question stringlengths 278 1.46k | options dict | answer_idx stringclasses 31 values | answer stringclasses 31 values | source stringclasses 1 value |
|---|---|---|---|---|
You are counseling the family of a 15-year-old female with a BMI of 38 and type II diabetes on the surgical options for weight loss.
Of the following bariatric procedures, which is most likely to produce adverse malabsorptive nutritional sequelae?
Answer Choices:
(option1) Laparoscopic adjustable gastric banding (LAGB)
(option2) Roux-en-Y gastric bypass (RYGB)
(option3) laparoscopic sleeve gastrectomy (LSG)
(option4) biliopancreatic diversion with duodenal switch (BPDS)
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Laparoscopic adjustable gastric banding (LAGB)",
"option2": "Roux-en-Y gastric bypass (RYGB)",
"option3": "laparoscopic sleeve gastrectomy (LSG)",
"option4": "biliopancreatic diversion with duodenal switch (BPDS)",
"option5": "n/a"
} | option4 | option4 | AFRIMEDQA |
A 14-year-old male is being assessed for weight loss surgery.
Which of the following is an indication for surgical management?
Answer Choices:
(option1) BMI 32 and Type II diabetes
(option2) BMI 37 and obstructive sleep apnea
(option3) BMI 37 and hypertension
(option4) BMI 46 and no identifiable co-morbidities
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "BMI 32 and Type II diabetes",
"option2": "BMI 37 and obstructive sleep apnea",
"option3": "BMI 37 and hypertension",
"option4": "BMI 46 and no identifiable co-morbidities",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
A 15-year-old female presents to a specialised adolescent unit for assessment for weight-loss surgery. Her BMI for age falls on the 90 th centile.
By definition how would you classify this patient?
Answer Choices:
(option1) Obese
(option2) Normal
(option3) Overweight
(option4) Severely obese
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Obese",
"option2": "Normal",
"option3": "Overweight",
"option4": "Severely obese",
"option5": "n/a"
} | option3 | option3 | AFRIMEDQA |
Following resection of a patent urachus and bladder closure in a male infant, a transurethral catheter is lest in situ.
What is your post-operative plan for this patient?
Answer Choices:
(option1) Discharge when well with catheter in situ, and follow up at 1 week for removal
(option2) Removal of catheter 24 to 48 hours post op and discharge if good urinary stream
(option3) Inpatient ultrasound and discharge if normal
(option4) Voiding cystourethrogram after removal of catheter at 10 to 14 days post op
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Discharge when well with catheter in situ, and follow up at 1 week for removal",
"option2": "Removal of catheter 24 to 48 hours post op and discharge if good urinary stream",
"option3": "Inpatient ultrasound and discharge if normal",
"option4": "Voiding cystourethrogram after removal of catheter at 10 to 14 days post op",
"option5": "n/a"
} | option4 | option4 | AFRIMEDQA |
A 1-week old term baby presents with clear fluid draining from t the umbilicus. At exploration, you confirm a patent urachus
What is the most correct description of the operation required for this anomaly?
Answer Choices:
(option1) Suture ligate the patent urachus at the umbilicus
(option2) Ligate and divide the patent urachus at the dome of the bladder
(option3) Resect the entire patent urachus and ligate and divide at the dome of the bladder
(option4) Excision of the patent urachus, with wedge resection at dome of bladder and formal bladder repair
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Suture ligate the patent urachus at the umbilicus",
"option2": "Ligate and divide the patent urachus at the dome of the bladder",
"option3": "Resect the entire patent urachus and ligate and divide at the dome of the bladder",
"option4": "Excision of the patent urachus, with wedge resection at dome of bladder and formal bladder repair",
"option5": "n/a"
} | option4 | option4 | AFRIMEDQA |
A 3-year-old child with no significant medical or surgical history presents with bowel obstruction and is taken to theatre for exploratory laparotomy. At laparotomy you find a loop of small intestine volved around a fibrous band which extends from the umbilicus to the jejunum.
What is the most likely cause of this finding?
Answer Choices:
(option1) adhesive bowel obstruction
(option2) omphalomesenteric duct remnant
(option3) internal hernia
(option4) remnant of the omphalomesenteric artery
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "adhesive bowel obstruction",
"option2": "omphalomesenteric duct remnant",
"option3": "internal hernia",
"option4": "remnant of the omphalomesenteric artery",
"option5": "n/a"
} | option4 | option4 | AFRIMEDQA |
A newborn presents with fever, tachycardia and erythema around the umbilicus.
What is your immediate management for this child?
Answer Choices:
(option1) Surgical debridement
(option2) Incision and drainage
(option3) Intravenous antibiotics
(option4) Oral antibiotics and observation
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Surgical debridement",
"option2": "Incision and drainage",
"option3": "Intravenous antibiotics",
"option4": "Oral antibiotics and observation",
"option5": "n/a"
} | option3 | option3 | AFRIMEDQA |
You are asked to review a 2-month old infant admitted to paediatrics with a severe lower respiratory tract infection. On examination you note that the umbilical cord has not yet separated.
What would your advice to the paediatrician be?
Answer Choices:
(option1) Apply daily chlorhexidine to the cord
(option2) Suture ligated the excess cord
(option3) Investigate for neutrophil mobility defects
(option4) Investigate for vertical transmission of HIV
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Apply daily chlorhexidine to the cord",
"option2": "Suture ligated the excess cord",
"option3": "Investigate for neutrophil mobility defects",
"option4": "Investigate for vertical transmission of HIV",
"option5": "n/a"
} | option3 | option3 | AFRIMEDQA |
A two-week old newborn is brought to the surgical clinic with and undifferentiated lesion of the umbilicus. Prior to any investigations the parents would like to know what it could be and what it is caused by.
Which of the following options regarding variants of normal embryological structures is correctly paired?
Answer Choices:
(option1) Meckel diverticulum originating from the urachus
(option2) Umbilical polyp originating from remnants of the omphalomesenteric duct
(option3) Umbilical granuloma originating from the omphalomesenteric vein
(option4) Patent urachus originating from the allantois
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Meckel diverticulum originating from the urachus",
"option2": "Umbilical polyp originating from remnants of the omphalomesenteric duct",
"option3": "Umbilical granuloma originating from the omphalomesenteric vein",
"option4": "Patent urachus originating from the allantois",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
A 4 year old girl falls from the balcony of an apartment on the third floor. On arrival in the Emergency Room she is haemodynamically stable. Initial radiographs demonstrate a right femur fracture and bilateral tibia fractures. Her chest radiograph shows no rib or sternal fractures. There is no pneumo or haemothorax. Despite this, her Sats drop to 86% on nasal prong oxygen, and she develops subcostal recessions.
What is the most likely cause for her respiratory distress?
Answer Choices:
(option1) Cardiac contusion
(option2) Fat embolism
(option3) Aspiration pneumonia
(option4) Pulmonary contusion
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Cardiac contusion",
"option2": "Fat embolism",
"option3": "Aspiration pneumonia",
"option4": "Pulmonary contusion",
"option5": "n/a"
} | option4 | option4 | AFRIMEDQA |
A 12 year old male sustains a penetrating injury to the left chest with a bicycle spoke. His chest x-ray is normal. An ECG shows J-waves and e FAST demonstrates a 4 mm pericardial effusion. The patient remains haemodynamically stable, and is planned for surgical procedure the following day.
What is the most appropriate procedure in this scenario?
Answer Choices:
(option1) a sternotomy
(option2) an emergency room thoracotomy
(option3) a clambshell thoracotomy
(option4) a subxiphoid pericardial window
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "a sternotomy",
"option2": "an emergency room thoracotomy",
"option3": "a clambshell thoracotomy",
"option4": "a subxiphoid pericardial window",
"option5": "n/a"
} | option4 | option4 | AFRIMEDQA |
A 6 year old male is brought into the resus bay after being accidentally stabbed in the chest with a pair of scissors whilst playing with his friends at school. He is haemodynamically stable, with a single 1 cm wound on this anterior chest, to the left of the sternum in the 4 th intercostal space. After establishing intravenous access, an erect chest radiograph is done which shows a blunting of the costophrenic angle on the left.
What is the next most appropriate step in the management of this patient?
