow points to the hyoid bone, a U-shaped bone found in the anterior aspect of the neck inferior to the mandible.
name: Epiglottis
label: e
answer: no

Correct answer: a
A 60-year-old male presents to his GP after noticing a new lesion on his cheek. On closer inspection, you notice a raised, flesh-coloured nodule approximately 4mm in diameter. You notice a pearly rolled edge and an ulceration in the centre of the lesion, with multiple small telangiectasia on the surface of the nodule.

Which of the following is the most likely diagnosis?

Options:
explanation: This is a typical description of a basal cell carcinoma. Basal cell carcinomas usually present with the following three features: a pearly rolled edge, central ulceration and fine telangiectasias. They do not commonly present with any pain or bleeding. They are slow-growing and are more likely to appear on sun exposed areas of skin.
name: Basal cell carcinoma
label: a
answer: yes
explanation: These often appear as irregular red nodules with a scaly or crusty surface and irregular and raised margins. Unlike basal cell carcinomas, they can cause pain and bleeding and grow more quickly, over weeks to months.
name: Squamous cell carcinoma
label: e
answer: no
explanation: These are premalignant skins lesions that often precede the development of squamous cell carcinomas. Actinic keratosis present as lesions with surrounding erythema and a rough or warty surface. They are often described as incredibly itchy lesions on sun exposed areas of skin.
name: Actinic Keratosis
label: b
answer: no
explanation: Features of melanomas can be recognised using the ABCDE approach, which stands for: Asymmetrical lesion, Border irregularity, Colour variation, Diameter more than 6mm and Evolution over time. Melanomas can also be itchy or bleed and often grow more quickly than basal cell carcinomas.
name: Malignant melanoma
label: c
answer: no
explanation: These often have a ‘stuck on’ appearance. They can range in colour from light to black. The lesion described in this question is more likely to be a basal cell carcinoma.
name: Seborrheic Keratosis
label: d
answer: no

Correct answer: a
A 20-year-old female presents to the emergency department as she has dislocated her shoulder. She has a past medical history of Ehlers-Danlos syndrome.

Ehlers-Danlos syndrome is caused by a genetic mutation of which structure?

Options:
explanation: Ehlers-Danlos syndrome occurs due to a genetic mutation in collagen, not fibrin. Different types of mutations in fibrin can cause bleeding disorders such as hypofibrinogenemia.
name: Fibrin
label: c
answer: no
explanation: Ehlers-Danlos syndrome occurs due to a genetic mutation in collagen, not elastin. Loss of function mutations in the elastin gene can cause the heart defect supravalvular aortic stenosis.
name: Elastin
label: d
answer: no
explanation: A mutation of the CFTR gene, otherwise known as the cystic fibrosis transmembrane conductance regulator gene, causes cystic fibrosis. Ehlers-Danlos syndrome is caused by a genetic mutation of collagen.
name: Cystic fibrosis transmembrane conductance regulator (CFTR)
label: b
answer: no
explanation: Enlers-Danlos syndrome is a group of inherited conditions that cause hypermobile joints, hyperelastic skin and fragile blood vessels. This occurs due to a genetic mutation of collagen.
name: Collagen
label: a
answer: yes
explanation: Keratin is the building block of hair and nails. Mutations in keratin does not cause the development of Ehlers-Danlos syndrome.
name: Keratin
label: e
answer: no

Correct answer: a
An 18-year-old university student presents to her GP with a sore throat and fatigue for the past three weeks. She was prescribed a course of amoxicillin a week ago which she stopped taking as she developed a widespread macular rash. On examination, she is noted to have cervical lymphadenopathy.

Which of the following is a possible complication of the most likely diagnosis?

Options:
explanation: Ramsey-Hunt syndrome occurs when a herpes zoster infection affects the facial nerve. It is not a complication of glandular fever.
name: Ramsey-Hunt syndrome
label: b
answer: no
explanation: Hodgkin's lymphoma is not a known complication of glandular fever. However, having glandular fever can be assoictaed with a higher risk of developing non-Hodgkin's lymphoma.
name: Hodgkin's lymphoma
label: d
answer: no
explanation: This question describes a patient with glandular fever. An important complication of glandular fever is splenic rupture. ST-elevation myocardial infarction is not a complication of this condition.
name: ST-elevation myocardial infarction (STEMI)
label: e
answer: no
explanation: This is a typical description of glandular fever. An important complication of this condition includes splenic rupture, so individuals are advised to avoid contact sports for a month after diagnosis. Signs of splenic rupture include: abdominal pain, referred shoulder tip pain and tachycardia.
name: Splenic rupture
label: a
answer: yes
explanation: Hepatitis A is not a complication of glandular fever. Glandular fever can, however, lead to development of autoimmune hepatitis which is an important complication to monitor for.
name: Hepatitis A
label: c
answer: no

Correct answer: a
A 15-year-old male attends his GP with a six-month history of weight loss and diarrhoea. On further questioning, he is found to be sweaty and restless, and has had trouble sleeping. On examination, he has diplopia and you notice the upper eyelid is slow to descend on downgaze. The GP suspects a diagnosis of Graves' disease.

Which type of hypersensitivity reaction is Graves' disease?

