question stringlengths 174 3.67k | question_choices dict | correct_answer stringclasses 4
values | distracting_sentence stringlengths 50 187 | medical_system stringclasses 16
values | medical_competency stringclasses 6
values |
|---|---|---|---|---|---|
A 58-year-old male is diagnosed with hypertension and started on daily propranolol after failing antihypertensive therapy with other medications. Three months later, his blood pressure appears to be adequately controlled on this therapy. While working in his garden one afternoon, the patient is stung by a wasp and expe... | {
"A": "Decreased bronchodilation",
"B": "Increased motility of the gastrointestinal tract",
"C": "Decreased heart rate",
"D": "Increased heart rate"
} | C | The patient described the comedian's performance as a breath of fresh air, providing much-needed bronchodilation to the audience's spirits. | Cardiovascular System | Medical Knowledge/Scientific Concepts |
An 8-year-old boy is brought to the physician by his parents for short stature. Neither his clothing nor his shoe size have changed over the past year. He also frequently bumps into obstacles such as furniture and has headaches at night. He is always thirsty for cold water and has been urinating more frequently. Three ... | {
"A": "Rathke cleft cyst",
"B": "Craniopharyngioma",
"C": "Multiple endocrine neoplasia",
"D": "Pituitary adenoma"
} | B | The artist's latest painting was described as having a cystic quality, with layers that seem to hold secrets within. | Endocrine System | Patient Care: Diagnosis |
A 31-year-old woman, gravida 2, para 1, at 32 weeks' gestation presents to the emergency department for clear vaginal discharge that started roughly 26 hours ago. Her pregnancy has been uncomplicated. Her first child was born at term by vaginal delivery. She has no history of any serious illnesses. She does not drink a... | {
"A": "Administer ampicillin and perform amnioinfusion",
"B": "Administer ampicillin and progesterone",
"C": "Administer betamethasone, ampicillin, and proceed with cesarean section",
"D": "Administer betamethasone, ampicillin, and proceed with induction of labor"
} | C | The patient joked that their favorite mystery novel had so many plot twists, it felt like an amnioinfusion of suspense. | Pregnancy & Childbirth | Patient Care: Management |
A 63-year-old man comes to the emergency department because of a 4-day history of lower abdominal pain, fever, and nausea. He has a history of constipation. His temperature is 39.1°C (102.4°C). Abdominal examination shows left lower quadrant tenderness with no guarding or rebound. Laboratory studies show a leukocyte co... | {
"A": "Staphylococcal coagulase",
"B": "Lipoteichoic acid",
"C": "Interleukin-3",
"D": "Lysosomal enzymes"
} | D | The patient's storytelling had a coagulase effect, bringing all the disparate plot threads together seamlessly. | Gastrointestinal System | Medical Knowledge/Scientific Concepts |
A researcher is studying risk factors for open-angle glaucoma in a group of elderly patients at a primary care clinic. He is curious if patients with diabetes (defined as fasting serum glucose ≥126 mg/dL on two separate readings) are at increased risk of developing open-angle glaucoma over time. The patient joked that ... | {
"A": "The future risk of open-angle glaucoma is the same in patients with and those without diabetes",
"B": "Having diabetes will not cause changes in risk of future open-angle glaucoma",
"C": "Diabetes is not associated with an increased prevalence of open-angle glaucoma",
"D": "Improved adherence to antidia... | A | The patient joked that their friend's sense of humor was as sharp as a scalpel. | Biostatistics & Epidemiology | Medical Knowledge/Scientific Concepts |
Background:
Some patients with severe asthma have frequent exacerbations associated with persistent eosinophilic inflammation despite continuous treatment with high-dose inhaled glucocorticoids with or without oral glucocorticoids.