Answer Choices:
(option1) do an eFAST
(option2) insert an intercostal chest drain in the 5th intercostal space mid axillary line on the left
(option3) needle decompression on the left 2nd intercostal space
(option4) do a CT chest
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "do an eFAST",
"option2": "insert an intercostal chest drain in the 5th intercostal space mid axillary line on the left",
"option3": "needle decompression on the left 2nd intercostal space",
"option4": "do a CT chest",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
A 8 year old male is involved in a motor vehicle accident and ejected from the vehicle. On arrival in the Emergency Centre he has a HR 155 and Sats 88% on nasal prong oxygen. A supine chest radiograph is done which demonstrates fractures of rib 5 and 6 on the right, and ‘veiling’ of the right hemithorax.
What is the next most appropriate step in the management of this patient?
Answer Choices:
(option1) Endotracheal intubation to protect the airway
(option2) Insertion of an intercostal chest drain in the 5ths intercostal space on the right
(option3) Emergency room thoracotomy
(option4) Needle decompression on the right 2nd intercostal space
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Endotracheal intubation to protect the airway",
"option2": "Insertion of an intercostal chest drain in the 5ths intercostal space on the right",
"option3": "Emergency room thoracotomy",
"option4": "Needle decompression on the right 2nd intercostal space",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
A four year old female is brought into a level 1 trauma centre following a pedestrian vehicle accident. Her GCS is 9/15, HR of 140, BP 85/62. On examination her neck veins are distended and trachea is deviated to the left. On auscultation, she has reduced breath sounds on the right.
What is the most likely diagnosis:
Answer Choices:
(option1) Left heamothorax
(option2) Right occult pneumothorax
(option3) Cardiac tamponade
(option4) Right tension pneumothorax
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Left heamothorax",
"option2": "Right occult pneumothorax",
"option3": "Cardiac tamponade",
"option4": "Right tension pneumothorax",
"option5": "n/a"
} | option4 | option4 | AFRIMEDQA |
A 2-year-old child presents with a slow growing, round subcutaneous lesion on the scalp. It is 2 cm in size and feels superficial, so you proceed to an excision.
Which of the following histological features would confirm the diagnosis of a epidermal cyst?
Answer Choices:
(option1) The presence of pilosebaceous units
(option2) The presence of hair
(option3) A wall composed of true epidermis
(option4) Sebaceous material
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "The presence of pilosebaceous units",
"option2": "The presence of hair",
"option3": "A wall composed of true epidermis",
"option4": "Sebaceous material",
"option5": "n/a"
} | option3 | option3 | AFRIMEDQA |
A 4 year old female presents is referred to you for assessment and possible excision of a large neurofibroma in the abdomen, picked up on CT scan. When you examine the child, you have a clinical suspicion of neurofibromatosis Type 1 (NF-1):
Which of the following features, in addition to the neurofibroma, would prompt genetic testing for NF-1?
Answer Choices:
(option1) Optic neuritis
(option2) Axillary lymphadenopathy
(option3) 2 or more café-au-lait spots
(option4) Tibial pseudoarthrosis
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Optic neuritis",
"option2": "Axillary lymphadenopathy",
"option3": "2 or more café-au-lait spots",
"option4": "Tibial pseudoarthrosis",
"option5": "n/a"
} | option4 | option4 | AFRIMEDQA |
During a fetal medicine meeting you review the case of a 32 week fetus with ultrasound features of a large mass protruding from the oral cavity. The mass appears to arise from the palate and fills the entire oral cavity.
Which of the following terms describes a teratoma arising from the hard palate?
Answer Choices:
(option1) Epignathus
(option2) Congenital Epulis
(option3) Desmoid tumour
(option4) Cervical teratoma
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Epignathus",
"option2": "Congenital Epulis",
"option3": "Desmoid tumour",
"option4": "Cervical teratoma",
"option5": "n/a"
} | option1 | option1 | AFRIMEDQA |
You are call to labour ward nursery to assess a new-born baby with a large right neck mass. The child has mild tachypnoea with no signs of tracheal deviation. You request an MRI which confirms the presence of multiple line as well as adipose tissue and areas of calcifications in the mass
Which of the following is the most likely diagnosis in this case?
Answer Choices:
(option1) Foregut duplication cyst
(option2) Cervical teratoma
(option3) Congenital goitre
(option4) Cervical lymphangioma
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Foregut duplication cyst",
"option2": "Cervical teratoma",
"option3": "Congenital goitre",
"option4": "Cervical lymphangioma",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
You review a nine month old infant at your clinic, who had a benign sacrococcygeal teratoma resected as a neonate. The alpha-feto protein levels is elevated, and a CT scan is ordered which confirms the presence of recurrence.
Which of the following is likely to account for the recurrence?
Answer Choices:
(option1) a sampling error of the original tumor,
(option2) complete resection of a malignant focus with clear margins
(option3) progression of malignant disease
(option4) the lack of established neo-adjuvant therapy
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "a sampling error of the original tumor,",
"option2": "complete resection of a malignant focus with clear margins",
"option3": "progression of malignant disease",
"option4": "the lack of established neo-adjuvant therapy",
"option5": "n/a"
} | option1 | option1 | AFRIMEDQA |
You are referred a 6-day old term neonate with a large sacral mass. Your clinical impression is that of a sacrococcygeal teratoma.
In order to plan your surgical approach, which of the following investigations would you request?
Answer Choices:
(option1) Blood for alpha-feto protein
(option2) Ultrasound and/or CT scan
(option3) Abdominal radiograph
(option4) MRI of the spine
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Blood for alpha-feto protein",
"option2": "Ultrasound and/or CT scan",
"option3": "Abdominal radiograph",
"option4": "MRI of the spine",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
An 4-year-old boy was referred for evaluation of chronic constipation. A contrast enema was ordered to rule out anatomic abnormalities. When performing the enema, difficulty was encountered passing the catheter through the anus. The procedure was aborted an a plain pelvic radiograph showed dysplastic sacral vertebra.
What would you consider next in the work up of this patient?
Answer Choices:
(option1) A digital rectal examination to assess for explosive stools
(option2) A rectal suction biopsy to investigate for Hirschsprung’s disease
(option3) A digital rectal examination to assess for a pre-sacral mass
(option4) A augmented pressure distal colostogram to assess for an anorectal malformation
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "A digital rectal examination to assess for explosive stools",
"option2": "A rectal suction biopsy to investigate for Hirschsprung’s disease",
"option3": "A digital rectal examination to assess for a pre-sacral mass",
"option4": "A augmented pressure distal colostogram to assess for an anorectal malformation",
"option5": "n/a"
} | option3 | option3 | AFRIMEDQA |
The diagnosis of a SCT is made on antenatal ultrasound.
Which of the following features would mandate delivery by caesarean section?
Answer Choices:
(option1) Tumor size > 10cm
(option2) Presence of fetal hydrops
(option3) Altman IV SCT
(option4) Tumor size >5cm
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Tumor size > 10cm",
"option2": "Presence of fetal hydrops",
"option3": "Altman IV SCT",
"option4": "Tumor size >5cm",
"option5": "n/a"
} | option4 | option4 | AFRIMEDQA |
You are asked to see a new born baby in labour ward with a soft mass protruding from the sacral region?
Which of the following clinical features make the diagnosis of a Altman III SCT more likely?
Answer Choices:
(option1) Male sex
(option2) Associated abdominal mass
(option3) When palpating the mass there is no bulging of the fontanelles
(option4) Clinical features of Turners syndrome
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Male sex",
"option2": "Associated abdominal mass",
"option3": "When palpating the mass there is no bulging of the fontanelles",
"option4": "Clinical features of Turners syndrome",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
You attend a fetal medicine combined meeting and review the case of a 35 year old primigravida whose antenatal ultrasound done at 24 weeks detects a fetus with a 5 cm sacrococcygeal teratoma (SCT). The mother would like to know how this condition occurs.
Which of the following is most correct regarding the embryology of SCTs?
Answer Choices:
(option1) Teratomas are thought to arise from totipotent germ cells in the 8th week of gestation
(option2) Primordial germ cells migrate cranially from the primitive streak
(option3) During the 5th week of gestation totipotent primordial germ cells migrate towards the gonadal ridges
(option4) SCTs are always remnants of incomplete twinning
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Teratomas are thought to arise from totipotent germ cells in the 8th week of gestation",
"option2": "Primordial germ cells migrate cranially from the primitive streak",
"option3": "During the 5th week of gestation totipotent primordial germ cells migrate towards the gonadal ridges",
"option4": "SCTs are always remnants of incomplete twinning",
"option5": "n/a"
} | option3 | option3 | AFRIMEDQA |
You are called to assess a term newborn on day 1 of life, after the paediatrician fails to insert an nasogastric tube. A chest radiograph demonstrates coiling of the nasogastric tube in the neck, and a gasless abdomen
What is the most likely diagnosis?
