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 |
|---|---|---|---|---|---|---|---|---|---|---|
200 | Which of the following explains these findings? | [
"A 28-year-old woman presents to the clinic with 2 months of palpitations, tremor, heat intolerance, insomnia, and loose bowel movements.",
"She has lost 20 kg (44 lb).",
"A physical examination indicates that the body temperature is 37.8°C (100.0°F), the heart rate is 120/min, and the blood pressure is 130/80 ... | 10 | {
"A": "Exogenous thyroxine intake",
"B": "Graves’ disease",
"C": "Hashimoto’s thyroiditis",
"D": "Pregnancy"
} | Graves’ disease | B | {
"gender": "Female",
"age": "28 years old",
"specialties": [
"Internal Medicine",
"Endocrinology, Diabetes, and Metabolism"
],
"subspecialties": [
"Endocrinology, Diabetes, and Metabolism",
"General Endocrinology"
],
"specialty_prob": [
0.6,
0.4
],
"subspecialty_prob": [
0... | [
"1. A 28-year-old woman presents to the clinic with 2 months of palpitations, tremor, heat intolerance, insomnia, and loose bowel movements.",
"2. She has lost 20 kg (44 lb).",
"3. A physical examination indicates that the body temperature is 37.8°C (100.0°F).",
"4. The heart rate is 120/min.",
"5. The bloo... | [
"1. She has lost 20 kg (44 lb).",
"2. The body temperature is 37.8°C (100.0°F).",
"3. The heart rate is 120/min.",
"4. The blood pressure is 130/80 mm Hg.",
"5. A moderately-sized diffuse goiter and a bruit were present.",
"6. She was agitated and experienced a fine tremor with warm moist palms.",
"7. S... | |
201 | Which of the following is the most likely underlying cause of this patient's symptoms?" | [
"A 45-year-old woman comes to the physician because of fatigue and irregular menstrual cycles for the past year.",
"She also complains of recurrent sinus infections.",
"During the past 6 months, she has had increased urinary frequency and swelling of her feet.",
"She has also had difficulty lifting her 3-year... | 17 | {
"A": "Adrenal carcinoma",
"B": "Hypothyroidism",
"C": "Small cell lung cancer",
"D": "Adrenal adenoma"
} | Small cell lung cancer | C | {
"gender": "Female",
"age": "45",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Endocrinology, Diabetes, and Metabolism"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is a 45-year-old woman.",
"2. Patient has been experiencing fatigue and irregular menstrual cycles for the past year.",
"3. Patient has had recurrent sinus infections.",
"4. Patient has had increased urinary frequency and swelling of her feet for the past 6 months.",
"5. Patient has had difficul... | [
"1. The patient complains of recurrent sinus infections.",
"2. Over the past 6 months, she has experienced increased urinary frequency and swelling of her feet.",
"3. She has had difficulty lifting her 3-year-old niece for the past 3 weeks.",
"4. The patient was recently diagnosed with depression.",
"5. She... | |
202 | Which of the following is the most appropriate next step in management? | [
"A 39-year-old woman, gravida 3, para 2, at 39 weeks' gestation is admitted to the hospital with leakage of fluid and contractions.",
"She noticed the fluid leak about an hour ago and has no associated bleeding.",
"Contractions have been about 20 minutes apart.",
"On admission, she is dilated 2 cm, 50% efface... | 8 | {
"A": "Cesarean delivery",
"B": "Assisted vaginal delivery",
"C": "Amnioinfusion",
"D": "Intrauterine pressure catheter\n\""
} | Cesarean delivery | A | {
"gender": "Female",
"age": "39 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 39 years old.",
"2. Patient is gravida 3, para 2.",
"3. Patient is at 39 weeks' gestation.",
"4. Patient has leakage of fluid and contractions.",
"5. Patient noticed fluid leak about an hour ago.",
"6. Patient has no associated bleeding.",
"7. Contractions are about 20 minutes apart.",
... | [
"1. She noticed the fluid leak about an hour ago",
"2. She has no associated bleeding",
"3. Contractions have been about 20 minutes apart",
"4. On admission, she is dilated 2 cm",
"5. She is 50% effaced",
"6. She is at -2 station",
"7. Spontaneous rupture of membranes is confirmed",
"8. She is monitor... | |
203 | Which of the following is the best initial management for this patient? | [
"A 32-year-old homeless man presents to the emergency department with dyspnea, left-sided chest pain, chills, and a productive cough over the last week or so.",
"He does not have medical insurance and has not seen a doctor for many years.",
