id int64 0 1.27k | question stringlengths 19 424 | context listlengths 0 41 | context_len int64 0 41 | options dict | answer stringlengths 1 196 | answer_idx stringclasses 4
values | explanation stringclasses 1
value | patient dict | facts_old listlengths 0 35 | atomic_facts listlengths 0 35 |
|---|---|---|---|---|---|---|---|---|---|---|
1,200 | Which of the following is the best initial diagnostic test for her current complaint? | [
"A 56-year-old woman presents to the emergency department with acute onset of pain and redness of the skin of her right arm for the past 3 days.",
"She has had type 2 diabetes mellitus for the past 22 years, but she is not compliant with her medications.",
"Her temperature is 38.0°C (100.4°F), pulse is 105/min,... | 6 | {
"A": "Complete blood count with differential",
"B": "Sigmoidoscopy or colonoscopy",
"C": "Fecal occult blood test",
"D": "Polymerase chain reaction"
} | Polymerase chain reaction | D | {
"gender": "Female",
"age": "56 years old",
"specialties": [
"Dermatology"
],
"subspecialties": [
"General Dermatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 56-year-old woman presents to the emergency department.",
"2. She has had type 2 diabetes mellitus for the past 22 years.",
"3. She is not compliant with her medications.",
"4. Her temperature is 38.0°C (100.4°F).",
"5. Her pulse is 105/min.",
"6. Her blood pressure is 116/74 mm Hg.",
"7. On physi... | [
"1. She has had type 2 diabetes mellitus for the past 22 years.",
"2. She is not compliant with her medications.",
"3. Her temperature is 38.0°C (100.4°F).",
"4. Her pulse is 105/min.",
"5. Her blood pressure is 116/74 mm Hg.",
"6. On physical examination, her forearm is tender and erythematous.",
"7. S... | |
1,201 | Which of the following correlates with the estimated standard error of the mean for this population? | [
"A group of researchers attempts to determine the mean fasting triglyceride levels in patients between the ages of 30 and 60 in a suburb of Tampa, FL.",
"Over the course of several years, the team manages to obtain the blood levels of a random sample of 10,000 volunteers who fit their inclusion criteria.",
"The... | 3 | {
"A": "0.02",
"B": "0.05",
"C": "0.10",
"D": "0.15"
} | 0.05 | B | {
"gender": "study",
"age": "study",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"General Internal Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Preventive Medicine"
} | [
"1. A group of researchers attempts to determine the mean fasting triglyceride levels in patients.",
"2. The patients are between the ages of 30 and 60.",
"3. The research is conducted in a suburb of Tampa, FL.",
"4. The team manages to obtain the blood levels of a random sample of 10,000 volunteers.",
"5. ... | [
"1. The team obtained the blood levels of a random sample of 10,000 volunteers.",
"2. The volunteers fit the team's inclusion criteria.",
"3. The blood levels were measured.",
"4. The blood levels demonstrated a standard deviation of 5."
] | |
1,202 | Which of the following is the most likely underlying cause of this patient's symptoms? | [
"A 14-year-old girl is brought to the physician by her mother for evaluation of several bruises on her lower extremities.",
"She has had these bruises for about 6 weeks, and the mother is concerned that she might be bullied at school.",
"The patient has had increasing fatigue and paleness over the past several ... | 11 | {
"A": "Immune thrombocytopenic purpura",
"B": "Sickle cell disease",
"C": "Systemic lupus erythematosus",
"D": "Adverse effect of medication"
} | Adverse effect of medication | D | {
"gender": "Female",
"age": "14 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Hematology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Pediatrics"
} | [
"1. Patient is a 14-year-old girl.",
"2. Patient has several bruises on her lower extremities for 6 weeks.",
"3. Mother is concerned that patient might be bullied at school.",
"4. Patient has increasing fatigue and paleness over the past several days.",
"5. Patient has a history of recurrent generalized ton... | [
"1. She has had bruises for about 6 weeks.",
"2. The mother is concerned that she might be bullied at school.",
"3. The patient has had increasing fatigue and paleness over the past several days.",
"4. She has a history of recurrent generalized tonic-clonic seizures treated with carbamazepine.",
"5. She app... | |
1,203 | Histopathologic examination of these macules is most likely to show which of the following? | [
"A 51-year-old man comes to the emergency department because of a 3-day history of shortness of breath, fever, and chills.",
"He has no history of serious illness.",
"His temperature is 39.5°C (103.1°F).",
"Physical examination shows a grade 4/6, holosystolic, blowing murmur over the apex that radiates to the... | 6 | {
"A": "Microabscesses with neutrophil infiltration of capillaries",
"B": "Epithelioid cells with surrounding multinucleated giant cells",
"C": "Cleft-like vacuoles within the arterioles",
"D": "Spiral-shaped bacteria with axial filaments in the epidermis"
} | Microabscesses with neutrophil infiltration of capillaries | A | {
"gender": "Male",
"age": "51",
"specialties": [
"Dermatology"
],
"subspecialties": [
"Dermatopathology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Pathology"
} | [
"1. A 51-year-old man comes to the emergency department.",
"2. He has a 3-day history of shortness of breath, fever, and chills.",
"3. He has no history of serious illness.",
"4. His temperature is 39.5°C (103.1°F).",
"5. Physical examination shows a grade 4/6, holosystolic, blowing murmur over the apex.",
... | [
"1. He has no history of serious illness.",
"2. His temperature is 39.5°C (103.1°F).",
"3. Physical examination shows a grade 4/6, holosystolic, blowing murmur over the apex that radiates to the axilla.",
"4. Crackles are heard in both lower lung fields.",
"5. Examination of the extremities shows several no... | |
1,204 | Which of the following terms describes the investigator's statistical measure of interest? | [
"An investigator is studying the maternal and fetal consequences of a recent spike in benzodiazepine addiction in Ireland.",
"She is particularly interested in whether benzodiazepine use contributes to oral cleft deformities in newborns exposed to alprazolam, clonazepam, or lorazepam during the first trimester.",... | 3 | {
"A": "Mortality rate",
"B": "Relative risk",
"C": "Cumulative incidence",
"D": "Attributable risk"
} | Cumulative incidence | C | {
"gender": "study",
"age": "study",
"specialties": [
"Psychiatry",
"Internal Medicine"
],
"subspecialties": [
"Addiction Psychiatry",
"Addiction Medicine"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Medical Genetics and G... | [
"1. An investigator is studying the maternal and fetal consequences of a recent spike in benzodiazepine addiction in Ireland.",
"2. She is particularly interested in whether benzodiazepine use contributes to oral cleft deformities in newborns exposed to alprazolam, clonazepam, or lorazepam during the first trimes... | [
"1. The investigator is interested in benzodiazepine use and oral cleft deformities in newborns.",
"2. The focus is on alprazolam, clonazepam, and lorazepam use during the first trimester.",
"3. Statistical data from the local demographic institute is used.",
"4. The data is used to calculate the number of ne... | |
1,205 | What is the next best step in management of this patient? | [
"A 55-year-old woman comes to the office for preventive health care.",
"She has recently migrated to the United States from Hong Kong.",
"Her past medical history is noncontributory.",
"She denies smoking cigarettes or drinking alcohol.",
"She last saw a doctor at the age of 14 when she was diagnosed with a... | 9 | {
"A": "Bone scan",
"B": "Ultrasonography of the abdomen",
"C": "Gamma glutamyl transferase",
"D": "Anti mitochondrial antibody"
} | Gamma glutamyl transferase | C | {
"gender": "Female",
"age": "55",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"General Internal Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Preventive Medicine"
} | [
"1. A 55-year-old woman comes to the office for preventive health care.",
"2. She has recently migrated to the United States from Hong Kong.",
"3. Her past medical history is noncontributory.",
"4. She denies smoking cigarettes or drinking alcohol.",
"5. She last saw a doctor at the age of 14 when she was d... | [
"1. She has recently migrated to the United States from Hong Kong.",
"2. Her past medical history is noncontributory.",
"3. She denies smoking cigarettes or drinking alcohol.",
"4. She last saw a doctor at the age of 14 when she was diagnosed with appendicitis and underwent an appendectomy.",
"5. Her father... | |
1,206 | Which is the most likely diagnosis of this condition? | [
"A 33-year-old man presents to his primary care practitioner, complaining about the presence of white spots in both of his hands.",
"He states that the white spots have expanded in the last few months; they are not tender nor ulcerated.",
"His past medical history is relevant for hypothyroidism.",
"Upon physi... | 7 | {
"A": "Vitiligo",
"B": "Tinea versicolor",
"C": "Pityriasis alba",
"D": "Halo nevus"
} | Vitiligo | A | {
"gender": "Male",
"age": "33 years old",
"specialties": [
"Dermatology"
],
"subspecialties": [
"General Dermatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Dermatology"
} | [
"1. Patient is 33 years old.",
"2. Patient complains of white spots in both hands.",
"3. White spots have expanded in last few months.",
"4. White spots are not tender nor ulcerated.",
"5. Patient has past medical history of hypothyroidism.",
"6. Physical examination shows hypopigmented macules on both ha... | [
"1. The patient reports that the white spots have expanded in the last few months.",
"2. The white spots are not tender nor ulcerated.",
"3. The patient has a past medical history of hypothyroidism.",
"4. Upon physical examination, the patient shows hypopigmented macules on both hands and on the back and shou... | |
1,207 | Which of the following is the most likely site where the aspirated foreign body is lodged? | [
"A 3-year-old boy is brought to the emergency department by his mother.",
"He started violently coughing, wheezing, and having difficulty breathing about 10 minutes ago.",
"She had briefly left him lying on his back playing with toys and when she returned he was choking.",
"She attempted the Heimlich maneuver... | 7 | {
"A": "Basilar segment of the right upper lobe",
"B": "Posterior segment of the right upper lobe",
"C": "Basilar segment of the left lower lobe",
"D": "Basilar segment of the right lower lobe"
} | Posterior segment of the right upper lobe | B | {
"gender": "Male",
"age": "3 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Pulmonology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 3-year-old boy is brought to the emergency department by his mother.",
"2. He started violently coughing, wheezing, and having difficulty breathing about 10 minutes ago.",
"3. She had briefly left him lying on his back playing with toys and when she returned he was choking.",
"4. She attempted the Heiml... | [
"1. He started violently coughing, wheezing, and having difficulty breathing about 10 minutes ago.",
"2. She had briefly left him lying on his back playing with toys and when she returned he was choking.",
"3. She attempted the Heimlich maneuver with no improvement.",
"4. His heart rate is 120/min.",
"5. Hi... | |
1,208 | Which of the following drugs should be prescribed to this patient? | [
"A 38-year-old man presents with weakness, loss of appetite, headaches, and irritability.",
"He developed these symptoms gradually over the past 4 months.",
"He was diagnosed with Crohn’s disease, which was moderate at the time of diagnosis 6 months ago.",
"He takes methotrexate 15 mg, which effectively contr... | 10 | {
"A": "Riboflavin",
"B": "Niacin",
"C": "Pyridoxine",
"D": "Folic acid"
} | Folic acid | D | {
"gender": "Male",
"age": "38",
"specialties": [
"Neurology",
"Internal Medicine"
],
"subspecialties": [
"General Neurology",
"General Internal Medicine"
],
"specialty_prob": [
0.6,
0.4
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is 38 years old.",
"2. Patient has weakness, loss of appetite, headaches, and irritability.",
"3. Symptoms developed gradually over the past 4 months.",
"4. Patient was diagnosed with Crohn's disease 6 months ago.",