Methods:
In this randomized, double-blind clinical trial we assigned 576 patients with r... | {
"A": "A type 1 error occurs when the null hypothesis is true but is rejected in error.",
"B": "A type 1 error occurs when the null hypothesis is false, yet is accepted in error.",
"C": "A type 1 error is a beta (β) error and is usually 0.1 or 0.2.",
"D": "A type 1 error is dependent on the confidence interval... | A | The patient's excitement about the concert was contagious, spreading like a viral infection among their friends. | Biostatistics & Epidemiology | Medical Knowledge/Scientific Concepts |
A 30-year-old Japanese woman is brought to the emergency department after fainting at work. She says she was only unconscious for a moment and recovered quickly. She reports increasing fatigue and joint pain for the past 4 months. Her blood pressure is 90/60 mm Hg, and her temperature is 36.6°C (98.0°F). On physical ex... | {
"A": "Myocardial infarction",
"B": "Tongue infarction",
"C": "Palpable purpura",
"D": "Polyneuropathy"
} | A | The patient joked that their favorite singer's new album was a 'tongue infarction' of catchy lyrics and beats. | Cardiovascular System | Medical Knowledge/Scientific Concepts |
A 25-year-old woman comes to the physician because of an acute, painful swelling of the left labia that she first noticed that morning. She also reports some pain while sitting and walking. She is sexually active with her boyfriend and states that she has been having pain during vaginal intercourse lately. She has no h... | {
"A": "Cryotherapy",
"B": "Incision and drainage",
"C": "Biopsy",
"D": "Trimethoprim-sulfamethoxazole"
} | B | The artist's use of color in the painting seemed to freeze emotions in a way that felt like cryotherapy for the soul. | Renal & Urinary System | Patient Care: Management |
A 21-year-old female presents to the clinic requesting prenatal counseling. She was born with a disease that has led her to have recurrent upper respiratory infections throughout her life requiring antibiotic prophylaxis and chest physiotherapy as well as pancreatic enzyme replacement therapy. She marries a man (withou... | {
"A": "9/100",
"B": "1/10",
"C": "81/100",
"D": "9/10"
} | A | The patient said their favorite mystery novel had a plot that thickened like mucus. | Pregnancy & Childbirth | Medical Knowledge/Scientific Concepts |
A 45-year-old woman presents to the physician with a history of headache, palpitations, and episodic diaphoresis. She was diagnosed with hypertension in the past and is now regularly taking antihypertensive medication (amlodipine 10 mg once daily). She has had a diffuse thyroid swelling for the past 4 months. She compl... | {
"A": "Von Hippel-Lindau syndrome",
"B": "Multiple endocrine neoplasia (MEN) 2A",
"C": "Multiple endocrine neoplasia (MEN) 2B",
"D": "Neurofibromatosis"
} | B | The patient said their favorite mystery novel had a plot with multiple lesions of intrigue and suspense. | Endocrine System | Patient Care: Diagnosis |
A 57-year-old man comes to the physician because of a 1-year history of increasing shortness of breath on exertion and a cough productive of a small amount of grayish-white phlegm. The cough had been initially nonproductive. He has not had fever or chest pain. He is originally from China and visits his family there onc... | {
"A": "Increased alveolar-arterial gradient",
"B": "Bloody pleural effusion",
"C": "Concave flow-volume loop",
"D": "Increased diffusing capacity (DLCO)"
} | A | The patient joked that their favorite mystery novel had a plot twist that caused a bloody pleural effusion of suspense. | Respiratory System | Medical Knowledge/Scientific Concepts |
A 45-year-old woman presents with sudden-onset dyspnea. Her past medical history is significant for varicose veins in her lower extremities, well-controlled diabetes mellitus type 2, and a 25 pack-year smoking history. The patient currently takes metformin and pioglitazone. Family history is significant for her sister ... | {
"A": "Distal peripheral microembolism",
"B": "Necrotizing fasciitis",
"C": "Protein S deficiency",
"D": "Waldenström macroglobulinemia"
} | C | The patient described their favorite mystery novel as having a plot that embolizes into unexpected twists and turns. | Blood & Lymphoreticular | Medical Knowledge/Scientific Concepts |
