answer_idx int64 0 4 | source stringclasses 4
values | metadata stringlengths 236 9.02k | prompt stringlengths 36 2.27k | answer_letter stringclasses 5
values | answer_string stringlengths 1 208 | reasoning stringlengths 826 29.7k | distilled_answer_string stringlengths 60 2.79k | text stringlengths 1.35k 32.1k |
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2 | GBaker/MedQA-USMLE-4-options | {'question': "A mother brings her 3-week-old infant to the pediatrician's office because she is concerned about his feeding habits. He was born without complications and has not had any medical problems up until this time. However, for the past 4 days, he has been fussy, is regurgitating all of his feeds, and his vomit... | A mother brings her 3-week-old infant to the pediatrician's office because she is concerned about his feeding habits. He was born without complications and has not had any medical problems up until this time. However, for the past 4 days, he has been fussy, is regurgitating all of his feeds, and his vomit is yellow in ... | C | Abnormal migration of ventral pancreatic bud | Okay, let me try to work through this question. Let's start by reading it carefully.
So, the scenario is a 3-week-old infant with fussiness, regurgitating all feeds, and yellow vomit for the past 4 days. The baby was born without complications and no prior medical issues. On physical exam, the abdomen is minimally dis... | The infant’s presentation of bilious vomiting (yellow vomit) and mild abdominal distension suggests an intestinal obstruction **distal to the ampulla of Vater**, as bile enters the duodenum at this point. The key embryologic errors to consider are:
1. **Option C: Abnormal migration of ventral pancreatic bud**
Thi... | <|begin_of_text|><|start_header_id|>system<|end_header_id|>
Cutting Knowledge Date: December 2023
Today Date: 26 Jul 2024
<|eot_id|><|start_header_id|>user<|end_header_id|>
A mother brings her 3-week-old infant to the pediatrician's office because she is concerned about his feeding habits. He was born without compli... |
2 | GBaker/MedQA-USMLE-4-options | {'question': "A 46-year-old woman comes to the physician because of a 2-week history of diplopia and ocular pain when reading the newspaper. She also has a 3-month history of amenorrhea, hot flashes, and increased sweating. She reports that she has been overweight all her adult life and is happy to have lost 6.8-kg (15... | A 46-year-old woman comes to the physician because of a 2-week history of diplopia and ocular pain when reading the newspaper. She also has a 3-month history of amenorrhea, hot flashes, and increased sweating. She reports that she has been overweight all her adult life and is happy to have lost 6.8-kg (15-lb) of weight... | C | Glycosaminoglycan accumulation in the orbit | Okay, let's see. I need to figure out the most likely cause of this patient's ocular complaints. Let's start by summarizing the information given. The main symptoms are diplopia (double vision) and ocular pain when reading, which have been present for two weeks. She also has a three-month history of amenorrhea, hot fla... | The patient's clinical presentation is consistent with Graves' disease, an autoimmune disorder causing hyperthyroidism and associated ophthalmopathy. Key findings include systemic symptoms of hyperthyroidism (weight loss, tachycardia, hypertension, tremor, hyperreflexia) and ocular manifestations (proptosis, lid retrac... | <|begin_of_text|><|start_header_id|>system<|end_header_id|>
Cutting Knowledge Date: December 2023
Today Date: 26 Jul 2024
<|eot_id|><|start_header_id|>user<|end_header_id|>
A 46-year-old woman comes to the physician because of a 2-week history of diplopia and ocular pain when reading the newspaper. She also has a 3-... |
1 | GBaker/MedQA-USMLE-4-options | {'question': 'A 68-year-old man comes to the physician because of recurrent episodes of nausea and abdominal discomfort for the past 4 months. The discomfort is located in the upper abdomen and sometimes occurs after eating, especially after a big meal. He has tried to go for a walk after dinner to help with digestion,... | A 68-year-old man comes to the physician because of recurrent episodes of nausea and abdominal discomfort for the past 4 months. The discomfort is located in the upper abdomen and sometimes occurs after eating, especially after a big meal. He has tried to go for a walk after dinner to help with digestion, but his compl... | B | Cardiac stress test | Okay, let's start thinking through this case. So, the patient is a 68-year-old man with recurrent nausea and upper abdominal discomfort, especially after big meals. Walking after eating makes it worse. He also has trouble climbing stairs for the past three weeks. His history includes type 2 diabetes, hypertension, peri... | The patient's presentation of upper abdominal discomfort associated with both postprandial and exertional triggers, alongside significant cardiac risk factors (diabetes, hypertension, smoking, obesity, peripheral arterial disease), raises concern for coronary artery disease (CAD) manifesting as atypical angina. Diabeti... | <|begin_of_text|><|start_header_id|>system<|end_header_id|>
Cutting Knowledge Date: December 2023
Today Date: 26 Jul 2024
<|eot_id|><|start_header_id|>user<|end_header_id|>
A 68-year-old man comes to the physician because of recurrent episodes of nausea and abdominal discomfort for the past 4 months. The discomfort ... |
