instance_id stringlengths 9 18 | patient_vignette stringlengths 52 559 | question stringlengths 52 139 | options dict | answer listlengths 1 5 | taxonomy_clinical_department stringclasses 11
values | taxonomy_clinical_system stringclasses 9
values | taxonomy_drug_categories listlengths 1 4 | taxonomy_patient_info_type stringclasses 8
values | taxonomy_population_source stringclasses 3
values | taxonomy_reasoning_operation stringclasses 5
values | benchmark_task_family stringclasses 2
values |
|---|---|---|---|---|---|---|---|---|---|---|---|
DDI-CF-LI-001-A | A 67-year-old man with bipolar I disorder is currently taking lithium carbonate 300 mg three times daily, with a stable serum lithium level of 0.8 mEq/L. He is presenting for management of newly diagnosed hypertension and bilateral lower extremity edema, and his physician is considering antihypertensive and diuretic th... | Which of the following medications would be potentially inappropriate to add to this patient's current regimen? | {
"A": "Lisinopril",
"B": "Atenolol",
"C": "Metformin",
"D": "Furosemide",
"E": "None of the above"
} | [
"A",
"D"
] | psychiatry | nervous system | [
"lithium"
] | drug interaction | older adults | interaction identification | counterfactual |
DDI-CF-LI-001-B | A 67-year-old man with bipolar I disorder is currently taking valproate 500 mg twice daily for mood stabilization, with stable serum valproate levels within therapeutic range. He is presenting for management of newly diagnosed hypertension and bilateral lower extremity edema, and his physician is considering antihypert... | Which of the following medications would be potentially inappropriate to add to this patient's current regimen? | {
"A": "Lisinopril",
"B": "Atenolol",
"C": "Metformin",
"D": "Furosemide",
"E": "None of the above"
} | [
"E"
] | psychiatry | nervous system | [
"lithium"
] | drug interaction | older adults | interaction identification | counterfactual |
DDI-CF-PH-001-A | A 69-year-old woman with focal epilepsy is currently taking phenytoin 300 mg daily, with a stable serum phenytoin level of 14 mg/L (therapeutic range 10–20 mg/L). She presents with a urinary tract infection requiring antibiotic therapy. Her physician is selecting an appropriate antibiotic. She has no sulfa allergy. She... | Which of the following medications would be potentially inappropriate to add to this patient's current regimen? | {
"A": "Trimethoprim-sulfamethoxazole",
"B": "Nitrofurantoin",
"C": "None of the above",
"D": "Azithromycin",
"E": "Amoxicillin-clavulanate"
} | [
"A"
] | neurology | nervous system | [
"antiepileptics"
] | drug interaction | older adults | interaction identification | counterfactual |
DDI-CF-PH-001-B | A 69-year-old woman with focal epilepsy is currently taking levetiracetam 1000 mg twice daily for seizure control. She presents with a urinary tract infection requiring antibiotic therapy. Her physician is selecting an appropriate antibiotic. She has no sulfa allergy. She has no history of heart failure, CKD, or hepati... | Which of the following medications would be potentially inappropriate to add to this patient's current regimen? | {
"A": "Trimethoprim-sulfamethoxazole",
"B": "Nitrofurantoin",
"C": "Azithromycin",
"D": "None of the above",
"E": "Amoxicillin-clavulanate"
} | [
"D"
] | neurology | nervous system | [
"antiepileptics"
] | drug interaction | older adults | interaction identification | counterfactual |
DDI-CF-TH-001-A | A 73-year-old man with COPD is currently taking theophylline extended-release 200 mg twice daily for bronchodilation, with a most recent serum theophylline level of 12 mg/L (therapeutic range 8–15 mg/L). He presents with an acute COPD exacerbation complicated by a suspected community-acquired pneumonia. His pulmonologi... | Which of the following medications would be potentially inappropriate to add to this patient's current regimen? | {
"A": "Ranitidine",
"B": "Ciprofloxacin",
"C": "Azithromycin",
"D": "None of the above",
"E": "Cimetidine"
} | [
"B",
"E"
] | pulmonology | respiratory system | [
"theophyllines"
] | drug interaction | older adults | interaction identification | counterfactual |
DDI-CF-TH-001-B | A 73-year-old man with COPD and comorbid asthma is currently taking montelukast 10 mg daily for leukotriene-mediated airway inflammation. He presents with an acute COPD exacerbation complicated by a suspected community-acquired pneumonia. His pulmonologist is selecting antibiotic therapy, and his gastroenterologist is ... | Which of the following medications would be potentially inappropriate to add to this patient's current regimen? | {
"A": "None of the above",
"B": "Ranitidine",
"C": "Ciprofloxacin",
"D": "Azithromycin",
"E": "Cimetidine"
} | [
"A"
] | pulmonology | respiratory system | [
"theophyllines"
] | drug interaction | older adults | interaction identification | counterfactual |
DDI-CF-WA-001-A | A 74-year-old woman with chronic atrial fibrillation is currently taking warfarin 5 mg daily for stroke prevention, with a therapeutic INR maintained between 2.0 and 3.0. She presents with a urinary tract infection and her physician is also considering additional antihypertensive therapy. Culture and sensitivity result... | Which of the following medications would be potentially inappropriate to add to this patient's current regimen? | {
"A": "Trimethoprim-sulfamethoxazole",
"B": "Amlodipine",
"C": "Ciprofloxacin",
"D": "Atenolol",
"E": "None of the above"
} | [
"A",
"C"
] | cardiology | cardiovascular system | [
"anticoagulants"
] | drug interaction | older adults | interaction identification | counterfactual |
DDI-CF-WA-001-B | A 74-year-old woman with chronic atrial fibrillation is currently taking apixaban 5 mg twice daily for stroke prevention. She presents with a urinary tract infection requiring antibiotic therapy, and her physician is also considering additional antihypertensive therapy. She has no history of heart failure, CKD, or seiz... | Which of the following medications would be potentially inappropriate to add to this patient's current regimen? | {
"A": "Trimethoprim-sulfamethoxazole",
"B": "None of the above",
"C": "Amlodipine",
"D": "Ciprofloxacin",
"E": "Atenolol"
} | [
"B"
] | cardiology | cardiovascular system | [
"anticoagulants"
] | drug interaction | older adults | interaction identification | counterfactual |
RK-CF-CIP-001-A | A 74-year-old woman presents with a complicated lower urinary tract infection requiring oral antibiotic therapy. Her most recent serum creatinine is 2.2 mg/dL, corresponding to an estimated CrCl of 22 mL/min. She has no known drug allergies and culture results indicate susceptibility to the antibiotics listed below. He... | Which of the following antibiotics requires dose reduction given this patient's renal function? | {
"A": "None of the above",
"B": "Ciprofloxacin",
"C": "Azithromycin",
"D": "Amoxicillin",
"E": "Doxycycline"
} | [
"B"
] | nephrology | urinary system | [
"fluoroquinolone antibacterials"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-CIP-001-B | A 74-year-old woman presents with a complicated lower urinary tract infection requiring oral antibiotic therapy. Her most recent serum creatinine is 1.0 mg/dL, corresponding to an estimated CrCl of 52 mL/min. She has no known drug allergies and culture results indicate susceptibility to the antibiotics listed below. He... | Which of the following antibiotics requires dose reduction given this patient's renal function? | {