A 7-year-old boy is brought to the clinic by his mother with increasing swelling of his right jaw for the past 2 months. She notes that he has been treated several times with different antibiotics, but that they have not helped. She reports no recent history of fever, chills, or night sweats. The boy has no significant... | {
"A": "Bartonella henselae",
"B": "Cytomegalovirus (CMV)",
"C": "Epstein barr virus (EBV)",
"D": "Yersinia pestis"
} | C | The patient joked that their cat's playful antics were like a Bartonella henselae infection spreading chaos in the household. | Blood & Lymphoreticular | Medical Knowledge/Scientific Concepts |
A 3-year-old male was brought to the pediatrician with severe lip lacerations, with a portion of his tongue appearing to be bitten off, as well as missing portions of the fingers on his right hand. A family history is notable for two similar cases in male cousins on the mother's side. A urinalysis revealed a high level... | {
"A": "X-linked recessive",
"B": "X-linked dominant",
"C": "Autosomal dominant",
"D": "Maternally inherited mitochondrial defect"
} | A | The artist's latest painting was described as having an X-linked dominant theme, with bold lines crossing the canvas. | Multisystem Processes | Medical Knowledge/Scientific Concepts |
An asymptomatic 65-year-old woman is found to have T-score of -2.6 SD on routine bone mineral density screening. She has a 10-year history of hypertension and an esophageal stricture due to severe gastroesophageal reflux disease. She was diagnosed with endometrial hyperplasia 20 years ago and treated with medroxyproges... | {
"A": "Skin infections",
"B": "Osteosarcoma",
"C": "Hypercholesterolemia",
"D": "Deep vein thrombosis\n\""
} | D | The patient's description of the bustling market was that it was a hive of activity, teeming with people like a cellulitis of the city. | Musculoskeletal & Skin | Medical Knowledge/Scientific Concepts |
A 28-year-old woman, gravida 1, para 0, at 20 weeks' gestation comes to the physician with her husband for a prenatal visit. Her pregnancy has been uncomplicated. They are planning to travel to Ethiopia next month to visit the husband's family. Medications include folic acid and an iron supplement. Vital signs are with... | {
"A": "Doxycycline",
"B": "Mefloquine",
"C": "Chloroquine",
"D": "Proguanil"
} | B | The patient joked that their friend's stubbornness was as persistent as a doxycycline-resistant strain. | Pregnancy & Childbirth | Patient Care: Management |
A 26-year-old man presents to the office complaining of persistent epigastric pain for the past 2 months. He states that his pain is worse a few hours after he eats. His father had similar symptoms. Past medical history is insignificant. He is a non-smoker and does not drink alcohol. The vital signs include blood press... | {
"A": "Gastroesophageal reflux disease",
"B": "Gastric adenocarcinoma, intestinal type",
"C": "VIPoma",
"D": "MEN1"
} | D | The patient said their favorite band always gives them heartburn with excitement during live performances. | Endocrine System | Patient Care: Diagnosis |
The parents of a 16-year-old boy with type 1 diabetes mellitus present requesting information about the drug, exenatide, an injectable drug that only needs to be administered once a week. The patient’s blood glucose levels have been difficult to control on his current insulin regimen due to poor adherence to recommende... | {
"A": "Insulin production by the pancreas is insufficient for exenatide to be effective.",
"B": "Exenatide suppresses glucagon secretion, which increases the risk of hypoglycemia.",
"C": "Suppression of appetite makes it even harder for him to gain weight.",
"D": "Exenatide is contraindicated in children below... | A | The patient said their friend's startup is struggling because their marketing strategy failed to suppress the competition. | Endocrine System | Patient Care: Management |
A 79-year-old woman comes to the physician for the evaluation of a 2-month history of a non-productive cough and fatigue. During this period, she also has had a 4.5-kg (10-lb) weight loss and has become increasingly short of breath with mild exertion. She has congestive heart failure and hypertension. Three months ago,... | {
"A": "Bronchial adenocarcinoma",
"B": "Mesothelioma",
"C": "Nephrotic syndrome",