0 | GBaker/MedQA-USMLE-4-options | {'question': 'A previously healthy 36-year-old man comes to the physician for a yellow discoloration of his skin and dark-colored urine for 2 weeks. He does not drink any alcohol. Physical examination shows jaundice. Abdominal and neurologic examinations show no abnormalities. Serum studies show increased levels of ala... | A previously healthy 36-year-old man comes to the physician for a yellow discoloration of his skin and dark-colored urine for 2 weeks. He does not drink any alcohol. Physical examination shows jaundice. Abdominal and neurologic examinations show no abnormalities. Serum studies show increased levels of alanine aminotran... | A | Bullous changes of the lung bases on chest CT | Okay, let's take a look at this case. So we have a 36-year-old man who is previously healthy but presents with jaundice, dark urine for two weeks. No alcohol use, which probably rules out alcoholic liver disease. The physical exam shows jaundice, but the abdominal and neuro exams are normal. His serum ALT and AST are e... | The patient presents with jaundice, elevated transaminases (ALT/AST), and a liver biopsy showing PAS-stained findings. The absence of alcohol use and neurologic symptoms, combined with the histologic clues, points to **alpha-1 antitrypsin deficiency**. This condition is characterized by abnormal protein accumulation in... | <|begin_of_text|><|start_header_id|>system<|end_header_id|>
Cutting Knowledge Date: December 2023
Today Date: 26 Jul 2024
<|eot_id|><|start_header_id|>user<|end_header_id|>
A previously healthy 36-year-old man comes to the physician for a yellow discoloration of his skin and dark-colored urine for 2 weeks. He does n... |
0 | GBaker/MedQA-USMLE-4-options | {'question': 'A 42-year-old woman is in the hospital recovering from a cholecystectomy performed 3 days ago that was complicated by cholangitis. She is being treated with IV piperacillin-tazobactam. She calls the nurse to her room because she says that her heart is racing. She also demands that someone come in to clean... | A 42-year-old woman is in the hospital recovering from a cholecystectomy performed 3 days ago that was complicated by cholangitis. She is being treated with IV piperacillin-tazobactam. She calls the nurse to her room because she says that her heart is racing. She also demands that someone come in to clean the pile of g... | A | Delirium tremens | Okay, let's tackle this question step by step. The patient is a 42-year-old woman who's post-op day 3 from a cholecystectomy complicated by cholangitis. She's on IV piperacillin-tazobactam. She presents with racing heart, delirium (disoriented to place and time), sweating, restlessness, and she's seeing garbage and fli... | The patient presents with tachycardia, hypertension, low-grade fever, visual hallucinations (perceiving garbage and flies), disorientation, restlessness, and sweating following a cholecystectomy complicated by cholangitis. Key considerations include:
1. **Delirium Tremens (DT)**: Classic features of autonomic hyperact... | <|begin_of_text|><|start_header_id|>system<|end_header_id|>
Cutting Knowledge Date: December 2023
Today Date: 26 Jul 2024
<|eot_id|><|start_header_id|>user<|end_header_id|>
A 42-year-old woman is in the hospital recovering from a cholecystectomy performed 3 days ago that was complicated by cholangitis. She is being ... |
0 | GBaker/MedQA-USMLE-4-options | {'question': 'A 43-year-old woman presents to the emergency department complaining of palpitations, dry cough, and shortness of breath for 1 week. She immigrated to the United States from Korea at the age of 20. She says that her heart is racing and she has never felt these symptoms before. Her cough is dry and is asso... | A 43-year-old woman presents to the emergency department complaining of palpitations, dry cough, and shortness of breath for 1 week. She immigrated to the United States from Korea at the age of 20. She says that her heart is racing and she has never felt these symptoms before. Her cough is dry and is associated with sh... | A | A bacterium that induces complete lysis of the red cells of a blood agar plate with an oxygen-sensitive cytotoxin | Okay, let's try to work through this problem step by step. So we have a 43-year-old woman who presented with palpitations, dry cough, and shortness of breath for a week. She's from Korea, immigrated when she was 20. Her symptoms include racing heart, dry cough, SOB on exertion. Exam findings are bibasilar crackles, a m... | The patient's presentation of mitral stenosis (mid-diastolic rumble at the apex), heart failure symptoms (jugular vein distention, bibasilar crackles, bilateral pitting edema), and history of immigration from an area with higher prevalence of rheumatic fever strongly suggest rheumatic heart disease. This condition is a... | <|begin_of_text|><|start_header_id|>system<|end_header_id|>
Cutting Knowledge Date: December 2023
Today Date: 26 Jul 2024
<|eot_id|><|start_header_id|>user<|end_header_id|>
A 43-year-old woman presents to the emergency department complaining of palpitations, dry cough, and shortness of breath for 1 week. She immigra... |
