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{
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},
{
"role": "user",
"content": "A 61-year-old woman with a long history of involuntary urine loss during activities like coughing or sneezing but no leakage at night undergoes a gynecological exam and Q-tip test. Based on these findings, what would cystometry m... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 45-year-old man with a history of alcohol use, who has been abstinent for the past 10 years, presents with sudden onset dysarthria, shuffling gait, and intention tremors. Given this clinical presentation and history, what is th... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 45-year-old man presents with symptoms including a wide-based gait, a blank facial expression, hallucinations, memory issues, a resting tremor that resolves with movement, and bradykinesia. Based on these clinical findings, wha... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A patient with psoriasis was treated with systemic steroids, and upon discontinuation of the treatment, developed generalized pustules all over the body. What is the most likely cause of this condition?"
},
{
"role": "ass... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "What is the most likely diagnosis for a 2-year-old 70 kg child who presents with limitation of abduction and internal rotation, tenderness in Scarpa's triangle, and abduction of the limb upon flexing the hip?"
},
{
"role"... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "Scientists are developing a new non-steroidal anti-inflammatory drug for osteoarthritis, aiming for higher potency but the same efficacy as ibuprofen to reduce gastrointestinal side effects. If ibuprofen is represented by curve C... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 15-year-old boy presents with decreased facial hair, bilateral breast enlargement, long extremities, scant pubic hair, small testes, and normal-sized penis. He is at the 97th percentile for height and the 50th percentile for we... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "In a patient with dermatomyositis as indicated by fatigue, muscle weakness, a scaly rash, elevated creatine kinase-MB, anti-Jo-1 antibodies, and perimysial inflammation, which type of cancer is most often associated with this con... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "Based on the presentation of gait disturbances, tremors, speech difficulties, and genetic testing revealing GAA trinucleotide repeat expansions, which chromosome is most commonly associated with the mutated gene in this condition... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 25-year-old male presents with high-grade fever and hypotension, with lab results indicating hemoglobin at 5 g/dL, total leukocyte count of 9000/mm3, and differential count of 2% polymorphs, 96% lymphocytes, and 2% eosinophils.... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 42-year-old man with decreased triiodothyronine (T3) levels following recovery from pneumonia is found to have the following thyroid function test results: Thyroid-stimulating hormone (TSH) is 4.7 µU/mL, Thyroxine (T4) is 6 µg/... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 21-year-old female presents with 3 weeks of headaches, sweating, and palpitations, along with a family history of similar symptoms across three generations. Genetic analysis reveals a mutation of a gene on chromosome 3p. Given ... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 26-year-old man presents with lower abdominal pain that shifted from the umbilical area to the right lower abdomen. Initially managed with antibiotics, his condition worsens over two days. A CT scan reveals new hepatic abscesse... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 33-year-old woman from Peru presents with easy fatigability, shortness of breath, worsening breathlessness at night, and leg swelling. Her examination reveals distended jugular veins, basal lung crepitations, and a high-pitched... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 49-year-old man presents with heartburn and mild epigastric pain after meals for 6 months, symptoms worsening in a supine position, and a 'sour' taste in the mouth. He has tried dietary changes without relief. Laboratory tests ... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "What is the most likely direct cause of the 11-year-old boy's symptoms of vomiting, morning worsening of symptoms, occasional headaches, and mild narrowing of visual fields, considering his intact cranial nerves and visual sympto... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 62-year-old man with a history of hypertension and type 2 diabetes, who is a smoker, is brought to the emergency department with suspected stroke. A CT scan reveals a lacunar stroke involving the left subthalamic nucleus. Based... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 25-day-old newborn presents with lethargy, poor muscle tone, feeding difficulties, and projectile vomiting. The examination reveals oral thrush, hepatosplenomegaly, and generalized hypotonia. Lab tests show normal citrulline le... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 69-year-old retired demolition foreman presents with a 4-month history of progressive fatigue, cough, shortness of breath, weight loss, and has recently experienced blood-tinged sputum. Physical examination reveals dullness to ... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 73-year-old man is evaluated for increasing forgetfulness, getting lost while walking, irritability, and difficulty recalling recent events while retaining detailed memories from over 20 years ago. On examination, he is oriente... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 40-year-old female presents with fever, fatigue, and diffuse painful swelling in the midline of the neck. Fine needle aspiration cytology (FNAC) reveals epithelioid cells and giant cells. Based on these clinical and cytological... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 38-year-old man presents with sudden onset abdominal pain and undergoes an emergent laparoscopic appendectomy. After the surgery, he experiences visual and auditory hallucinations. Given his lack of prior medical or psychiatric... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A young adult presents with proptosis, pain in the eye after trauma, chemosis, conjunctival congestion, and extraocular muscle palsy with inability to move the eye. Based on these symptoms, what is the most appropriate diagnostic... