question stringlengths 188 2.27k | options dict | answer stringlengths 2 111 | answer_idx stringclasses 6
values |
|---|---|---|---|
A 74-year-old man who had a stroke 2 years ago is admitted to the hospital from the nursing care facility because of a 4-day history of reduced urinary output, and worsening abdominal pain, nausea, and lethargy. The stroke had resulted in right-sided hemiparesis and difficulties with speech and swallowing. Medical hist... | {
"A": "Administration of bethanechol",
"B": "Administration of prazosin",
"C": "Hemodialysis",
"D": "Placement of a suprapubic catheter",
"E": "Ultrafiltration",
"F": null,
"G": null
} | Placement of a suprapubic catheter | D |
A 47-year-old man comes to the emergency department because of a 3-day history of increasing pain, tenderness, and swelling near the fingernail of his right index finger. He rates the pain as an 8 on a 10-point scale. He has not had fever or chills, and he has not sustained any trauma to the finger. Medical history is ... | {
"A": "Incision and drainage",
"B": "Oral cefazolin therapy",
"C": "Topical neomycin therapy",
"D": "Warm-water soaks",
"E": null,
"F": null,
"G": null
} | Incision and drainage | A |
A 12-year-old girl with type 1 diabetes mellitus is brought to the emergency department by her parents because of a 2-day history of nausea, vomiting, and decreased oral intake. Medications are insulin glargine and insulin aspart. She decreased her insulin dose at the onset of symptoms but her condition has since worse... | {
"A": "Bicarbonate ",
"B": "Dexamethasone ",
"C": "50% Dextrose ",
"D": "Furosemide",
"E": "Mannitol",
"F": null,
"G": null
} | Mannitol | E |
A 54-year-old woman, gravida 2, para 2, comes to the office because of a 4-month history of hot flushes that awaken her from sleep on most nights. She also reports increased irritability during this time. She has not had fever, shortness of breath, or cough. She says her appetite has been good and her weight has been s... | {
"A": "Clonidine",
"B": "Conjugated estrogen",
"C": "Fluoxetine",
"D": "Isoniazid and rifampin",
"E": "Raloxifene",
"F": null,
"G": null
} | Conjugated estrogen | B |
A 55-year-old woman, gravida 1, para 1, comes to the office because she is concerned that she has continued to have regular menses while her friends of the same age have gone through menopause. She reports having her usual premenstrual breast tenderness and menstrual cramping. She has not had change in flow, intermenst... | {
"A": "Order fine-needle biopsy of the endometrium",
"B": "Order pelvic ultrasonography",
"C": "Order serum estradiol and follicle-stimulating hormone concentrations",
"D": "Provide reassurance that she is simply still premenopausal",
"E": "Recommend losing weight to help facilitate the onset of menopause",
... | Provide reassurance that she is simply still premenopausal | D |
A 25-year-old man comes to the emergency department because he developed chest pain and shortness of breath 1 hour ago, shortly after snorting cocaine for the first time. He rates the chest pain as a 7 on a 10-point scale and notes that the pain is radiating down his left arm. Medical history is unremarkable and the pa... | {
"A": "Carvedilol ",
"B": "Furosemide ",
"C": "Metoprolol ",
"D": "Phentolamine ",
"E": "Streptokinase",
"F": null,
"G": null
} | Phentolamine | D |
A 70-year-old man, who was admitted to the hospital 3 days ago for treatment of pneumonia, has now developed diarrhea and severe lower abdominal cramping. The patient has passed watery and yellow stools every 2 hours for the past 12 hours. Since admission, the patient has been treated with intravenous levofloxacin ther... | {
"A": "Bicarbonate",
"B": "Calcium gluconate",
"C": "5% Dextrose in water",
"D": "0.9% Saline",
"E": null,
"F": null,
"G": null
} | 0.9% Saline | D |