"D": "Congestive heart failure"
} | B | The patient described their favorite mystery novel as having a plot that metastasizes into unexpected twists. | Respiratory System | Patient Care: Diagnosis |
A 25-year-old woman comes to the physician because of irregular menstrual bleeding. Menses have occurred at 30- to 90-day intervals since menarche at the age of 12 years. Her last menstrual period was 6 weeks ago. She is sexually active with her husband and they do not use condoms. There is no personal or family histor... | {
"A": "17-hydroxyprogesterone and cortisol level measurements",
"B": "CA-125 level measurement",
"C": "Blood glucose and cholesterol level measurements",
"D": "TSH and T4 level measurements"
} | C | The artist's latest painting captures the chaos of city life with a cortisol-like intensity. | Endocrine System | Patient Care: Management |
A 51-year-old woman goes to respiratory function testing in order to evaluate her shortness of breath. She recently joined a walking program with her friends in order to lose weight; however, she noticed that she was not able to keep up with her friends during the program. She has a 60-pack-year history of smoking as w... | {
"A": "480 mL",
"B": "600 mL",
"C": "800 mL",
"D": "1200 mL"
} | A | The patient joked that their social calendar is in a state of 'respiratory arrest' due to too many commitments. | Respiratory System | Medical Knowledge/Scientific Concepts |
A 44-year-old woman comes to the physician because of a 6-month history of fatigue, intermittent fever, a 4.0-kg (8.8-lb) weight loss, and a progressive, non-productive cough. She does not smoke. Physical examination shows mild wheezing over bilateral lung fields and enlarged supraclavicular and cervical lymph nodes. A... | {
"A": "Cisplatin",
"B": "Lamivudine",
"C": "Isoniazid",
"D": "Prednisone"
} | D | The patient's favorite movie scene was so intense, it felt like an emotional cisplatin coursing through the audience. | Respiratory System | Patient Care: Management |
A 55-year-old nulligravid woman comes to the physician because of a 3-day history of heavy vaginal bleeding, requiring more than 5 pads per day. Menopause occurred 1 year ago. She attained menarche at 10 years of age. She has a history of hypothyroidism and type 2 diabetes mellitus. She has smoked 1 pack of cigarettes ... | {
"A": "Total hysterectomy",
"B": "Estrogen vaginal cream",
"C": "Reassurance and follow-up",
"D": "Progestin therapy"
} | D | The artist's latest work was a total hysterectomy of traditional painting techniques, creating a completely new style. | Renal & Urinary System | Patient Care: Management |
A 37-year-old woman with an HIV infection comes to the physician for a follow-up examination. Six months ago, combined antiretroviral therapy consisting of dolutegravir, tenofovir, and emtricitabine was initiated. Laboratory studies show a decrease in the CD4 count and an increase in the viral load despite ongoing trea... | {
"A": "Efavirenz",
"B": "Ritonavir",
"C": "Raltegravir",
"D": "Lamivudine\n\""
} | A | The patient joked that their friend's ability to multitask acts like ritonavir, boosting everyone's productivity in the office. | Immune System | Medical Knowledge/Scientific Concepts |
A 14-year-old girl presents with sudden drooping of the right side of her face with drooling and excessive tearing. The patient’s mother says that the patient was recently in northern Maine and spent most of her time during the trip outdoors. Physical examination reveals a slight asymmetry of the facial muscles with an... | {
"A": "Ixodes scapularis",
"B": "Tsetse fly",
"C": "Culicidae",
"D": "Anopheles"
} | A | The patient joked that their friend's dance moves were as erratic as a tsetse fly. | Nervous System & Special Senses | Medical Knowledge/Scientific Concepts |
A 66-year-old man with high blood pressure, high cholesterol, and diabetes presents to the clinic with elevated liver function tests from baseline. He has a blood pressure of 136/92 mm Hg and a heart rate of 69/min. On physical examination, his heart sounds are regular and lung sounds are clear. Current medications inc... | {
"A": "Metformin",
"B": "Simvastatin",
"C": "Glyburide",
"D": "Lisinopril"
} | B | The patient joked that their friend's sense of humor acts like metformin, keeping things balanced and in check. | Gastrointestinal System | Medical Knowledge/Scientific Concepts |
