hllj/quesmed huggingface dataset:
A 41-week pregnant woman is being induced into labour.

Which of the following hormone(s) is involved in preventing uterine contractions before labour?

Options:
explanation: Prostaglandins trigger labour by priming the cervix. Progesterone is involved in maintaining the pregnancy in the uterus.
name: Prostaglandins and progesterone
label: c
answer: no
explanation: These are the main pregnancy hormones which prevent uterine contractions and initiation of labour. Oestrogen is involved in the development of the foetus throughout pregnancy. Progesterone is involved in maintaining the pregnancy in the uterus.
name: Oestrogen and progesterone
label: a
answer: yes
explanation: Oestrogen is involved in the development of the foetus throughout pregnancy. Prolactin triggers labour and breast milk production.
name: Oestrogen and prolactin
label: e
answer: no
explanation: Oxytocin triggers the initiation of labour and promotes uterine contractions. Prostaglandins trigger labour by priming the cervix.
name: Oxytocin and prostaglandins
label: d
answer: no
explanation: Oxytocin triggers the initiation of labour and promotes uterine contractions.
name: Oxytocin
label: b
answer: no

Correct answer: a
A 32-year-old male has had a prostatectomy after being diagnosed with prostate cancer.

Why is he considered sub-fertile?

Options:
explanation: This is not a function of the prostate gland, but rather the epididymis.
name: He is unable to store sperm
label: d
answer: no
explanation: This is not a function of the prostate gland, but rather the testes.
name: He is unable to produce sperm
label: c
answer: no
explanation: This is not a function of the prostate gland, but rather the muscles and neuro vasculature in the penis.
name: He is unable to get an erection
label: b
answer: no
explanation: This is not a function of the prostate gland, but rather the vas deferens.
name: He is unable to transport sperm
label: e
answer: no
explanation: The prostate gland is involved in production of the seminal fluid that nourishes and transports sperm out of the penis. Since his prostate has been removed, he is unable to ejaculate and is hence, sub-fertile.
name: He is unable to ejaculate semen
label: a
answer: yes

Correct answer: a
A 68-year-old male is diagnosed with erectile dysfunction (ED). The GP prescribes a medicine while the cause is being investigated.

Which of the following is a contraindication for the medication ?

Options:
explanation: PDE-5 inhibitor is not contraindicated in patients with COPD as it does not affect the lungs or airways. They can be used to treat pulmonary hypertension secondary to COPD.
name: COPD
label: e
answer: no
explanation: PDE-5 inhibitors are contraindicated in patients with recent (~6 months) history of stroke.
name: Stroke 2 years
label: d
answer: no
explanation: PDE-5 inhibitor is not contraindicated in patients with previous vasectomy as they can still engage in sexual activity.
name: Vasectomy 5 years ago
label: c
answer: no
explanation: PDE-5 inhibitor is not contraindicated in patients with asthma as it does not affect the airways.
name: Asthma
label: b
answer: no
explanation: The man is most likely prescribed a Phosphodiesterase type 5 inhibitor (PDE-5 inhibitor) like sildenafil. These are used in ED to aid in achieving an erection through vasodilation. This can potentiate the effect of systemic hypotension and is contraindicated if the patient has pre-existing hypotension.
name: Hypotension
label: a
answer: yes

Correct answer: a
A 30 year old woman is giving birth to her first child. A midwife comes to review her and deems her to be in the first stage of labour.

Which of the following defines the first stage of labour?