"His chest pain increases with inspiration.",
"The pain does not radi... | 11 | {
"A": "Supplemental oxygen",
"B": "IV antibiotics and thoracentesis",
"C": "Inhaled bronchodilators",
"D": "Upper endoscopy"
} | IV antibiotics and thoracentesis | B | {
"gender": "Male",
"age": "32 years old",
"specialties": [
"Emergency Medicine",
"Internal Medicine"
],
"subspecialties": [
"General Emergency Medicine",
"Pulmonary Disease"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Eme... | [
"1. Patient is 32 years old.",
"2. Patient is homeless.",
"3. Patient presents with dyspnea, left-sided chest pain, chills, and a productive cough over the last week or so.",
"4. Patient has not had medical insurance and has not seen a doctor for many years.",
"5. Patient's chest pain increases with inspira... | [
"1. He does not have medical insurance.",
"2. He has not seen a doctor for many years.",
"3. His chest pain increases with inspiration.",
"4. The pain does not radiate or worsen with movement.",
"5. He has a productive cough with yellow sputum with flecks of blood.",
"6. He drinks 6 beers a night.",
"7.... | |
204 | Which of the following is the most likely etiology of this patient’s condition? | [
"A 43-year-old woman presents with left calf pain.",
"She denies any previous episodes of such pain.",
"Past medical history is significant for cervical carcinoma treated with cryosurgery with no evidence of recurrence.",
"Current medications are an estrogen-containing oral contraceptive and a multivitamin.",... | 8 | {
"A": "Fibromyalgia",
"B": "Oral contraceptives",
"C": "Protein C deficiency",
"D": "Protein S deficiency"
} | Oral contraceptives | B | {
"gender": "Female",
"age": "43",
"specialties": [
"Internal Medicine",
"Orthopaedic Surgery"
],
"subspecialties": [
"Orthopaedic Sports Medicine",
"General Internal Medicine",
"Vascular Medicine"
],
"specialty_prob": [
0.6666666666666666,
0.3333333333333333
],
"subspecial... | [
"1. Patient is 43 years old.",
"2. Patient presents with left calf pain.",
"3. Patient denies any previous episodes of such pain.",
"4. Patient has past medical history of cervical carcinoma treated with cryosurgery with no evidence of recurrence.",
"5. Patient is currently taking an estrogen-containing ora... | [
"1. She denies any previous episodes of such pain.",
"2. Past medical history is significant for cervical carcinoma treated with cryosurgery with no evidence of recurrence.",
"3. Current medications are an estrogen-containing oral contraceptive and a multivitamin.",
"4. The patient reports a 40-pack-year smok... | |
205 | Assuming all other parameters remain constant, which of the following is most likely to decrease the volume of retrograde blood flow in this patient? | [
"A 53-year-old woman with hypertension and hyperlipidemia comes to the physician because of a 3-month history of progressively worsening shortness of breath.",
"Her pulse is 92/min, respirations are 22/min, and blood pressure is 110/70 mm Hg.",
"Cardiac examination shows a grade 3/6 holosystolic murmur at the a... | 3 | {
"A": "Increase in atrioventricular orifice size",
"B": "Increase in left ventricular inotropy",
"C": "Decrease in systemic vascular resistance",
"D": "Increase in left ventricular end-diastolic pressure"
} | Decrease in systemic vascular resistance | C | {
"gender": "Female",
"age": "53 years old",
"specialties": [
"Cardiology"
],
"subspecialties": [
"General Cardiology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 53-year-old woman comes to the physician.",
"2. She has hypertension and hyperlipidemia.",
"3. She has a 3-month history of progressively worsening shortness of breath.",
"4. Her pulse is 92/min.",
"5. Her respirations are 22/min.",
"6. Her blood pressure is 110/70 mm Hg.",
"7. Cardiac examination... | [
"1. Pulse rate: 92/min",
"2. Respiratory rate: 22/min",
"3. Blood pressure: 110/70 mm Hg",
"4. Cardiac examination: Grade 3/6 holosystolic murmur at the apex",
"5. Murmur radiation: To the axilla",
"6. Extra heart sound: During early diastole"
] | |
206 | What is the most likely cause of his symptoms? | [
"A 66-year-old man presents to his primary care physician with abdominal pain in the setting of progressively worsening constipation.",
"He complains of epigastric pain that waxes and wanes, and expressed concern that he has not defecated for the past 5 days.",
"Upon further questioning, he relates that he has ... | 4 | {