Answer Choices:
(option1) Oesophageal atresia no fistula
(option2) Iatrogenic oesophageal perforation
(option3) Oesophageal stenosis
(option4) Common type oesophageal atresia with mucus plugging of the distal tracheoesophageal fistula
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Oesophageal atresia no fistula",
"option2": "Iatrogenic oesophageal perforation",
"option3": "Oesophageal stenosis",
"option4": "Common type oesophageal atresia with mucus plugging of the distal tracheoesophageal fistula",
"option5": "n/a"
} | option1 | option1 | AFRIMEDQA |
A day 2 of life 2 kg neonate is diagnosed with a common type (Gross C) oesophageal atresia with distal tracheoesophageal fistula.
Which of the following investigations for VACTERL association is required prior to operative intervention?
Answer Choices:
(option1) An echocardiogram
(option2) A babygram
(option3) A renal ultrasound
(option4) A spinal ultrasound
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "An echocardiogram",
"option2": "A babygram",
"option3": "A renal ultrasound",
"option4": "A spinal ultrasound",
"option5": "n/a"
} | option1 | option1 | AFRIMEDQA |
A 32-year-old P 1 G 2 female, undergoes an antenatal ultrasound at 22 weeks of gestation. The sonographer notes an AFI (amniotic fluid index) of 28.
What other finding would raise concern for oesophageal atresia?
Answer Choices:
(option1) An associated congenital cardiac defect
(option2) A double bubble
(option3) Small or absent stomach bubble
(option4) Hydrops fetalis
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "An associated congenital cardiac defect",
"option2": "A double bubble",
"option3": "Small or absent stomach bubble",
"option4": "Hydrops fetalis",
"option5": "n/a"
} | option3 | option3 | AFRIMEDQA |
A day one of life tm 2.8 kg neonate is diagnosed with an oesophageal atresia. The babygram shows coiling of the nasogastric tube in the neck and no gas in the abdomen
In this scenario, which of the following is the most relevant indication for bronchoscopy?
Answer Choices:
(option1) To identify and inject glue into the distal tracheoesophageal fistula
(option2) To identify a proximal fistula
(option3) To diagnose tracheomalacia
(option4) To occlude the fistula with an endotracheal tube
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "To identify and inject glue into the distal tracheoesophageal fistula",
"option2": "To identify a proximal fistula",
"option3": "To diagnose tracheomalacia",
"option4": "To occlude the fistula with an endotracheal tube",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
A premature neonate with pure oesophageal atresia, undergoes a gastrostomy for feeding access. The baby is unstable intra-operatively due to an underlying cardiac defect. Post-operatively the baby is ventilated and a Replogle tube in left in the upper pouch.
What is the next most appropriate step in the investigation of this child?
Answer Choices:
(option1) Perform a cervical oesophagostomy
(option2) Perform a “gapogram” once the baby is stable
(option3) Perform a thoracotomy and primary anastomosis once the baby is stable
(option4) Perform hydrostatic distension of the upper pouch
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Perform a cervical oesophagostomy",
"option2": "Perform a “gapogram” once the baby is stable",
"option3": "Perform a thoracotomy and primary anastomosis once the baby is stable",
"option4": "Perform hydrostatic distension of the upper pouch",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
In a counselling session with the parents of a child born with oesophageal atresia, they ask you how this congenital anomaly occurs.
Which of the following is the most recent theory explaining the normal embryological development of the oesophagus and trachea?
Answer Choices:
(option1) Watershed model
(option2) Septation model
(option3) Outgrowth model
(option4) Splitting and extension model
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Watershed model",
"option2": "Septation model",
"option3": "Outgrowth model",
"option4": "Splitting and extension model",
"option5": "n/a"
} | option4 | option4 | AFRIMEDQA |
Six weeks after the successful repair of a common type oesophageal atresia, the infant develops difficulty feeding. A contrast swallow demonstrates an oesophageal stricture.
What would the most appropriate management strategy be?
Answer Choices:
(option1) Resection and re-anastomosis
(option2) Oesophagoscopy and dilatation
(option3) Systemic steroids
(option4) Topical mitomycin application
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Resection and re-anastomosis",
"option2": "Oesophagoscopy and dilatation",
"option3": "Systemic steroids",
"option4": "Topical mitomycin application",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
A 3-month-old infant who had a successful repair of a common type oeosphageal atresia with tracheoesophageal fistula in the neonatal period, is diagnosed with gastro-oesophageal reflux disease (GORD).
Which of the following statements is true regarding the management of GORD in patients with oesophageal atresia?
Answer Choices:
(option1) Most patients with GORD and recurrent strictures will respond to non-operative management
(option2) Up to 50% of patients with GORD will require surgical management
(option3) A Dor fundoplication is recommended in patients who do not respond to medical management
(option4) Nissen fundoplication is the most appropriate initial management
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Most patients with GORD and recurrent strictures will respond to non-operative management",
"option2": "Up to 50% of patients with GORD will require surgical management",
"option3": "A Dor fundoplication is recommended in patients who do not respond to medical management",
"option4": "Nissen fundoplication is the most appropriate initial management",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
You are called to assess a newborn with a suspected oesophageal atresia. The abdominal radiograph demonstrates a double bubble sign. The child is in respiratory distress, and the neonatologists are planning to intubate.
What is your approach to this scenario?
Answer Choices:
(option1) Intubate the right main bronchus to achieve single lung ventilation
(option2) Take the child to theatre to perform an emergency gastrostomy
(option3) Take the child to theatre and perform a right thoracotomy and emergency ligation of the trache-oesophegeal fistula
(option4) Perform a diagnostic bronchoscopy
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Intubate the right main bronchus to achieve single lung ventilation",
"option2": "Take the child to theatre to perform an emergency gastrostomy",
"option3": "Take the child to theatre and perform a right thoracotomy and emergency ligation of the trache-oesophegeal fistula",
"option4": "Perform a diagnostic bronchoscopy",
"option5": "n/a"
} | option3 | option3 | AFRIMEDQA |
A 2-month old who presented with choking after feeds, undergoes a contrast oesophagogram which demonstrates a trache-oesophageal fistula at the level of C 4
What would your surgical approach be?
Answer Choices:
(option1) A left cervical incision
(option2) A right cervical incision
(option3) A right thoracotomy
(option4) Combine bronchoscopic and endoscopic management
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "A left cervical incision",
"option2": "A right cervical incision",
"option3": "A right thoracotomy",
"option4": "Combine bronchoscopic and endoscopic management",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
NEC is the leading cause of mortality amongst premature neonates.
Which one of the following statements is most correct regarding the mortality associated with NEC?
Answer Choices:
(option1) Mortality is similar in VLBW neonates and ELBW neonates
(option2) Mortality is as high as 50% in NEC requiring surgical management
(option3) The mortality in recurrent NEC is higher than it is in a single episode of NEC
(option4) In some centres mortality in medical NEC is as high as in surgical NEC
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Mortality is similar in VLBW neonates and ELBW neonates",
"option2": "Mortality is as high as 50% in NEC requiring surgical management",
"option3": "The mortality in recurrent NEC is higher than it is in a single episode of NEC",
"option4": "In some centres mortality in medical NEC is as high as in surgical NEC",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
In his seminal paper in 1975 Santulli hypothesized that the development of NEC requires three things: injury to the intestinal mucosa, bacterial colonisation and a metabolic substrate.
Which one of the following statements is true with regards to the intestinal tract of a premature neonate?
Answer Choices:
(option1) The high pH of the stomach is the GI tracts first barrier to infection
(option2) Increased motility results in increased epithelial exposure to potentially noxious substances
(option3) Mucin secreted by chief cells plays a key role in lubrication
(option4) Tight junctions link epithelial cells to form a semipermeable membrane
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "The high pH of the stomach is the GI tracts first barrier to infection",
"option2": "Increased motility results in increased epithelial exposure to potentially noxious substances",
"option3": "Mucin secreted by chief cells plays a key role in lubrication",
"option4": "Tight junctions link epithelial cells to form a semipermeable membrane",
"option5": "n/a"
} | option4 | option4 | AFRIMEDQA |
The immune system has a protective effect against NEC, but in the presence of an immature intestinal tract, an initial insult can trigger an exaggerated immune response which can be harmful.