Options:
explanation: This defines the third stage of labour.
name: From delivery of foetus till delivery of the placenta and foetal membranes
label: b
answer: no
explanation: This defines the second stage of labour.
name: From complete cervical dilation till delivery of the foetus
label: d
answer: no
explanation: This defines the first stage of labour. The cervix dilates from 0-3cm in the latent phase and then 3-10cm in the active phase. This is associated with regular painful uterine contractions and descent of the foetal head in the pelvis.
name: From start of regular uterine contractions till complete dilation of the cervix (10cm)
label: a
answer: yes
explanation: This is incorrect, regular uterine contractions start first, followed by cervical dilation till 10cm.
name: From complete dilation of the cervix (10cm) till the start of regular uterine contractions
label: c
answer: no
explanation: This is incorrect, the foetus is delivered first, followed by the placenta and foetal membranes
name: From delivery of the placenta and foetal membranes till delivery of the foetus
label: e
answer: no

Correct answer: a
A 25-year-old female presents to her GP with painless breast lumps. These were discovered 2 weeks ago and have moved from the upper to the lower half of the right breast. There has been no change in size, history of trauma or systemic symptoms. There is no significant past medical or family history.

On examination, there are multiple firm, smooth, round lumps, approximately 2cm in diameter, in the right lower breast. There are no skin changes observed, and the left breast is normal.

What is the most probable diagnosis?

Options:
explanation: This is unlikely as there has been no variation in the symptoms over the patient's menstrual cycle. This presents as bilateral lumpy breasts.
name: Fibrocystic disease
label: c
answer: no
explanation: This is the most likely diagnosis. Fibroadenomas are benign fibrous tumours arising from breast lobules that present as small highly mobile firm non-tender round masses.
name: Fibroadenoma
label: a
answer: yes
explanation: This is unlikely as the patient would be systemically unwell. This presents as a fluctuant painful mass with overlying skin redness and swelling.
name: Breast abscess
label: d
answer: no
explanation: This is unlikely as there is no history of trauma. This presents as firm irregular lumps associated with overlying skin bruising.
name: Fat necrosis
label: b
answer: no
explanation: While it is important to rule out breast cancer, it is unlikely as the lump is mobile and has not grown. This presents with fixed hard lumps with associated skin and/or nipple changes.
name: Breast cancer
label: e
answer: no

Correct answer: a
A 54-year-old man attends his local GP practice for an annual well-man check.

He is found to have a BMI of 33 kg/m2. The GP advises him to start an exercise programme to lose weight, however, the patient does not see a problem with his weight.

What is the most appropriate model of health to use in this situation?

Options:
explanation: The “Theory of Planned Behaviour” is a clinical tool used to predict and explain why people engage in risky behaviours. It considers the influence of factors such as one’s attitude, perceived behavioural control, and intention to carry out the behaviour. This patient is not carrying out risky behaviour (e.g. smoking), so this model is not appropriate.
name: Theory of Planned Behaviour
label: d
answer: no
explanation: This framework looks at the factors which affect one’s beliefs about their health such as perceived susceptibility, severity, and cues to action. This patient does not see his health as a problem, so the Health Belief Model would be a good model to use to challenge his beliefs about his health.
name: Health Belief Model
label: a
answer: yes
explanation: The ‘Biomedical Model’ is an approach that considers the influence of biological factors (e.g. hormones) on human behaviour. It has been criticized for biological reductionism as it does not consider the possible influence of environmental and cognitive factors on behaviour. This model is therefore inappropriate.
name: Biomedical Model
label: e
answer: no
explanation: The ‘Stages of Change Model’ identifies which stage of behavioural change a person is currently in. The 6 stages in this model are pre-contemplation, contemplation, preparation, action, maintenance and relapse. This patient does not consider his weight to be a problem so would not even be in the pre-contemplation stage. Hence, this model is not appropriate.
name: Stages of Change Model
label: c
answer: no
explanation: The COM-B model looks at 3 factors - capability, opportunity and motivation - all of which affect our ability and probability of carrying out a risky behaviour. This patient is not carrying out risky behaviour (e.g. smoking), so this model is not appropriate.
name: COM-B Model
label: b
answer: no

Correct answer: a
A 6-year-old boy is taken to see the GP by his adopted mother.

His birth mother left him at an orphanage at the age of 2 months. He was eventually adopted at age 5 after experiencing a difficult early childhood.

Which behavioural trait is he most likely to develop as he gets older?