"A": "Magnesium overdose",
"B": "Iron overdose",
"C": "Potassium overdose",
"D": "Folic acid overdose"
} | Iron overdose | B | {
"gender": "Male",
"age": "66 years old",
"specialties": [
"Gastroenterology"
],
"subspecialties": [
"General Gastroenterology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 66-year-old man presents to his primary care physician with abdominal pain.",
"2. The abdominal pain is in the setting of progressively worsening constipation.",
"3. He complains of epigastric pain that waxes and wanes.",
"4. He has not defecated for the past 5 days.",
"5. He has been taking three of ... | [
"1. Patient complains of epigastric pain",
"2. Pain waxes and wanes",
"3. Patient has not defecated for the past 5 days",
"4. Patient has been taking three of his wife's multivitamins each day for the past three weeks",
"5. Patient took multivitamins to combat a cold",
"6. Vital signs are within normal li... | |
207 | Which of the following findings in the nephron best describes the tubular osmolality, compared with serum, in this patient? | [
"Two days after undergoing transsphenoidal removal of a pituitary macroadenoma, a 35-year-old woman reports increased thirst and frequent urination.",
"The surgery was uncomplicated.",
"Neurologic examination shows no abnormalities.",
"Her serum sodium concentration is 153 mEq/L and serum glucose concentratio... | 4 | {
"A": "Distal ascending loop of Henle is hypertonic",
"B": "Proximal convoluted tubule is hypertonic",
"C": "Collecting duct is hypotonic",
"D": "Distal convoluted tubule is hypertonic"
} | Collecting duct is hypotonic | C | {
"gender": "Female",
"age": "35",
"specialties": [
"Nephrology"
],
"subspecialties": [
"General Nephrology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 35-year-old woman underwent transsphenoidal removal of a pituitary macroadenoma.",
"2. Two days after the surgery, the woman reported increased thirst and frequent urination.",
"3. The surgery was uncomplicated.",
"4. Neurologic examination showed no abnormalities.",
"5. The woman's serum sodium conce... | [
"1. The surgery was uncomplicated.",
"2. Neurologic examination shows no abnormalities.",
"3. Her serum sodium concentration is 153 mEq/L.",
"4. Her serum glucose concentration is 92 mg/dL."
] | |
208 | This patient's symptoms are most likely caused by obstruction at which of the following locations? | [
"A 67-year-old woman comes to the physician because of a 5-day history of episodic abdominal pain, nausea, and vomiting.",
"She has coronary artery disease and type 2 diabetes mellitus.",
"She takes aspirin, metoprolol, and metformin.",
"She is 163 cm (5 ft 4 in) tall and weighs 91 kg (200 lb); her BMI is 34 ... | 7 | {
"A": "Third part of the duodenum",
"B": "Distal ileum",
"C": "Proximal jejunum",
"D": "Pancreatic duct"
} | Distal ileum | B | {
"gender": "Female",
"age": "67 years old",
"specialties": [
"Surgery",
"General Surgery"
],
"subspecialties": [
"General Surgery"
],
"specialty_prob": [
0.6666666666666666,
0.3333333333333333
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Surgery"
} | [
"1. A 67-year-old woman comes to the physician.",
"2. She has a 5-day history of episodic abdominal pain, nausea, and vomiting.",
"3. She has coronary artery disease and type 2 diabetes mellitus.",
"4. She takes aspirin, metoprolol, and metformin.",
"5. She is 163 cm (5 ft 4 in) tall.",
"6. She weighs 91 ... | [
"1. She has coronary artery disease.",
"2. She has type 2 diabetes mellitus.",
"3. She takes aspirin.",
"4. She takes metoprolol.",
"5. She takes metformin.",
"6. She is 163 cm (5 ft 4 in) tall.",
"7. She weighs 91 kg (200 lb).",
"8. Her BMI is 34 kg/m2.",
"9. Her temperature is 38.1°C (100.6°F).",
... | |
209 | Which of the following is the most likely diagnosis? | [
"A 47-year-old man presents to his ophthalmologist for abnormal vision.",
"The patient was discharged from the hospital 2 weeks ago after a motor vehicle accident where he was given 1L of blood.",
"He also underwent several surgical procedures including enucleation of the right globe and exploratory abdominal l... | 8 | {
"A": "Anterior uveitis",
"B": "Normal post-operative visual adaptations",
"C": "Seasonal allergies",
"D": "Sympathetic ophthalmia"
} | Sympathetic ophthalmia | D | {
"gender": "Male",
"age": "47",
"specialties": [
"Ophthalmology"
],
"subspecialties": [