"5. Disease was moderate at time of diagnosis.",
"6. Patient takes methotrexat... | [
"1. Symptoms developed gradually over the past 4 months.",
"2. Diagnosed with Crohn’s disease 6 months ago.",
"3. Crohn’s disease was moderate at the time of diagnosis.",
"4. Takes methotrexate 15 mg.",
"5. Methotrexate effectively controls his symptoms.",
"6. Vital signs: blood pressure 105/70 mm Hg, hea... | |
1,209 | What is the most likely cause of his hypercalcemia? | [
"A 75-year-old man with coronary artery disease and mitral valve stenosis status-post coronary artery bypass graft and mitral bioprosthetic valve replacement is evaluated in the intensive care unit.",
"His postsurgical course was complicated by ventilator-associated pneumonia and bilateral postoperative pleural e... | 9 | {
"A": "Euthyroid sick syndrome",
"B": "Immobilization",
"C": "Malignancy",
"D": "Primary hyperparathyroidism"
} | Immobilization | B | {
"gender": "Male",
"age": "75",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Endocrinology, Diabetes, and Metabolism"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is a 75-year-old man with coronary artery disease and mitral valve stenosis.",
"2. Patient has had coronary artery bypass graft and mitral bioprosthetic valve replacement.",
"3. Patient's postsurgical course was complicated by ventilator-associated pneumonia and bilateral postoperative pleural effus... | [
"1. His postsurgical course was complicated by ventilator-associated pneumonia.",
"2. His postsurgical course was complicated by bilateral postoperative pleural effusions requiring chest tubes.",
"3. He has been weaned from the ventilator.",
"4. He has had his chest tubes removed.",
"5. He has required freq... | |
1,210 | Which of the following would be the next best step in the treatment of this patient’s depression? | [
"A 35-year-old woman presents for a follow-up.",
"The patient was diagnosed with major depressive disorder 16 months ago and has tried multiple medications with no improvement, namely bupropion, fluoxetine, sertraline, and imipramine.",
"Upon inquiry, she assures the psychiatrist that she has been fully complia... | 5 | {
"A": "St John’s Wort",
"B": "Selegiline",
"C": "Phenelzine",
"D": "Electroconvulsive therapy"
} | Phenelzine | C | {
"gender": "Female",
"age": "35",
"specialties": [
"Psychiatry"
],
"subspecialties": [
"General Psychiatry"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Psychiatry"
} | [
"1. A 35-year-old woman presents for a follow-up.",
"2. The patient was diagnosed with major depressive disorder 16 months ago.",
"3. The patient has tried multiple medications with no improvement.",
"4. The medications tried were bupropion, fluoxetine, sertraline, and imipramine.",
"5. The patient has been... | [
"1. The patient was diagnosed with major depressive disorder 16 months ago.",
"2. The patient has tried multiple medications with no improvement, including bupropion, fluoxetine, sertraline, and imipramine.",
"3. The patient has been fully compliant with her medications so far.",
"4. The patient stopped her c... | |
1,211 | Which of the following best describes an effect of the next best step in management? | [
"A 17-year-old boy is brought in by paramedics to the emergency department.",
"He was found down at a family picnic.",
"The boy's parents state that he tried many new foods at the picnic.",
"Additionally, because it is springtime, many insects were out while he was playing football.",
"His temperature is 99... | 7 | {
"A": "Decreased serum potassium",
"B": "Equilibration of environmental and chest cavity pressure",
"C": "Hypoglycemia",
"D": "Increased systemic vascular resistance"
} | Decreased serum potassium | A | {
"gender": "Male",
"age": "17",
"specialties": [
"Emergency Medicine"
],
"subspecialties": [
"General Emergency Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 17-year-old boy was brought in by paramedics to the emergency department.",
"2. He was found down at a family picnic.",
"3. The boy's parents state that he tried many new foods at the picnic.",
"4. It is springtime.",
"5. Many insects were out while he was playing football.",
"6. His temperature is ... | [
"1. He was found down at a family picnic.",
"2. The boy's parents state that he tried many new foods at the picnic.",
"3. Many insects were out while he was playing football due to springtime.",
"4. His temperature is 99.5°F (37.5°C).",
"5. His blood pressure is 127/68 mmHg.",
"6. His pulse is 120/min.",
... | |
1,212 | Which of the following is the best initial step in management? | [
"A 45-year-old woman comes to the emergency department with her 17-year-old son because she believes she has been poisoned by her ex-husband.",
"She reports that her coffee tasted “strange” this morning.",
"After breakfast, she then saw a black car drive by the house, which she concludes must have been her ex-h... | 11 | {
"A": "Ziprasidone therapy",
"B": "Repetitive transcranial magnetic stimulation",
"C": "Examine mother and son separately",
"D": "Report the case to the authorities"
} | Examine mother and son separately | C | {
"gender": "Female",
"age": "45 years old",
"specialties": [
"Psychiatry"
],
"subspecialties": [
"Forensic Psychiatry",
"Consultation"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Psychiatry"
} | [
"1. Patient is a 45-year-old woman.",
"2. Patient is accompanied by her 17-year-old son.",
"3. Patient believes she has been poisoned by her ex-husband.",
"4. Patient reports her coffee tasted “strange” this morning.",
"5. Patient saw a black car drive by the house.",
"6. Patient's ex-husband drives a bla... | [
"1. She reports that her coffee tasted “strange” this morning.",
"2. After breakfast, she saw a black car drive by the house, which she concludes must have been her ex-husband, who also drives a black car.",
"3. Since the divorce 3 years ago, her ex-husband has been seeking revenge and thinks that he has instal... | |
1,213 | This patient is most likely deficient in which of the following enzymes? | [
"A 2-year-old boy is brought to the physician after his adoptive mother observed jerking movements of his arms and legs earlier that morning.",
"He was adopted from an orphanage in Albania at 4 months of age.",
"He has a history of intellectual disability.",
"Examination shows pale skin and light blue eyes.",... | 5 | {
"A": "Phenylalanine hydroxylase",
"B": "α-ketoacid dehydrogenase",
"C": "Cystathionine synthase",
"D": "Homogentisate oxidase"
} | Phenylalanine hydroxylase | A | {
"gender": "Male",
"age": "2 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Neurology with Special Qualification in Child Neurology",
"Child Neurology",
"Pediatric Neurology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6,
0.2,
0.2
],
"gp... | [
"1. A 2-year-old boy was brought to the physician.",
"2. His adoptive mother observed jerking movements of his arms and legs earlier that morning.",
"3. He was adopted from an orphanage in Albania at 4 months of age.",
"4. He has a history of intellectual disability.",
"5. Examination shows pale skin and li... | [
"1. He was adopted from an orphanage in Albania at 4 months of age.",
"2. He has a history of intellectual disability.",
"3. Examination shows pale skin.",
"4. Examination shows light blue eyes.",
"5. There is a dry rash on the extensor surfaces of the extremities.",
"6. There is an eczematous rash on the... | |
1,214 | Laboratory evaluation in this patient is most likely to show which of the following? | [
"A 45-year-old man comes to the physician because of a 4-month history of increased frequency of urination.",
"He wakes up several times a night to urinate and feels fatigued during the day.",
"He also complains of increased thirst; he drinks multiple liters of water and soda daily and still feels thirsty.",
... | 5 | {
"A": "Elevated serum thyroxine concentration",
"B": "Elevated glycated hemoglobin concentration",
"C": "Positive urinary leukocyte esterase",
"D": "Low urine osmolality"
} | Elevated glycated hemoglobin concentration | B | {
"gender": "Male",
"age": "45 years old",
"specialties": [
"Urology"
],
"subspecialties": [
"General Urology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Urology"
} | [
"1. A 45-year-old man comes to the physician.",
"2. He has a 4-month history of increased frequency of urination.",
"3. He wakes up several times a night to urinate.",
"4. He feels fatigued during the day.",
"5. He complains of increased thirst.",
"6. He drinks multiple liters of water and soda daily.",
... | [
"1. He wakes up several times a night to urinate.",
"2. He feels fatigued during the day.",
"3. He complains of increased thirst.",
"4. He drinks multiple liters of water and soda daily.",
"5. He still feels thirsty.",
"6. Vital signs are within normal limits.",
"7. Physical examination shows patches of... | |
1,215 | Which of the following agents is most likely to improve the patient's long-term survival? | [
"A 69-year-old man comes to the physician with a 9-month history of worsening shortness of breath on exertion and need to urinate at night.",
"He occasionally has palpitations but does not have chest pain.",
"The patient had a transient ischemic attack 5 years ago for which he underwent right-sided carotid enda... | 13 | {
"A": "Eplerenone",
"B": "Ivabradine",
"C": "Verapamil",
"D": "Digoxin"
} | Eplerenone | A | {
"gender": "Male",
"age": "69 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Cardiovascular Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is 69 years old.",
"2. Patient has 9-month history of worsening shortness of breath on exertion and need to urinate at night.",
"3. Patient occasionally has palpitations but does not have chest pain.",
"4. Patient had transient ischemic attack 5 years ago and underwent right-sided carotid endarter... | [
"1. The patient occasionally has palpitations.",
"2. The patient does not have chest pain.",
"3. The patient had a transient ischemic attack 5 years ago.",
"4. The patient underwent right-sided carotid endarterectomy for the transient ischemic attack.",
"5. The patient has hypertension.",
"6. The patient ... | |
1,216 | Which of the following is the next best step in diagnosis? | [
"A 22-year-old woman presents to her primary care provider complaining of a facial rash.",
"She says the rash began 3 weeks ago after hiking in the White Mountains of New Hampshire this summer.",
"Since that time she has also experienced pain in her hands and wrists that is worse in the morning and accompanied ... | 8 | {
"A": "Anti-cardiolipin antibodies",
"B": "Anti-dsDNA antibodies",
"C": "Anti-nuclear antibodies",
"D": "Anti-Smith antibodies"
} | Anti-nuclear antibodies | C | {
"gender": "Female",
"age": "22 years old",
"specialties": [
"Dermatology"
],
"subspecialties": [
"General Dermatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Dermatology"
} | [
"1. Patient is a 22-year-old woman.",
"2. Patient presents to primary care provider complaining of facial rash.",
"3. Patient says rash began 3 weeks ago after hiking in White Mountains of New Hampshire.",
"4. Patient has experienced pain in hands and wrists that is worse in the morning and accompanied by sub... | [
"1. The rash began 3 weeks ago after hiking in the White Mountains of New Hampshire this summer.",
"2. She has experienced pain in her hands and wrists that is worse in the morning and accompanied by subjective fevers.",
"3. She denies chest pain, shortness of breath, nausea, or vomiting.",
"4. Vital signs: 9... | |
1,217 | Which of the following organisms is the most likely cause of this patient’s condition? | [
"A 54-year-old man presents with fever and a painful jaw mass with a yellowish discharge.",
"He says that he first noticed the jaw mass 6 weeks ago and that the mass has been progressively increasing in size.",
"He reports a history of chronic alcoholism and currently takes more than 6 drinks daily.",
"His te... | 7 | {
"A": "Peptostreptococcus magnus",
"B": "Actinomyces israelii",
"C": "Nocardia asteroides",
"D": "Eikenella corrodens"
} | Actinomyces israelii | B | {
"gender": "Male",
"age": "54 years old",
"specialties": [
"Otolaryngology",
"Pathology"
],
"subspecialties": [
"General Otolaryngology",
"Medical Microbiology Pathology"
],
"specialty_prob": [
0.75,
0.25
],
"subspecialty_prob": [
0.75,
0.25
],
"gpt_specialty": "Ot... | [
"1. Patient is 54 years old.",
"2. Patient has fever.",