"A": "Ciprofloxacin",
"B": "Azithromycin",
"C": "Amoxicillin",
"D": "Doxycycline",
"E": "None of the above"
} | [
"E"
] | nephrology | urinary system | [
"fluoroquinolone antibacterials"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-NIT-001-A | A 78-year-old woman with a history of recurrent urinary tract infections presents with dysuria and urinary frequency. Her estimated CrCl is 18 mL/min due to progressive chronic kidney disease. She has no sulfa allergy. Urine culture is pending but her physician is initiating empirical antibiotic therapy for an uncompli... | Which of the following antibiotics should be avoided given this patient's renal function? | {
"A": "Fosfomycin",
"B": "None of the above",
"C": "Trimethoprim",
"D": "Nitrofurantoin",
"E": "Amoxicillin"
} | [
"D"
] | nephrology | urinary system | [
"urinary antibacterials"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-NIT-001-B | A 78-year-old woman with a history of recurrent urinary tract infections presents with dysuria and urinary frequency. Her estimated CrCl is 48 mL/min. She has no sulfa allergy. Urine culture is pending but her physician is initiating empirical antibiotic therapy for an uncomplicated UTI. | Which of the following antibiotics should be avoided given this patient's renal function? | {
"A": "None of the above",
"B": "Fosfomycin",
"C": "Trimethoprim",
"D": "Nitrofurantoin",
"E": "Amoxicillin"
} | [
"A"
] | nephrology | urinary system | [
"urinary antibacterials"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-TMP-001-A | A 76-year-old man with HIV on antiretroviral therapy requires Pneumocystis jirovecii pneumonia prophylaxis. His estimated CrCl is 22 mL/min due to HIV-associated nephropathy. He has no known sulfa allergy. His physician is selecting the most appropriate prophylactic antibiotic regimen and is reviewing any necessary ren... | Which of the following antibiotics requires dose reduction given this patient's renal function? | {
"A": "Amoxicillin",
"B": "None of the above",
"C": "Trimethoprim-sulfamethoxazole",
"D": "Azithromycin",
"E": "Doxycycline"
} | [
"C"
] | nephrology | urinary system | [
"antibacterials"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-TMP-001-B | A 76-year-old man with HIV on antiretroviral therapy requires Pneumocystis jirovecii pneumonia prophylaxis. His estimated CrCl is 52 mL/min. He has no known sulfa allergy. His physician is selecting the most appropriate prophylactic antibiotic regimen and is reviewing any necessary renal dosing adjustments. | Which of the following antibiotics requires dose reduction given this patient's renal function? | {
"A": "Amoxicillin",
"B": "Trimethoprim-sulfamethoxazole",
"C": "Azithromycin",
"D": "None of the above",
"E": "Doxycycline"
} | [
"D"
] | nephrology | urinary system | [
"antibacterials"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-TMP-002-A | A 80-year-old man with HIV on antiretroviral therapy requires Pneumocystis jirovecii pneumonia prophylaxis. His estimated CrCl is 10 mL/min due to advanced chronic kidney disease. He has no known sulfa allergy. His physician is determining which antibiotic options should be completely avoided rather than dose-adjusted ... | Which of the following antibiotics should be avoided given this patient's renal function? | {
"A": "Azithromycin",
"B": "Trimethoprim-sulfamethoxazole",
"C": "None of the above",
"D": "Doxycycline",
"E": "Amoxicillin"
} | [
"B"
] | nephrology | urinary system | [
"antibacterials"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-TMP-002-B | A 80-year-old man with HIV on antiretroviral therapy requires Pneumocystis jirovecii pneumonia prophylaxis. His estimated CrCl is 22 mL/min due to chronic kidney disease. He has no known sulfa allergy. His physician is determining which antibiotic options should be completely avoided rather than dose-adjusted in this p... | Which of the following antibiotics should be avoided given this patient's renal function? | {
"A": "Azithromycin",
"B": "Trimethoprim-sulfamethoxazole",
"C": "Doxycycline",
"D": "Amoxicillin",
"E": "None of the above"
} | [
"E"
] | nephrology | urinary system | [
"antibacterials"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-DAB-001-A | A 79-year-old man with nonvalvular atrial fibrillation and a CHA₂DS₂-VASc score of 4 requires anticoagulation for stroke prevention. His estimated CrCl is 22 mL/min due to diabetic nephropathy. He has no history of mechanical heart valve or significant hepatic disease. His physician is selecting an appropriate oral ant... | Which of the following oral anticoagulants should be avoided given this patient's renal function? | {
"A": "Warfarin",
"B": "None of the above",
"C": "Heparin",
"D": "Apixaban",
"E": "Dabigatran"
} | [
"E"
] | nephrology | urinary system | [
"direct thrombin inhibitors/anticoagulants"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-DAB-001-B | A 79-year-old man with nonvalvular atrial fibrillation and a CHA₂DS₂-VASc score of 4 requires anticoagulation for stroke prevention. His estimated CrCl is 52 mL/min. He has no history of mechanical heart valve or significant hepatic disease. His physician is selecting an appropriate oral anticoagulant. | Which of the following oral anticoagulants should be avoided given this patient's renal function? | {
"A": "Warfarin",
"B": "Heparin",
"C": "Apixaban",
"D": "Dabigatran",
"E": "None of the above"
} | [
"E"
] | nephrology | urinary system | [
"direct thrombin inhibitors/anticoagulants"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-DOF-001-A | A 73-year-old woman with persistent atrial fibrillation refractory to rate control is being evaluated for rhythm control therapy. Her estimated CrCl is 35 mL/min. Her QTc interval is 420 ms and she has no history of torsades de pointes. Her cardiologist is reviewing antiarrhythmic options and considering necessary rena... | Which of the following antiarrhythmic medications requires dose reduction given this patient's renal function? | {
"A": "Dofetilide",
"B": "Metoprolol",
"C": "None of the above",
"D": "Amiodarone",
"E": "Flecainide"
} | [
"A"
] | nephrology | urinary system | [
"antiarrhythmics"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-DOF-001-B | A 73-year-old woman with persistent atrial fibrillation refractory to rate control is being evaluated for rhythm control therapy. Her estimated CrCl is 75 mL/min. Her QTc interval is 420 ms and she has no history of torsades de pointes. Her cardiologist is reviewing antiarrhythmic options and considering necessary rena... | Which of the following antiarrhythmic medications requires dose reduction given this patient's renal function? | {
"A": "Dofetilide",
"B": "Metoprolol",
"C": "Amiodarone",
"D": "None of the above",
"E": "Flecainide"
} | [
"D"
] | nephrology | urinary system | [
"antiarrhythmics"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-DOF-002-A | A 76-year-old woman with persistent atrial fibrillation and advanced chronic kidney disease is being considered for rhythm control. Her estimated CrCl is 15 mL/min. Her QTc is 430 ms. Her cardiologist is determining which antiarrhythmic agents should be completely avoided rather than dose-adjusted given her renal funct... | Which of the following antiarrhythmic medications should be avoided given this patient's renal function? | {
