hllj/quesmed huggingface dataset:
A 39-year-old woman presents to the GP asking for contraception. On further questioning, she is found to have a past medical history of thromboembolism (DVT).

What contraception option would be best suited for her to take?

Options:
explanation: This is incorrect. The COCP is contraindicated in patients who have a history of thromboembolism due to increasing the risk of blood clots.
name: The combined oral contraception pill
label: b
answer: no
explanation: This is incorrect. The hormonal coil (IUS) is contraindicated in patients who have a history of thromboembolism due to increasing the risk of blood clots.
name: IUS (hormonal coil)
label: e
answer: no
explanation: This is incorrect. The progesterone-only pill is contraindicated in patients who have a history of thromboembolism due to increasing the risk of blood clots.
name: Progesterone only pill
label: d
answer: no
explanation: This is incorrect. The contraceptive injection is contraindicated in patients who have a history of thromboembolism due to increasing the risk of blood clots.
name: Depo-Provera (contraceptive injection)
label: c
answer: no
explanation: This is correct. The copper coil is safe to use in patients with a history of thromboembolism.
name: Copper coil (IUCD)
label: a
answer: yes

Correct answer: a
A 32-year-old pregnant woman has prematurely entered labour. The doctor wants to delay the woman's uterine contractions.

What medication should be given?

Options:
explanation: This is incorrect. Prostaglandin E2 is used to induce labour by stimulating the cervix to dilate.
name: Prostaglandin E2
label: c
answer: no
explanation: This is correct. Terbutaline is a beta-2 receptor agonist and is referred to as a tocolytic drug. It acts by relaxing the myometrium and delaying contractions.
name: Terbutaline
label: a
answer: yes
explanation: This is incorrect. Oxytocin is used to induce labour by stimulating the contraction of the uterus.
name: Oxytocin
label: b
answer: no
explanation: This is incorrect. Labetalol is used in the management of pre-eclampsia during pregnancy.
name: Labetalol
label: d
answer: no
explanation: This is incorrect. Magnesium sulphate is used in the management of eclampsia in pregnancy.
name: Magnesium sulphate
label: e
answer: no

Correct answer: a
Where does fertilisation typically take place?

Options:
explanation: This is correct. Fertilisation occurs at the ampulla of the fallopian tube.
name: Ampulla
label: a
answer: yes
explanation: This is incorrect. Fertilisation occurs at the ampulla of the fallopian tube. The fimbriae are responsible for catching the ovulated egg and sweeping the egg into the fallopian tube.
name: Fimbriae of the fallopian tube
label: e
answer: no
explanation: This is incorrect. Fertilisation occurs at the ampulla of the fallopian tube. The uterine cavity is where the fetus grows and develops.
name: Uterine cavity
label: d
answer: no
explanation: This is incorrect. Fertilisation occurs at the ampulla of the fallopian tube.
name: Isthmus of the fallopian tube
label: c
answer: no
explanation: This is incorrect. Fertilisation occurs at the ampulla of the fallopian tube.
name: Infundibulum of the fallopian tube
label: b
answer: no

Correct answer: a
When the fertilised egg implants into the uterine wall, what stage of development is it at?

Options:
explanation: This is incorrect. The morula contains 16 cells and is the stage before the embryo becomes a blastocyst.
name: Morula
label: b
answer: no
explanation: This is incorrect. The embryo becomes a blastocyst first before implantation occurs.
name: 8 cell stage
label: e
answer: no
explanation: This is correct. A blastocyst is when the embryo reaches a stage where it is a rapidly dividing ball of cells. The embryo reaches the blastocyst stage around 5 days after fertilisation after which it begins to implant into the uterine wall.
name: Blastocyst
label: a
answer: yes
explanation: This is incorrect. The embryo becomes a blastocyst first before implantation occurs.
name: 4 cell stage
label: d
answer: no
explanation: This is incorrect. A zygote is a diploid cell formed after fertilisation when the two haploid gametes fuse.
name: Zygote
label: c
answer: no

Correct answer: a
A 17-year-old girl presents to the GP worried about not starting her period yet. On examination, she has a short stature, a webbed neck and a high-arched palate.

Which of the following syndromes is she likely to have?