"3. Patient has a painful jaw mass with a yellowish discharge.",
"4. Patient first noticed the jaw mass 6 weeks ago.",
"5. Mass has been progressively increasing in size.",
"6. Patient has a history of chronic alcoholism.",
"7. Patient currently ta... | [
"1. He first noticed the jaw mass 6 weeks ago.",
"2. The mass has been progressively increasing in size.",
"3. He has a history of chronic alcoholism.",
"4. He currently takes more than 6 drinks daily.",
"5. His temperature is 37.9°C (100.2°F).",
"6. On physical examination, there is a 7 × 7 cm mass at th... | |
1,218 | Which of the following is the best initial diagnostic test for this patient’s condition? | [
"A 57-year-old homosexual man presents to the emergency department with epigastric pain.",
"He has presented multiple times for the same complaint in the past.",
"The patient has a past medical history of alcoholism and is homeless.",
"He states that his symptoms at this time are constant and occur at all tim... | 5 | {
"A": "CT scan",
"B": "Lipase",
"C": "Secretin stimulation test",
"D": "Stool ova and parasite analysis"
} | CT scan | A | {
"gender": "Male",
"age": "57 years old",
"specialties": [
"Gastroenterology",
"Internal Medicine"
],
"subspecialties": [
"General Gastroenterology",
"Gastroenterology"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Emergenc... | [
"1. A 57-year-old man presents to the emergency department with epigastric pain.",
"2. He has presented multiple times for the same complaint in the past.",
"3. The patient has a past medical history of alcoholism.",
"4. The patient is homeless.",
"5. He states that his symptoms at this time are constant.",... | [
"1. The patient has presented multiple times for the same complaint in the past.",
"2. The patient has a past medical history of alcoholism.",
"3. The patient is homeless.",
"4. The patient states that his symptoms at this time are constant.",
"5. The patient's symptoms occur at all times of the day.",
"6... | |
1,219 | Which of the following cells is responsible for the initial cascade by the release of TGF-β and PDGF? | [
"A 6-year-old boy is rushed to the emergency department after being involved in a motor vehicle accident.",
"He has abrasions on his left knee and left elbow.",
"His wounds are cleaned and a pressure bandage is applied.",
"Typically, neutrophils and macrophages are attracted toward the site of injury by vario... | 4 | {
"A": "Mast cells",
"B": "Fibroblasts",
"C": "Platelets",
"D": "Basophils"
} | Platelets | C | {
"gender": "Male",
"age": "6 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Emergency Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 6-year-old boy is rushed to the emergency department.",
"2. He has abrasions on his left knee and left elbow.",
"3. His wounds are cleaned.",
"4. A pressure bandage is applied.",
"5. Neutrophils and macrophages are typically attracted toward the site of injury.",
"6. Various chemical mediators attra... | [
"1. He has abrasions on his left knee.",
"2. He has abrasions on his left elbow.",
"3. His wounds are cleaned.",
"4. A pressure bandage is applied.",
"5. Neutrophils are attracted toward the site of injury.",
"6. Macrophages are attracted toward the site of injury.",
"7. They are attracted by various ch... | |
1,220 | Which of the following is the most likely cause of this patient's presentation? | [
"A 70-year-old man comes to the emergency department after briefly losing consciousness and collapsing when rising from a chair.",
"He did not sustain any injuries from his collapse.",
"He has had a two-week history of dizziness upon standing.",
"He has smoked one pack of cigarettes daily for 55 years.",
"H... | 9 | {
"A": "Stokes-Adams attack",
"B": "Constricted aortic valve orifice",
"C": "Cardiac tumor",
"D": "Left ventricular dilation"
} | Cardiac tumor | C | {
"gender": "Male",
"age": "70 years old",
"specialties": [
"Cardiology"
],
"subspecialties": [
"General Cardiology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 70-year-old man comes to the emergency department.",
"2. He briefly lost consciousness and collapsed when rising from a chair.",
"3. He did not sustain any injuries from his collapse.",
"4. He has had a two-week history of dizziness upon standing.",
"5. He has smoked one pack of cigarettes daily for 5... | [
"1. He did not sustain any injuries from his collapse.",
"2. He has had a two-week history of dizziness upon standing.",
"3. He has smoked one pack of cigarettes daily for 55 years.",
"4. He drinks three beers and two glasses of whiskey daily.",
"5. He currently takes dutasteride and tamsulosin for benign p... | |
1,221 | Which of the following congenital heart diseases does this infant most likely present with? | [
"A 6-month-old infant is brought to a pediatrician for his scheduled immunizations.",
"The parents deny any specific current complaints, but his facial features differ from those of other children in the family.",
"During the physical examination, the pediatrician notes that the infant’s vital signs are stable.... | 6 | {
"A": "Supravalvar aortic stenosis",
"B": "Tetralogy of Fallot",
"C": "Atrial septal defect",
"D": "Atrioventricular septal defect"
} | Atrioventricular septal defect | D | {
"gender": "Not specified",
"age": "6 months",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Cardiology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Pediatrics"
} | [
"1. A 6-month-old infant is brought to a pediatrician for his scheduled immunizations.",
"2. The parents deny any specific current complaints.",
"3. His facial features differ from those of other children in the family.",
"4. During the physical examination, the pediatrician notes that the infant’s vital sign... | [
"1. The parents deny any specific current complaints.",
"2. His facial features differ from those of other children in the family.",
"3. The pediatrician notes that the infant’s vital signs are stable.",
"4. His facial features include a medial epicanthic fold.",
"5. His facial features include a face that ... | |
1,222 | WBC 0–1/hpf | Fatty casts numerous | A renal biopsy specimen is most likely to show which of the following?" | [
"A 32-year-old white woman comes to the physician because of fatigue, lethargy, and swelling of the lower legs for 2 months.",
"She reports recurrent episodes of pain in both wrists, her right knee, and her right ankle in the past year.",
"She has had skin problems that are aggravated by exposure to sunlight fo... | 8 | {
"A": "Thickened capillary loops",
"B": "Segmental sclerosis",
"C": "Crescent formation",
"D": "Hypercellular glomeruli"
} | Thickened capillary loops | A | {
"gender": "Female",
"age": "32 years old",
"specialties": [
"Nephrology",
"Internal Medicine"
],
"subspecialties": [
"General Nephrology",
"Nephrology"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is a 32-year-old white woman.",
"2. Patient has been experiencing fatigue, lethargy, and swelling of the lower legs for 2 months.",
"3. Patient has had recurrent episodes of pain in both wrists, her right knee, and her right ankle in the past year.",
"4. Patient has had skin problems that are aggr... | [
"1. She reports recurrent episodes of pain in both wrists, her right knee, and her right ankle in the past year.",
"2. She has had skin problems that are aggravated by exposure to sunlight for the past 18 months.",
"3. She has smoked one pack of cigarettes daily for 13 years and drinks one alcoholic beverage da... | |
1,223 | Which of the following is most likely responsible for this patient’s breathing pattern? | [
"A 60-year-old man presents to the clinic with his wife for “weird breathing” during the night.",
"The patient’s wife says that his breathing pattern is irregular but he does not snore.",
"The patient says he is not aware of these symptoms.",
"Past medical history is remarkable for an NSTEMI when he was 50 ye... | 5 | {
"A": "Diabetic ketoacidosis",
"B": "Hypothyroidism",
"C": "Left ventricular heart failure",
"D": "Obesity"
} | Left ventricular heart failure | C | {
"gender": "Male",
"age": "60 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Pulmonary Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 60-year-old man presents to the clinic with his wife.",
"2. The patient's wife reports that his breathing pattern is irregular.",
"3. The patient does not snore.",
"4. The patient is not aware of these symptoms.",
"5. The patient's past medical history is remarkable for an NSTEMI when he was 50 years ... | [
"1. The patient's wife reports irregular breathing pattern.",
"2. The patient does not snore.",
"3. The patient denies awareness of the reported symptoms.",
"4. Past medical history includes an NSTEMI at age 50.",
"5. The patient spent a night at a sleep lab.",
"6. Tidal volume was monitored overnight.",
... | |
1,224 | Which of the following is the most likely diagnosis? | [
"A 72-year-old man with a history of chronic kidney disease presents to his primary care physician complaining of recurrent chest pain with activity.",
"The patient used to have chest pain when he mowed his lawn.",
"Now he gets chest pain whenever he walks short distances such as to get his mail.",
"The pain ... | 8 | {
"A": "NSTEMI",
"B": "Stable angina",
"C": "Unstable angina",
"D": "Variant angina"
} | Unstable angina | C | {
"gender": "Male",
"age": "72 years old",
"specialties": [
"Internal Medicine",
"Cardiovascular Disease",
"Cardiology"
],
"subspecialties": [
"Cardiovascular Disease",
"Cardiology",
"General Cardiology",
"General Internal Medicine"
],
"specialty_prob": [
0.6,
0.2,
... | [
"1. Patient is 72 years old.",
"2. Patient has a history of chronic kidney disease.",
"3. Patient presents to primary care physician with recurrent chest pain with activity.",
"4. Patient used to have chest pain when mowing lawn.",
"5. Patient now gets chest pain when walking short distances such as to get ... | [
"1. The patient used to have chest pain when he mowed his lawn.",
"2. Now he gets chest pain whenever he walks short distances such as to get his mail.",
"3. The pain resolves on its own when the patient sits and rests.",
"4. His temperature is 98.2°F (36.8°C).",
"5. Blood pressure is 157/98 mm Hg.",
"6. ... | |
1,225 | Which of the following procedures involves the removal of an entire breast? | [
"A 55-year-old woman presents to the surgical oncology clinic as a new patient for evaluation of recently diagnosed breast cancer.",
"She has a medical history of hypertension for which she takes lisinopril.",
"She denies any surgical history.",
"Her family history is notable for breast cancer in her maternal... | 6 | {
"A": "Vasectomy",
"B": "Mastectomy",
"C": "Lumpectomy",
"D": "Arthroplasty"
} | Mastectomy | B | {
"gender": "Female",
"age": "55 years old",
"specialties": [
"Surgery"
],
"subspecialties": [
"General Surgery"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Surgery"
} | [
"1. A 55-year-old woman presents to the surgical oncology clinic as a new patient.",
"2. She has a medical history of hypertension.",
"3. She takes lisinopril for her hypertension.",
"4. She denies any surgical history.",
"5. Her family history is notable for breast cancer in her maternal grandmother.",
"... | [
"1. She has a medical history of hypertension.",
"2. She takes lisinopril for her hypertension.",
"3. She denies any surgical history.",
"4. Her family history includes breast cancer in her maternal grandmother.",
"5. She is visibly anxious during the encounter.",
"6. Physical examination is otherwise unr... | |
1,226 | Which of the following did the physician add? | [
"A 14-year-old female is seeing her pulmonologist in clinic after a recent asthma exacerbation.",
"She has been adherent to her original controller medication so the physician prescribes an additional new drug which prevents IgE binding to mast cells."
] | 2 | {
"A": "Theophylline",
"B": "Albuterol",
"C": "Omalizumab",
"D": "Beclamethasone"
} | Omalizumab | C | {
"gender": "Female",
"age": "14",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Pulmonology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Allergy and Immunology"
} | [
"1. A 14-year-old female is seeing her pulmonologist in clinic.",
"2. The visit is due to a recent asthma exacerbation.",
"3. She has been adherent to her original controller medication.",
"4. The physician prescribes an additional new drug.",
"5. The new drug prevents IgE binding to mast cells."