"A": "Metoprolol",
"B": "Amiodarone",
"C": "Flecainide",
"D": "None of the above",
"E": "Dofetilide"
} | [
"E"
] | nephrology | urinary system | [
"antiarrhythmics"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-DOF-002-B | A 76-year-old woman with persistent atrial fibrillation and chronic kidney disease is being considered for rhythm control. Her estimated CrCl is 35 mL/min. Her QTc is 430 ms. Her cardiologist is determining which antiarrhythmic agents should be completely avoided rather than dose-adjusted given her renal function. | Which of the following antiarrhythmic medications should be avoided given this patient's renal function? | {
"A": "None of the above",
"B": "Metoprolol",
"C": "Amiodarone",
"D": "Flecainide",
"E": "Dofetilide"
} | [
"A"
] | nephrology | urinary system | [
"antiarrhythmics"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-EDO-001-A | A 75-year-old man with nonvalvular atrial fibrillation requires long-term anticoagulation. His estimated CrCl is 30 mL/min. He has no history of mechanical heart valve or significant hepatic disease. His physician is reviewing which anticoagulants require dose reduction given his current renal function. | Which of the following oral anticoagulants requires dose reduction given this patient's renal function? | {
"A": "Heparin",
"B": "Warfarin",
"C": "None of the above",
"D": "Apixaban",
"E": "Edoxaban"
} | [
"E"
] | nephrology | urinary system | [
"factor xa inhibitors/anticoagulants"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-EDO-001-B | A 75-year-old man with nonvalvular atrial fibrillation requires long-term anticoagulation. His estimated CrCl is 75 mL/min. He has no history of mechanical heart valve or significant hepatic disease. His physician is reviewing which anticoagulants require dose reduction given his current renal function. | Which of the following oral anticoagulants requires dose reduction given this patient's renal function? | {
"A": "Heparin",
"B": "Warfarin",
"C": "Apixaban",
"D": "Edoxaban",
"E": "None of the above"
} | [
"E"
] | nephrology | urinary system | [
"factor xa inhibitors/anticoagulants"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-EDO-002-A | A 78-year-old woman with nonvalvular atrial fibrillation and severe chronic kidney disease requires anticoagulation. Her estimated CrCl is 10 mL/min. She has no mechanical heart valve. Her physician is determining which anticoagulants should be completely avoided rather than dose-adjusted given her renal function. | Which of the following oral anticoagulants should be avoided given this patient's renal function? | {
"A": "None of the above",
"B": "Apixaban",
"C": "Warfarin",
"D": "Heparin",
"E": "Edoxaban"
} | [
"E"
] | nephrology | urinary system | [
"factor xa inhibitors/anticoagulants"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-EDO-002-B | A 78-year-old woman with nonvalvular atrial fibrillation and moderate chronic kidney disease requires anticoagulation. Her estimated CrCl is 30 mL/min. She has no mechanical heart valve. Her physician is determining which anticoagulants should be completely avoided rather than dose-adjusted given her renal function. | Which of the following oral anticoagulants should be avoided given this patient's renal function? | {
"A": "Apixaban",
"B": "Warfarin",
"C": "None of the above",
"D": "Heparin",
"E": "Edoxaban"
} | [
"C"
] | nephrology | urinary system | [
"factor xa inhibitors/anticoagulants"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-ENO-001-A | A 72-year-old woman with a provoked pulmonary embolism requires parenteral anticoagulation bridging to long-term therapy. Her estimated CrCl is 22 mL/min. She has no contraindications to anticoagulation. Her physician is reviewing which parenteral anticoagulants require dose reduction given her renal function. | Which of the following parenteral anticoagulants requires dose reduction given this patient's renal function? | {
"A": "Enoxaparin",
"B": "Unfractionated heparin",
"C": "None of the above",
"D": "Warfarin",
"E": "Apixaban"
} | [
"A"
] | nephrology | urinary system | [
"low-molecular-weight heparin anticoagulants"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-ENO-001-B | A 72-year-old woman with a provoked pulmonary embolism requires parenteral anticoagulation bridging to long-term therapy. Her estimated CrCl is 52 mL/min. She has no contraindications to anticoagulation. Her physician is reviewing which parenteral anticoagulants require dose reduction given her renal function. | Which of the following parenteral anticoagulants requires dose reduction given this patient's renal function? | {
"A": "Enoxaparin",
"B": "Unfractionated heparin",
"C": "None of the above",
"D": "Warfarin",
"E": "Apixaban"
} | [
"C"
] | nephrology | urinary system | [
"low-molecular-weight heparin anticoagulants"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-FON-001-A | A 74-year-old man with a proximal deep vein thrombosis requires anticoagulation therapy. His estimated CrCl is 22 mL/min. He has no history of heparin-induced thrombocytopenia and no mechanical heart valve. His physician is selecting which anticoagulant options should be avoided entirely given his renal function. | Which of the following parenteral anticoagulants should be avoided given this patient's renal function? | {
"A": "Apixaban",
"B": "Fondaparinux",
"C": "Enoxaparin",
"D": "Warfarin",
"E": "None of the above"
} | [
"B"
] | nephrology | urinary system | [
"factor xa inhibitors/anticoagulants"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-FON-001-B | A 74-year-old man with a proximal deep vein thrombosis requires anticoagulation therapy. His estimated CrCl is 52 mL/min. He has no history of heparin-induced thrombocytopenia and no mechanical heart valve. His physician is selecting which anticoagulant options should be avoided entirely given his renal function. | Which of the following parenteral anticoagulants should be avoided given this patient's renal function? | {
"A": "Apixaban",
"B": "None of the above",
"C": "Fondaparinux",
"D": "Enoxaparin",
"E": "Warfarin"
} | [
"B"
] | nephrology | urinary system | [
"factor xa inhibitors/anticoagulants"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-RIV-001-A | A 77-year-old woman with nonvalvular atrial fibrillation and a history of venous thromboembolism requires long-term anticoagulation. Her estimated CrCl is 30 mL/min. She has no mechanical heart valve or significant hepatic disease. Her physician is reviewing which oral anticoagulants require dose reduction given her re... | Which of the following oral anticoagulants requires dose reduction given this patient's renal function? | {
"A": "None of the above",
"B": "Warfarin",
"C": "Apixaban",
"D": "Dabigatran",
"E": "Rivaroxaban"
} | [
"E"
] | nephrology | urinary system | [
"factor xa inhibitors/anticoagulants"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-RIV-001-B | A 77-year-old woman with nonvalvular atrial fibrillation and a history of venous thromboembolism requires long-term anticoagulation. Her estimated CrCl is 70 mL/min. She has no mechanical heart valve or significant hepatic disease. Her physician is reviewing which oral anticoagulants require dose reduction given her re... | Which of the following oral anticoagulants requires dose reduction given this patient's renal function? | {