"General Ophthalmology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Ophthalmology"
} | [
"1. Patient is 47 years old.",
"2. Patient was discharged from hospital 2 weeks ago after motor vehicle accident.",
"3. Patient was given 1L of blood.",
"4. Patient underwent enucleation of right globe and exploratory abdominal laparotomy.",
"5. Patient has noticed decreased vision in left eye.",
"6. Pati... | [
"1. The patient was discharged from the hospital 2 weeks ago after a motor vehicle accident.",
"2. The patient was given 1L of blood.",
"3. The patient underwent enucleation of the right globe.",
"4. The patient underwent exploratory abdominal laparotomy to stop internal bleeding.",
"5. The patient has noti... | |
210 | Which of the following is the best next step in management? | [
"A 26-year-old female presents to her primary care physician with several months of mood swings, which she feels are affecting her work and personal relationships.",
"She states that on roughly a quarter of days each month, she feels highly irritable, sensitive to criticism and rejection, and easily saddened.",
... | 10 | {
"A": "Selective serotonin reuptake inhibitor",
"B": "Combined oral contraceptive therapy",
"C": "Serotonin-norepinephrine reuptake inhibitor",
"D": "Cognitive behavioral therapy"
} | Selective serotonin reuptake inhibitor | A | {
"gender": "Female",
"age": "26",
"specialties": [
"Psychiatry"
],
"subspecialties": [
"General Psychiatry"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Psychiatry"
} | [
"1. Patient is a 26-year-old female.",
"2. Patient has been experiencing mood swings for several months.",
"3. Patient feels highly irritable, sensitive to criticism and rejection, and easily saddened on roughly a quarter of days each month.",
"4. Patient's appetite varies greatly on days when she is particul... | [
"1. The patient experiences irritability, sensitivity to criticism and rejection, and sadness on roughly a quarter of days each month.",
"2. She also experiences varying appetite and increased hunger on emotional days.",
"3. Her work performance has suffered due to these symptoms.",
"4. Her boyfriend has comp... | |
211 | In addition to restarting medications for his hypertension and diabetes, what of the following is most appropriate treatment for the patient’s symptoms? | [
"A 63-year-old male presents to the emergency department complaining of worsening nausea.",
"He reports that the nausea began several months ago and is accompanied by occasional bloating and heartburn.",
"He reports that he frequently feels full even after eating only a little at each meal, and occasionally he ... | 9 | {
"A": "Ondansetron",
"B": "Scopolamine",
"C": "Proton-pump inhibitor",
"D": "Erythromycin"
} | Erythromycin | D | {
"gender": "Male",
"age": "63",
"specialties": [
"Emergency Medicine"
],
"subspecialties": [
"General Emergency Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. Patient is 63 years old.",
"2. Patient is male.",
"3. Patient presents to emergency department with worsening nausea.",
"4. Nausea began several months ago.",
"5. Symptoms include occasional bloating and heartburn.",
"6. Patient frequently feels full after eating only a little.",
"7. Patient occasio... | [
"1. The patient reports nausea that began several months ago.",
"2. The nausea is accompanied by occasional bloating and heartburn.",
"3. The patient frequently feels full even after eating only a little at each meal.",
"4. Occasionally, the patient will vomit if he eats too much.",
"5. The vomit is non-blo... | |
212 | Which of the following is the most appropriate next step in management? | [
"A 27-year-old Japanese man presents to the emergency department with diarrhea.",
"The patient states that whenever he goes out to eat he experiences bloating, flatulence, abdominal cramps, and watery diarrhea.",
"Today, his symptoms started after he went out for frozen yogurt.",
"The patient is otherwise hea... | 6 | {
"A": "Hydrogen breath test",
"B": "Lactose-free diet",
"C": "Loperamide",
"D": "Stool osmotic gap"
} | Lactose-free diet | B | {
"gender": "Male",
"age": "27",
"specialties": [
"Gastroenterology"
],
"subspecialties": [
"General Gastroenterology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is 27-year-old Japanese man.",
"2. Patient presents to emergency department with diarrhea.",
"3. Patient experiences bloating, flatulence, abdominal cramps, and watery diarrhea when going out to eat.",