] | [
"1. The patient has been adherent to her original controller medication.",
"2. The physician prescribes an additional new drug.",
"3. The new drug prevents IgE binding to mast cells."
] | |
1,227 | Which of the following is the best next step in management for this patient? | [
"A 24-year-old man is brought in to the emergency room after being retrieved by firefighters from a burning building.",
"The patient is responding coherently to questions but reports pain secondary to a burn on his leg.",
"He states he also has a headache and feels dizzy.",
"His temperature is 98.5°F (36.9°C)... | 9 | {
"A": "100% oxygen",
"B": "Hydroxocobalamin",
"C": "Normal saline",
"D": "Ondansetron"
} | 100% oxygen | A | {
"gender": "Male",
"age": "24 years old",
"specialties": [
"Emergency Medicine"
],
"subspecialties": [
"General Emergency Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 24-year-old man is brought in to the emergency room. ",
"2. He was retrieved by firefighters from a burning building. ",
"3. He is responding coherently to questions. ",
"4. He reports pain secondary to a burn on his leg. ",
"5. He also has a headache and feels dizzy. ",
"6. His temperature is 98.5°... | [
"1. The patient is responding coherently to questions.",
"2. The patient reports pain secondary to a burn on his leg.",
"3. The patient states he also has a headache and feels dizzy.",
"4. The patient's temperature is 98.5°F (36.9°C).",
"5. The patient's blood pressure is 129/66 mmHg.",
"6. The patient's ... | |
1,228 | Which of the following vitamin deficiencies is she most likely to develop? | [
"A 29-year-old female presents to her psychiatrist with concerns that she may be \"OCD.\" She explains that she has become extremely obsessed with making sure that her fruits and vegetables are completely sanitized by first rinsing with water for exactly 60 seconds and then boiling for exactly 60 minutes.",
"She ... | 2 | {
"A": "Vitamin A",
"B": "Vitamin K",
"C": "Vitamin C",
"D": "Vitamin E"
} | Vitamin C | C | {
"gender": "Female",
"age": "29",
"specialties": [
"Psychiatry"
],
"subspecialties": [
"General Psychiatry"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Others"
} | [
"1. A 29-year-old female presents to her psychiatrist.",
"2. She has concerns that she may be \"OCD.\"",
"3. She rinses fruits and vegetables with water for exactly 60 seconds.",
"4. She boils fruits and vegetables for exactly 60 minutes.",
"5. She refuses to eat any fruits or vegetables that did not underg... | [
"1. She refuses to eat fruits or vegetables.",
"2. The fruits or vegetables must undergo a specific process.",
"3. She began this process about 3 months ago."
] | |
1,229 | What is the most likely diagnosis? | [
"A 73-year-old male is brought to his family practitioner by his daughter with the complaints of a spinning sensation for the past 4 weeks.",
"He says that the room appears to be continuously spinning.",
"This has progressively worsened over the last 4 weeks to the point that he has become bed bound and cannot ... | 9 | {
"A": "Acute labyrinthitis",
"B": "Benign paroxysmal positional vertigo",
"C": "Cerebellar tumor",
"D": "Meniere's disease"
} | Cerebellar tumor | C | {
"gender": "Male",
"age": "73 years old",
"specialties": [
"Neurology"
],
"subspecialties": [
"Neurology with Special Qualification in Child Neurology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Neurology"
} | [
"1. Patient is 73 years old.",
"2. Patient was brought to family practitioner by daughter.",
"3. Patient has been experiencing a spinning sensation for 4 weeks.",
"4. Spinning sensation has progressively worsened over 4 weeks.",
"5. Patient has become bed bound and cannot walk without support.",
"6. Spinn... | [
"1. The patient experiences continuous spinning sensations in the room.",
"2. The spinning sensations have worsened progressively over the last 4 weeks.",
"3. The patient has become bed bound due to the spinning sensations and cannot walk without support.",
"4. The spinning sensations are present throughout t... | |
1,230 | On physical exam, one would also expect: | [
"A 79-year-old man presents to the emergency room after a syncopal event.",
"The patient has a history of hyperlipidemia for which he is taking atorvastatin.",
"On physical examination, his vital signs are stable, but on cardiac auscultation, you detect a crescendo-decrescendo systolic murmur loudest on the rig... | 3 | {
"A": "That the murmur would best be heard in the lateral left decubitus position",
"B": "The character of the murmur would be machine-like",
"C": "The murmur would also have a mid-systolic click loudest before S2",
"D": "Palpation of the carotid pulse would be weak and late relative to the patient’s heart sou... | Palpation of the carotid pulse would be weak and late relative to the patient’s heart sounds | D | {
"gender": "Male",
"age": "79 years old",
"specialties": [
"Cardiology"
],
"subspecialties": [
"General Cardiology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 79-year-old man presents to the emergency room.",
"2. The patient has a history of hyperlipidemia.",
"3. The patient is taking atorvastatin.",
"4. Vital signs are stable.",
"5. Cardiac auscultation reveals a crescendo-decrescendo systolic murmur.",
"6. The murmur is loudest on the right upper sterna... | [
"1. The patient has a history of hyperlipidemia.",
"2. The patient is taking atorvastatin for hyperlipidemia.",
"3. The patient's vital signs are stable on physical examination.",
"4. A crescendo-decrescendo systolic murmur is detected on cardiac auscultation.",
"5. The murmur is loudest on the right upper ... | |
1,231 | Which of the following best describes this type of study design? | [
"A researcher is designing a study to examine a possible correlation between exposure to a particular pesticide and chronic bronchitis.",
"The researcher gathers all records of patients presenting with bronchitis for the past 10 years from the local hospital and contacts the qualifying subjects to ask them about ... | 3 | {
"A": "Case-control study",
"B": "Cross-sectional study",
"C": "Cohort study",
"D": "Double-blind, randomized, placebo-controlled clinical trial"
} | Cross-sectional study | B | {
"gender": "study",
"age": "study",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Pulmonary Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A researcher is designing a study to examine a possible correlation between exposure to a particular pesticide and chronic bronchitis.",
"2. The researcher gathers all records of patients presenting with bronchitis for the past 10 years from the local hospital.",
"3. The researcher contacts the qualifying s... | [
"1. The researcher gathers all records of patients presenting with bronchitis for the past 10 years from the local hospital.",
"2. The researcher contacts the qualifying subjects to ask them about exposure to the particular pesticide.",
"3. The researcher uses the data to calculate an estimate for the relative ... | |
1,232 | Which of the following will most likely be found on cardiac auscultation? | [
"A 49-year-old woman presents to her primary care physician due to fatigue and shortness of breath.",
"She finds herself being short of breath when climbing the stairs or walking uphill.",
"Approximately 1 year ago, she was able to partake in long-distance running and weightlifting.",
"Two weeks ago she notic... | 8 | {
"A": "Crescendo-decrescendo systolic ejection murmur",
"B": "High-pitched, early diastolic decrescendo murmur",
"C": "Holosystolic, high-pitched murmur loudest at the left lower sternal border",
"D": "Opening snap with a mid-to-late diastolic murmur"
} | Opening snap with a mid-to-late diastolic murmur | D | {
"gender": "Female",
"age": "49",
"specialties": [
"Cardiology"
],
"subspecialties": [
"General Cardiology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is a 49-year-old woman.",
"2. Patient presents to primary care physician due to fatigue and shortness of breath.",
"3. Patient finds herself being short of breath when climbing stairs or walking uphill.",
"4. Approximately 1 year ago, patient was able to partake in long-distance running and weight... | [
"1. She finds herself being short of breath when climbing the stairs or walking uphill.",
"2. Approximately 1 year ago, she was able to partake in long-distance running and weightlifting.",
"3. Two weeks ago she noticed blood-tinged sputum after severely coughing during sleep.",
"4. She emigrated from Mexico ... | |
1,233 | Which of the following is the most appropriate pharmacotherapy at this time? | [
"A 60-year-old man presents to the physician for a follow-up examination.",
"During the previous visit, splenomegaly was detected on the abdominal exam, which has been confirmed by abdominal ultrasound.",
"He has no complaints other than fatigue for several months.",
"He has no history of serious illness and ... | 9 | {
"A": "All-trans retinoic acid",
"B": "Aspirin",
"C": "Imatinib",
"D": "Hydroxyurea"
} | Imatinib | C | {
"gender": "Male",
"age": "60 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Geriatric Medicine",
"Hematology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 60-year-old man presents to the physician for a follow-up examination.",
"2. During the previous visit, splenomegaly was detected on the abdominal exam, which has been confirmed by abdominal ultrasound.",
"3. He has no complaints other than fatigue for several months.",
"4. He has no history of serious ... | [
"1. Splenomegaly was detected on the abdominal exam during the previous visit.",
"2. The splenomegaly has been confirmed by abdominal ultrasound.",
"3. The patient has been experiencing fatigue for several months.",
"4. The patient has no complaints other than fatigue.",
"5. The patient has no history of se... | |
1,234 | What is the most likely cause of the following findings? | [
"A 45-year-old man presents to the outpatient unit with a complaint of lower extremity edema for the past few weeks.",
"He has also been observing puffiness of the face lately.",
"The urinalysis shows 4+ proteinuria.",
"The serum creatinine is 3.5 mg/dL, and antinuclear antibodies are absent.",
"The biopsy ... | 5 | {
"A": "Membranoproliferative glomerulonephritis",
"B": "Rapidly progressive glomerlonephritis",
"C": "Postinfectious glomerulonephritis",
"D": "Membranous glomerulonephritis"
} | Membranous glomerulonephritis | D | {
"gender": "Male",
"age": "45 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Nephrology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 45-year-old man presents to the outpatient unit.",
"2. Complaint is lower extremity edema for the past few weeks.",
"3. Puffiness of the face has been observed lately.",
"4. Urinalysis shows 4+ proteinuria.",
"5. Serum creatinine is 3.5 mg/dL.",
"6. Antinuclear antibodies are absent.",
"7. Biopsy ... | [
"1. He has been observing puffiness of the face lately.",
"2. The urinalysis shows 4+ proteinuria.",
"3. The serum creatinine is 3.5 mg/dL.",
"4. Antinuclear antibodies are absent.",
"5. The biopsy findings are given in the picture."
] | |
1,235 | If the child’s condition is left untreated, levels of which of the following hormones is most likely to be decreased most when the child reaches sexual maturity? | [
"A 2-year-old male is brought to his pediatrician by his parents because of a lack of testes in his scrotum.",
"Physical examination confirms that testes are absent from the scrotal sac and palpable masses are found bilaterally around the inguinal canal."
] | 2 | {
"A": "FSH",
"B": "LH",
"C": "Inhibin",
"D": "Prolactin"
} | Inhibin | C | {
"gender": "Male",
"age": "2 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Endocrinology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 2-year-old male is brought to his pediatrician by his parents.",
"2. The reason for the visit is a lack of testes in his scrotum.",
"3. Physical examination confirms that testes are absent from the scrotal sac.",
"4. Palpable masses are found bilaterally around the inguinal canal."
] | [
"1. Physical examination confirms testes are absent from the scrotal sac.",
"2. Palpable masses are found bilaterally around the inguinal canal."