3 | GBaker/MedQA-USMLE-4-options | {'question': "A 21-year-old man presents to the emergency department after sustaining a stab wound to the neck at a local farmer's market. The patient is otherwise healthy and is complaining of pain. The patient is able to offer the history himself. His temperature is 97.6°F (36.4°C), blood pressure is 120/84 mmHg, pul... | A 21-year-old man presents to the emergency department after sustaining a stab wound to the neck at a local farmer's market. The patient is otherwise healthy and is complaining of pain. The patient is able to offer the history himself. His temperature is 97.6°F (36.4°C), blood pressure is 120/84 mmHg, pulse is 90/min, ... | D | CT angiogram | Okay, let's tackle this question. So, it's a 21-year-old man with a stab wound to the neck. The location is 1 cm inferior to the mastoid process on the right side. So, I need to recall the anatomy of that area. The mastoid process is part of the temporal bone, right? And structures near there... Well, the carotid arter... | The most appropriate next step in the management of this stable patient with a stab wound to the neck is **CT angiogram**. While Zone II injuries (between the cricoid cartilage and angle of the mandible) were historically managed with surgical exploration, current guidelines favor imaging in hemodynamically stable pati... | <|begin_of_text|><|start_header_id|>system<|end_header_id|>
Cutting Knowledge Date: December 2023
Today Date: 26 Jul 2024
<|eot_id|><|start_header_id|>user<|end_header_id|>
A 21-year-old man presents to the emergency department after sustaining a stab wound to the neck at a local farmer's market. The patient is othe... |
2 | GBaker/MedQA-USMLE-4-options | {'question': "A 48-year-old man with HIV comes to the physician because of skin lesions over his face and neck for 2 weeks. They are not itchy or painful. He does not have fever or a sore throat. He was treated for candidal esophagitis 3 months ago. He is sexually active with his wife, who knows of his condition, and u... | A 48-year-old man with HIV comes to the physician because of skin lesions over his face and neck for 2 weeks. They are not itchy or painful. He does not have fever or a sore throat. He was treated for candidal esophagitis 3 months ago. He is sexually active with his wife, who knows of his condition, and uses condoms co... | C | Poxvirus | Okay, let's try to work through this case step by step. So, the patient is a 48-year-old man with HIV who presents with skin lesions on his face and neck for two weeks. The lesions aren't itchy or painful. He doesn't have a fever or sore throat. He had candidal esophagitis three months ago. He's on antiretroviral thera... | The patient's presentation of multiple skin-colored papules with central umbilication (dimpled centers) and cervical lymphadenopathy in the context of HIV and a CD4+ T-lymphocyte count of 312/mm³ strongly suggests **Molluscum contagiosum**, caused by a poxvirus. Key factors supporting this diagnosis include:
1. **Clin... | <|begin_of_text|><|start_header_id|>system<|end_header_id|>
Cutting Knowledge Date: December 2023
Today Date: 26 Jul 2024
<|eot_id|><|start_header_id|>user<|end_header_id|>
A 48-year-old man with HIV comes to the physician because of skin lesions over his face and neck for 2 weeks. They are not itchy or painful. He ... |
1 | GBaker/MedQA-USMLE-4-options | {'question': 'A new screening test utilizing a telemedicine approach to diagnosing diabetic retinopathy has been implemented in a diabetes clinic. An ophthalmologist’s exam was also performed on all patients as the gold standard for diagnosis. In a pilot study of 500 patients, the screening test detected the presence o... | A new screening test utilizing a telemedicine approach to diagnosing diabetic retinopathy has been implemented in a diabetes clinic. An ophthalmologist’s exam was also performed on all patients as the gold standard for diagnosis. In a pilot study of 500 patients, the screening test detected the presence of diabetic ret... | B | Sensitivity = 95%, Specificity = 83%, PPV = 80%, NPV = 96% | Okay, let me try to figure out this statistics problem. It's about calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for a screening test. I remember these terms from my epidemiology class, but I need to recall exactly how to compute them.
First, let me read the... | To determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the screening test, we start by identifying the true positives (TP), false positives (FP), false negatives (FN), and true negatives (TN) from the given data:
- **True Positives (TP)**: 200 patients (confi... | <|begin_of_text|><|start_header_id|>system<|end_header_id|>
Cutting Knowledge Date: December 2023
Today Date: 26 Jul 2024
<|eot_id|><|start_header_id|>user<|end_header_id|>
A new screening test utilizing a telemedicine approach to diagnosing diabetic retinopathy has been implemented in a diabetes clinic. An ophthalm... |
2 | GBaker/MedQA-USMLE-4-options | "{'question': 'A healthy 22-year-old male participates in a research study you are leading to compar(...TRUNCATED) | "A healthy 22-year-old male participates in a research study you are leading to compare the properti(...TRUNCATED) | C | Increase of tension in all phases | "Okay, let's tackle this multiple-choice question step by step. The question involves understanding (...TRUNCATED) | "To analyze the tension and electrical activity in each phase:\n\n**Phase 1 (Biceps lifting 2.3 kg w(...TRUNCATED) | "<|begin_of_text|><|start_header_id|>system<|end_header_id|>\n\nCutting Knowledge Date: December 202(...TRUNCATED) |
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