"4. Symptoms started today after going out for frozen yogurt.",
"5. Patient is otherwise healt... | [
"1. The patient experiences bloating, flatulence, abdominal cramps, and watery diarrhea when going out to eat.",
"2. Symptoms started after the patient went out for frozen yogurt.",
"3. The patient is otherwise healthy.",
"4. The patient is not currently taking any medications.",
"5. The patient's temperatu... | |
213 | Which of the following is the most likely etiology of this patient's symptoms? | [
"A 29-year-old woman presents to her primary care physician with worsening fatigue and lightheadedness over the past several months.",
"She states that she has felt easily fatigued and has experienced several falls during this time frame as well.",
"She drinks 5 to 8 drinks per day and works as a waitress.",
... | 5 | {
"A": "Alcohol use",
"B": "Folate deficiency",
"C": "Iron deficiency",
"D": "Vitamin B12 deficiency"
} | Vitamin B12 deficiency | D | {
"gender": "Female",
"age": "29",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Hematology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is a 29-year-old female.",
"2. Patient has been experiencing worsening fatigue and lightheadedness over the past several months.",
"3. Patient has felt easily fatigued and has experienced several falls during this time frame.",
"4. Patient drinks 5 to 8 drinks per day and works as a waitress.",
... | [
"1. The patient has felt easily fatigued.",
"2. The patient has experienced several falls.",
"3. The patient drinks 5 to 8 drinks per day.",
"4. The patient works as a waitress.",
"5. The patient's temperature is 98.2°F (36.8°C).",
"6. The patient's blood pressure is 114/64 mmHg.",
"7. The patient's pul... | |
214 | Which of the following laboratory tests should be performed in this patient prior to initiating treatment? | [
"A 32-year-old man from the Czech Republic is brought to the emergency department by his girlfriend with a 2-day history of yellowing of the skin.",
"His girlfriend also reports a several-week history of anorexia, nausea without vomiting, and diffuse low-grade abdominal pain.",
"He is a frequent injection drug ... | 9 | {
"A": "Hepatitis D serologies",
"B": "HIV ELISA",
"C": "PPD skin test",
"D": "Lumbar puncture"
} | Hepatitis D serologies | A | {
"gender": "Male",
"age": "32 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Gastroenterology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 32-year-old man from the Czech Republic is brought to the emergency department by his girlfriend. ",
"2. His girlfriend reports a 2-day history of yellowing of the skin and a several-week history of anorexia, nausea without vomiting, and diffuse low-grade abdominal pain. ",
"3. He is a frequent injection ... | [
"1. His girlfriend reports a several-week history of anorexia.",
"2. His girlfriend reports a several-week history of nausea without vomiting.",
"3. His girlfriend reports a several-week history of diffuse low-grade abdominal pain.",
"4. He is a frequent injection drug user.",
"5. His temperature is 38.1°C ... | |
215 | What is the most likely cause of her symptoms? | [
"A 63-year-old woman with a history of adult polycystic kidney disease and COPD presents to her optometrist after having difficulty watching a movie.",
"She has no other complaints.",
"She is accompanied by her daughter, who notes that her mother hasn’t been able to look at her since the previous day.",
"On e... | 4 | {
"A": "Vascular abnormality",
"B": "Seizure",
"C": "Demyelinating disease",
"D": "Impaired dopaminergic neurons"
} | Vascular abnormality | A | {
"gender": "Female",
"age": "63 years old",
"specialties": [
"Neurology"
],
"subspecialties": [
"Vascular Neurology",
"General Neurology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.75,
0.25
],
"gpt_specialty": "Neurology"
} | [
"1. A 63-year-old woman presents to her optometrist.",
"2. She has a history of adult polycystic kidney disease and COPD.",
"3. She has difficulty watching a movie.",
"4. She has no other complaints.",
"5. She is accompanied by her daughter.",
"6. Her daughter notes that her mother hasn't been able to loo... | [
"1. She has no other complaints.",
"2. She is accompanied by her daughter.",
"3. Her daughter notes that her mother hasn’t been able to look at her since the previous day.",
"4. On exam, her right eye has full range of motion.",
"5. Her left eye is fixed in a down and outward position."