Which of the following statements is true with regards to adaptive immunity in premature neonates?
Answer Choices:
(option1) The transfer of IgG across the placenta occurs during the last 4 weeks of gestation
(option2) Breast milk contains protective factors such as lactoferrin and lysosyme
(option3) T-cells promote intestinal cell regeneration
(option4) Breast milk contains the IgA
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "The transfer of IgG across the placenta occurs during the last 4 weeks of gestation",
"option2": "Breast milk contains protective factors such as lactoferrin and lysosyme",
"option3": "T-cells promote intestinal cell regeneration",
"option4": "Breast milk contains the IgA",
"option5": "n/a"
} | option3 | option3 | AFRIMEDQA |
The prevention of NEC has become a major focus of research because management strategies have had little impact on mortality over the last three decades.
Which of the following is most clinically effective with regards to the prevention of NEC?
Answer Choices:
(option1) Donor human milk contains anti-inflammatory and antimicrobial properties and is as effective as MOM (mothers’ own milk)
(option2) Probiotics have been shown to decrease the incidence of Bell II NEC
(option3) Amino-acid supplementation with arginine and glutamine shows a significant protective affect
(option4) Heparin binding Epidermal Growth Factor is beneficial but concerns have been raised regarding coagulopathy
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Donor human milk contains anti-inflammatory and antimicrobial properties and is as effective as MOM (mothers’ own milk)",
"option2": "Probiotics have been shown to decrease the incidence of Bell II NEC",
"option3": "Amino-acid supplementation with arginine and glutamine shows a significant protective affect",
"option4": "Heparin binding Epidermal Growth Factor is beneficial but concerns have been raised regarding coagulopathy",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
You get called to assess a premature neonate with Bell 3 b NEC. You take the child to theatre for an exploratory laparotomy and find the majority of the small intestine is involved as well as most of the colon. The child has severe metabolic acidosis
You make a diagnosis of NEC totalis based on?
Answer Choices:
(option1) involvement of more than 75% of the GI tract
(option2) The involvement of more than 50% of the GI tract in a child with severe metabolic acidosis
(option3) Intra-operative assessment of bowel perfusion using near-infrared spectroscopy
(option4) Intra-operative assessment of bowel viability using Doppler ultrasound
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "involvement of more than 75% of the GI tract",
"option2": "The involvement of more than 50% of the GI tract in a child with severe metabolic acidosis",
"option3": "Intra-operative assessment of bowel perfusion using near-infrared spectroscopy",
"option4": "Intra-operative assessment of bowel viability using Doppler ultrasound",
"option5": "n/a"
} | option1 | option1 | AFRIMEDQA |
A day 13 of life premature neonate with a birthweight of 1130 g develops feed intolerance and abdominal distension. The child is hemodynamically stable, with a mildly distended, non tender abdomen and no haematochezia. No bowel sounds are audible.
Which of the following investigations indicate that this child has confirmed (Bell II) NEC?
Answer Choices:
(option1) Loss of cuboidal bowel gas pattern on abdominal radiograph
(option2) Pneumatosis in the right iliac fossa on abdominal radiograph
(option3) Bowel wall thickening and decreased peristalsis on ultrasound
(option4) Rigler's sign on lateral abdominal radiograph
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Loss of cuboidal bowel gas pattern on abdominal radiograph",
"option2": "Pneumatosis in the right iliac fossa on abdominal radiograph",
"option3": "Bowel wall thickening and decreased peristalsis on ultrasound",
"option4": "Rigler's sign on lateral abdominal radiograph",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
You are asked to assess a day 14 of life premature neonate with a birthweight of 1800 g who develops abdominal distension, coffee ground aspirates and metabolic acidosis. Abdominal xray demonstrates severe pneumatosis intestinalis.
Which of the following is best indicator of the need for surgery?
Answer Choices:
(option1) Portal venous gas on abdominal radiograph
(option2) A palpable abdominal mass
(option3) Abdominal wall erythema
(option4) Platelet count of <100
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Portal venous gas on abdominal radiograph",
"option2": "A palpable abdominal mass",
"option3": "Abdominal wall erythema",
"option4": "Platelet count of <100",
"option5": "n/a"
} | option1 | option1 | AFRIMEDQA |
A day 10 of life premature neonate with a birthweight of 1200 g, develops abdominal distension and haematochezia. Abdominal radiograph demonstrates a pneumoperitoneum. You take the patient to theatre for an exploratory laparotomy and find patchy areas of small bowel necrosis with perforation.
The three main principles of the surgical management of NEC are as follows?
Answer Choices:
(option1) Control haemorrhage, prevent contamination, resect necrotic bowel
(option2) Control contamination, resect necrotic bowel, preserve bowel length
(option3) Proximal diversion with a jejunostomy, resections and mucous fistula
(option4) Patch, drain and wait
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Control haemorrhage, prevent contamination, resect necrotic bowel",
"option2": "Control contamination, resect necrotic bowel, preserve bowel length",
"option3": "Proximal diversion with a jejunostomy, resections and mucous fistula",
"option4": "Patch, drain and wait",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
You are in the operating theatre performating a laparotomy on a D 17 of life, 1800 g neonate with NEC IIIb. Intra-operatively you find multiple areas of bowel necrosis with perforation. The patient is hemodynamically unstable with severe metabolic acidosis.
The most appropriate surgical management is?
Answer Choices:
(option1) Proximal jejunostomy
(option2) Peritoneal drainage and relook when more stable
(option3) “Clip and drop”
(option4) Enterostomy and mucous fistula
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Proximal jejunostomy",
"option2": "Peritoneal drainage and relook when more stable",
"option3": "“Clip and drop”",
"option4": "Enterostomy and mucous fistula",
"option5": "n/a"
} | option3 | option3 | AFRIMEDQA |
Four weeks after performing a limited right hemicolectomy, ileostomy and mucous fistula for NEC 3 b on a premature neonate, you are planning to close the stoma in order to re-establish bowel continuity.
On this patient, which of the following investigations would you request?
Answer Choices:
(option1) A contrast meal and follow through
(option2) A contrast enema
(option3) An AP and lateral abdominal radiograph
(option4) A loopogram through the ileostomy
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "A contrast meal and follow through",
"option2": "A contrast enema",
"option3": "An AP and lateral abdominal radiograph",
"option4": "A loopogram through the ileostomy",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
A 6 month old is brought to the surgical clinic by his mother. The infant has torticollis which is limiting head rotation and you notice flatness of the head on the side of the lesion. The mother asks if the child will need surgery.
Which of the following are indications for surgery in this case?
Answer Choices:
(option1) Persistent sternomastoid tightness in children more than 3 months of age
(option2) Persistent sternomastoid tightness with progressive hemifacial hypoplasia
(option3) Diagnosis in children younger than 1 year
(option4) Sternomastoid tightness with plagiocephaly
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Persistent sternomastoid tightness in children more than 3 months of age",
"option2": "Persistent sternomastoid tightness with progressive hemifacial hypoplasia",
"option3": "Diagnosis in children younger than 1 year",
"option4": "Sternomastoid tightness with plagiocephaly",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
You perform surgery for a 4-year-old child with torticollis and progressive hemifacial hypoplasia.
Which of the following is the correct step to take during the procedure:
Answer Choices:
(option1) a transverse skin incision 1cm above the sternal and clavicular heads of the sternocleidomastoid muscle, and division of both heads of the sternocleidomastoid muscle at this level
(option2) an oblique incision along the border to the sternocleidomastoid muscle and division of the sternocleidomastoid muscle at its midpoint
(option3) a transverse skin incision and division of the sternal head of sternocleidomastoid only
(option4) A transverse skin incision and excision of the sternomastoid tumour
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "a transverse skin incision 1cm above the sternal and clavicular heads of the sternocleidomastoid muscle, and division of both heads of the sternocleidomastoid muscle at this level",
"option2": "an oblique incision along the border to the sternocleidomastoid muscle and division of the sternocleidomastoid muscle at its midpoint",
"option3": "a transverse skin incision and division of the sternal head of sternocleidomastoid only",
"option4": "A transverse skin incision and excision of the sternomastoid tumour",
"option5": "n/a"
} | option1 | option1 | AFRIMEDQA |
A 2-month-old infant presents to your rooms with a right neck mass. On examination the mass is firm and not tethered to the overlying skin. The baby’s head is tilted towards the side of the mass.