"A": "Warfarin",
"B": "Apixaban",
"C": "Dabigatran",
"D": "None of the above",
"E": "Rivaroxaban"
} | [
"D"
] | nephrology | urinary system | [
"factor xa inhibitors/anticoagulants"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-BAC-001-A | A 71-year-old woman with multiple sclerosis presents with worsening spasticity significantly limiting her mobility. Her most recent eGFR is 38 mL/min/1.73m² due to hypertensive nephrosclerosis. She has no hepatic disease. Her neurologist is selecting a muscle relaxant and is reviewing which options should be avoided gi... | Which of the following muscle relaxants should be avoided given this patient's renal function? | {
"A": "Baclofen",
"B": "Tizanidine",
"C": "Dantrolene",
"D": "None of the above",
"E": "Methocarbamol"
} | [
"A"
] | nephrology | urinary system | [
"muscle relaxants"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-BAC-001-B | A 71-year-old woman with multiple sclerosis presents with worsening spasticity significantly limiting her mobility. Her most recent eGFR is 75 mL/min/1.73m². She has no hepatic disease. Her neurologist is selecting a muscle relaxant and is reviewing which options should be avoided given her renal function. | Which of the following muscle relaxants should be avoided given this patient's renal function? | {
"A": "Baclofen",
"B": "Tizanidine",
"C": "Dantrolene",
"D": "None of the above",
"E": "Methocarbamol"
} | [
"D"
] | nephrology | urinary system | [
"muscle relaxants"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-DUL-001-A | A 74-year-old woman with major depressive disorder and diabetic peripheral neuropathy is being considered for an antidepressant that also addresses neuropathic pain. Her estimated CrCl is 22 mL/min due to diabetic nephropathy. She has no history of seizures or hepatic disease. Her physician is reviewing which antidepre... | Which of the following antidepressants should be avoided given this patient's renal function? | {
"A": "Duloxetine",
"B": "None of the above",
"C": "Bupropion",
"D": "Sertraline",
"E": "Escitalopram"
} | [
"A"
] | nephrology | urinary system | [
"antidepressants/analgesics"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-DUL-001-B | A 74-year-old woman with major depressive disorder and diabetic peripheral neuropathy is being considered for an antidepressant that also addresses neuropathic pain. Her estimated CrCl is 50 mL/min. She has no history of seizures or hepatic disease. Her physician is reviewing which antidepressants should be avoided giv... | Which of the following antidepressants should be avoided given this patient's renal function? | {
"A": "None of the above",
"B": "Duloxetine",
"C": "Bupropion",
"D": "Sertraline",
"E": "Escitalopram"
} | [
"A"
] | nephrology | urinary system | [
"antidepressants/analgesics"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-GPT-001-A | A 78-year-old woman with diabetic peripheral neuropathy presents for evaluation of neuropathic pain management. Her estimated CrCl is 35 mL/min due to diabetic nephropathy. She has no history of delirium or recurrent falls. Her physician is reviewing neuropathic pain medications and identifying those that require dose ... | Which of the following neuropathic pain medications requires dose reduction given this patient's renal function? Select all that apply. | {
"A": "None of the above",
"B": "Capsaicin cream",
"C": "Pregabalin",
"D": "Amitriptyline",
"E": "Gabapentin"
} | [
"C",
"E"
] | nephrology | urinary system | [
"gabapentinoids"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-GPT-001-B | A 78-year-old woman with diabetic peripheral neuropathy presents for evaluation of neuropathic pain management. Her estimated CrCl is 75 mL/min. She has no history of delirium or recurrent falls. Her physician is reviewing neuropathic pain medications and identifying those that require dose reduction given her renal fu... | Which of the following neuropathic pain medications requires dose reduction given this patient's renal function? Select all that apply. | {
"A": "Capsaicin cream",
"B": "Pregabalin",
"C": "Amitriptyline",
"D": "Gabapentin",
"E": "None of the above"
} | [
"E"
] | nephrology | urinary system | [
"gabapentinoids"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-LEV-001-A | A 75-year-old woman with focal epilepsy is maintained on levetiracetam 1000 mg twice daily with good seizure control. Her estimated CrCl is 55 mL/min. Her neurologist is reviewing her antiepileptic regimen and identifying medications that require dose reduction based on her renal function. | Which of the following antiepileptic medications requires dose reduction given this patient's renal function? | {
"A": "Levetiracetam",
"B": "Lamotrigine",
"C": "None of the above",
"D": "Phenytoin",
"E": "Valproic acid"
} | [
"A"
] | nephrology | urinary system | [
"antiepileptics"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-LEV-001-B | A 75-year-old woman with focal epilepsy is maintained on levetiracetam 1000 mg twice daily with good seizure control. Her estimated CrCl is 90 mL/min. Her neurologist is reviewing her antiepileptic regimen and identifying medications that require dose reduction based on her renal function. | Which of the following antiepileptic medications requires dose reduction given this patient's renal function? | {
"A": "None of the above",
"B": "Levetiracetam",
"C": "Lamotrigine",
"D": "Phenytoin",
"E": "Valproic acid"
} | [
"A"
] | nephrology | urinary system | [
"antiepileptics"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-NSA-001-A | A 76-year-old man with osteoarthritis of the knees and hips reports inadequate pain control with non-pharmacologic measures. His estimated CrCl is 22 mL/min due to hypertensive nephropathy. He has no history of peptic ulcer disease. His physician is evaluating oral analgesic options and identifying those that should be... | Which of the following analgesics should be avoided given this patient's renal function? Select all that apply. | {
"A": "Naproxen",
"B": "Ibuprofen",
"C": "Acetaminophen",
"D": "None of the above",
"E": "Celecoxib"
} | [
"A",
"B",
"E"
] | nephrology | urinary system | [
"nsaids/antipyretic analgesics"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-NSA-001-B | A 76-year-old man with osteoarthritis of the knees and hips reports inadequate pain control with non-pharmacologic measures. His estimated CrCl is 52 mL/min. He has no history of peptic ulcer disease. His physician is evaluating oral analgesic options and identifying those that should be avoided given his renal functio... | Which of the following analgesics should be avoided given this patient's renal function? Select all that apply. | {
"A": "Naproxen",
"B": "Ibuprofen",
"C": "Acetaminophen",
"D": "None of the above",
"E": "Celecoxib"
} | [
"D"
] | nephrology | urinary system | [
"nsaids/antipyretic analgesics"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-TRA-001-A | A 73-year-old man with moderate chronic low back pain has an estimated CrCl of 22 mL/min. His pain is inadequately controlled with non-opioid analgesics alone. He has no history of seizures or substance use disorder. His physician is reviewing which analgesics require dose reduction given his renal function. | Which of the following analgesics requires dose reduction given this patient's renal function? | {