Options:
explanation: This is incorrect. Edward's syndrome is a genetic condition that has an extremely low life expectancy with most babies affected not living past their 1st birthday. The key features of Edward's syndrome include micrognathia, low-set ears, rocker bottom feet and overlapping of fingers.
name: Edward's syndrome
label: c
answer: no
explanation: This is correct. Turner's syndrome results when one of the X chromosomes is missing (XO). This results in a range of problems including a short height, heart defects and failure of the development of ovaries. A webbed neck and a high-arched palate are commonly seen in Turner's syndrome.
name: Turner's syndrome
label: a
answer: yes
explanation: This is incorrect. William's syndrome is a developmental disorder due to microdeletion on chromosome 7 that causes mild to moderate intellectual disability, learning problems and short stature. Other features include elfin-like facies, a very friendly personality and supra-valvular aortic stenosis.
name: William's syndrome
label: e
answer: no
explanation: This is incorrect. Androgen insensitivity syndrome is when a person has the genotype of a male (XY) but the phenotype of a female due to a lack of function of androgens. This would present as a female with a lack of starting periods along with little or no axillary and pubic hair. On examination, there may be groin swellings indicative of undescended testes. In this case, the short stature, webbed neck and high-arched palate are suggestive of Turner's syndrome.
name: Androgen insensitivity syndrome
label: d
answer: no
explanation: This is incorrect. Although Noonan syndrome also presents with a webbed neck, short stature and potentially delayed secondary sexual characteristics, it is less likely in this case than Turner's syndrome. Additionally, other features of Noonan syndrome are not present such as pulmonary stenosis and pectus excavated.
name: Noonan syndrome
label: b
answer: no

Correct answer: a
A fall in which hormone causes menstruation?

Options:
explanation: This is incorrect. Oestrogen levels rise in the mid-follicular phase and drop after ovulation before rising again in the mid-luteal phase and decreasing at the end of the menstrual cycle. However, progesterone plays a role in maintaining the endometrial lining. Therefore, the fall in progesterone leads to the shedding of the endometrial lining and causes menstruation.
name: Oestrogen
label: b
answer: no
explanation: This is correct. When the corpus luteum dies, there is a fall in progesterone. As progesterone plays a role in maintaining the endometrial lining, the fall in progesterone leads to the shedding of the endometrial lining and causes menstruation.
name: Progesterone
label: a
answer: yes
explanation: This is incorrect. Testosterone does not play a vital role in the menstrual cycle.
name: Testosterone
label: e
answer: no
explanation: This is incorrect. LH aids in egg maturation and ovulation during the menstrual cycle.
name: LH
label: c
answer: no
explanation: This is incorrect. FSH is involved in stimulating follicular growth and selecting the dominant follicle prior to ovulation.
name: FSH
label: d
answer: no

Correct answer: a
During sexual differentiation, the Mullerian ducts and Wolffian ducts are the progenitors for female and male reproductive organs respectively. Sex hormones play vital roles in controlling sexual differentiation.

Which of the following is true for the development of the female reproductive organs?

Options:
explanation: This is incorrect. The Mullerian ducts develop into the female reproductive system. The regression of the Mullerian ducts is caused by the presence of AMH and this leads to the development of the male reproductive organs.
name: The presence of oestrogen causes regression of the Mullerian ducts
label: d
answer: no
explanation: This is incorrect. The presence of AMH causes regression of the Mullerian ducts whilst the presence of testosterone causes growth of the Wolffian ducts. This leads to the development of the male reproductive system.
name: The lack of AMH and testosterone causes regression of the Mullerian ducts and development of the Wolffian ducts
label: b
answer: no
explanation: This is incorrect. The presence of testosterone causes the Wolffian ducts to develop into the male reproductive organs.
name: The presence of oestrogen causes the development of the Wolffian ducts
label: e
answer: no
explanation: This is incorrect. The lack of testosterone causes regression of the Wolffian ducts.
name: The presence of oestrogen causes the regression of the Wolffian ducts
label: c
answer: no
explanation: This is correct. The lack of testosterone causes regression of the Wolffian ducts whilst the lack of AMH inhibits the regression of the Mullerian ducts, hence allowing the Mullerian ducts to develop. This starts the development of the female reproductive system.
name: The lack of AMH and testosterone causes regression of the Wolffian ducts and development of the Mullerian ducts
label: a
answer: yes

Correct answer: a
Which of the following is a 14-month-old child expected to be able to do?

Options:
explanation: This is correct. This is expected when a child is 12 months old
name: Walks with one hand held
label: a
answer: yes
explanation: This is incorrect. This is expected when a child is 3 years old.
name: Ride a tricycle using pedals
label: c
answer: no
explanation: This is incorrect. This is expected when a child is 2 years old.
name: Walk upstairs and downstairs holding onto a rail
label: b
answer: no
explanation: This is incorrect. This is expected when a child is 3 years old.
name: Talks in short sentences
label: d
answer: no
explanation: This is incorrect. This is expected when a child is 2 and a half years old.
name: The vocabulary of 200 words
label: e
answer: no

Correct answer: a
Following birth, which antibody is the last to be produced and reach adult levels?