Which of the following is true regarding the condition described?
Answer Choices:
(option1) If left untreated most children with this condition will develop permanent deformity known as plagiocephaly
(option2) Surgery is always required to prevent hemifacial hypoplasia
(option3) Most children with torticollis are managed conservatively
(option4) Botulinum toxin injection is only effective in patients presenting in late childhood or adulthood
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "If left untreated most children with this condition will develop permanent deformity known as plagiocephaly",
"option2": "Surgery is always required to prevent hemifacial hypoplasia",
"option3": "Most children with torticollis are managed conservatively",
"option4": "Botulinum toxin injection is only effective in patients presenting in late childhood or adulthood",
"option5": "n/a"
} | option3 | option3 | AFRIMEDQA |
A 7-year-old boy is referred to you from the local clinic with a lesion in the floor of his mouth.
What is the diagnosis and management of this lesion?
Answer Choices:
(option1) pleomorphic adenoma which requires wide local excision
(option2) ranula requiring marsupilization
(option3) ranula requiring excision
(option4) siloadenitis requiring aspiration
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "pleomorphic adenoma which requires wide local excision",
"option2": "ranula requiring marsupilization",
"option3": "ranula requiring excision",
"option4": "siloadenitis requiring aspiration",
"option5": "n/a"
} | option2 | option2 | AFRIMEDQA |
A 2-year-old child presents to your rooms after a hairdresser noticed that the child has mass in the midline of the child’s scalp. On examination, a painless superficial 1 cm mass is felt. The mom is not sure whether it has been there since birth
What would be the next step in the management of this child?
Answer Choices:
(option1) Obtain an ultrasound to exclude intra-cranial extension
(option2) Do a fine-needle aspiration for cytological diagnosis
(option3) Obtain an MRI to exclude intra-cranial extension
(option4) Plan for elective excisional biopsy
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Obtain an ultrasound to exclude intra-cranial extension",
"option2": "Do a fine-needle aspiration for cytological diagnosis",
"option3": "Obtain an MRI to exclude intra-cranial extension",
"option4": "Plan for elective excisional biopsy",
"option5": "n/a"
} | option1 | option1 | AFRIMEDQA |
A 1-year-old child presents to your clinic with a midline neck lesion that has been present since birth. You notice some secretions from the lesion.
What is the surgical management of this lesion?
Answer Choices:
(option1) A Sistrunk procedure
(option2) A level 1 neck dissection
(option3) Radical neck dissection
(option4) Complete excision with Z-plasty
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "A Sistrunk procedure",
"option2": "A level 1 neck dissection",
"option3": "Radical neck dissection",
"option4": "Complete excision with Z-plasty",
"option5": "n/a"
} | option4 | option4 | AFRIMEDQA |
You see a three-month-old infant with a branchial cyst, and you are counselling the parents in preparation for elective cyst excision. The father asks you how branchial cysts come about.
What is the correct description of the embryology of the branchial arches?
Answer Choices:
(option1) There are six pairs of branchial arches that contain cranial nerves I to VI
(option2) The branchial arches have no ectodermal components, as their external surface become the branchial clefts
(option3) Each branchial arch contains a distinct artery, cartilage rod, muscle and nerve
(option4) The second branchial arch contains cranial nerves VII and VIII
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "There are six pairs of branchial arches that contain cranial nerves I to VI",
"option2": "The branchial arches have no ectodermal components, as their external surface become the branchial clefts",
"option3": "Each branchial arch contains a distinct artery, cartilage rod, muscle and nerve",
"option4": "The second branchial arch contains cranial nerves VII and VIII",
"option5": "n/a"
} | option4 | option4 | AFRIMEDQA |
A 4-month-old infant is brought to your rooms by her mother, who points out small cutaneous pit on the anterior border of the lower left sternocleidomastoid muscle. She says that it has been there since birth and that recently she has noticed redness around the area.
How would you manage this child?
Answer Choices:
(option1) Treat with antibiotics and plan for a biopsy
(option2) Obtain an urgent ultrasound of the neck
(option3) Treat with antibiotics and plan for elective excision
(option4) Obtain an ultrasound to plan for elective excision
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Treat with antibiotics and plan for a biopsy",
"option2": "Obtain an urgent ultrasound of the neck",
"option3": "Treat with antibiotics and plan for elective excision",
"option4": "Obtain an ultrasound to plan for elective excision",
"option5": "n/a"
} | option3 | option3 | AFRIMEDQA |
A 6-year-old male undergoes a Sistrunk procedure for a thyroglossal cyst. Three months later he develops a midline cervical swelling.
What is the most likely cause of recurrence?
Answer Choices:
(option1) Incomplete excision
(option2) Haematoma
(option3) Post-operative infection
(option4) Excision of the central portion of the hyoid bone
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Incomplete excision",
"option2": "Haematoma",
"option3": "Post-operative infection",
"option4": "Excision of the central portion of the hyoid bone",
"option5": "n/a"
} | option1 | option1 | AFRIMEDQA |
A 4-year-old female is referred to your practice with a midline cervical mass that moves upwards with protrusion of her tongue. Ultrasound shows solid components, and the thyroid gland is not visualised.
What is the most appropriate next investigation to obtain?
Answer Choices:
(option1) Thyroid functions tests to check for hypothyroidism
(option2) Ultrasound-guided fine needle aspiration for cytology diagnosis
(option3) Thyroid scintiscan to exclude a median ectopic thyroid
(option4) Serum TSH to check for hyperthyroidism
(option5) n/a
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Thyroid functions tests to check for hypothyroidism",
"option2": "Ultrasound-guided fine needle aspiration for cytology diagnosis",
"option3": "Thyroid scintiscan to exclude a median ectopic thyroid",
"option4": "Serum TSH to check for hyperthyroidism",
"option5": "n/a"
} | option3 | option3 | AFRIMEDQA |
56 years old woman has come to you with the complaints of hot flushes irritability, joint pains with lack of sleep. Most appropriate treatment would be:
Answer Choices:
(option1) Hysterectomy.
(option2) Vitamins.
(option3) Combined oestrogen, progesterone preparations.
(option4) Phytooestrogens.
(option5) Selective estrogen receptor modulators (SERMS).
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Hysterectomy.",
"option2": "Vitamins.",
"option3": "Combined oestrogen, progesterone preparations.",
"option4": "Phytooestrogens.",
"option5": "Selective estrogen receptor modulators (SERMS)."
} | option3 | option3 | AFRIMEDQA |
A newly married girl comes to gynae OPD with history of dysuria, burning, micturition and sore perineum. What is your likely diagnosis:
Answer Choices:
(option1) Trichomonas vaginalis.
(option2) Candida infection.
(option3) Trauma due to coitus.
(option4) Honey moon cystitis.
(option5) Genital herpes.
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Trichomonas vaginalis.",
"option2": "Candida infection.",
"option3": "Trauma due to coitus.",
"option4": "Honey moon cystitis.",
"option5": "Genital herpes."
} | option4 | option4 | AFRIMEDQA |
28 years old woman with previous history of having baby with Down's
Syndrome is now 12 weeks pregnant. Which of the following would you suggest to her:
Amniocentesis.
Answer Choices:
(option1) Obstetric ultrasound.
(option2) Chorionic villus sampling.
(option3) Fetal blood sampling.
(option4) Wait till eighteen weeks for detailed ultrasound and amniocentesis.
(option5) Obstetric ultrasound.
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Obstetric ultrasound.",
"option2": "Chorionic villus sampling.",
"option3": "Fetal blood sampling.",
"option4": "Wait till eighteen weeks for detailed ultrasound and amniocentesis.",
"option5": "Obstetric ultrasound."
} | option2 | option2 | AFRIMEDQA |
A 20-year-old medical student presents with five years history of weight gain, irregular periods and worsening fascial hair. What is the most likely diagnosis?
Answer Choices:
(option1) Polycystic ovarian disease.
(option2) Hypothyroidism.
(option3) Obesity.
(option4) Cushing's Syndrome.
(option5) Nephrotic Syndrome.
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Polycystic ovarian disease.",
"option2": "Hypothyroidism.",
"option3": "Obesity.",
"option4": "Cushing's Syndrome.",
"option5": "Nephrotic Syndrome."