"A": "None of the above",
"B": "Acetaminophen",
"C": "Codeine",
"D": "Hydrocodone",
"E": "Tramadol immediate-release"
} | [
"E"
] | nephrology | urinary system | [
"opioid-like analgesics"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-TRA-001-B | A 73-year-old man with moderate chronic low back pain has an estimated CrCl of 52 mL/min. His pain is inadequately controlled with non-opioid analgesics alone. He has no history of seizures or substance use disorder. His physician is reviewing which analgesics require dose reduction given his renal function. | Which of the following analgesics requires dose reduction given this patient's renal function? | {
"A": "Acetaminophen",
"B": "Codeine",
"C": "Hydrocodone",
"D": "None of the above",
"E": "Tramadol immediate-release"
} | [
"D"
] | nephrology | urinary system | [
"opioid-like analgesics"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-TRA-002-A | A 74-year-old woman with chronic low back pain has an estimated CrCl of 22 mL/min. She requires around-the-clock analgesia for consistent pain relief. She has no history of seizures or substance use disorder. Her physician is identifying which analgesic options should be completely avoided given her renal function. | Which of the following analgesics should be avoided given this patient's renal function? | {
"A": "Hydrocodone",
"B": "Codeine",
"C": "Tramadol extended-release",
"D": "None of the above",
"E": "Acetaminophen"
} | [
"C"
] | nephrology | urinary system | [
"opioid-like analgesics"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-TRA-002-B | A 74-year-old woman with chronic low back pain has an estimated CrCl of 52 mL/min. She requires around-the-clock analgesia for consistent pain relief. She has no history of seizures or substance use disorder. Her physician is identifying which analgesic options should be completely avoided given her renal function. | Which of the following analgesics should be avoided given this patient's renal function? | {
"A": "Hydrocodone",
"B": "None of the above",
"C": "Codeine",
"D": "Tramadol extended-release",
"E": "Acetaminophen"
} | [
"B"
] | nephrology | urinary system | [
"opioid-like analgesics"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-H2B-001-A | A 79-year-old woman with gastroesophageal reflux disease and a history of peptic ulcer disease requires acid suppression therapy. Her estimated CrCl is 35 mL/min. She has no hepatic disease. Her physician is identifying which acid suppression medications require dose reduction given her renal function. | Which of the following acid suppression medications requires dose reduction given this patient's renal function? Select all that apply. | {
"A": "None of the above",
"B": "Famotidine",
"C": "Nizatidine",
"D": "Omeprazole",
"E": "Cimetidine"
} | [
"B",
"C",
"E"
] | nephrology | urinary system | [
"h2-receptor blockers"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-H2B-001-B | A 79-year-old woman with gastroesophageal reflux disease and a history of peptic ulcer disease requires acid suppression therapy. Her estimated CrCl is 65 mL/min. She has no hepatic disease. Her physician is identifying which acid suppression medications require dose reduction given her renal function. | Which of the following acid suppression medications requires dose reduction given this patient's renal function? Select all that apply. | {
"A": "Famotidine",
"B": "Nizatidine",
"C": "Omeprazole",
"D": "Cimetidine",
"E": "None of the above"
} | [
"E"
] | nephrology | urinary system | [
"h2-receptor blockers"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-COL-001-A | A 72-year-old man with gout presents with an acute flare involving the right first metatarsophalangeal joint. His estimated CrCl is 22 mL/min. He has no hepatic disease or prior colchicine toxicity. His physician is reviewing which gout medications require dose reduction given his renal function. | Which of the following gout medications requires dose reduction given this patient's renal function? | {
"A": "Methylprednisolone",
"B": "None of the above",
"C": "Febuxostat",
"D": "Allopurinol",
"E": "Colchicine"
} | [
"E"
] | nephrology | urinary system | [
"antigout agents"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-COL-001-B | A 72-year-old man with gout presents with an acute flare involving the right first metatarsophalangeal joint. His estimated CrCl is 52 mL/min. He has no hepatic disease or prior colchicine toxicity. His physician is reviewing which gout medications require dose reduction given his renal function. | Which of the following gout medications requires dose reduction given this patient's renal function? | {
"A": "None of the above",
"B": "Methylprednisolone",
"C": "Febuxostat",
"D": "Allopurinol",
"E": "Colchicine"
} | [
"A"
] | nephrology | urinary system | [
"antigout agents"
] | dose threshold | older adults | risk deactivation | counterfactual |
RK-CF-PRO-001-A | A 73-year-old woman with recurrent gout and tophi requires long-term urate-lowering therapy. Her estimated CrCl is 22 mL/min. She has no history of urolithiasis and no known drug allergies. Her physician is identifying which urate-lowering agents should be avoided entirely given her renal function. | Which of the following urate-lowering agents should be avoided given this patient's renal function? | {
"A": "Allopurinol",
"B": "None of the above",
"C": "Probenecid",
"D": "Febuxostat",
"E": "Colchicine"
} | [
"C"
] | nephrology | urinary system | [
"antigout agents"
] | dose threshold | older adults | risk activation | counterfactual |
RK-CF-PRO-001-B | A 73-year-old woman with recurrent gout and tophi requires long-term urate-lowering therapy. Her estimated CrCl is 52 mL/min. She has no history of urolithiasis and no known drug allergies. Her physician is identifying which urate-lowering agents should be avoided entirely given her renal function. | Which of the following urate-lowering agents should be avoided given this patient's renal function? | {
"A": "Allopurinol",
"B": "Probenecid",
"C": "None of the above",
"D": "Febuxostat",
"E": "Colchicine"
} | [
"C"
] | nephrology | urinary system | [
"antigout agents"
] | dose threshold | older adults | risk deactivation | counterfactual |
PG-IBU-NEG-001 | A 28-year-old woman at 16 weeks of gestation presents with low back pain. She requests guidance on analgesic options. | Which of the following medications should be avoided due to trimester-specific pregnancy contraindications? | {
"A": "Cefalexin",
"B": "None of the above",
"C": "Codeine",
"D": "Ibuprofen",
"E": "Acetaminophen"
} | [
"B"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-IBU-POS-001 | A 28-year-old woman at 32 weeks of gestation presents with low back pain. She requests guidance on analgesic options. | Which of the following medications should be avoided due to trimester-specific pregnancy contraindications? | {
"A": "Cefalexin",
"B": "None of the above",
"C": "Codeine",
"D": "Ibuprofen",
"E": "Acetaminophen"
} | [
"D"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-IBU-POS-002 | A 25-year-old woman at 36 weeks of gestation presents with dental pain and requests an over-the-counter pain reliever. | Which of the following medications poses the greatest fetal risk if used at this gestational age? | {