] | |
1,236 | Which of the following is the volume of isotonic fluid that should be given to this patient over the next 24 hours? | [
"A 23-year-old man presents to the emergency department by ambulance after being rescued from a burning house.",
"The patient was intubated in the field and is maintaining his oxygen saturation above 98%.",
"Physical exam reveals partial or full-thickness burns across an estimated 30% of his total body surface ... | 4 | {
"A": "1,100 mL",
"B": "4,200 mL",
"C": "8,400 mL",
"D": "16,800 mL"
} | 8,400 mL | C | {
"gender": "Male",
"age": "23",
"specialties": [
"Emergency Medicine"
],
"subspecialties": [
"General Emergency Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 23-year-old man presents to the emergency department by ambulance.",
"2. The patient was intubated in the field.",
"3. The patient is maintaining his oxygen saturation above 98%.",
"4. Physical exam reveals partial or full-thickness burns across an estimated 30% of his total body surface area.",
"5. H... | [
"1. The patient was intubated in the field.",
"2. The patient is maintaining his oxygen saturation above 98%.",
"3. Physical exam reveals partial or full-thickness burns.",
"4. The burns are across an estimated 30% of his total body surface area.",
"5. The patient's weight is 70 kg."
] | |
1,237 | Which of the following statements best describes the rationale for administering RhO(D) immunoglobulins (RhoGAM) in this patient? | [
"A 28-year-old G1P0 primigravida woman at 28 weeks estimated gestational age presents for routine prenatal care.",
"She has no complaints and says she can feel her baby move and respond to outside sounds.",
"The patient has no significant past medical or family history.",
"Currently, she is taking a prenatal ... | 14 | {
"A": "RhO(D) immunoglobulin will prevent hemolytic disease in this pregnancy.",
"B": "The father requires RhO(D) immunoglobulin administration rather than the patient.",
"C": "RhO(D) immunoglobulins will prevent anti-D antibody formation in the mother.",
"D": "RhO(D) immunoglobulins will prevent anti-D antibo... | RhO(D) immunoglobulins will prevent anti-D antibody formation in the mother. | C | {
"gender": "Female",
"age": "28 years old",
"specialties": [
"Obstetrics and Gynecology"
],
"subspecialties": [
"General Obstetrics and Gynecology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Obstetrics and Gynecology"
} | [
"1. Patient is a 28-year-old G1P0 primigravida woman.",
"2. Patient is at 28 weeks estimated gestational age.",
"3. Patient has no complaints.",
"4. Patient can feel her baby move and respond to outside sounds.",
"5. Patient has no significant past medical or family history.",
"6. Patient is taking a pren... | [
"1. The patient has no complaints.",
"2. The patient can feel her baby move and respond to outside sounds.",
"3. The patient has no significant past medical history.",
"4. The patient has no significant family history.",
"5. The patient is taking a prenatal multivitamin containing iron and folic acid.",
"... | |
1,238 | The underlying cause of this patient's condition is best classified as which of the following? | [
"A 51-year-old man comes to the physician for evaluation of inability to attain an erection during sexual activity for 6 months.",
"He has had an active sexual life in the past.",
"He reports that early morning erections are present every other day.",
"He has a history of hypertension and diabetes mellitus.",... | 8 | {
"A": "Hormonal",
"B": "Neurogenic",
"C": "Psychogenic",
"D": "Vascular"
} | Psychogenic | C | {
"gender": "Male",
"age": "51 years old",
"specialties": [
"Urology"
],
"subspecialties": [
"General Urology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Urology"
} | [
"1. A 51-year-old man comes to the physician for evaluation of inability to attain an erection during sexual activity for 6 months.",
"2. He has had an active sexual life in the past.",
"3. He reports that early morning erections are present every other day.",
"4. He has a history of hypertension.",
"5. He ... | [
"1. He has had an active sexual life in the past.",
"2. He reports that early morning erections are present every other day.",
"3. He has a history of hypertension and diabetes mellitus.",
"4. His wife recently filed for divorce.",
"5. He has smoked one pack of cigarettes daily for 25 years.",
"6. His onl... | |
1,239 | What is the most likely explanation for this patient’s symptoms? | [
"A 49-year-old G4P4 woman comes to the clinic complaining of repeated leakage of fluid from her vagina for the past 5 months.",
"She noticed an increase in episodes following her cold last week when she was coughing and sneezing a lot.",
"Her past medical history is significant for Crohn disease, which is well ... | 7 | {
"A": "Prolapse of the bladder",
"B": "Detrusor muscle overactivity",
"C": "Genitourinary syndrome of menopause",
"D": "Rectovaginal fistula"
} | Prolapse of the bladder | A | {
"gender": "Female",
"age": "49 years old",
"specialties": [
"Obstetrics and Gynecology"
],
"subspecialties": [
"Female Pelvic Medicine and Reconstructive Surgery"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Obstetrics and Gynecology"
} | [
"1. A 49-year-old G4P4 woman comes to the clinic.",
"2. She has been experiencing repeated leakage of fluid from her vagina for the past 5 months.",
"3. She noticed an increase in episodes following her cold last week.",
"4. She was coughing and sneezing a lot during her cold.",
"5. Her past medical history... | [
"1. She noticed an increase in episodes following her cold last week when she was coughing and sneezing a lot.",
"2. Her past medical history is significant for Crohn disease, which is well controlled with sulfasalazine.",
"3. Her last menstrual period was 1 year ago.",
"4. She is currently sexually active wi... | |
1,240 | Which of the following cellular mechanisms best explains the effects of stimulation of sympathetic cardiac nerves on the pacemaker cells in the sinoatrial node? | [
"A 24-year-old woman presents to a physician with recurrent episodes of palpitations, shortness of breath, and perspiration.",
"The episodes are self-limited and are usually preceded by specific social circumstances that she does not enjoy.",
"There is no significant past medical history.",
"After a complete ... | 5 | {
"A": "Decreased intracellular cyclic adenosine monophosphate (cAMP) level in the sinoatrial node",
"B": "Inactivation of L-type voltage-gated calcium channels",
"C": "Facilitation of If currents through HCN channels",
"D": "Opening of G-protein activated potassium channels"
} | Facilitation of If currents through HCN channels | C | {
"gender": "Female",
"age": "24",
"specialties": [
"Cardiology"
],
"subspecialties": [
"General Cardiology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 24-year-old woman presents to a physician.",
"2. She has recurrent episodes of palpitations, shortness of breath, and perspiration.",
"3. The episodes are self-limited.",
"4. The episodes are usually preceded by specific social circumstances that she does not enjoy.",
"5. There is no significant past ... | [
"1. The episodes are self-limited.",
"2. The episodes are usually preceded by specific social circumstances that she does not enjoy.",
"3. There is no significant past medical history.",
"4. After a complete history and physical examination, the physician diagnoses an anxiety disorder.",
"5. Anxiety is asso... | |
1,241 | What is the most likely etiology of this patient’s diagnosis? | [
"A 14-year-old boy is brought to the office by his parents because he states that for the past 2 months he has been feeling constantly tired, and also noticed a dull pain in the pit of his stomach.",
"The patient has no relevant family history.",
"The vital signs include a heart rate of 105/min, a respiratory r... | 5 | {
"A": "Behçet's syndrome",
"B": "Protein C deficiency",
"C": "Factor V Leiden mutation",
"D": "Polycythemia vera"
} | Polycythemia vera | D | {
"gender": "Male",
"age": "14 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"General Pediatrics"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Pediatrics"
} | [
"1. Patient is a 14-year-old boy.",
"2. Patient has been feeling constantly tired for the past 2 months.",
"3. Patient has noticed a dull pain in the pit of his stomach.",
"4. Patient has no relevant family history.",
"5. Heart rate is 105/min.",
"6. Respiratory rate is 16/min.",
"7. Temperature is 37.0... | [
"1. The patient has no relevant family history.",
"2. Vital signs: heart rate 105/min, respiratory rate 16/min, temperature 37.0°C (98.6°F), blood pressure 111/66 mm Hg.",
"3. Physical exam findings: distended abdomen with hepatomegaly 5 cm underneath the xiphoid process.",
"4. Complete blood count results: H... | |
1,242 | Which of the following is the best treatment for this patient? | [
"A 17-year-old girl is presented to the clinic by her mom for hair loss.",
"Both the girl and her mom have noted random patches of hair loss across the girl's scalp, eyebrows, and eyelashes, 1st appearing several months ago.",
"The girl has noticed no other symptoms, though the spots of hair loss are sometimes ... | 8 | {
"A": "Cognitive-behavioral therapy",
"B": "Intralesional steroids",
"C": "Oral griseofulvin",
"D": "Systemic steroids"
} | Cognitive-behavioral therapy | A | {
"gender": "Female",
"age": "17 years old",
"specialties": [
"Dermatology"
],
"subspecialties": [
"General Dermatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Dermatology"
} | [
"1. A 17-year-old girl is presented to the clinic by her mom.",
"2. Both the girl and her mom have noted random patches of hair loss across the girl's scalp, eyebrows, and eyelashes.",
"3. The hair loss 1st appeared several months ago.",
"4. The girl has noticed no other symptoms.",
"5. The spots of hair lo... | [
"1. Both the girl and her mom have noted random patches of hair loss across the girl's scalp, eyebrows, and eyelashes.",
"2. The hair loss first appeared several months ago.",
"3. The girl has noticed no other symptoms.",
"4. The spots of hair loss are sometimes sore.",
"5. The girl has been very stressed l... | |
1,243 | Which of the following best describes the findings obtained from the study? | [
"In a town with a hepatitis B prevalence of 4%, a new screening test is introduced as part of a study.",
"The first round of the study detects cases of hepatitis B using the new test, which has a sensitivity of 99% and a specificity of 77%.",
"In the second round of the study, the same test is used again in a d... | 3 | {
"A": "The positive predictive value would increase in the second round.",
"B": "The sensitivity would decrease in the second round.",
"C": "The negative predictive value would increase in the second round.",
"D": "The positive likelihood ratio would increase in the second round."