A 3-week-old male infant is brought to the office by his mother because of a 2-day history of white lesions in the mouth. The infant was born at term via uncomplicated spontaneous vaginal delivery; he has been breast-feeding well and is urinating and having bowel movements normally. At birth, he weighed 3289 g (7 lb 4 ... | {
"A": "Acyclovir",
"B": "Fluconazole",
"C": "Nystatin",
"D": "Valacyclovir",
"E": "No pharmacotherapy is necessary",
"F": null,
"G": null
} | Nystatin | C |
A 55-year-old man is brought to the emergency department by his wife because he told her he did not want to live anymore. During the past 6 weeks, he has experienced fatigue, loss of interest in usual activities, a 7-kg (15-lb) weight loss, and insomnia. He has no history of serious medical or psychiatric illness. Vita... | {
"A": "Divalproex",
"B": "Fluoxetine",
"C": "Lamotrigine",
"D": "Lithium carbonate",
"E": "No other therapy is necessary",
"F": null,
"G": null
} | Fluoxetine | B |
A 78-year-old man, who underwent coronary angiography with stent placement 8 years ago, comes to the office for a routine health maintenance examination. The patient reports no new symptoms except for shortness of breath and fatigue during exercise that began 3 months ago when he tried to increase the distance of his d... | {
"A": "Decrease the dose of metoprolol",
"B": "Increase the dose of prednisone",
"C": "Obtain serum vitamin D concentration",
"D": "Order a transthoracic echocardiography",
"E": null,
"F": null,
"G": null
} | Order a transthoracic echocardiography | D |
A 28-year-old man comes to the office because he would like to quit smoking cigarettes. He says, "I cannot go more than a day without cigarettes because I get so anxious and irritable. I even wake up at night to smoke." The patient began smoking cigarettes at age 12 years; he was smoking two packs of cigarettes daily b... | {
"A": "Cold intolerance",
"B": "Hypertension",
"C": "Polyuria",
"D": "Renal insufficiency",
"E": "The patient is at no increased risk",
"F": null,
"G": null
} | The patient is at no increased risk | E |
A 25-year-old woman comes to the office because of a 24-hour history of right-sided facial weakness. Two days ago she developed mild aching behind the right ear, which resolved spontaneously. This morning, however, the entire right side of her face was drooping and she was unable to close her right eye. When she tried ... | {
"A": "Prognosis cannot be determined without results of cerebral angiography",
"B": "Prognosis cannot be determined without results of MRI of the brain and cerebrospinal fluid analysis",
"C": "She has an 80% chance of complete recovery within the next 12 months without treatment",
"D": "With oral corticostero... | She has an 80% chance of complete recovery within the next 12 months without treatment | C |
A 20-year-old woman comes to the office because of a 2-day history of nasal congestion, runny nose, and nonproductive cough that has made it difficult for her to sleep. She has not had fever. Her brother with whom she resides also has similar symptoms. The patient's medical history is significant for mild persistent as... | {
"A": "Codeine",
"B": "Diphenhydramine",
"C": "Guaifenesin",
"D": "Ipratropium bromide",
"E": "Prednisone",
"F": null,
"G": null
} | Prednisone | E |
A 34-year-old woman, gravida 2, para 1, comes to the office at 26 weeks' gestation to establish prenatal care after obtaining health insurance coverage. She has gained 14 kg (31 lb) during this pregnancy. Her last pregnancy 4 years ago resulted in delivery of a 4564-g (10-lb 1-oz) male newborn. Today, the patient is 16... | {
"A": "Gestational diabetes",
"B": "Multiple gestation",
"C": "Placenta previa",
"D": "Polyhydramnios",
"E": "Preeclampsia",
"F": null,
"G": null
} | Gestational diabetes | A |
A 39-year-old woman, gravida 6, para 5, is admitted to the hospital at 39 weeks' gestation for a scheduled induction of labor for delivery of twins. Her prior pregnancies were uncomplicated. Her current pregnancy has been complicated by well- controlled gestational diabetes. Vital signs are temperature 36.7°C (98.1°F),... | {