Options:
explanation: This is incorrect. IgG1 is produced early on during development.
name: IgG1
label: c
answer: no
explanation: This is incorrect. IgE levels rise in childhood and peak at around 15 years old.
name: IgE
label: e
answer: no
explanation: This is correct. IgA is the last to reach adult levels during development. Babies receive IgA from breast milk.
name: IgA
label: a
answer: yes
explanation: This is incorrect. IgG2 is produced later than IgG1 and IgG3 but it reaches adult levels before IgA.
name: IgG2
label: d
answer: no
explanation: This is incorrect. IgG4 is produced later than IgG1 and IgG3 but it reaches adult levels before IgA.
name: IgG4
label: b
answer: no

Correct answer: a
Prolactin is the main hormone that drives lactation for breastfeeding.

Which of the following hormones inhibits prolactin action?

Options:
explanation: This is incorrect. Progesterone does not inhibit prolactin.
name: Progesterone
label: d
answer: no
explanation: This is incorrect. Oxytocin stimulates prolactin secretion.
name: Oxytocin
label: b
answer: no
explanation: This is correct. Dopamine inhibits prolactin production via the dopamine receptor 2.
name: Dopamine
label: a
answer: yes
explanation: This is incorrect. Testosterone does not inhibit prolactin.
name: Testosterone
label: e
answer: no
explanation: This is incorrect. Oestrogen stimulates prolactin production.
name: Oestrogen
label: c
answer: no

Correct answer: a
What changes are observed in pharmacokinetics with increased age?

Options:
explanation: This is incorrect. Ageing results in an increase in body fat percentage and a decrease in lean muscle mass.
name: A change in drug distribution due to a decrease in body fat percentage and an increase in lean muscle mass
label: c
answer: no
explanation: This is correct. In the elderly, there is a reduction in gastric pH and a reduction in intestinal blood flow which can decrease drug absorption.
name: Generalised decrease in drug absorption
label: a
answer: yes
explanation: This is incorrect. Ageing results in a reduction in liver blood flow.
name: Hepatic blood flow increases
label: d
answer: no
explanation: This is incorrect. Ageing results in a decreased renal elimination of drugs.
name: Renal excretion unchanged
label: b
answer: no
explanation: This is incorrect. Ageing results in a decrease in hepatic drug metabolism.
name: Intrinsic hepatic drug metabolism increases
label: e
answer: no

Correct answer: a
How does the urinary system change during ageing?

Options:
explanation: This is incorrect. Ageing causes a decline in the glomerular filtration rate.
name: The glomerular filtration rate increases
label: b
answer: no
explanation: This is incorrect. Ageing results in a stiffer bladder wall which is not able to hold as much volume as before.
name: The bladder wall becomes more flexible and elastic
label: e
answer: no
explanation: This is incorrect. The prostate increases in size during ageing in men with benign prostatic hyperplasia being a common medical condition in this population.
name: Prostatic gland shrinks
label: c
answer: no
explanation: This is correct. Ageing causes a decline in the glomerular filtration rate. Nephron loss also occurs.
name: The glomerular filtration rate declines
label: a
answer: yes
explanation: This is incorrect. Ageing does not cause the urethral mucosa to hypertrophy.
name: Urethral mucosa hypertrophies
label: d
answer: no

Correct answer: a
Which of the following is true regarding changes to the skin during ageing?

Options:
explanation: This is incorrect. During ageing, the epidermis does become thinner but the number of cell layers within the epidermis stays the same.
name: The epidermis thins and the number of cell layers decrease
label: b
answer: no
explanation: This is correct. During ageing, the epidermis becomes thinner. However, the number of cell layers within the epidermis stays the same.
name: The epidermis thins but the number of cell layers remains the same
label: a
answer: yes
explanation: This is incorrect. The dermis thickness may decrease with age.
name: The dermis becomes thicker
label: e
answer: no
explanation: This is incorrect. A decrease in melanocytes would make the skin paler.
name: The number of melanocytes increases making the skin more pale
label: c
answer: no
explanation: This is incorrect. Skin elasticity decreases due to a reduction in collagen and elastin.
name: Skin elasticity increases giving rise to wrinkles
label: d
answer: no

Correct answer: a
In the elderly, which of the following changes in the cardiorespiratory system can be observed?