Options:
explanation: Securely attached children are likely to have better educational attainment compared to insecurely attached children. This child has an insecure attachment, so this option is incorrect.
name: Good educational attainment
label: d
answer: no
explanation: This child is likely to have an insecure attachment. Insecurely attached children are likely to have a negative “Internal Working Model” which reduces their ability to form good social relationships.
name: Emotional and social incompetence
label: a
answer: yes
explanation: This child is unlikely to have formed a secure attachment style as his attachment behaviours have developed outside the critical period of 0 to 2 ½ years. Children with insecure attachment styles typically struggle to handle grief as they become older.
name: Better able to deal with grief
label: b
answer: no
explanation: Securely attached children are likely to become better parents compared to insecurely attached children. This is due to them forming a positive “Internal Working Model” in their first prime attachment (i.e. to their caregiver). The “Internal Working Model” forms a template for all future relationships including parental and romantic relationships. This child is likely to have a negative “Internal Working Model” due to his insecure attachment, so this option is incorrect.
name: Likely to be a better parent
label: c
answer: no
explanation: Securely attached children are more likely to have a positive outlook on life than insecurely attached children. This results in lower rates of depression and anger in childhood and more feelings of happiness. This child has an insecure attachment, so this option is incorrect.
name: Likely to be more optimistic
label: e
answer: no

Correct answer: a
A 14-year-old girl decides to visit her school nurse and counsellor to ask for some help. She is torn between studying Medicine and Business studies. She finds she is learning new things about herself every day and is finding it difficult to navigate life, sexuality, interests and dislikes.

Which of the following psychosocial stages is she most likely to currently be in?

Options:
explanation: This phase occurs in children aged 0-18 months and is based on their relationship with their parents and/or guardians. Children with a good relationship with their caregivers acquire the virtue of ‘hope’ and can progress to the next psychosocial stage.
name: Trust vs mistrust
label: b
answer: no
explanation: This phase occurs in children aged 12-18 years. It is the stage in which a young person finds their identity i.e. interests, possible career options and their sense of self. The ability for one to stay true to their sense of self leads one to acquire the virtue of ‘fidelity’, whereas failure leads to confusion and a weak sense of self.
name: Identity vs role confusion
label: a
answer: yes
explanation: This phase occurs in people aged 21-39 years old. In this stage, conflict is centred around forming long-term relationships with romantic partners, not just family members. Successful completion leads to a sense of safety and the individual acquires the virtue of ‘love’.
name: Intimacy vs isolation
label: e
answer: no
explanation: This phase occurs in children aged 6-11 years and is based on their ability to cope with new challenges in life, particularly academic and social challenges. Those who are successful acquire the virtue of ‘competence’, whereas those who are not develop a sense of inferiority.
name: Industry vs inferiority
label: c
answer: no
explanation: This phase occurs in children aged 18 months – 3 years. At this age, they learn to take personal control over physical skills such as writing, drawing, and playing, and have a need to acquire some independence. Success leads to a sense of autonomy whilst failure leads to shame and doubt. In this phase, children acquire the virtue of ‘will’.
name: Autonomy vs shame and doubt
label: d
answer: no

Correct answer: a
A 34-year-old man presents to the hospital with an acutely swollen knee.

A knee examination is conducted, during which an anterior drawer test is performed. This finds that the tibia moves anteriorly in relation to the femur.

What does this indicate?

Options:
explanation: Injury to the anterior cruciate ligament is identified via the anterior drawer test. A positive test results in anterior movement of the tibia in relation to the femur.
name: Anterior cruciate ligament injury
label: a
answer: yes
explanation: Injury to the medial collateral ligament is tested through a medial collateral ligament stress test. A positive stress test would produce pain on the medial side of the knee.
name: Medial collateral ligament injury
label: c
answer: no
explanation: Injury to the posterior cruciate ligament is tested through a posterior drawer test. A positive test results in posterior movement of the tibia in relation to the femur.
name: Posterior cruciate ligament injury
label: d
answer: no
explanation: Injury to the lateral collateral ligament is tested through a lateral collateral ligament stress test. A positive stress test would produce pain on the lateral side of the knee.
name: Lateral collateral ligament injury
label: e
answer: no
explanation: A normal test would result in no movement of the tibia in relation to the femur.
name: Normal test
label: b
answer: no

Correct answer: a
Which nerve roots form the nerve that innervates the lateral half of the ring finger and the anterior aspect of the hand?