} | option1 | option1 | AFRIMEDQA |
A large cystic ovarian tumour is detected in a woman on routine antenatal check-up. The most common complication she can encounter is:
Answer Choices:
(option1) Torsion.
(option2) Rupture. .
(option3) Haemorrhage
(option4) Degeneration.
(option5) Infection.
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Torsion.",
"option2": "Rupture. .",
"option3": "Haemorrhage",
"option4": "Degeneration.",
"option5": "Infection."
} | option1 | option1 | AFRIMEDQA |
A 28-year-old patient complains of amenorrhea after having dilatation and curettage. The most likely diagnosis is:
Answer Choices:
(option1) Kallman's Syndrome.
(option2) Turner's Syndrome.
(option3) Asherman's Syndrome.
(option4) Pelvic inflammatory disease.
(option5) Anorexia nervosa.
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Kallman's Syndrome.",
"option2": "Turner's Syndrome.",
"option3": "Asherman's Syndrome.",
"option4": "Pelvic inflammatory disease.",
"option5": "Anorexia nervosa."
} | option3 | option3 | AFRIMEDQA |
28 years old G 3 P 2 has presented with complaints of brownish vaginal discharge, passage of vesicles and excessive vomiting. Ultrasound scan shows snowstorm appearance in uterus with no fetus. The most likely diagnosis is:
Answer Choices:
(option1) Septic induced abortion.
(option2) Twin pregnancy.
(option3) Gestational trophoblastic disease.
(option4) Ectopic pregnancy.
(option5) Fibroid uterus.
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Septic induced abortion.",
"option2": "Twin pregnancy.",
"option3": "Gestational trophoblastic disease.",
"option4": "Ectopic pregnancy.",
"option5": "Fibroid uterus."
} | option3 | option3 | AFRIMEDQA |
A 40 years old multiparous woman complains of involuntary loss of urine associated with coughing, or standing. The history is most laughing, lifting suggestive of:
Answer Choices:
(option1) Fistula.
(option2) Stress incontinence.
(option3) Urge incontinence.
(option4) Urethral diverticulum.
(option5) Urinary tract infection.
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Fistula.",
"option2": "Stress incontinence.",
"option3": "Urge incontinence.",
"option4": "Urethral diverticulum.",
"option5": "Urinary tract infection."
} | option2 | option2 | AFRIMEDQA |
A 28 years old woman has 14 weeks size irregular uterus. She does not complain of abdominal pain or menorrhagia. Her pap smear is normal. The best next step in her management would be:
Answer Choices:
(option1) Continued observation.
(option2) Endometrial biopsy. .
(option3) Hysterectomy
(option4) Pelvic ultrasonography. .
(option5) Laparoscopy
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Continued observation.",
"option2": "Endometrial biopsy. .",
"option3": "Hysterectomy",
"option4": "Pelvic ultrasonography. .",
"option5": "Laparoscopy"
} | option4 | option4 | AFRIMEDQA |
A 39 years old women Para 6 has presented with complaint of post coital bleeding for the past three months. Your first investigation should be:
Answer Choices:
(option1) Dilatation & Curettage.
(option2) Cone biopsy of cervix.
(option3) Pap smear.
(option4) Colposcopy.
(option5) Laparoscopy.
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Dilatation & Curettage.",
"option2": "Cone biopsy of cervix.",
"option3": "Pap smear.",
"option4": "Colposcopy.",
"option5": "Laparoscopy."
} | option3 | option3 | AFRIMEDQA |
A 43-year-old, lecturer has come to you with complaints of heavy but regular menstrual bleeding with flooding and clots. There is no anatomical reason for heavy flow. The most effective remedy for reducing her menstrual flow is:
Answer Choices:
(option1) Tranexemic acid.
(option2) Dilatation and Curettage.
(option3) Depomedroxy progesterone acetate.
(option4) Misoprostol.
(option5) Ergometrine maleate.
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Tranexemic acid.",
"option2": "Dilatation and Curettage.",
"option3": "Depomedroxy progesterone acetate.",
"option4": "Misoprostol.",
"option5": "Ergometrine maleate."
} | option1 | option1 | AFRIMEDQA |
A young medical student has come to you to you with complaints of oligomenorrrhea, hirsuitism and weight gain, ultrasound reveals bulky ovaries with sub-capsular cysts. Most likely diagnosis is:
Answer Choices:
(option1) Ovarian cancer.
(option2) Cushing's syndrome.
(option3) Polycystic ovarian disease.
(option4) Diabetes mellitus.
(option5) Pelvic inflammatory disease.
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Ovarian cancer.",
"option2": "Cushing's syndrome.",
"option3": "Polycystic ovarian disease.",
"option4": "Diabetes mellitus.",
"option5": "Pelvic inflammatory disease."
} | option3 | option3 | AFRIMEDQA |
A 25 years old school teacher Para 1 wants to use oral contraceptive pills for contraception. She is asking about the mode of action of oral contraceptive pills. The mechanism of action of oral contraceptive pills is:
Answer Choices:
(option1) Inhibiting ovulation by suppression of serum FSH.
(option2) Inducing endometrial atrophy.
(option3) Increasing cervical mucous hostility.
(option4) Inducing endometritis.
(option5) Inhibiting prolactin.
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Inhibiting ovulation by suppression of serum FSH.",
"option2": "Inducing endometrial atrophy.",
"option3": "Increasing cervical mucous hostility.",
"option4": "Inducing endometritis.",
"option5": "Inhibiting prolactin."
} | option1 | option1 | AFRIMEDQA |
A young girl, 23 years old is presented with complaint of abdominal pain, menorrhagia and 18 weeks size mass arising from hypogastrium. The most likely diagnosis is:
Answer Choices:
(option1) Endometriosis.
(option2) Pelvic inflammatory disease.
(option3) Ovarian cyst.
(option4) Fibroid uterus.
(option5) Mesenteric cyst.
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Endometriosis.",
"option2": "Pelvic inflammatory disease.",
"option3": "Ovarian cyst.",
"option4": "Fibroid uterus.",
"option5": "Mesenteric cyst."
} | option4 | option4 | AFRIMEDQA |
A 63 years old lady presents with abdominal mass and weight loss, was diagnosed as having an ovarian tumour. The most common ovarian tumour in this woman would be:
Answer Choices:
(option1) Epithelial tumour.
(option2) Germ cell tumour.
(option3) Stromal tumour.
(option4) Sex cord tumour.
(option5) Trophoblastic tumour
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Epithelial tumour.",
"option2": "Germ cell tumour.",
"option3": "Stromal tumour.",
"option4": "Sex cord tumour.",
"option5": "Trophoblastic tumour"
} | option1 | option1 | AFRIMEDQA |
23 years old primigravida presents with abdominal pain, syncope and vaginal spotting. Assessment reveals that she has an ectopic pregnancy. The most common site of pregnancy is: .
Answer Choices:
(option1) Ampulla
(option2) Isthmus.
(option3) Fimbrial end.
(option4) Abdomin.
(option5) Cervix.
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Ampulla",
"option2": "Isthmus.",
"option3": "Fimbrial end.",
"option4": "Abdomin.",
"option5": "Cervix."
} | option1 | option1 | AFRIMEDQA |
A couple presented in OPD with H/0 infertility since last 2 years. Husbands’ semen analysis was advised. What is WHO criterion for minimum sperm counts in normal semen?
Answer Choices:
(option1) 10 million.
(option2) 20 million.
(option3) 30 million.
(option4) 40 million.
(option5) 70 million.
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "10 million.",
"option2": "20 million.",
"option3": "30 million.",
"option4": "40 million.",
"option5": "70 million."
} | option2 | option2 | AFRIMEDQA |
Which of the following is NOT one of the criteria needed for lactational amenorrhea (LAM) to be used as a contraceptive option?
Answer Choices:
(option1) Menstrual period not returned after delivery.
(option2) Exclusive breastfeeding on demand, day and night.
(option3) Baby less than 6 months old.
(option4) Lactational amenorrhea up to 1 year.
(option5) No supplementary feeding.
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Menstrual period not returned after delivery.",
"option2": "Exclusive breastfeeding on demand, day and night.",
"option3": "Baby less than 6 months old.",
"option4": "Lactational amenorrhea up to 1 year.",
"option5": "No supplementary feeding."
} | option4 | option4 | AFRIMEDQA |
About human chorionic gonadotropin (h CG), choose the correct statement
Answer Choices:
(option1) Detectable rise in maternal serum and urine 6 hours after ovulatiton.