Options:
explanation: This is incorrect. There is no change in tidal volume with age.
name: The tidal volume decreases
label: e
answer: no
explanation: This is incorrect. During ageing, there is a decrease in total body water so blood volume also decreases.
name: There is an increase in total body water and blood volume
label: c
answer: no
explanation: This is correct. The maximum cardiac output and aerobic capacity are reduced during ageing.
name: The maximum cardiac output is generally reduced with age
label: a
answer: yes
explanation: This is incorrect. Ageing causes a decrease in the strength of respiratory muscles which can lead to a reduced effectiveness in coughing to clear airway secretions.
name: The respiratory muscles increase in strength
label: d
answer: no
explanation: This is incorrect. During ageing, the aorta becomes thicker and stiffer.
name: The aorta becomes thinner increasing the likelihood of tears
label: b
answer: no

Correct answer: a
Tetanus is an infection caused by Clostridium tetani. This bacteria releases toxins into the blood to cause symptoms including painful muscle contraction.

What kind of toxin is released?

Options:
explanation: This is incorrect. Hemotoxins are toxins that destroy red blood cells. Clostridium tetani releases exotoxins into the bloodstream.
name: Hemotoxin
label: d
answer: no
explanation: This is incorrect. Clostridium tetani release exotoxins into the bloodstream.
name: Chemical toxin
label: c
answer: no
explanation: This is incorrect. An endotoxin is released when bacteria are lysed. Clostridium tetani release exotoxins into the bloodstream.
name: Endotoxin
label: b
answer: no
explanation: This is incorrect. Phototoxins cause one to become photosensitive.  Clostridium tetani release exotoxins into the bloodstream.
name: Phototoxic
label: e
answer: no
explanation: This is correct. An exotoxin is a toxin excreted by organisms.
name: Exotoxin
label: a
answer: yes

Correct answer: a
A 5-year-old boy is brought to the GP by his father with a sore throat and cough. The GP believes this is most likely a viral infection.

Which of the antigens of the following present to cytotoxic T cells for the immune system to fight off the infection?

Options:
explanation: This is incorrect. MHC class II presents antigens to helper T cells with CD4+ receptors. Cytotoxic T cells recognise antigens that are presented by MHC protein type 1.
name: MHC class II
label: c
answer: no
explanation: This is correct. Cytotoxic T cells recognise antigens that are presented by MHC protein type 1 via CD8+ receptors.
name: MHC class I molecules
label: a
answer: yes
explanation: This is incorrect. Antibodies bind to and recognise a specific antigen. Antibodies then stimulate the complement system and phagocytes to destroy pathogens. Cytotoxic T cells recognise antigens that are presented by MHC protein type 1.
name: Antibodies
label: b
answer: no
explanation: This is incorrect. Cytotoxic T cells recognise antigens that are presented by MHC protein type 1.
name: MHC class III
label: d
answer: no
explanation: This is incorrect. Interleukins are involved in inflammatory and immune responses but they do not present antigens to cytotoxic T cells. Cytotoxic T cells recognise antigens that are presented by MHC protein type 1.
name: Interleukins
label: e
answer: no

Correct answer: a
A 32-year-old male comes into the A+E with a history of haemoptysis and wakes up at night in a pool of sweat. On further questioning, it is discovered that he returned from a holiday in Pakistan a few months ago. A diagnosis of tuberculosis is suspected. Macrophages are involved in the defence against tuberculosis.

Which cytokines are primarily responsible for activating these macrophages?

Options:
explanation: This is incorrect. IL-1 promotes the recruitment of inflammatory cells at the site of inflammation through the release of chemokines. However, interferon-gamma promotes macrophages to aid in defence against microbes.
name: IL-1
label: b
answer: no
explanation: This is incorrect. IL-4 promotes the recruitment of inflammatory cells at the site of inflammation through the release of chemokines as well as regulating antibody production. However, interferon gamma promotes macrophages to aid in defence against microbes.
name: IL-4
label: c
answer: no
explanation: This is incorrect. IL-10 has anti-inflammatory properties hence limiting the host's immune response. Interferon-gamma promotes macrophages to aid in defence against microbes.
name: IL-10
label: e
answer: no
explanation: This is incorrect. C3 protein is not a cytokine and is essential for activating the complement system. Interferon-gamma promotes macrophages to aid in defence against microbes.
name: C3
label: d
answer: no
explanation: This is correct. Interferon-gamma promotes macrophages to aid in defence against microbes.
name: Interferon-gamma
label: a
answer: yes

Correct answer: a
Which one of the following is a live attenuated vaccine?