"A": "Clotrimazole",
"B": "Acetaminophen",
"C": "Amoxicillin",
"D": "Ibuprofen",
"E": "None of the above"
} | [
"D"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-IBU-POS-003 | A 32-year-old woman at 30 weeks of gestation is being discharged after an outpatient procedure. The team is reviewing her discharge analgesic prescription. | Which of the following medications is inappropriate to include in the discharge prescription at this gestational age? | {
"A": "None of the above",
"B": "Ibuprofen",
"C": "Cefalexin",
"D": "Acetaminophen",
"E": "Amoxicillin"
} | [
"B"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-NAP-NEG-001 | A 33-year-old woman at 16 weeks of gestation presents with an acute headache. Her physician is selecting an analgesic. | Which of the following medications should be withheld due to gestational contraindications? | {
"A": "Naproxen",
"B": "None of the above",
"C": "Cefalexin",
"D": "Amoxicillin",
"E": "Acetaminophen"
} | [
"B"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-NAP-POS-001 | A 33-year-old woman at 34 weeks of gestation presents with an acute headache. Her physician is selecting an analgesic. | Which of the following medications should be withheld due to gestational contraindications? | {
"A": "Naproxen",
"B": "None of the above",
"C": "Cefalexin",
"D": "Amoxicillin",
"E": "Acetaminophen"
} | [
"A"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-NAP-POS-002 | A 31-year-old woman at 28 weeks of gestation has joint pain requiring analgesic treatment. The physician is reviewing available options. | Which of the following would be an inappropriate medication choice at this gestational age? | {
"A": "Acetaminophen",
"B": "Naproxen",
"C": "None of the above",
"D": "Codeine",
"E": "Cefalexin"
} | [
"B"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-NAP-POS-003 | A 27-year-old woman at 32 weeks of gestation has a mild osteoarthritis flare. The rheumatologist is reviewing her pain regimen. | Which of the following medications is contraindicated in the third trimester of pregnancy? | {
"A": "Naproxen",
"B": "None of the above",
"C": "Clotrimazole",
"D": "Acetaminophen",
"E": "Ampicillin"
} | [
"A"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-CEL-NEG-001 | A 29-year-old woman at 18 weeks of gestation with rheumatoid arthritis presents with a disease flare. Her physician is reviewing anti-inflammatory options. | Which of the following medications is contraindicated at this stage of pregnancy? | {
"A": "Amoxicillin",
"B": "Codeine",
"C": "None of the above",
"D": "Celecoxib",
"E": "Acetaminophen"
} | [
"C"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-CEL-POS-001 | A 29-year-old woman at 32 weeks of gestation with rheumatoid arthritis presents with a disease flare. Her physician is reviewing anti-inflammatory options. | Which of the following medications is contraindicated at this stage of pregnancy? | {
"A": "Amoxicillin",
"B": "Codeine",
"C": "None of the above",
"D": "Celecoxib",
"E": "Acetaminophen"
} | [
"D"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-CEL-POS-002 | A 34-year-old woman at 35 weeks of gestation requests continuation of her pre-pregnancy arthritis medications. Her current regimen includes celecoxib. | Which of the following should be discontinued given the patient's gestational age? | {
"A": "Acetaminophen",
"B": "Celecoxib",
"C": "None of the above",
"D": "Cefalexin",
"E": "Amoxicillin-clavulanate"
} | [
"B"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-CEL-POS-003 | A 31-year-old woman at 30 weeks of gestation is evaluated for musculoskeletal discomfort following a minor fall. She has no prior arthritis history and no known drug allergies. Her physician is selecting a short-course analgesic. | Which of the following medications is contraindicated at this gestational age? | {
"A": "Celecoxib",
"B": "None of the above",
"C": "Clotrimazole",
"D": "Cefalexin",
"E": "Acetaminophen"
} | [
"A"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-MEL-NEG-001 | A 29-year-old woman at 18 weeks of gestation with osteoarthritis requests pain management. Her physician is reviewing analgesic choices. | Which of the following medications is contraindicated at this gestational age? | {
"A": "Amoxicillin",
"B": "Acetaminophen",
"C": "None of the above",
"D": "Meloxicam",
"E": "Cefalexin"
} | [
"C"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-MEL-POS-001 | A 29-year-old woman at 32 weeks of gestation with osteoarthritis requests pain management. Her physician is reviewing analgesic choices. | Which of the following medications is contraindicated at this gestational age? | {
"A": "Amoxicillin",
"B": "Acetaminophen",
"C": "None of the above",
"D": "Meloxicam",
"E": "Cefalexin"
} | [
"D"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-MEL-POS-002 | A 31-year-old woman at 28 weeks of gestation is seen for pain management review. Her physician is assessing which medications should be removed from her regimen. | Which of the following should be excluded from the patient's medication regimen at this gestational age? | {
"A": "Amoxicillin",
"B": "Meloxicam",
"C": "Clotrimazole",
"D": "Codeine",
"E": "None of the above"
} | [
"B"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-DIC-NEG-001 | A 31-year-old woman at 16 weeks of gestation presents with acute musculoskeletal pain. Her physician is selecting an analgesic. | Which of the following medications is inappropriate for use at this gestational age? | {
"A": "Diclofenac",
"B": "Cefalexin",
"C": "Acetaminophen",
"D": "None of the above",
"E": "Amoxicillin"
} | [
"D"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-DIC-POS-001 | A 31-year-old woman at 32 weeks of gestation presents with acute musculoskeletal pain. Her physician is selecting an analgesic. | Which of the following medications is inappropriate for use at this gestational age? | {
"A": "Diclofenac",
"B": "Cefalexin",
"C": "Acetaminophen",
"D": "None of the above",
"E": "Amoxicillin"
} | [
"A"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-DIC-POS-002 | A 28-year-old woman at 34 weeks of gestation reports knee pain and asks about topical analgesic options. Her physician is reviewing the safety of topical agents. | Which of the following agents should be avoided at this gestational age? | {
"A": "None of the above",
"B": "Diclofenac gel",
"C": "Clotrimazole cream",
"D": "Topical lidocaine",
"E": "Cefalexin"
} | [
"B"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-ASP-NEG-001 | A 26-year-old woman at 18 weeks of gestation presents with a tension headache. Her physician is selecting an analgesic at standard therapeutic doses. | Which of the following medications is contraindicated based on trimester-specific pregnancy guidelines? | {
"A": "None of the above",
"B": "Acetaminophen",
"C": "Amoxicillin",
"D": "Cefalexin",
"E": "Aspirin"
} | [
"A"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-ASP-POS-001 | A 26-year-old woman at 34 weeks of gestation presents with a tension headache. Her physician is selecting an analgesic at standard therapeutic doses. | Which of the following medications is contraindicated based on trimester-specific pregnancy guidelines? | {
"A": "None of the above",
"B": "Acetaminophen",
"C": "Amoxicillin",
"D": "Cefalexin",
"E": "Aspirin"
} | [