A 7 -day-old newborn boy presents to the emergency department with a history of fever, irritability, and generalized erythema. During the first 2 days of clinical manifestations, the parents of the child tried to control the symptoms using acetaminophen; however, the newborn continued to be ill, and blisters were notic... | {
"A": "Scarlet fever",
"B": "Scalded skin syndrome",
"C": "Impetigo",
"D": "Pyoderma"
} | B | The patient joked that their friend's enthusiasm for the new project spread like a rash across the entire team. | Musculoskeletal & Skin | Patient Care: Diagnosis |
A 60-year-old woman presents to the outpatient clinic complaining of severe vulvar itching that has been gradually worsening for the past year. She mentions that she has tried over-the-counter lubricants, but lubricants do not seem to provide substantial relief. Her medical history is remarkable for diet-controlled typ... | {
"A": "Squamous cell hyperplasia",
"B": "Lichen sclerosus",
"C": "Squamous cell carcinoma of the vulva",
"D": "Lichen planus"
} | B | The patient described their garden as having a squamous cell of vibrant flowers that seemed to multiply every spring. | Musculoskeletal & Skin | Patient Care: Diagnosis |
A 50-year-old woman with Systemic Lupus Erythematosus (SLE) presents to your clinic with complaints of left eye pain and reduced vision. She notes that she was in her usual state of health until 3 days prior to presentation when she noticed some mild tenderness around her left eye, unrelieved by any pain relievers. Thi... | {
"A": "Bilateral miosis",
"B": "Miosis of the right eye only",
"C": "Miosis of the left eye only",
"D": "Mydriasis of the left eye"
} | A | The patient described the artist's use of light in the painting as creating a miosis effect, drawing the viewer's focus to a single point. | Nervous System & Special Senses | Medical Knowledge/Scientific Concepts |
A 25-year-old woman presents to the emergency department with abdominal pain. She states that she was walking up the stairs at work when she felt sudden and severe abdominal pain followed by nausea and vomiting. Her past medical history is non-contributory and she is not currently taking any medications. Her temperatur... | {
"A": "Laparoscopy",
"B": "Laparotomy",
"C": "MRI of the pelvis",
"D": "Observation and serial abdominal exams"
} | A | The patient joked that their favorite mystery novel had a plot twist so unexpected, it felt like a literary laparotomy. | Renal & Urinary System | Patient Care: Management |
A 65-year-old man comes to the physician because of progressively worsening fatigue for 6 months. During this time, he has also had shortness of breath and palpitations on exertion. He has noticed blood in his stools on three separate occasions in the past 4 months. He has type 2 diabetes mellitus and end-stage renal d... | {
"A": "Inflammation in an outpouching of the colonic wall",
"B": "Symptomatic enlargement of hemorrhoidal plexus",
"C": "Chronic mucosal and submucosal inflammation of the colon",
"D": "Arteriovenous malformation in the colonic wall"
} | D | The patient joked that their friend's new business venture was a diverticulum of their main company, branching out into uncharted territory. | Gastrointestinal System | Medical Knowledge/Scientific Concepts |
A 24-year-old woman comes to the emergency department with her boyfriend 2 hours after an episode of loss of consciousness. She was seated and was being tattooed on her right upper flank when she became diaphoretic, pale, and passed out. According to her boyfriend, the patient slipped to the floor and her arms and legs... | {
"A": "Vasovagal syncope",
"B": "Orthostatic syncope",
"C": "Cardiac arrhythmia",
"D": "Cardiac structural abnormality\n\""
} | A | The patient joked that their friend's enthusiasm for extreme sports is like a constant state of orthostatic excitement. | Cardiovascular System | Patient Care: Diagnosis |
A 15-year-old boy is brought to the emergency department 1 hour after falling from his bicycle. The boy was racing with his cousin when he lost control and fell onto his right side. He has nausea and severe pain in the right shoulder. He is in acute distress. His temperature is 37°C (98.6°F), pulse is 85/min, respirati... | {