Options:
explanation: Type 4 hypersensitivity reactions are known as delayed-type hypersensitivity reactions. They involve T lymphocytes and reactions often occur 24 to 72 hours after exposure to an antigen. Examples of type 4 hypersensitivity reactions include contact dermatitis and transplant rejections.
name: Type 4
label: e
answer: no
explanation: Graves' Disease is a type 5 hypersensitivity reaction. These reactions occur when antibodies bind to cell surface receptors. A further example of a type 5 hypersensitivity reaction is myasthenia gravis. Type 5 reactions are relatively new within the medical literature, and previously Graves' would have been considered a Type 2 reaction, which your university may still be teaching. If this is the case, we would advise clarifying with your university.
name: Type 5
label: a
answer: yes
explanation: Examples of type 3 hypersensitivity reactions include systemic lupus erythematosus, and less commonly post-streptococcal glomerulonephritis. These reactions are mediated by immune complexes.
name: Type 3
label: b
answer: no
explanation: Type 2 hypersensitivity reactions include rheumatic fever and autoimmune haemolytic anaemia. These reactions take place when either IgG or IgM bind to a cell surface antigen, so are known as cell bound reactions. The patient in this question has Graves' disease, which is a type 5 hypersensitivity reaction.
name: Type 2
label: d
answer: no
explanation: Type 1 hypersensitivity reactions occur when antigens bind and react to IgE immunoglobulins. Common examples of type 1 hypersensitivity reactions include anaphylaxis, asthma, eczema and hay fever.
name: Type 1
label: c
answer: no

Correct answer: a
A 30-year-old male has a new skin lesion. He has a smooth, hard growth on the left side of his nose where he has recently has his nose pierced. The lesion extends beyond the margin of the initial piercing.

What is the name given to this skin leison?

Options:
explanation: This is a typical presentation of a keloid scar. The description of a smooth, hard growth at the site of trauma is typical of this type of scar. Keloids are most commonly found after injury to the upper chest, sternum, shoulder, face, earlobes and lower legs.
name: Keloid Scar
label: a
answer: yes
explanation: Actinic keratosis are premalignant lesions that often appear before the development of squamous cell carcinoma. They look like thickened papule or plaques and often have surrounding erythematous skin. They have a rough warty surface and can cause pruritis. The patient in this question is likely to have a keloid scar at the site of injury.
name: Actinic keratosis
label: b
answer: no
explanation: The patient in this question is most likely to have  a keloid scar. A pickaxe scar is a type of scar that is often seen if an individual has severe acne.
name: Pickaxe scar
label: c
answer: no
explanation: Hypertrophic scars are usually hard and raised. They do not exceed past the borders of the original wound- which makes them different to keloid scars.
name: Hypertrophic scar
label: e
answer: no
explanation: Pitted scars are often seen in individuals with acne. The description of the skin lesion in this question is more typical of a keloid scar.
name: Pitted scar
label: d
answer: no

Correct answer: a
A 10-year-old female presents to the emergency department with shortness of breath and facial swelling after eating peanuts.

Which of the following cell types are responsible for releasing histamine in allergic reactions?

Options:
explanation: Neutrophils play an important role in fighting early stages of bacterial infections as they destroy rapidly dividing bacteria. They are not the cells responsible for producing histamine in allergic reactions.
name: Neutrophils
label: e
answer: no
explanation: Eosinophils defend against protozoan and parasitic infections. They would not be responsible for releasing histamine in allergic reactions.
name: Eosinophils
label: b
answer: no
explanation: Dendritic cells are antigen-presenting cells that help to trigger the adaptive immune response to an infectious agent. They are not responsible for releasing histamine in allergic reactions.
name: Dendritic cells
label: c
answer: no
explanation: Mast cells are responsible for triggering the inflammatory response. They are present in tissues and are the cells responsible for releasing histamine during allergic reactions.
name: Mast cells
label: a
answer: yes
explanation: Macrophages act to increase body temperature when individuals have a fever. They also act as antigen-presenting cells and are involved in phagocytosis of pathogens. Mast cells are the cells responsible for releasing histamine during allergic reactions.
name: Macrophages
label: d
answer: no

Correct answer: a
Which of the following options best describes the mechanism of action of trimethoprim?

Options:
explanation: Antibiotics like macrolides and aminoglycosides act by inhibiting protein synthesis. Trimethoprim instead acts by inhibiting folic acid formation.
name: Inhibits protein synthesis
label: b
answer: no
explanation: Trimethoprim acts by inhibiting folic acid formation, not by inhibiting the formation of cell walls. Cell wall inhibitors include antibiotics like penicillin, glycopeptides and cephalosporins.
name: Inhibits cell wall formation
label: c
answer: no
explanation: Antibiotics like rifampicin work by inhibiting the synthesis of RNA. Trimethoprim acts by inhibiting folic acid synthesis.
name: Inhibits RNA synthesis
label: d
answer: no
explanation: Trimethoprim is an antibiotic that acts by inhibiting folic acid formation.
name: Inhibits folic acid formation
label: a
answer: yes
explanation: Trimethoprim acts by inhibiting folic acid formation. It does not damage DNA, unlike antibiotics such as metronidazole.
name: Damages DNA
label: e
answer: no

Correct answer: a