"E"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-ASP-POS-002 | A 30-year-old woman at 38 weeks of gestation requests an over-the-counter pain reliever for mild discomfort. She is asking the pharmacist about options. | Which of the following medications should be avoided in the current trimester? | {
"A": "Aspirin",
"B": "Acetaminophen",
"C": "Clotrimazole",
"D": "None of the above",
"E": "Codeine"
} | [
"A"
] | obstetrics and gynecology | reproductive system | [
"nsaids/antipyretic analgesics"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-TMP-NEG-001 | A 27-year-old woman at 20 weeks of gestation is diagnosed with an uncomplicated urinary tract infection. Her physician is selecting an antibiotic. | Which of the following medications is contraindicated at the current gestational age? | {
"A": "None of the above",
"B": "Amoxicillin",
"C": "Cefalexin",
"D": "Trimethoprim-sulfamethoxazole",
"E": "Nitrofurantoin"
} | [
"A"
] | obstetrics and gynecology | reproductive system | [
"sulfonamide antibacterials"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-TMP-POS-001 | A 27-year-old woman at 35 weeks of gestation is diagnosed with an uncomplicated urinary tract infection. Her physician is selecting an antibiotic. | Which of the following medications is contraindicated at the current gestational age? | {
"A": "None of the above",
"B": "Amoxicillin",
"C": "Cefalexin",
"D": "Trimethoprim-sulfamethoxazole",
"E": "Nitrofurantoin"
} | [
"D"
] | obstetrics and gynecology | reproductive system | [
"sulfonamide antibacterials"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-TMP-POS-002 | A 29-year-old woman at 33 weeks of gestation presents with a recurrent urinary tract infection. Her physician is reviewing antibiotic options. | Which of the following would be an inappropriate medication choice at this gestational age? | {
"A": "Cefalexin",
"B": "Amoxicillin",
"C": "Fosfomycin",
"D": "None of the above",
"E": "Trimethoprim-sulfamethoxazole"
} | [
"E"
] | obstetrics and gynecology | reproductive system | [
"sulfonamide antibacterials"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-TMP-POS-003 | A 29-year-old woman at 38 weeks of gestation presents with an acute urinary tract infection. Her physician is reviewing the safety of common antibiotics at term. | Which of the following medications are contraindicated at this gestational age? (Select all that apply.) | {
"A": "Amoxicillin",
"B": "Trimethoprim-sulfamethoxazole",
"C": "None of the above",
"D": "Nitrofurantoin",
"E": "Cefalexin"
} | [
"B",
"D"
] | obstetrics and gynecology | reproductive system | [
"sulfonamides/urinary antibacterials"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-MTR-POS-001 | A 24-year-old woman at 9 weeks of gestation is diagnosed with trichomoniasis. Her physician is selecting appropriate treatment. | Which of the following treatments should be deferred due to trimester-specific concerns in this patient? | {
"A": "Clotrimazole",
"B": "None of the above",
"C": "Metronidazole",
"D": "Amoxicillin",
"E": "Cefalexin"
} | [
"C"
] | obstetrics and gynecology | reproductive system | [
"nitroimidazole antibacterials"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-MTR-NEG-001 | A 24-year-old woman at 22 weeks of gestation is diagnosed with trichomoniasis. Her physician is selecting appropriate treatment. | Which of the following treatments should be deferred due to trimester-specific concerns in this patient? | {
"A": "Clotrimazole",
"B": "None of the above",
"C": "Metronidazole",
"D": "Amoxicillin",
"E": "Cefalexin"
} | [
"B"
] | obstetrics and gynecology | reproductive system | [
"nitroimidazole antibacterials"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-MTR-POS-002 | A 26-year-old woman at 11 weeks of gestation presents with vaginal trichomoniasis confirmed on wet mount preparation. | Which of the following medications carries a trimester-specific contraindication in this patient? | {
"A": "None of the above",
"B": "Cefalexin",
"C": "Metronidazole",
"D": "Amoxicillin",
"E": "Nitrofurantoin"
} | [
"C"
] | obstetrics and gynecology | reproductive system | [
"nitroimidazole antibacterials"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-MTR-NEG-002 | A 26-year-old woman at 30 weeks of gestation presents with vaginal trichomoniasis confirmed on wet mount preparation. | Which of the following medications carries a trimester-specific contraindication in this patient? | {
"A": "None of the above",
"B": "Cefalexin",
"C": "Metronidazole",
"D": "Amoxicillin",
"E": "Nitrofurantoin"
} | [
"A"
] | obstetrics and gynecology | reproductive system | [
"nitroimidazole antibacterials"
] | gestational-week threshold | pregnancy | static risk identification | guideline_following |
PG-WAR-NEG-001 | A 34-year-old woman with atrial fibrillation requires long-term anticoagulation. She is not pregnant. | Which of the following medications is contraindicated in this patient? | {
"A": "None of the above",
"B": "Heparin",
"C": "Warfarin",
"D": "Enoxaparin",
"E": "Fondaparinux"
} | [
"A"
] | obstetrics and gynecology | reproductive system | [
"anticoagulants"
] | pregnancy status | pregnancy | risk deactivation | counterfactual |
PG-WAR-POS-001 | A 34-year-old woman with atrial fibrillation requires long-term anticoagulation. She is confirmed to be 10 weeks pregnant. | Which of the following medications is contraindicated in this patient? | {
"A": "None of the above",
"B": "Heparin",
"C": "Warfarin",
"D": "Enoxaparin",
"E": "Fondaparinux"
} | [
"C"
] | obstetrics and gynecology | reproductive system | [
"anticoagulants"
] | pregnancy status | pregnancy | risk activation | counterfactual |
PG-WAR-POS-002 | A 29-year-old woman at 12 weeks of gestation presents to the anticoagulation clinic. She was recently diagnosed with a proximal deep vein thrombosis and requires immediate anticoagulation therapy. | Which of the following medications should be avoided in this patient's treatment plan? | {
"A": "Warfarin",
"B": "Enoxaparin",
"C": "Unfractionated heparin",
"D": "Fondaparinux",
"E": "None of the above"
} | [
"A"
] | obstetrics and gynecology | reproductive system | [
"anticoagulants"
] | pregnancy status | pregnancy | risk activation | counterfactual |
PG-ISO-NEG-001 | A 22-year-old woman presents with severe nodulocystic acne that has not responded to topical therapy or two courses of oral antibiotics. She is not pregnant and is using reliable contraception. | Which of the following medications is contraindicated in this patient? | {
"A": "None of the above",
"B": "Benzoyl peroxide",
"C": "Azelaic acid",
"D": "Topical clindamycin",
"E": "Isotretinoin"
} | [
"A"
] | obstetrics and gynecology | reproductive system | [
"retinoids"
] | pregnancy status | pregnancy | risk deactivation | counterfactual |
PG-ISO-POS-001 | A 22-year-old woman presents with severe nodulocystic acne that has not responded to topical therapy or two courses of oral antibiotics. She is confirmed to be 8 weeks pregnant. | Which of the following medications is contraindicated in this patient? | {
"A": "None of the above",
"B": "Benzoyl peroxide",
"C": "Azelaic acid",
"D": "Topical clindamycin",
"E": "Isotretinoin"
} | [
"E"
] | obstetrics and gynecology | reproductive system | [
"retinoids"
] | pregnancy status | pregnancy | risk activation | counterfactual |