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 23-year-old woman experiences bilateral loss of central vision due to retinal ganglion cell degeneration and is concerned about her children's risk of developing the same condition. Considering her family history and that her h... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 25-year-old primigravida at 35 weeks gestation presents with lower leg edema and blood pressure of 155/90 mm Hg, and 24-hour urine assessment shows proteinuria of 1.2 g. Given these findings and assuming no further medical comp... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 68-year-old man with a history of hypertension and coronary artery disease presents with shortness of breath, bilateral pitting edema, and pulmonary crackles on auscultation. His vital signs show a pulse of 120/min and blood pr... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 68-year-old woman presented with unstable angina and underwent cardiac catheterization by radial access where there was difficulty advancing the guidewire. A brachial angiogram was performed and showed abnormalities. Based on t... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 7-year-old boy with sickle cell disease is experiencing knee and hip pain, has been admitted for pain crises in the past, and now walks with a limp. His physical exam shows a normal and cool hip to the touch, with decreased ran... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 5-year-old boy presents with bleeding gums, malnutrition, and small, curled hairs, while having a normal CBC except for mild anemia with an MCV of 85. His diet primarily consists of boiled and preserved vegetables due to financ... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "Based on the clinical presentation and examination findings of a 62-year-old woman with diplopia, fatigue, muscle weakness predominantly affecting proximal muscles, absent deep tendon reflexes that become positive after exercise,... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 28-year-old woman presents with a painless lump in her left breast detected during a self-examination. She has no personal or family history of breast cancer, and physical examination reveals a firm, 1 to 2 cm mass with no skin... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 45-year-old male patient experiences double vision specifically when walking upstairs. Considering his well-controlled history of Type-II diabetes, which cranial nerve is most likely involved in his symptoms?"
},
{
"rol... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "In a 5-month-old boy presenting with restricted joint movement, coarse facial features, hepatosplenomegaly, skeletal malformations, and high plasma levels of lysosomal enzymes, which specific substance's production is most likely... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 3-year-old child presents with tall stature, developmental delay, joint hypermobility, hyperelastic skin, fair complexion, prominent sternum, and downward lens subluxation in the right eye. Considering these features, what comp... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 27-year-old man who has been recently released from prison presents with fatigue, cough, and significant weight loss, and is diagnosed and started on specific treatment. During his treatment monitoring, what clinical finding wo... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 64-year-old female with a new distal radius fracture and a T-score of -3.5 on her DEXA scan needs management for her hypertension. Which antihypertensive medication would be preferred to possibly aid in addressing her osteoporo... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A patient presents with a singular, indurated, nontender ulcer on the vulva, and tests return positive for VDRL and FTA. If left untreated, what is the next clinical stage of this disease characterized by?"
},
{
"role": "... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "Given a patient who experiences sudden-onset chest pain radiating to the neck and left arm, with a past medical history of hypercholesterolemia and coronary artery disease, elevated troponin I levels, and tachycardia, what is the... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 2-day-old male newborn delivered at 36 weeks presents with generalized convulsions, lethargy, feeding difficulties, icterus, purpura, posterior uveitis, and failed auditory screening. Cranial ultrasonography shows ventricular d... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 62-year-old man with stage II adenocarcinoma of the left lower lung lobe, without distant metastases, presents for a follow-up. Considering his diagnosis and the fact that his vital signs and blood work are within normal limits... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "In a patient who, five days post-open colectomy for colon cancer, develops severe pain and swelling of the left calf along with necrotic lesions, a fever, and thrombocytopenia while on unfractionated heparin, what is the most app... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 54-year-old male patient was involved in a road traffic accident and is now unable to move his right arm. Based on the typical injuries associated with this scenario and the provided X-ray findings, which nerve is most likely i... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 25-year-old woman presents with nausea, vomiting, abdominal pain, tender hepatomegaly, and ascites. She recently started using oral contraceptives. Based on these symptoms and history, what is the most likely clinical diagnosis... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 3-year-old boy presents with recurrent long bone fractures following minor trauma, accompanied by decreased bone density on X-ray and he is at the lower percentiles for height and weight. Given these symptoms, what is the most ... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "In the case of a 17-year-old male presenting with a stabbing injury to his left anterior deltoid and requesting the physician to keep the injury confidential due to fear of gang retaliation, what is the appropriate action the phy... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "In the case of a 24-year-old mother who is 7 weeks pregnant and presents to the antenatal care clinic with accidental exposure to radiation, what is the recommended course of action regarding the pregnancy?"