Options:
explanation: The C3-C5 nerve roots form the phrenic nerve which innervates the diaphragm.
name: C3-C5
label: b
answer: no
explanation: The C5-T1 nerve roots form the median nerve (a nerve derived from the brachial plexus). The median nerve innervates the lateral half of the ring finger and the anterior aspect of the hand.
name: C5-T1
label: a
answer: yes
explanation: The C8-T1 nerve roots form the ulnar nerve which innervates the medial half of the ring finger and the anterior aspect of the 5th digit.
name: C8-T1
label: c
answer: no
explanation: The L4,5 and S1-S4 nerve roots form the sacral plexus which gives rise to nerves that innervate the sacral region.
name: L4-S4
label: e
answer: no
explanation: The L2-L4 nerve roots are found in the lower limb, and they form the femoral nerve which innervates the anterior thigh.
name: L2-L4
label: d
answer: no

Correct answer: a
You witness a GP performing a knee examination.

The GP asks the patient to straighten their leg as part of the examination.

Which myotome is being assessed in this movement?

Options:
explanation: The movement described in the question is knee extension. L3 is the myotome for knee extension.
name: L3
label: a
answer: yes
explanation: C8 is the myotome for thumb extension and finger flexion.
name: C8
label: e
answer: no
explanation: L4 is the myotome for ankle dorsiflexion.
name: L4
label: b
answer: no
explanation: L5 is the myotome for great toe extension.
name: L5
label: c
answer: no
explanation: C6 is the myotome for elbow flexion and wrist extension.
name: C6
label: d
answer: no

Correct answer: a
An 11-year-old boy sustains an injury whilst playing football. He describes a violent tackle where he tripped and fell onto an inwardly rotated foot.

Which structure is most likely to have been affected by this injury?

Options:
explanation: The posterior talofibular ligament may be damaged in an inversion injury of the foot, but this is usually in conjunction with an anterior talofibular ligament injury.
name: Posterior talofibular ligament
label: c
answer: no
explanation: The anterior talofibular ligament (ATFL) is most likely to be damaged in an inversion injury of the foot. This is due to its anatomical origins and insertions in the foot and because it carries the lowest ultimate load in the foot.
name: Anterior talofibular ligament
label: a
answer: yes
explanation: The medial collateral ligament is found in the knee and is unlikely to be injured in an inversion injury of the foot. Injury to this ligament would likely be due to excessive force on the lateral side of the knee.
name: Medial collateral ligament
label: d
answer: no
explanation: The calcaneofibular ligament may be damaged in an inversion injury of the foot, but this is usually in conjunction with an anterior talofibular ligament injury.
name: Calcaneofibular ligament
label: b
answer: no
explanation: The lateral collateral ligament is found in the knee and is unlikely to be injured in an inversion injury of the foot. Injury to this ligament would likely be due to excessive force on the medial side of the knee.
name: Lateral collateral ligament
label: e
answer: no

Correct answer: a
Which of the following is a right of a doctor in Talcott Parson’s idea of the "Sick Role"?

Options:
explanation: Doctors do not have the right or obligation to be fair and impartial nor to blame patients for their condition. The "Sick Role" states that patients are not to blame for their condition, but they have an obligation to seek competent help.
name: Right to be fair and impartial, to blame patients for their condition
label: c
answer: no
explanation: Doctors do not have the right or obligation to blame patients for their condition, but they have a right to examine patients.
name: To blame patients for their condition and to examine patients
label: e
answer: no
explanation: Doctors have a right to examine patients in the "Sick Role". This includes intimate examinations and a right to enquire into personal problems. This has been criticised as it does not consider the importance of patient consent.
name: To examine patients and enquire about personal problems
label: a
answer: yes
explanation: Doctors have an obligation, not a right, to apply specialist knowledge in their practice.
name: Apply specialist knowledge
label: d
answer: no
explanation: Doctors do not have the right or obligation to be fair and impartial in the "Sick Role", but they do have a right to examine patients.
name: Right to be fair and impartial, and to examine patients
label: b
answer: no

Correct answer: a
An 81-year-old woman who lives alone and is not married views her town as predominantly androcentric and is very displeased.