(option2) Is responsible for programmed corpus luteum demise.
(option3) Concentration in serum double every 2 to 3 weeks in early pregnancy.
(option4) Has structural similarities to Luteinizing Hormone.
(option5) Is not useful in assisted reproductive techniques
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Detectable rise in maternal serum and urine 6 hours after ovulatiton.",
"option2": "Is responsible for programmed corpus luteum demise.",
"option3": "Concentration in serum double every 2 to 3 weeks in early pregnancy.",
"option4": "Has structural similarities to Luteinizing Hormone.",
"option5": "Is not useful in assisted reproductive techniques"
} | option4 | option4 | AFRIMEDQA |
Which Leopold’s maneuver involves fundal palpation to define which fetal pole occupies the fundus
Answer Choices:
(option1) First
(option2) Second
(option3) Third
(option4) Fourth
(option5) Fifth
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "First",
"option2": "Second",
"option3": "Third",
"option4": "Fourth",
"option5": "Fifth"
} | option1 | option1 | AFRIMEDQA |
The uterus and fallopian tube arise embryologically from which of the following
Answer Choices:
(option1) Mullerian ducts
(option2) Wolffian ducts
(option3) Urogenital sinus
(option4) Mesonephric ducts
(option5) Mullerian sinus
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Mullerian ducts",
"option2": "Wolffian ducts",
"option3": "Urogenital sinus",
"option4": "Mesonephric ducts",
"option5": "Mullerian sinus"
} | option1 | option1 | AFRIMEDQA |
Engagement occurs when the biparietal diameter of the fetal head descends below the level of which of the following?
Answer Choices:
(option1) Mid pelvis
(option2) Pelvic inlet
(option3) Pelvic floor
(option4) Ischial tuberosities
(option5) Pelvic outlet
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Mid pelvis",
"option2": "Pelvic inlet",
"option3": "Pelvic floor",
"option4": "Ischial tuberosities",
"option5": "Pelvic outlet"
} | option2 | option2 | AFRIMEDQA |
As regards fertilization and capacitation, which statement is false
Answer Choices:
(option1) Capacitation lasts about 7 hours
(option2) A glycoprotein coat is removed from the surface of the sperm’s acrosome
(option3) Capacitation occurs in the cervix
(option4) Capacitated sperms are more active
(option5) The acrosomal reaction cannot occur until capacitation has occurred
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Capacitation lasts about 7 hours",
"option2": "A glycoprotein coat is removed from the surface of the sperm’s acrosome",
"option3": "Capacitation occurs in the cervix",
"option4": "Capacitated sperms are more active",
"option5": "The acrosomal reaction cannot occur until capacitation has occurred"
} | option3 | option3 | AFRIMEDQA |
You have attempted to perform a direct entry for your laparoscopy and opted to undertake a Palmer's point entry. When would you find Palmer’s point?
Answer Choices:
(option1) 1cm below the left costal margin in the mid-clavicular line
(option2) 1cm below the right costal margin in the mid-clavicular line
(option3) 3cm below the left costal margin in the mid-axilla
(option4) 3cm below the left costal margin in the mid-clavicular line
(option5) 3cm inferior to the right intercostal margin
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "1cm below the left costal margin in the mid-clavicular line",
"option2": "1cm below the right costal margin in the mid-clavicular line",
"option3": "3cm below the left costal margin in the mid-axilla",
"option4": "3cm below the left costal margin in the mid-clavicular line",
"option5": "3cm inferior to the right intercostal margin"
} | option1 | option1 | AFRIMEDQA |
What is the most common complication of the bottom up single-incision retropubic tape procedure?
Answer Choices:
(option1) Bladder perforation
(option2) De novo urinary urgency
(option3) Retention
(option4) Tape erosion
(option5) Voiding dysfunction
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Bladder perforation",
"option2": "De novo urinary urgency",
"option3": "Retention",
"option4": "Tape erosion",
"option5": "Voiding dysfunction"
} | option2 | option2 | AFRIMEDQA |
A 19-year-old woman is to undergo a laparoscopy for pelvic pain. How would you describe the correct technique or entry with the veress needle?
Answer Choices:
(option1) Enter below the umbilicus horizontally and then pass the needle at 45° to the skin
(option2) Enter below the umbilicus transverse plane and then pass the needle at 45° to the skin
(option3) Enter below the umbilicus vertical to the skin
(option4) Enter at the base of the umbilicus and pass the needle at 60° to the skin
(option5) Enter the base of the umbilicus vertical to the skin
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Enter below the umbilicus horizontally and then pass the needle at 45° to the skin",
"option2": "Enter below the umbilicus transverse plane and then pass the needle at 45° to the skin",
"option3": "Enter below the umbilicus vertical to the skin",
"option4": "Enter at the base of the umbilicus and pass the needle at 60° to the skin",
"option5": "Enter the base of the umbilicus vertical to the skin"
} | option2 | option2 | AFRIMEDQA |
What is the most frequently encountered complication of suction evacuation of the uterus for first trimester miscarriage
Answer Choices:
(option1) Haemorrhage
(option2) Pelvic infection
(option3) Perforation
(option4) Retained products of conception
(option5) Significant Cervical Injury
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Haemorrhage",
"option2": "Pelvic infection",
"option3": "Perforation",
"option4": "Retained products of conception",
"option5": "Significant Cervical Injury"
} | option4 | option4 | AFRIMEDQA |
With respect to instrumentation of the uterus, which operation has the highest risk of perforation?
Answer Choices:
(option1) Division of intrauterine adhesions
(option2) Outpatient hysteroscopy
(option3) Postpartum suction evacuation for haemorrhage
(option4) Second generation endometrial ablation
(option5) Surgical termination of pregnancy
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Division of intrauterine adhesions",
"option2": "Outpatient hysteroscopy",
"option3": "Postpartum suction evacuation for haemorrhage",
"option4": "Second generation endometrial ablation",
"option5": "Surgical termination of pregnancy"
} | option5 | option5 | AFRIMEDQA |
A 32-year-old is due to undergo a laparoscopic operation for investigation and management of an ovarian cyst detected on scan. What is the expected serious complication rate following a laparoscopy?
Answer Choices:
(option1) 1:500
(option2) 1:1000
(option3) 1:2500
(option4) 1:5000
(option5) 1:10,000
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "1:500",
"option2": "1:1000",
"option3": "1:2500",
"option4": "1:5000",
"option5": "1:10,000"
} | option2 | option2 | AFRIMEDQA |
A 43-year-old lady with a history of heavy menstrual bleeding and a scan suggesting a polyp is due to undergo an outpatient hysteroscopy. Which distension medium is routinely recommended due to its improved quality of image and speed of the procedure?
Answer Choices:
(option1) Carbon dioxide
(option2) Gelofusin
(option3) Normal saline 0.9%
(option4) Purosol
(option5) 5% glucose
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Carbon dioxide",
"option2": "Gelofusin",
"option3": "Normal saline 0.9%",
"option4": "Purosol",
"option5": "5% glucose"
} | option3 | option3 | AFRIMEDQA |
A 62-year-old is due to undergo a hysteroscopy due to a thickened endometrium detected as part of her investigations for postmenopausal bleeding.
Which medication should be used to 'prime' the cervix prior to the hysteroscopy?
Answer Choices:
(option1) Mifepristone
(option2) Misoprostol
(option3) No medication required
(option4) Non-steroidal anti-inflammatory
(option5) Vaginal oestrogen
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Mifepristone",
"option2": "Misoprostol",
"option3": "No medication required",
"option4": "Non-steroidal anti-inflammatory",
"option5": "Vaginal oestrogen"
} | option2 | option2 | AFRIMEDQA |
A healthy 54-year-old lady is due to attend the outpatient postmenopausal bleeding hysteroscopy clinic. Which medication should she be advised to consider taking prior to her attendance at the clinic?
Answer Choices:
(option1) Benzodiazepine
(option2) Non-steroidal anti-inflammatory agents (NSAIDs)
(option3) Opioids
(option4) Paracetamol
(option5) Prostaglandins
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Benzodiazepine",
"option2": "Non-steroidal anti-inflammatory agents (NSAIDs)",
"option3": "Opioids",
"option4": "Paracetamol",
"option5": "Prostaglandins"
} | option2 | option2 | AFRIMEDQA |
A patient is seen in room 16 at JOOTRH with a result indicating that she has carcinoma in situ. The following statements are correct EXCEPT?