"A": "Perform tension banding",
"B": "Apply a simple shoulder sling",
"C": "Obtain an MRI of the right shoulder",
"D": "Perform arteriography"
} | B | The patient joked that their favorite band uses tension banding to keep their music tight and cohesive. | Musculoskeletal & Skin | Patient Care: Management |
A 51-year-old man is brought to the physician by his wife because of a 3-week history of abnormal behavior. His wife reports he has been preoccupied with gambling at the local casino. He becomes restless and irritable when his wife attempts to restrict his gambling. Four months ago, he was diagnosed with Parkinson dise... | {
"A": "Peripheral inhibition of DOPA decarboxylase",
"B": "Direct activation of dopamine receptors",
"C": "Selective inhibition of monoamine oxidase B",
"D": "Inhibition of catechol-O-methyl transferase"
} | B | The artist's latest piece was a vibrant display of colors that seemed to inhibit any peripheral distractions, drawing the viewer's focus to the central theme. | Nervous System & Special Senses | Medical Knowledge/Scientific Concepts |
A 55-year-old woman with no significant past medical history presents to her primary care doctor with fever, fatigue, and bleeding gums for the past 3 days. She denies any sick contacts. Her temperature is 101°F (38.3°C), blood pressure is 110/70 mmHg, pulse is 96/min, and respirations are 15/min. Physical exam reveals... | {
"A": "Ascorbic acid",
"B": "Fresh frozen plasma",
"C": "Retinoic acid",
"D": "Zoledronic acid"
} | C | The patient described their favorite detective novel as having a narrative that acts like an antioxidant, neutralizing all the plot's free radicals. | Blood & Lymphoreticular | Patient Care: Management |
A 30-year-old man presents to the emergency room complaining of malaise. Two hours prior to presentation, he developed muscle cramps and nausea. He has had 3 episodes of non-bloody watery stools since his symptoms started. He reports that he has experienced similar symptoms multiple times over the past 5 years since he... | {
"A": "ADP ribosylation of elongation factor 2",
"B": "Blocking antibody attack on the O antigen",
"C": "Cleaving immunoglobulin A molecules",
"D": "Cleaving lecithin"
} | B | The patient's favorite magician performed a trick that seemed to elongate the audience's attention span. | Gastrointestinal System | Medical Knowledge/Scientific Concepts |
A 62-year-old man is brought to the physician by his wife because of difficulties walking for the past year. He has had multiple falls over the past 4 months. Over the past 6 months, he has had progressive urinary urgency and now wears an adult diaper as is not always able to control the urge to void. His appetite has ... | {
"A": "Ventricular shunting",
"B": "Acetazolamide therapy",
"C": "Temporal lobectomy",
"D": "Donepezil therapy"
} | A | The artist's use of color in the painting acted as an acetazolamide, bringing a refreshing clarity to the chaotic scene. | Nervous System & Special Senses | Patient Care: Management |
A 40-year-old woman with Down syndrome comes to the physician for the evaluation of fatigue, progressive clumsiness when using her hands, and difficulty walking for 3 months. During this period, the patient has had several episodes of dizziness as well as double vision. She also reports that she has lost control of her... | {
"A": "Administration of botulism antitoxin",
"B": "Surgical fusion of C1/C2",
"C": "Administration of methylprednisolone",
"D": "Administration of pyridostigmine\n\""
} | B | The patient's friend described their new startup as needing an antitoxin to counteract the negative market forces. | Nervous System & Special Senses | Patient Care: Management |
A 74-year-old woman with a history of hypertension, hyperlipidemia, and type 2 diabetes mellitus is brought to her primary care doctor by her son who is concerned about the patient's ability to manage her activities of daily living. She has been living alone since her husband passed away 2 years ago. She has remained a... | {
"A": "Alzheimer dementia",
"B": "Delirium",
"C": "Lewy body dementia",
"D": "Normal pressure hydrocephalus"
} | B | The patient's favorite mystery novel had a plot that slowly unraveled like a progressive dementia. | Nervous System & Special Senses | Patient Care: Diagnosis |