Options:
explanation: This is incorrect. The diphtheria vaccine is a toxoid vaccine (inactivated toxin).
name: Diphtheria
label: d
answer: no
explanation: This is incorrect. The pertussis vaccine is a toxoid vaccine (inactivated toxin).
name: Pertussis
label: e
answer: no
explanation: This is incorrect. The tetanus vaccine is a toxoid vaccine (inactivated toxin).
name: Tetanus
label: c
answer: no
explanation: This is correct. The MMR vaccine is an example of a live attenuated vaccine.
name: Measles, Mumps and Rubella
label: a
answer: yes
explanation: This is incorrect. The rabies vaccine is inactivated.
name: Rabies
label: b
answer: no

Correct answer: a
A 45-year-old woman requires an emergency blood transfusion. Her blood type is AB-.

Which of the following blood donors can she not have?

Options:
explanation: This is incorrect. The woman is safe to receive this blood type as she will not have anti-A antibodies.
name: A-
label: d
answer: no
explanation: This is incorrect. The woman is safe to receive this blood type as she will not have anti-B antibodies.
name: B-
label: c
answer: no
explanation: This is incorrect. O- blood is the universal donor as anyone can receive this blood.
name: O-
label: b
answer: no
explanation: This is incorrect. The woman is safe to receive this blood type as she will not have anti-A or anti-B antibodies.
name: AB-
label: e
answer: no
explanation: This is correct. As the woman has Rhesus negative blood, she will have antibodies against rhesus positive blood hence she cannot have blood from an A+ donor.
name: A+
label: a
answer: yes

Correct answer: a
The activity of which enzyme has the greatest effect on the rate of glycolysis?

Options:
explanation: This enzyme catalyses the splitting of fructose-1,6-bisphosphate into glyceraldehyde-3-phosphate and dihydroxyacetone phosphate. This is the step in glycolysis after the main rate-limiting step catalysed by phosphofructokinase and has little regulatory effect on the glycolysis rate.
name: Fructose-bisphosphate aldolase
label: c
answer: no
explanation: This enzyme decarboxylates oxalosuccinate to A-ketoglutarate and CO2. This reaction is the main rate-limiting step of the citric acid cycle.
name: Isocitrate dehydrogenase
label: e
answer: no
explanation: This catalyses the conversion of fructose-1,6-bisphosphate to fructose-6-phosphate. This reaction is the rate-limiting step in gluconeogenesis, not glycolysis.
name: Fructose 1,6-bisphosphatase
label: b
answer: no
explanation: This catalyses the phosphorylation of fructose-6-phosphate to fructose-1,6-biphosphate. It is allosterically activated by AMP and inhibited by ATP, allowing the rate of glycolysis to be altered according to the energetic demands of the cell.
name: Phosphofructokinase-1
label: a
answer: yes
explanation: Pyruvate dehydrogenase is not involved in glycolysis. This decarboxylates pyruvate to generate acetyl-CoA, the starting point for the citric acid cycle.
name: Pyruvate dehydrogenase
label: d
answer: no

Correct answer: a
Which of the following statements, regarding the muscles of the forearm, is correct?

Options:
explanation: The flexor digitorum profundus attaches to the bases of the distal phalanges, it flexes the wrist, metacarpophalangeal, proximal interphalangeal and distal inter-phalangeal joints.
name: The flexor digitorum profundus flexes the wrist, metacarpophalangeal, and proximal inter-phalangeal joints only
label: b
answer: no
explanation: Muscles in the extensor compartment of the forearm, including brachioradialis, are supplied by the radial nerve.
name: The brachioradialis is innervated by the radial nerve
label: a
answer: yes
explanation: The pronator quadratus is in the deepest layer of forearm flexors, whereas the pronator teres is in the most superficial layer.
name: The pronator quadratus lies superficial to the pronator teres
label: d
answer: no
explanation: The flexor muscles of the forearm originate from the medial epicondyle, whereas the lateral epicondyle gives rise to the extensor muscles of the forearm.
name: The flexor carpi radialis originates from the lateral epicondyle
label: c
answer: no
explanation: The extensor carpi ulnaris acts to extend and adduct the wrist. This muscle moves the wrist towards the ulna, which is on the medial side of the forearm and is therefore adduction.
name: The extensor carpi ulnaris acts to extend and abduct the wrist
label: e
answer: no

Correct answer: a