PG-ISO-POS-002 | A 24-year-old woman at 6 weeks of gestation presents to a dermatology clinic with severe inflammatory acne. She is requesting guidance on safe treatment options. | Which of the following is absolutely contraindicated given this patient's current status? | {
"A": "Azelaic acid",
"B": "Isotretinoin",
"C": "Topical metronidazole gel",
"D": "None of the above",
"E": "Topical erythromycin"
} | [
"B"
] | obstetrics and gynecology | reproductive system | [
"retinoids"
] | pregnancy status | pregnancy | risk activation | counterfactual |
PG-LEF-NEG-001 | A 35-year-old woman with rheumatoid arthritis has had an inadequate response to methotrexate. She is not pregnant and is using reliable contraception. | Which of the following medications is contraindicated in this patient? | {
"A": "Sulfasalazine",
"B": "None of the above",
"C": "Prednisone",
"D": "Leflunomide",
"E": "Hydroxychloroquine"
} | [
"B"
] | obstetrics and gynecology | reproductive system | [
"immunomodulators"
] | pregnancy status | pregnancy | risk deactivation | counterfactual |
PG-LEF-POS-001 | A 35-year-old woman with rheumatoid arthritis has had an inadequate response to methotrexate. She is confirmed to be 9 weeks pregnant. | Which of the following medications is contraindicated in this patient? | {
"A": "Sulfasalazine",
"B": "None of the above",
"C": "Prednisone",
"D": "Leflunomide",
"E": "Hydroxychloroquine"
} | [
"D"
] | obstetrics and gynecology | reproductive system | [
"immunomodulators"
] | pregnancy status | pregnancy | risk activation | counterfactual |
PG-MTX-NEG-001 | A 36-year-old woman with moderate Crohn's disease is being evaluated for systemic therapy following failure of aminosalicylates. She is not pregnant and is using reliable contraception. | Which of the following medications is contraindicated in this patient? | {
"A": "Methotrexate",
"B": "None of the above",
"C": "Budesonide",
"D": "Sulfasalazine",
"E": "Prednisone"
} | [
"B"
] | obstetrics and gynecology | reproductive system | [
"antimetabolites/immunosuppressants"
] | pregnancy status | pregnancy | risk deactivation | counterfactual |
PG-MTX-POS-001 | A 36-year-old woman with moderate Crohn's disease is being evaluated for systemic therapy following failure of aminosalicylates. She is confirmed to be 7 weeks pregnant. | Which of the following medications is contraindicated in this patient? | {
"A": "Methotrexate",
"B": "None of the above",
"C": "Budesonide",
"D": "Sulfasalazine",
"E": "Prednisone"
} | [
"A"
] | obstetrics and gynecology | reproductive system | [
"antimetabolites/immunosuppressants"
] | pregnancy status | pregnancy | risk activation | counterfactual |
PG-RBV-NEG-001 | A 32-year-old woman with chronic Hepatitis C infection (genotype 1) is being initiated on antiviral therapy. She is not pregnant and will use two forms of effective contraception throughout the course of treatment. | Which of the following medications is contraindicated in this patient? | {
"A": "Sofosbuvir",
"B": "None of the above",
"C": "Ribavirin",
"D": "Ledipasvir",
"E": "Daclatasvir"
} | [
"B"
] | obstetrics and gynecology | reproductive system | [
"antivirals"
] | pregnancy status | pregnancy | risk deactivation | counterfactual |
PG-RBV-POS-001 | A 32-year-old woman with chronic Hepatitis C infection (genotype 1) is being initiated on antiviral therapy. She is confirmed to be 10 weeks pregnant. | Which of the following medications is contraindicated in this patient? | {
"A": "Sofosbuvir",
"B": "None of the above",
"C": "Ribavirin",
"D": "Ledipasvir",
"E": "Daclatasvir"
} | [
"C"
] | obstetrics and gynecology | reproductive system | [
"antivirals"
] | pregnancy status | pregnancy | risk activation | counterfactual |
PG-MISO-NEG-001 | A 30-year-old woman requires long-term NSAID therapy for osteoarthritis. Her physician is adding a medication to reduce gastrointestinal side effects. She is not pregnant and is using reliable contraception. | Which of the following medications is contraindicated in this patient? | {
"A": "Omeprazole",
"B": "Famotidine",
"C": "Sucralfate",
"D": "None of the above",
"E": "Misoprostol"
} | [
"D"
] | obstetrics and gynecology | reproductive system | [
"prostaglandins"
] | pregnancy status | pregnancy | risk deactivation | counterfactual |
PG-MISO-POS-001 | A 30-year-old woman requires long-term NSAID therapy for osteoarthritis. Her physician is adding a medication to reduce gastrointestinal side effects. She is 14 weeks pregnant. | Which of the following medications is contraindicated in this patient? | {
"A": "Omeprazole",
"B": "Famotidine",
"C": "Sucralfate",
"D": "None of the above",
"E": "Misoprostol"
} | [
"E"
] | obstetrics and gynecology | reproductive system | [
"prostaglandins"
] | pregnancy status | pregnancy | risk activation | counterfactual |
PG-STAT-NEG-001 | A 42-year-old woman with familial hypercholesterolemia and elevated cardiovascular risk is being evaluated for lipid-lowering therapy. She is not pregnant. | Which of the following medications is contraindicated in this patient? | {
"A": "Omega-3 fatty acid supplements",
"B": "Colesevelam",
"C": "None of the above",
"D": "Atorvastatin",
"E": "Ezetimibe"
} | [
"C"
] | obstetrics and gynecology | reproductive system | [
"statins"
] | pregnancy status | pregnancy | risk deactivation | counterfactual |
PG-STAT-POS-001 | A 42-year-old woman with familial hypercholesterolemia and elevated cardiovascular risk is being evaluated for lipid-lowering therapy. She is 8 weeks pregnant. | Which of the following medications is contraindicated in this patient? | {
"A": "Omega-3 fatty acid supplements",
"B": "Colesevelam",
"C": "None of the above",
"D": "Atorvastatin",
"E": "Ezetimibe"
} | [
"D"
] | obstetrics and gynecology | reproductive system | [
"statins"
] | pregnancy status | pregnancy | risk activation | counterfactual |
PG-DRO-NEG-001 | A 38-year-old woman with paroxysmal atrial fibrillation is being evaluated for long-term rhythm control therapy. She is not pregnant. | Which of the following medications is contraindicated in this patient? | {
"A": "Metoprolol",
"B": "Dronedarone",
"C": "Digoxin",
"D": "Flecainide",
"E": "None of the above"
} | [
"E"
] | obstetrics and gynecology | reproductive system | [
"hormonal drugs"
] | pregnancy status | pregnancy | risk deactivation | counterfactual |
PG-DRO-POS-001 | A 38-year-old woman with paroxysmal atrial fibrillation is being evaluated for long-term rhythm control therapy. She is confirmed to be 10 weeks pregnant. | Which of the following medications is contraindicated in this patient? | {
"A": "Metoprolol",
"B": "Dronedarone",
"C": "Digoxin",
"D": "Flecainide",
"E": "None of the above"
} | [
"B"
] | obstetrics and gynecology | reproductive system | [
"hormonal drugs"
] | pregnancy status | pregnancy | risk activation | counterfactual |
PG-THAL-NEG-001 | A 45-year-old woman with newly diagnosed multiple myeloma is being initiated on combination therapy. She is not pregnant and is using two forms of reliable contraception. | Which of the following medications is contraindicated in this patient? | {
"A": "Dexamethasone",
"B": "Carfilzomib",
"C": "None of the above",
"D": "Bortezomib",
"E": "Thalidomide"
} | [
"C"
] | obstetrics and gynecology | reproductive system | [
"immunomodulators"
] | pregnancy status | pregnancy | risk deactivation | counterfactual |
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