What type of perspective and view of society is she likely to have?

Options:
explanation: Radical feminists believe in female empowerment and strive to abolish the patriarchy. Some individuals completely discourage male involvement in life including in marriage and parenthood, but not all feminists adopt this view. This woman views her town as ‘androcentric,’ a term meaning ‘male-centred,’ so she is likely to have a radical feminist point of view.
name: Radical feminist
label: a
answer: yes
explanation: The conflict perspective suggests that society marginalises people of different backgrounds, particularly those who are affected by health inequities.
name: Conflict perspective
label: d
answer: no
explanation: An interactionist perspective suggests that humans learn from their environment which yields unique experiences. Thus, society is formed from people of different backgrounds coming together. Thomas Scheff was a leading sociologist that adopted this view.
name: Interactionist
label: c
answer: no
explanation: A functionalist view suggests that society is formed of different types of people, and we all have a role in society that we must fulfil for it to function. This perspective is illustrated through the "Structural-Functional Model of Society".
name: Functionalist
label: b
answer: no
explanation: The holistic approach is a psychological approach which was championed by Abraham Maslow. It considers the health and well-being of an individual from a biological, psychological, and social point of view and aims for an individual to reach self-actualisation.
name: Holistic approach
label: e
answer: no

Correct answer: a
Who devised the structural-functional model of society?

Options:
explanation: Abraham Maslow is the psychologist who developed and championed the holistic approach in psychology.
name: Abraham Maslow
label: b
answer: no
explanation: Karl Max was a sociologist that helped to develop the conflict perspective of society. This suggests that society marginalises people of different backgrounds, particularly those who are affected by health inequities.
name: Karl Marx
label: c
answer: no
explanation: Herbert Spencer was an English sociologist famous for his theory of social Darwinism.
name: Herbert Spencer
label: d
answer: no
explanation: Sigmund Freud was the psychologist who developed the psychodynamic approach. His famous theories led to the development of psychoanalysis, a widely used method in psychotherapy today.
name: Sigmund Freud
label: e
answer: no
explanation: Talcott Parsons developed the structural-functional model of society. This model suggests that society is formed of different types of people with varying levels of education and skills. With these skills, we all play a role in society so that it continues to function.
name: Talcott Parsons
label: a
answer: yes

Correct answer: a
The Montgomery case led to the development of which of the following Acts of Law?

Options:
explanation: Section 2 of the Mental Health Act allows patients to be sectioned for 28 days in a mental health facility while further investigation is sought for their mental health. The Montgomery case did not influence this.
name: Mental health Act 1983: Section 2
label: b
answer: no
explanation: Valid consent is voluntary, informed, and made by someone with capacity. The Montgomery case influenced the requirement for consent to be informed, not voluntary.
name: Mental Capacity Act 2005: Voluntary consent
label: d
answer: no
explanation: The Mental Capacity Act consists of 5 core principles, one of which is the right for a patient to make unwise decisions if they have capacity. The Montgomery case did not influence this part of the Act.
name: Mental Capacity Act 2005: The right to make unwise decisions
label: e
answer: no
explanation: The Mental Capacity Act is an act of law which determines how patients with or without capacity are treated. For consent to be valid, it must be informed, voluntary and with autonomy. The Montgomery case led to the requirement for consent to be informed.
name: Mental Capacity Act 2005: Informed consent
label: a
answer: yes
explanation: Section 3 of the Mental health Act allows patients to be detained for 6 months in a mental health facility for further investigation, diagnosis, and treatment of their mental health condition. The Montgomery case did not influence this.
name: Mental health Act 1983: Section 3
label: c
answer: no

Correct answer: a