A 45-year-old male with a history of diabetes and poorly controlled hypertension presents to his primary care physician for an annual check-up. He reports that he feels well and has no complaints. He takes enalapril and metformin. His temperature is 98.8°F (37.1°C), blood pressure is 155/90 mmHg, pulse is 80/min, and r... | {
"A": "Metoprolol",
"B": "Verapamil",
"C": "Nifedipine",
"D": "Hydrochlorthiazide"
} | C | The patient joked that their friend's new business strategy was like a metoprolol for their chaotic work life, slowing things down to a manageable pace. | Cardiovascular System | Medical Knowledge/Scientific Concepts |
A 29-year-old woman comes to the physician with high-grade fever, headache, and muscle pain. A week ago, she returned from India, where she was working with an NGO to build houses in rural areas. The patient took one dose of chloroquine one week before her trip. She also took a further dose during her trip. She has no ... | {
"A": "Plasmodium ovale",
"B": "Plasmodium falciparum",
"C": "Chikungunya virus",
"D": "Hepatitis A virus"
} | B | The patient described their friend's art style as having an ovale shape that stands out in every painting. | Blood & Lymphoreticular | Patient Care: Diagnosis |
A 39-year-old woman presents to the clinic for her annual physical. Although she feels generally healthy she has noticed gaining about 9 kg (20 lb) over the last year. She eats a healthy, varied diet and exercises at the gym 4 days a week, including 20 minutes of aerobic exercise. On further questioning, she has also n... | {
"A": "Glucose",
"B": "Triiodothyronine (T3)",
"C": "Thyroxine (T4)",
"D": "Thyroid-stimulating hormone (TSH)"
} | D | The patient described their friend's personality as having a high glycemic index, always full of energy and sweetness. | Endocrine System | Medical Knowledge/Scientific Concepts |
A 38-year-old woman comes to the physician because of persistent diarrhea and fatigue for 1 month. She has had up to 12 watery stools per day. Sometimes she awakens at night because she has to defecate. She has abdominal bloating and cramps. She has had a 2-kg weight loss in the past month. She returned from a trip to ... | {
"A": "Celiac disease",
"B": "Carcinoid tumor",
"C": "VIPoma",
"D": "Medication abuse"
} | D | The patient described their favorite novel as having a glutenous plot that sticks with you long after reading. | Gastrointestinal System | Patient Care: Diagnosis |
A 21-year-old college student comes to the physician because of daytime fatigue for 2 months. He has problems getting to sleep at night and frequently falls asleep during class. Recently he has started skipping classes altogether. He goes to bed between 11 p.m. and 1 a.m. but cannot fall asleep for 2–3 hours. When he w... | {
"A": "Trial of diphenhydramine",
"B": "Stop evening exercise",
"C": "Alcoholic beverage prior to bedtime",
"D": "Scheduled afternoon naps"
} | B | The patient joked that their friend's storytelling has an antihistamine effect, putting everyone to sleep. | Behavioral Health | Patient Care: Management |
A 19-year-old man is brought to the physician by his mother because she is worried about his strange behavior. Over the past 3 years, he has been dressing all in black and wears a long black coat, even in the summer. The mother reports that her son has always had difficulties fitting in. He does not have any friends an... | {
"A": "Social anxiety disorder",
"B": "Avoidant personality disorder",
"C": "Schizotypal personality disorder",
"D": "Schizophrenia"
} | C | The patient joked that his friend's social life flatlined after he moved to a new city. | Behavioral Health | Patient Care: Diagnosis |
A 79-year-old man presents to the office due to shortness of breath with moderate exertion and a slightly productive cough. He has a medical history of 25 years of heavy smoking. His vitals include: heart rate 89/min, respiratory rate 27/min, and blood pressure 120/90 mm Hg. The physical exam shows increased resonance ... | {
"A": "Asthma",
"B": "Lymphangioleiomyomatosis",
"C": "Chronic obstructive pulmonary disease (COPD)",
"D": "Heart failure"
} | C | The patient said their favorite jazz musician has an improvisational style that flows like bronchial passages in a lively performance. | Respiratory System | Patient Care: Diagnosis |
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