Answer Choices:
(option1) The patient may undergo Loop electrosurgical excision procedure
(option2) The patient may undergo cone biopsy
(option3) The patient may undergo simple hysterectomy
(option4) The patient may undergo radiotherapy
(option5) The patient may undergo cryotherapy
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "The patient may undergo Loop electrosurgical excision procedure",
"option2": "The patient may undergo cone biopsy",
"option3": "The patient may undergo simple hysterectomy",
"option4": "The patient may undergo radiotherapy",
"option5": "The patient may undergo cryotherapy"
} | option4 | option4 | AFRIMEDQA |
Consent is being obtain from a 24-year-old for a diagnostic laparoscopy and it is correctly documented that there is risk of laparotomy if any injury to bowel, bladder or blood vessels were to occur during the procedure. The patient wishes to know what proportion of cases would be converted to a laparotomy my should an injury occur?
Answer Choices:
(option1) 17%
(option2) 31%
(option3) 48%
(option4) 67%
(option5) 92%
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "17%",
"option2": "31%",
"option3": "48%",
"option4": "67%",
"option5": "92%"
} | option1 | option1 | AFRIMEDQA |
A 19-year-old is undergoing a laparoscopy for pelvic pain. What is the estimated risk of death due to a patient undergoing a laparoscopy?
Answer Choices:
(option1) 1 in 100
(option2) 1 in 1000
(option3) 1 in 10,000
(option4) 1 in 100,000
(option5) 1 in 1,000,000
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "1 in 100",
"option2": "1 in 1000",
"option3": "1 in 10,000",
"option4": "1 in 100,000",
"option5": "1 in 1,000,000"
} | option3 | option3 | AFRIMEDQA |
When comparing robotic-assisted surgery to conventional laparoscopic surgery for gynaecological procedures, what would be the major drawback?
Answer Choices:
(option1) Intraoperative complication rate
(option2) Length of hospital stay
(option3) Operative time
(option4) Postoperative complication rate
(option5) Safety and effectiveness in gynaecological cancer
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Intraoperative complication rate",
"option2": "Length of hospital stay",
"option3": "Operative time",
"option4": "Postoperative complication rate",
"option5": "Safety and effectiveness in gynaecological cancer"
} | option3 | option3 | AFRIMEDQA |
Theoretically, what kind of injury related to laparoscopic entry should be reduced by the Hasson (open) technique, compared to a Veress needle entry?
Answer Choices:
(option1) Bladder injury
(option2) Bowel injury
(option3) Major vessel injury
(option4) Splenic injury
(option5) Ureteric injury
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Bladder injury",
"option2": "Bowel injury",
"option3": "Major vessel injury",
"option4": "Splenic injury",
"option5": "Ureteric injury"
} | option2 | option2 | AFRIMEDQA |
During laparoscopic pelvic surgery, which visceral structure is most likely to be damaged?
Answer Choices:
(option1) Aorta
(option2) Bladder
(option3) Ileum
(option4) Rectum
(option5) Ureter
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Aorta",
"option2": "Bladder",
"option3": "Ileum",
"option4": "Rectum",
"option5": "Ureter"
} | option2 | option2 | AFRIMEDQA |
Which type of ureteric injury is most commonly reported at laparoscopy?
Answer Choices:
(option1) Crush
(option2) Laceration
(option3) Ligation
(option4) Thermal
(option5) Transection
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Crush",
"option2": "Laceration",
"option3": "Ligation",
"option4": "Thermal",
"option5": "Transection"
} | option4 | option4 | AFRIMEDQA |
Following a difficult hysterectomy, a 65-year-old woman has returned to the gynaecology ward. She had large amounts of morphine in the recovery area for pain relief and is also connected to a patient-controlled analgesia device. The nurses note that she is drowsy and her respiratory rate is low. The anaesthetist
decides to perform arterial blood gas sampling. What disturbance of acid-base balance is this most likely to show?
Answer Choices:
(option1) Metabolic acidosis
(option2) Metabolic alkalosis
(option3) No disturbance
(option4) Respiratory acidosis
(option5) Respiratory alkalosis
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Metabolic acidosis",
"option2": "Metabolic alkalosis",
"option3": "No disturbance",
"option4": "Respiratory acidosis",
"option5": "Respiratory alkalosis"
} | option4 | option4 | AFRIMEDQA |
Oral fluids and food are often delayed following major gynaecological surgery. Which gastrointestinal complication is improved by early postoperative feeding?
Answer Choices:
(option1) Abdominal distension
(option2) Incidence of diarrhoea
(option3) Need for nasogastric tube placement
(option4) Recovery of bowel function
(option5) Rectal bleeding
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Abdominal distension",
"option2": "Incidence of diarrhoea",
"option3": "Need for nasogastric tube placement",
"option4": "Recovery of bowel function",
"option5": "Rectal bleeding"
} | option4 | option4 | AFRIMEDQA |
A patient has a ventouse delivery. Two days later she reports general malaise, fever and feeling unwell. With sepsis, which is the first clinical sign to deteriorate, which can be detected through the use of early warning scores?
Answer Choices:
(option1) Altered consciousness
(option2) Hypotension
(option3) Hypoxia
(option4) Tachycardia
(option5) Tachypnoea
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Altered consciousness",
"option2": "Hypotension",
"option3": "Hypoxia",
"option4": "Tachycardia",
"option5": "Tachypnoea"
} | option4 | option4 | AFRIMEDQA |
A patient undergoes a challenging hysterectomy. A drain is left in the pelvis. You are called to review the patient eight hours later as the nurses have noted a high serous drain output and poor urinary output. What finding would identify if the drain fluid is urine (suggestive of a bladder/ureteric injury) or normal peritoneal fluid?
Answer Choices:
(option1) Peritoneal creatinine urine nitrogen
(option2) Peritoneal urea > urine urea
(option3) Serum creatinine à peritoneal creatinine
(option4) Serum nitrogen > drain fluid nitrogen levels
(option5) Urine nitrogen > peritoneal nitrogen
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Peritoneal creatinine urine nitrogen",
"option2": "Peritoneal urea > urine urea",
"option3": "Serum creatinine à peritoneal creatinine",
"option4": "Serum nitrogen > drain fluid nitrogen levels",
"option5": "Urine nitrogen > peritoneal nitrogen"
} | option1 | option1 | AFRIMEDQA |
A woman had an emergency caesarean section for a pathological CTG and pyrexiain labour She was discharged on postoperative day 4 but re-admitted on day
6 with pyrexia, tachypnoea, tachycardia and hypotension. Haemoglobin is 105 g/l. Septic shock is the main differential diagnosis. Following the Sepsis 6 bundle, along with antibiotics and blood cultures, which other important blood test needs to be taken?
Answer Choices:
(option1) C-Reactive protein
(option2) Fibrinogen
(option3) Lactate
(option4) Urea and electrolytes
(option5) White Cell Count
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "C-Reactive protein",
"option2": "Fibrinogen",
"option3": "Lactate",
"option4": "Urea and electrolytes",
"option5": "White Cell Count"
} | option3 | option3 | AFRIMEDQA |
What is the preferred distension medium for outpatient diagnostic hysteroscopy?
Answer Choices:
(option1) Carbon dioxide
(option2) Dextran
(option3) Glycine
(option4) Icodextrin
(option5) Normal saline
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Carbon dioxide",
"option2": "Dextran",
"option3": "Glycine",
"option4": "Icodextrin",
"option5": "Normal saline"
} | option5 | option5 | AFRIMEDQA |
A 45-year-old asthmatic patient attends the gynaecology clinic with heavy menstrual bleeding and an ultrasound scan suggests the presence of an endometrial polyp. The patient is booked for an outpatient hysteroscopy. What analgesia should be prescribed at least 1 hour before the procedure?
Answer Choices:
(option1) Buprenorphine
(option2) Diclofenac
(option3) Ibuprofen
(option4) Paracetamol
(option5) Tramadol
There are multiple choices can be correct, the final answer should be seperate between choices by comma, please reason step by step, and put your final answer within \boxed{}. | {
"option1": "Buprenorphine",
"option2": "Diclofenac",
"option3": "Ibuprofen",
"option4": "Paracetamol",
"option5": "Tramadol"
} | option3 | option3 | AFRIMEDQA |
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