},
{
"role": ... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 73-year-old woman with a 2-month history of diarrhea, recurrent upper respiratory tract infections, frequent tripping over obstacles at night, dry skin, and triangular keratin plaques on the temporal half of the conjunctiva is ... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 5-year-old boy has recurrent abdominal pain primarily occurring during school hours, with no significant findings on physical examination and normal stool characteristics. His symptoms resolve at home, and his laboratory tests ... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 25-year-old patient experiences crushing chest discomfort for 45 minutes and has no significant medical history. The ECG is normal, and the chest pain improved with sublingual nitroglycerin. Based on these findings, what is the... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "An investigator is studying a strain of bacteria that retains a blue color after crystal violet dye and acetone are applied, indicating it is Gram-positive. The bacteria are inoculated in a petri dish containing hypotonic saline.... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "Pierro was noted to be displaying facial grimaces after nurse Kara assessed his complaints of pain rated as 8 on a scale of 1 (no pain) 10 10 (worst pain). Which intervention should the nurse do?\nA. Administering the client’s or... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 50-year-old male presented with fever and chills along with chest pain during cough. His sputum specimen was cultured on blood agar and showed the presence of alpha-hemolytic colonies the next day. When further processing this ... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "In the context of small vessel disease, cerebral amyloid angiopathy, and Alzheimer's disease, describe the relationship between small vessel disease and Alzheimer's disease."
},
{
"role": "assistant",
"content": "<thi... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "Given a gas initially at 700 psia and 540°R, which passes through a heat exchanger and exits at 650 psia and 1000°R, calculate the heat transfer to the gas and the change in entropy of the system using the generalized enthalpy an... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "What is the best management approach for a hemodynamically stable patient presenting with a broad QRS complex caused by antidromic tachycardia as shown on an ECG?"
},
{
"role": "assistant",
"content": "<think>\nOkay, ... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "What are the features associated with Sturge-Weber syndrome?"
},
{
"role": "assistant",
"content": "<think>\nOkay, when I think about Sturge-Weber syndrome, the first thing that comes to mind is that it's a neurocutan... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "What is the maximum amount of I-131 radioactivity allowed in a cadaver for post-mortem examinations to be performed without special precautions?"
},
{
"role": "assistant",
"content": "<think>\nAlright, let's figure th... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 66-year-old woman with a history of type 2 diabetes mellitus, hypertension, hypercholesterolemia, and chronic kidney disease presents after a fall with a brief loss of consciousness and lightheadedness. Her medications include ... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 37-year-old man with a history of intravenous drug use presents to the emergency department with fever, chills, and malaise for a week. His vital signs include a temperature of 40.0 C, heart rate of 120 bpm, blood pressure of 1... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "In a clinical setting, what method can be used by a physician to ensure a patient understands and is able to follow the medication regimen for a newly prescribed drug like omeprazole?"
},
{
"role": "assistant",
"conte... |
[
{
"role": "system",
"content": ""
},
{
"role": "user",
"content": "A 6-month-old boy admitted with failure to thrive with high glutamine and Uracil in urine. Hypoglycemia, high blood ammonia. Treatment given for 2 months. At 8 months again admitted for failure to gain weight. Gastric tube feedin... |
End of preview. Expand
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Originally from FreedomIntelligence/medical-o1-reasoning-SFT
Reformatted for Unsloth Training.
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