} | The positive predictive value would increase in the second round. | A | {
"gender": "study",
"age": "study",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Infectious Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Medical Genetics and Genomics"
} | [
"1. In a town, the hepatitis B prevalence is 4%.",
"2. A new screening test is introduced as part of a study.",
"3. The first round of the study uses the new test.",
"4. The new test has a sensitivity of 99%.",
"5. The new test has a specificity of 77%.",
"6. The second round of the study uses the same te... | [
"1. The first round of the study detects cases of hepatitis B.",
"2. The new test has a sensitivity of 99%.",
"3. The new test has a specificity of 77%.",
"4. The same test is used again in a different population in the second round of the study.",
"5. The hepatitis B prevalence in the second round of the s... | |
1,244 | Which of the following is the most appropriate next step in management? | [
"A 5-year-old girl is brought to the physician for a well-child examination.",
"Her mother says she has been having trouble sleeping for 3 weeks because of pruritus in her genital area.",
"The girl has otherwise been feeling well.",
"She is at the 45th percentile for height and 51st percentile for weight.",
... | 7 | {
"A": "Potassium hydroxide preparation",
"B": "Perianal cellophane-tape examination",
"C": "Cultures for chlamydia and gonorrhea",
"D": "Stool microscopy"
} | Perianal cellophane-tape examination | B | {
"gender": "Female",
"age": "5 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"General Pediatrics"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Pediatrics"
} | [
"1. A 5-year-old girl is brought to the physician for a well-child examination.",
"2. Her mother says she has been having trouble sleeping for 3 weeks because of pruritus in her genital area.",
"3. The girl has otherwise been feeling well.",
"4. She is at the 45th percentile for height.",
"5. She is at the ... | [
"1. Her mother says she has been having trouble sleeping for 3 weeks because of pruritus in her genital area.",
"2. The girl has otherwise been feeling well.",
"3. She is at the 45th percentile for height.",
"4. She is at the 51st percentile for weight.",
"5. Vital signs are within normal limits.",
"6. Pe... | |
1,245 | Which of the following is the most likely underlying cause of this patient's symptoms? | [
"A 25-year-old man comes to the emergency department because of left flank pain for 2 hours.",
"The pain is colicky in nature and he describes it as 8 out of 10 in intensity.",
"He has nausea and has vomited once.",
"He had a similar episode 6 months ago for which he took naproxen.",
"There is no personal o... | 13 | {
"A": "Bilateral renal cysts",
"B": "Glomerular IgA deposits",
"C": "Ureteropelvic junction obstruction",
"D": "Ascending urinary tract infection\n\""
} | Ureteropelvic junction obstruction | C | {
"gender": "Male",
"age": "25 years old",
"specialties": [
"Urology"
],
"subspecialties": [
"General Urology",
"Urology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Urology"
} | [
"1. A 25-year-old man comes to the emergency department.",
"2. He has left flank pain for 2 hours.",
"3. The pain is colicky in nature.",
"4. He describes the pain as 8 out of 10 in intensity.",
"5. He has nausea and has vomited once.",
"6. He had a similar episode 6 months ago for which he took naproxen.... | [
"1. The pain is colicky in nature.",
"2. He describes the pain as 8 out of 10 in intensity.",
"3. He has nausea.",
"4. He has vomited once.",
"5. He had a similar episode 6 months ago for which he took naproxen.",
"6. There is no personal history of serious illness.",
"7. There is no family history of s... | |
1,246 | What is the next best step in management? | [
"An otherwise healthy 6-year-old boy presents for a follow-up visit to his pediatrician's office for persistent nocturnal enuresis.",
"He has never been dry at night and throughout the last year the pediatrician has seen him multiple times for this issue.",
"He and his family have tried not drinking liquids 2 h... | 6 | {
"A": "Cognitive behavioral therapy",
"B": "Desmopressin",
"C": "Imipramine",
"D": "Oxybutynin"
} | Desmopressin | B | {
"gender": "Male",
"age": "6 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Urology",
"Pediatric Nephrology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Pediatrics"
} | [
"1. Patient is a 6-year-old boy.",
"2. Patient presents for follow-up visit for persistent nocturnal enuresis.",
"3. Patient has never been dry at night.",
"4. Pediatrician has seen patient multiple times for this issue in the last year.",
"5. Patient and family have tried not drinking liquids 2 hours befor... | [
"1. He has never been dry at night.",
"2. Throughout the last year, the pediatrician has seen him multiple times for this issue.",
"3. He and his family have tried not drinking liquids 2 hours before bed.",
"4. They have tried bed wetting alarms.",
"5. They have tried a reward sticker chart with limited suc... | |
1,247 | Which of the following is the next best step in the management of this patient? | [
"A 41-year-old woman presents with acute right flank pain for the past 6 hours.",
"She says the pain is severe, colicky, ‘comes in waves’, and is localized to the right flank.",
"She also has associated nausea and vomiting.",
"The patient is afebrile, and her vital signs are within normal limits.",
"On phys... | 9 | {
"A": "Renal ultrasound",
"B": "24-hour urine chemistry",
"C": "Potassium citrate",
"D": "Hydrocodone/acetaminophen"
} | Hydrocodone/acetaminophen | D | {
"gender": "Female",
"age": "41",
"specialties": [
"Urology"
],
"subspecialties": [
"General Urology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Urology"
} | [
"1. Patient is a 41-year-old woman.",
"2. Patient has had acute right flank pain for the past 6 hours.",
"3. Patient describes the pain as severe, colicky, and ‘coming in waves’.",
"4. Pain is localized to the right flank.",
"5. Patient has associated nausea and vomiting.",
"6. Patient is afebrile.",
"7... | [
"1. The patient reports severe, colicky pain localized to the right flank.",
"2. The pain comes in waves.",
"3. The patient experiences associated nausea and vomiting.",
"4. The patient is afebrile.",
"5. Vital signs are within normal limits.",
"6. On physical examination, the patient is writhing in pain ... | |
1,248 | Which of the following drugs has the most similar mechanism to inflixmab? | [
"A 36-year-old female presents with a 6-month history of stiffness in her joints.",
"She reports bilateral knee pain that is worse in the morning prior to activity and stiffness of the fingers in both hands.",
"Anti-CCP antibody tests are positive.",
"Over several months, the patient's symptoms prove unrespon... | 4 | {
"A": "Imatinib",
"B": "Cyclophosphamide",
"C": "Trastuzumab",
"D": "Allopurinol"
} | Trastuzumab | C | {
"gender": "Female",
"age": "36",
"specialties": [
"Rheumatology"
],
"subspecialties": [
"General Rheumatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 36-year-old female presents.",
"2. She has a 6-month history of stiffness in her joints.",
"3. She reports bilateral knee pain.",
"4. The knee pain is worse in the morning prior to activity.",
"5. She has stiffness of the fingers in both hands.",
"6. Anti-CCP antibody tests are positive.",
"7. The... | [
"1. The patient reports bilateral knee pain.",
"2. The knee pain is worse in the morning prior to activity.",
"3. The patient experiences stiffness of the fingers in both hands.",
"4. Anti-CCP antibody tests are positive.",
"5. The patient's symptoms are unresponsive to NSAIDs.",
"6. The patient's symptom... | |
1,249 | Which of the following is the best explanation for this patient’s improvement in symptoms? | [
"A 55-year-old man presents to the emergency department with chest pain that started 1 hour ago and has not been improving.",
"He has a past medical history of diabetes, hypertension, and obesity.",
"His temperature is 98.5°F (36.9°C), blood pressure is 147/68 mmHg, pulse is 130/min, respirations are 13/min, an... | 5 | {
"A": "Coronary artery vasodilation",
"B": "Decreased adrenergic tone",
"C": "Mu receptor agonism",
"D": "Preload reduction"
} | Preload reduction | D | {
"gender": "Male",
"age": "55",
"specialties": [
"Cardiology",
"Internal Medicine"
],
"subspecialties": [
"Interventional Cardiology",
"Cardiovascular Disease"
],
"specialty_prob": [
0.6,
0.4
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Emergency Medicin... | [
"1. A 55-year-old man presents to the emergency department with chest pain.",
"2. The chest pain started 1 hour ago and has not been improving.",
"3. The patient has a past medical history of diabetes, hypertension, and obesity.",
"4. His temperature is 98.5°F (36.9°C).",
"5. His blood pressure is 147/68 mm... | [
"1. Past medical history of diabetes",
"2. Past medical history of hypertension",
"3. Past medical history of obesity",
"4. Temperature: 98.5°F (36.9°C)",
"5. Blood pressure: 147/68 mmHg",
"6. Pulse: 130/min",
"7. Respirations: 13/min",
"8. Oxygen saturation: 100% on room air",
"9. Physical exam not... | |
1,250 | This increase in serum lactate is necessary to regenerate an essential cofactor for which of the following enzymes? | [
"An investigator is studying energy metabolism in athletes.",
"Baseline serum lactate levels at rest are recorded and repeat levels are obtained directly after a 1000-meter sprint.",
"Compared to the baseline measurements, the serum lactate levels are significantly increased after the sprint."
] | 3 | {
"A": "Glycogen phosphorylase",
"B": "Glyceraldehyde-3 phosphate dehydrogenase",
"C": "Phosphofructokinase-1",
"D": "Pyruvate carboxylase"
} | Glyceraldehyde-3 phosphate dehydrogenase | B | {
"gender": "study",
"age": "study",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Endocrinology, Diabetes, and Metabolism",
"Sports Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Others"
} | [
"1. An investigator is studying energy metabolism in athletes.",
"2. Baseline serum lactate levels at rest are recorded.",
"3. Repeat levels are obtained directly after a 1000-meter sprint.",
"4. Compared to the baseline measurements, the serum lactate levels are significantly increased after the sprint."
] | [
"1. Baseline serum lactate levels are recorded at rest.",
"2. Repeat serum lactate levels are obtained directly after a 1000-meter sprint.",
"3. Serum lactate levels are significantly increased after the sprint compared to the baseline measurements."
] | |
1,251 | Which of the following processes is responsible for the loss of these marked CD8+ cells? | [
"A scientist is studying the development of CD8+ T cells.",
"In his experiments, he uses a radioactive isotope to mark a population of T cells.",
"Once injected into the thymus, these cells bind tightly to MHC I self-antigen complexes.",
"Later in the experiment, the scientist cannot find any marked cells in ... | 4 | {
"A": "Positive selection",
"B": "Negative selection",
"C": "APC antigen presentation",
"D": "IL-2 stimulation"
} | Negative selection | B | {
"gender": "study",
"age": "study",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Rheumatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Allergy and Immunology"
} | [
"1. A scientist is studying the development of CD8+ T cells.",
"2. In his experiments, he uses a radioactive isotope to mark a population of T cells.",
"3. The marked cells are injected into the thymus.",
"4. The marked cells bind tightly to MHC I self-antigen complexes.",
"5. Later in the experiment, the s... | [
"1. In his experiments, he uses a radioactive isotope to mark a population of T cells.",
"2. The radioactive isotope is injected into the thymus.",
"3. The marked cells bind tightly to MHC I self-antigen complexes.",
"4. The scientist cannot find any marked cells in the peripheral blood later in the experimen... | |
1,252 | Based on CXR and biopsy slides shown, you feel that all of the following would be consistent with her diagnosis EXCEPT? | [
"A 65-year-old woman who has smoked 2 packs per day for forty years comes to your practice complaining of a chronic cough, dyspnea, hemoptysis, and difficulty rising from a chair."
] | 1 | {
"A": "Decreasing muscle strength with repetitive stimulation",
"B": "Antibodies to presynaptic calcium channels",
"C": "Dry mouth",
"D": "Orthostatic hypotension"
} | Decreasing muscle strength with repetitive stimulation | A | {
"gender": "Female",
"age": "65 years old",
"specialties": [
"Pulmonary Disease"
],
"subspecialties": [
"General Pulmonary Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Neurology"
} | [
"1. Patient is 65 years old.",
"2. Patient has smoked 2 packs per day for 40 years.",
"3. Patient is complaining of a chronic cough.",
"4. Patient is complaining of dyspnea.",
"5. Patient is complaining of hemoptysis.",
"6. Patient is complaining of difficulty rising from a chair."
] | [
"1. The patient is a 65-year-old woman.",
"2. She has smoked 2 packs per day for forty years.",
"3. She complains of a chronic cough.",
"4. She complains of dyspnea.",
"5. She complains of hemoptysis.",
"6. She complains of difficulty rising from a chair."