"A": "Ergonovine",
"B": "Intramuscular vitamin K",
"C": "15-Methylprostaglandin F2α",
"D": "Misoprostol",
"E": "Oxytocin",
"F": null,
"G": null
} | Oxytocin | E |
A 32-year-old woman comes to the emergency department because of a 3-day history of worsening fever, dry cough, and shortness of breath. She also has had abdominal discomfort, diarrhea, and nausea, but she has not vomited. She returned home from a business trip to a midwestern city 2 days ago. She has had no known cont... | {
"A": "Cefuroxime alone",
"B": "Cefuroxime and azithromycin",
"C": "Levofloxacin alone",
"D": "Levofloxacin and ticarcillin",
"E": "Piperacillin-tazobactam",
"F": null,
"G": null
} | Cefuroxime and azithromycin | B |
A 72-year-old man is admitted to the intensive care unit for pain management and observation of ventricular ectopy 4 hours after undergoing uncomplicated left total knee replacement. He is receiving fentanyl via systemic patient-controlled analgesic pump for pain management. Medical history is remarkable for coronary a... | {
"A": "Continuous application of bilateral lower extremity pneumatic compression devices",
"B": "Continuous intravenous infusion of heparin titrated to a PTT of 1.5 to 2.0 times the control value",
"C": "Oral warfarin",
"D": "Subcutaneous enoxaparin",
"E": "Subcutaneous heparin",
"F": null,
"G": null
} | Subcutaneous enoxaparin | D |
A 45-year-old man comes to the emergency department because of a 1-month history of fatigue, generalized muscle weakness, and a 4-kg (8-lb) weight loss. He also reports a loss of appetite and nausea without vomiting during the past 2 weeks. Medical history is unremarkable and he takes no medications. He does not smoke ... | {
"A": "Calcitonin",
"B": "Dehydroepiandrosterone ",
"C": "Hydrocortisone",
"D": "Levothyroxine",
"E": "Mitotane",
"F": null,
"G": null
} | Hydrocortisone | C |
A 45-year-old man comes to the office because of severe pain of the right foot that awoke him from sleep last night. He says the pain kept him awake for the rest of the night. Walking has been difficult due to the pain, which he rates as a 9 on a 10- point scale. He reports no recent trauma. Medical history is remarkab... | {
"A": "Acetaminophen ",
"B": "Allopurinol",
"C": "Ceftriaxone ",
"D": "Indomethacin ",
"E": "Vancomycin",
"F": null,
"G": null
} | Indomethacin | D |
A 2-year-old boy is brought to the emergency department by his babysitter because of a 30-minute history of respiratory distress. The babysitter reports that she has cared for the patient on numerous occasions during the past year. The child's parents are currently out of town for business but will return later tonight... | {
"A": "Intravenous aminophylline therapy",
"B": "Intravenous antibiotic therapy",
"C": "Intubation",
"D": "Oral dexamethasone therapy",
"E": "Rectal acetaminophen therapy",
"F": null,
"G": null
} | Oral dexamethasone therapy | D |
A 30-year-old man comes to the office because of an itchy and painful facial rash that has worsened since he first noticed it 1 day ago. He has no other symptoms and says he otherwise has been generally healthy. Medical history is unremarkable and he takes no medications. He does not use any substances. He is unmarried... | {
"A": "Referral to a dermatologist ",
"B": "Serum HIV antibody test ",
"C": "Skin biopsy",
"D": "Tzanck test",
"E": null,
"F": null,
"G": null
} | Serum HIV antibody test | B |
A 31-year-old man with a 5-year history of HIV infection comes to the office because of anal pain, particularly on defecation, for the past 4 months. He says he has seen spots of blood on the toilet tissue but has not had any other noticeable bleeding. He reports no change in bowel habits and has not had recent fever, ... | {
"A": "Acyclovir",
"B": "Imiquimod ",
"C": "Levofloxacin ",
"D": "Metronidazole ",
"E": "Penicillin",
"F": null,
"G": null
} | Imiquimod | B |
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