] | |
1,253 | What is the most likely diagnosis? | [
"A 16-month-old boy is brought to the pediatrician after his parents noticed the appearance of a rash on his face, torso, and limbs.",
"The boy has been ill for almost 2 weeks, initiating with fever, malaise, coryza, headache, nausea, diarrhea, and a rash on both of his cheeks.",
"Physical examination is unrema... | 3 | {
"A": "Measles",
"B": "Chickenpox",
"C": "Erythema infectiosum",
"D": "Roseola infantum"
} | Erythema infectiosum | C | {
"gender": "Male",
"age": "16 months",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"General Pediatrics",
"Pediatric Dermatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Pediatrics"
} | [
"1. A 16-month-old boy is brought to the pediatrician.",
"2. His parents noticed the appearance of a rash on his face, torso, and limbs.",
"3. The boy has been ill for almost 2 weeks.",
"4. The illness initiated with fever, malaise, coryza, headache, nausea, diarrhea, and a rash on both of his cheeks.",
"5.... | [
"1. The boy has been ill for almost 2 weeks.",
"2. The illness initiated with fever, malaise, coryza, headache, nausea, diarrhea, and a rash on both of his cheeks.",
"3. Physical examination is unremarkable except for an erythematous maculopapular rash on the face, trunk, and extremities.",
"4. The rash has a... | |
1,254 | This patient’s symptoms are likely due to irritation of a nerve that passes through which of the following foramina? | [
"A 27-year-old woman presents to a neurologist complaining of facial pain.",
"She reports that over the past 6 months, she has developed intermittent burning unilateral facial pain that happens over 10 seconds to 3 minutes.",
"The pain is severe enough to completely stop her from her activities.",
"She is wor... | 11 | {
"A": "Foramen rotundum",
"B": "Inferior orbital fissure",
"C": "Jugular foramen",
"D": "Superior orbital fissure"
} | Foramen rotundum | A | {
"gender": "Female",
"age": "27 years old",
"specialties": [
"Neurology"
],
"subspecialties": [
"Pain Medicine",
"Neurology with Special Qualification in Child Neurology",
"General Neurology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.4,
0.4,
0.2
],
"gpt_... | [
"1. A 27-year-old woman presents to a neurologist.",
"2. She complains of facial pain.",
"3. She reports that over the past 6 months, she has developed intermittent burning unilateral facial pain.",
"4. The pain happens over 10 seconds to 3 minutes.",
"5. The pain is severe enough to completely stop her fro... | [
"1. She reports developing intermittent burning unilateral facial pain over the past 6 months.",
"2. The pain lasts for 10 seconds to 3 minutes.",
"3. The pain is severe enough to completely stop her from her activities.",
"4. She is worried about another attack happening whenever she goes out.",
"5. She is... | |
1,255 | Which of the following is the most likely causal organism? | [
"A 26-year-old man comes to the physician because of high-grade fever, fatigue, nausea, and headache for 4 days.",
"The headache is constant and feels like a tight band around his head.",
"He also reports that his eyes hurt while looking at bright lights.",
"He has been taking acetaminophen and using cold tow... | 11 | {
"A": "Borrelia burgdorferi",
"B": "Mycobacterium tuberculosis",
"C": "Herpes simplex virus 1",
"D": "Coxsackievirus"
} | Coxsackievirus | D | {
"gender": "Male",
"age": "26 years old",
"specialties": [
"Infectious Disease",
"Internal Medicine"
],
"subspecialties": [
"General Infectious Disease",
"Infectious Disease"
],
"specialty_prob": [
0.6,
0.4
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "In... | [
"1. Patient is a 26-year-old male.",
"2. Patient has high-grade fever, fatigue, nausea, and headache for 4 days.",
"3. Headache is constant and feels like a tight band around his head.",
"4. Eyes hurt while looking at bright lights.",
"5. Patient has been taking acetaminophen and using cold towels to help r... | [
"1. The patient reports a constant headache that feels like a tight band around his head.",
"2. The patient's eyes hurt when looking at bright lights.",
"3. The patient has been taking acetaminophen and using cold towels to relieve his symptoms.",
"4. The patient has been unable to go to work for 3 days.",
... | |
1,256 | Which of the following congenital defects is the most likely cause of these findings? | [
"A 4-year-old girl presents to the pediatrician’s office for a physical examination prior to starting preschool.",
"She was born at 39 weeks gestation via spontaneous vaginal delivery.",
"She is up to date on all vaccines and is meeting all developmental milestones.",
"Past medical history is noncontributory.... | 12 | {
"A": "Atrial septal defect",
"B": "Coarctation of the aorta",
"C": "Patent ductus arteriosus",
"D": "Tetralogy of Fallot"
} | Atrial septal defect | A | {
"gender": "Female",
"age": "4 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Cardiology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Pediatrics"
} | [
"1. Patient is a 4-year-old girl.",
"2. Patient was born at 39 weeks gestation via spontaneous vaginal delivery.",
"3. Patient is up to date on all vaccines and is meeting all developmental milestones.",
"4. Patient's past medical history is noncontributory.",
"5. Patient takes no medications but does take ... | [
"1. She was born at 39 weeks gestation",
"2. She was born via spontaneous vaginal delivery",
"3. She is up to date on all vaccines",
"4. She is meeting all developmental milestones",
"5. Past medical history is noncontributory",
"6. She takes no medications",
"7. She takes a chewable vitamin daily",
"... | |
1,257 | Which of the following is the most appropriate next step in management? | [
"A 24-year-old man is brought to the emergency department after his head was hit with a bat during a baseball game.",
"His teammates state that he was unresponsive after the incident but regained consciousness after 15 minutes.",
"The patient initially refused to go to the hospital and sat on the bench for the ... | 15 | {
"A": "Adminster hypotonic saline",
"B": "Administer dexamethasone",
"C": "Perform craniotomy",
"D": "Perform brain MRI"
} | Perform craniotomy | C | {
"gender": "Male",
"age": "24 years old",
"specialties": [
"Neurological Surgery"
],
"subspecialties": [
"General Neurological Surgery"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Neurology"
} | [
"1. A 24-year-old man was brought to the emergency department.",
"2. His head was hit with a bat during a baseball game.",
"3. His teammates state he was unresponsive after the incident but regained consciousness after 15 minutes.",
"4. The patient initially refused to go to the hospital and sat on the bench ... | [
"1. His teammates state that he was unresponsive after the incident but regained consciousness after 15 minutes.",
"2. The patient initially refused to go to the hospital and sat on the bench for the remainder of the game.",
"3. He initially appeared fine but became increasingly confused.",
"4. He appears let... | |
1,258 | Laboratory studies show: | Today 6 months ago | Hemoglobin A1c 6.2% 6.4% | Serum | Creatinine 1.3 mg/dL 1.1 mg/dL | Urine | Albumin:creatinine ratio (N < 30) 470 mg/g 260 mg/g | The addition of which of the following medications is most likely to have prevented this patient's progressively worsening renal function?" | [
"A 58-year-old woman comes to the physician for a routine follow-up examination.",
"She has a history of type 2 diabetes mellitus, hypertension, and asthma.",
"Last year, she received laser photocoagulation for proliferative retinopathy.",
"Her current medications include metformin, lisinopril, and an albuter... | 9 | {
"A": "Losartan",
"B": "Aspirin",
"C": "Atorvastatin",
"D": "Amlodipine"
} | Amlodipine | D | {
"gender": "Female",
"age": "58",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Nephrology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 58-year-old woman comes to the physician for a routine follow-up examination.",
"2. She has a history of type 2 diabetes mellitus, hypertension, and asthma.",
"3. Last year, she received laser photocoagulation for proliferative retinopathy.",
"4. Her current medications include metformin, lisinopril, an... | [
"1. She has a history of type 2 diabetes mellitus, hypertension, and asthma.",
"2. Last year, she received laser photocoagulation for proliferative retinopathy.",
"3. Her current medications include metformin, lisinopril, and an albuterol inhaler.",
"4. Her mother died of complications from diabetes.",
"5. ... | |
1,259 | Which of the following is the most effective intervention for this patient's skin lesion? | [
"A 4-year-old boy is brought to the physician by his mother because of a rash on his hands and feet for the past two weeks.",
"It is intensely pruritic, especially at night.",
"He has not had fever, headache, or diarrhea.",
"His mother has a history of eczema.",
"The child was due for an appointment later i... | 8 | {
"A": "Oral acyclovir",
"B": "Supportive care",
"C": "Topical permethrin",
"D": "Topical clotrimazole"
} | Topical permethrin | C | {
"gender": "Male",
"age": "4 years old",
"specialties": [
"Dermatology"
],
"subspecialties": [
"Pediatric Dermatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Dermatology"
} | [
"1. A 4-year-old boy is brought to the physician by his mother.",
"2. The boy has had a rash on his hands and feet for the past two weeks.",
"3. The rash is intensely pruritic, especially at night.",
"4. The boy has not had fever, headache, or diarrhea.",
"5. The boy's mother has a history of eczema.",
"6... | [
"1. It is intensely pruritic, especially at night.",
"2. He has not had fever, headache, or diarrhea.",
"3. His mother has a history of eczema.",
"4. The child was due for an appointment later in the week to follow up on any potentially missing vaccinations.",
"5. His temperature is 37.8°C (100.1°F).",
"6... | |
1,260 | Which of the following stages does this patient's behavior most likely represent? | [
"A 32-year-old man comes with his wife to the primary care physician because she is concerned about his drinking behavior.",
"Specifically, he drinks 7 drinks every day and has abandoned many social activities that he previously enjoyed.",
"In addition, he starts drinking in the morning because he feels shaky w... | 5 | {
"A": "Contemplation",
"B": "Precontemplation",
"C": "Preparation",
"D": "Relapse"
} | Contemplation | A | {
"gender": "Male",
"age": "32 years old",
"specialties": [
"Psychiatry"
],
"subspecialties": [
"Addiction Psychiatry"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Psychiatry"
} | [
"1. A 32-year-old man comes with his wife to the primary care physician.",
"2. His wife is concerned about his drinking behavior.",
"3. He drinks 7 drinks every day.",
"4. He has abandoned many social activities that he previously enjoyed.",
"5. He starts drinking in the morning.",
"6. He feels shaky when... | [
"1. He drinks 7 drinks every day.",
"2. He has abandoned many social activities.",
"3. He starts drinking in the morning because he feels shaky without a drink.",
"4. He knows he should drink less but feels unmotivated to change.",
"5. He suggests addressing the topic again next year."
] | |
1,261 | Which of the following is the most appropriate next step in management? | [
"An 18-month-old boy is brought to the emergency department 25 minutes after an episode of loss of consciousness.",
"The child began crying after his 4-year-old brother snatched a toy from him.",
"The brief shrill cry was followed by a period of expiration; he then turned blue, became unconscious, and briefly l... | 10 | {
"A": "CT scan of the head",
"B": "Echocardiography",
"C": "Reassurance",
"D": "Tilt table test"
} | Reassurance | C | {
"gender": "Male",
"age": "18 months",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Cardiology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Pediatrics"
} | [
"1. An 18-month-old boy was brought to the emergency department 25 minutes after an episode of loss of consciousness.",
"2. The episode began when the child's 4-year-old brother snatched a toy from him.",
"3. The child had a brief shrill cry, followed by a period of expiration.",
"4. He then turned blue, beca... | [
"1. The child began crying after his 4-year-old brother snatched a toy from him.",
"2. The brief shrill cry was followed by a period of expiration.",
"3. He then turned blue, became unconscious, and briefly lost his muscle tone.",
"4. He stiffened and had jerky movements of his arms and legs for 15 seconds.",... | |
1,262 | What is the most likely cause of this patient’s visual loss? | [
"A 67-year-old woman presents to the ophthalmologist with complaints of worsening visual loss.",
"She states that her vision is blurry.",
"Driving has become difficult, particularly at night, as she experiences substantial glare and sees halos around lights.",
"On physical examination, there is absence of a r... | 4 | {
"A": "Age-related macular degeneration",
"B": "Cataracts",
"C": "Open-angle glaucoma",
"D": "Refractive error"
} | Cataracts | B | {
"gender": "Female",
"age": "67 years old",
"specialties": [
"Ophthalmology"
],
"subspecialties": [
"General Ophthalmology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Ophthalmology"
} | [
"1. A 67-year-old woman presents to the ophthalmologist.",
"2. She has complaints of worsening visual loss.",
"3. She states that her vision is blurry.",
"4. Driving has become difficult, particularly at night.",
"5. She experiences substantial glare.",
"6. She sees halos around lights.",
"7. On physica... | [
"1. The patient states that her vision is blurry.",
"2. Driving has become difficult for the patient, particularly at night.",
"3. The patient experiences substantial glare and sees halos around lights.",
"4. On physical examination, there is absence of a red reflex."
] | |
1,263 | Further evaluation of this patient is most likely to show which of the following findings? | [
"A 30-year-old woman comes to the physician because of headaches and nausea for the past 3 weeks.",
"The headaches are holocranial and last up to several hours.",
"During this period, she has also had a swishing sound in both ears, which decreases when she turns her head to either side.",
"She has had multipl... | 14 | {
"A": "Hyperpigmentation of palmar creases",
"B": "Bilateral optic disc swelling",
"C": "Raised intra-ocular pressure",
"D": "Weakness of left upper and lower extremities"
} | Bilateral optic disc swelling | B | {
"gender": "Female",
"age": "30 years old",
"specialties": [
"Neurology"
],
"subspecialties": [
"Neurology with Special Qualification in Child Neurology",
"Vascular Neurology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Neurology"
} | [
"1. Patient is a 30-year-old woman.",
"2. Patient has had headaches and nausea for the past 3 weeks.",
"3. Headaches are holocranial and last up to several hours.",
"4. Patient has had a swishing sound in both ears, which decreases when she turns her head to either side.",
"5. Patient has had multiple episo... | [
"1. The headaches are holocranial and last up to several hours.",
"2. She has a swishing sound in both ears, which decreases when she turns her head to either side.",
"3. She has had multiple episodes of blurring of vision and double vision for the past 2 weeks.",
"4. She has vomited twice in the past week.",... | |
1,264 | A history involving which of the following conditions is most likely to explain the administration of this drug instead of another nonsteroidal anti-inflammatory drug? | [
"A 64-year-old woman with knee osteoarthritis comes to the physician for a follow-up examination.",
"She reports significantly improved pain control since starting celecoxib 1 month ago."
] | 2 | {
"A": "Reye syndrome",
"B": "Sulfa drug allergy",
"C": "Glanzmann thrombasthenia",
"D": "Gout"
} | Glanzmann thrombasthenia | C | {
"gender": "Female",
"age": "64",
"specialties": [
"Orthopaedic Surgery"
],
"subspecialties": [
"Orthopaedic Sports Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Orthopaedic Surgery"
} | [
"1. A 64-year-old woman comes to the physician for a follow-up examination.",
"2. She has knee osteoarthritis.",
"3. She has been taking celecoxib for 1 month.",
"4. She reports significantly improved pain control since starting celecoxib."
] | [
"1. Patient started taking celecoxib 1 month ago.",
"2. Patient reports significantly improved pain control since starting celecoxib."
] | |
1,265 | Which of the following drugs was administered? | [
"A 48-year-old woman is admitted to the hospital and requires anticoagulation.",
"She is administered a drug that binds tightly to antithrombin III."
] | 2 | {
"A": "Aspirin",
"B": "Warfarin",
"C": "Dabigatran",
"D": "Enoxaparin"
} | Enoxaparin | D | {
"gender": "Female",
"age": "48 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Hematology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 48-year-old woman is admitted to the hospital.",
"2. The woman requires anticoagulation.",
"3. She is administered a drug.",
"4. The drug binds tightly to antithrombin III."
] | [
"1. A drug is administered to her.",
"2. The drug binds tightly to antithrombin III."
] | |
1,266 | Which of the following best describes the properties of the most likely virus involved? | [
"A 20-year-old woman comes to the physician because of a 2-day history of low-grade fever and painful lesions on her left index finger.",
"Two weeks ago, she had a painful rash on the right labia majora that resolved without treatment.",
"Physical examination shows tender lymphadenopathy of the left epitrochlea... | 4 | {
"A": "Naked virus with a double-stranded, circular DNA structure",
"B": "Naked virus with a single-stranded, positive sense, linear RNA structure",
"C": "Enveloped virus with a double-stranded, linear DNA structure",
"D": "Enveloped virus with a partially double-stranded, circular DNA structure"
} | Enveloped virus with a double-stranded, linear DNA structure | C | {
"gender": "Female",
"age": "20 years old",
"specialties": [
"Dermatology"
],
"subspecialties": [
"General Dermatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Dermatology"
} | [
"1. A 20-year-old woman comes to the physician.",
"2. She has a 2-day history of low-grade fever.",
"3. She has painful lesions on her left index finger.",
"4. Two weeks ago, she had a painful rash on the right labia majora.",
"5. The rash resolved without treatment.",
"6. Physical examination shows tende... | [
"1. Two weeks ago, she had a painful rash on the right labia majora.",
"2. The painful rash resolved without treatment.",
"3. Physical examination shows tender lymphadenopathy of the left epitrochlear region.",
"4. Physical examination shows tender lymphadenopathy of the right inguinal region.",
"5. A photo... | |
1,267 | Which of the following is the most appropriate next step in management? | [
"A 37-year-old man comes to the emergency department because of unsteady gait that started after waking up that morning.",
"He has no fever, chills, headache, or myalgia.",
"He works as a logger in Washington.",
"His younger sister has multiple sclerosis.",
"The patient appears pale.",
"He is alert and re... | 12 | {
"A": "Perform enzyme‑linked immunosorbent assay",
"B": "Administer doxycycline",
"C": "Administer botulism antitoxin",
"D": "Locate and remove tick"
} | Locate and remove tick | D | {
"gender": "Male",
"age": "37 years old",
"specialties": [
"Neurology"
],
"subspecialties": [
"Vascular Neurology",
"Neurology with Special Qualification in Child Neurology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Neurology"
} | [
"1. A 37-year-old man comes to the emergency department.",
"2. His gait became unsteady after waking up that morning.",
"3. He has no fever, chills, headache, or myalgia.",
"4. He works as a logger in Washington.",
"5. His younger sister has multiple sclerosis.",
"6. The patient appears pale.",
"7. He i... | [
"1. He has no fever, chills, headache, or myalgia.",
"2. He works as a logger in Washington.",
"3. His younger sister has multiple sclerosis.",
"4. The patient appears pale.",
"5. He is alert and responsive.",
"6. His temperature is 37°C (98.9°F), pulse is 100/min, respirations are 11/min, and blood press... | |
1,268 | What is the next best step in the management of this patient? | [
"A 43-year-old man presents requesting a sleep aid for long-standing insomnia.",
"He says he has been having trouble falling asleep for as long as he can remember, but it has become increasingly worse after he and his wife moved to their new house.",
"He claims that his new neighbors are jealous of his huge swi... | 5 | {
"A": "Respond in a straightforward manner, be honest and non-threatening",
"B": "Encourage the patient to inform the police",
"C": "Set rules and be firm with adhering to them",
"D": "Refer this patient to another physician"
} | Respond in a straightforward manner, be honest and non-threatening | A | {
"gender": "Male",
"age": "43",
"specialties": [
"Psychiatry"
],
"subspecialties": [
"Sleep Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Psychiatry"
} | [
"1. A 43-year-old man presents requesting a sleep aid for long-standing insomnia.",
"2. He has been having trouble falling asleep for as long as he can remember.",
"3. His insomnia has become increasingly worse after he and his wife moved to their new house.",
"4. He claims that his new neighbors are jealous ... | [
"1. The patient has been having trouble falling asleep for as long as he can remember.",
"2. The sleep troubles have become worse after the patient and his wife moved to their new house.",
"3. The patient claims that his new neighbors are jealous of his huge swimming pool.",
"4. The patient believes that his ... | |
1,269 | Which of the following medications was most likely given to this patient? | [
"A 22-year-old man presents to the emergency room after an altercation with the police.",
"The police were called because the man was acting erratically in public.",
"On physical examination, the patient is disoriented, does not respond to questioning, and appears to be reacting to internal stimuli.",
"Labora... | 6 | {
"A": "Citalopram",
"B": "Haloperidol",
"C": "Phenelzine",
"D": "Alprazolam"
} | Haloperidol | B | {
"gender": "Male",
"age": "22",
"specialties": [
"Emergency Medicine"
],
"subspecialties": [
"General Emergency Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 22-year-old man presents to the emergency room.",
"2. The police were called because the man was acting erratically in public.",
"3. On physical examination, the patient is disoriented.",
"4. The patient does not respond to questioning.",
"5. The patient appears to be reacting to internal stimuli.",
... | [
"1. The police were called because the man was acting erratically in public.",
"2. On physical examination, the patient is disoriented.",
"3. The patient does not respond to questioning.",
"4. The patient appears to be reacting to internal stimuli.",
"5. Laboratory tests are performed.",
"6. The laborator... | |
1,270 | Which of the following antibiotic therapies would be most suitable for this patient? | [
"A 42-year-old man is brought to the emergency department by his wife with chills and a temperature of 38.5°C (101.3°F) for the past 2 days.",
"The patient’s wife mentions that he recently injured his leg 5 days ago, after which she noticed that his calf was swollen, red, and painful.",
"She says there was no p... | 8 | {
"A": "IV nafcillin",
"B": "Dicloxacillin",
"C": "IV daptomycin",
"D": "Doxycycline"
} | IV daptomycin | C | {
"gender": "Male",
"age": "42 years old",
"specialties": [
"Infectious Disease",
"Internal Medicine"
],
"subspecialties": [
"General Infectious Disease",
"Infectious Disease"
],
"specialty_prob": [
0.6,
0.4
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Em... | [
"1. Patient is 42 years old.",
"2. Patient has had chills and a temperature of 38.5°C (101.3°F) for the past 2 days.",
"3. Patient injured his leg 5 days ago.",
"4. Patient's calf was swollen, red, and painful.",
"5. Patient was in excruciating pain.",
"6. Patient's vital signs include temperature 38.9°C ... | [
"1. The patient injured his leg 5 days ago.",
"2. The patient's wife noticed swelling, redness, and pain in his calf after the injury.",
"3. There was no pus present in the calf.",
"4. The patient was in excruciating pain.",
"5. The patient's temperature is 38.9°C (102.1°F).",
"6. The patient's blood pres... | |
1,271 | Which of the following is the next best step? | [
"A 63-year-old man presents to the emergency department with the sudden onset of excruciating chest pain, which he describes as a tearing sensation",
"He was diagnosed with essential hypertension 20 years ago, but he is not compliant with his medications",
"On physical examination, the temperature is 37.1°C (98... | 5 | {
"A": "CT scan",
"B": "Surgery",
"C": "D-dimer",
"D": "Intravenous ultrasound"
} | CT scan | A | {
"gender": "Male",
"age": "63 years old",
"specialties": [
"Internal Medicine",
"Cardiology"
],
"subspecialties": [
"General Cardiology",
"Cardiovascular Disease"
],
"specialty_prob": [
0.6,
0.4
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Thoracic Surge... | [
"A 63-year-old man presents to the emergency department.",
"He is experiencing sudden, excruciating chest pain.",
"He describes the pain as a tearing sensation.",
"He was diagnosed with essential hypertension 20 years ago.",
"He is not compliant with his hypertension medications.",
"His physical examinati... | [
"1. Diagnosed with essential hypertension 20 years ago",
"2. Non-compliant with medications",
"3. Temperature is 37.1°C (98.8°F)",
"4. Heart rate is 95/min",
"5. Blood pressure is 195/90 mm Hg in the right arm",
"6. Blood pressure is 160/80 mm Hg in the left arm",
"7. Absent pulses in right leg",
"8. ... |
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