] | |
216 | Which of the following laboratory findings would confirm the most likely diagnosis in this patient? | [
"An 11-year-old boy presents to the office with his mother for the evaluation of weight loss, rash, and several weeks of bloating and diarrhea.",
"The mother states that the patient’s father had similar symptoms at his age.",
"On physical examination, the patient is pale with dry mucous membranes.",
"There is... | 4 | {
"A": "HLA-DQ2",
"B": "Anti-tTG or gliadin antibodies",
"C": "Anti-lactase antibodies",
"D": "HLA-B27"
} | Anti-tTG or gliadin antibodies | B | {
"gender": "Male",
"age": "11 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Gastroenterology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Pediatrics"
} | [
"1. An 11-year-old boy presents to the office with his mother.",
"2. The evaluation is for weight loss, rash, and several weeks of bloating and diarrhea.",
"3. The mother states that the patient's father had similar symptoms at his age.",
"4. On physical examination, the patient is pale with dry mucous membra... | [
"1. The mother states that the patient’s father had similar symptoms at his age.",
"2. On physical examination, the patient is pale with dry mucous membranes.",
"3. There is a vesicular rash on the bilateral lower extremities.",
"4. The patient says the rash is ‘very itchy’."
] | |
217 | Which of the following is the most likely diagnosis in this patient? | [
"A 23-year-old African American G1P0 woman at 18 weeks estimated gestational age presents with fatigue and lethargy.",
"She says the symptoms onset gradually about 1 week ago and have progressively worsened.",
"She has been otherwise healthy.",
"Past medical history is unremarkable.",
"She denies smoking, d... | 10 | {
"A": "Iron deficiency anemia",
"B": "Beta-thalassemia trait",
"C": "Alpha-thalassemia trait",
"D": "Folate deficiency anemia"
} | Alpha-thalassemia trait | C | {
"gender": "Female",
"age": "23 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Hematology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Obstetrics and Gynecology"
} | [
"1. Patient is a 23-year-old African American G1P0 woman.",
"2. Patient is at 18 weeks estimated gestational age.",
"3. Patient presents with fatigue and lethargy.",
"4. Symptoms onset gradually about 1 week ago and have progressively worsened.",
"5. Patient has been otherwise healthy.",
"6. Past medical ... | [
"1. Symptoms onset gradually about 1 week ago",
"2. Symptoms have progressively worsened",
"3. Patient has been otherwise healthy",
"4. Past medical history is unremarkable",
"5. Patient denies smoking, drug, or alcohol use",
"6. Patient is afebrile",
"7. Vital signs are within normal limits",
"8. Phy... | |
218 | Which of the following structures was most likely injured during the surgery? | [
"A 26-year-old woman comes to the physician for a follow-up examination 1 week after undergoing rotator cuff repair surgery.",
"Physical examination of the right shoulder shows decreased sensation to pinprick and light touch over the lateral shoulder.",
"There is normal passive range of motion of the shoulder, ... | 3 | {
"A": "Upper trunk of the brachial plexus",
"B": "Axillary nerve",
"C": "Lower trunk of the brachial plexus",
"D": "Long thoracic nerve"
} | Axillary nerve | B | {
"gender": "Female",
"age": "26 years old",
"specialties": [
"Orthopaedic Surgery"
],
"subspecialties": [
"Orthopaedic Sports Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Orthopaedic Surgery"
} | [
"1. A 26-year-old woman comes to the physician for a follow-up examination.",
"2. The follow-up examination is 1 week after undergoing rotator cuff repair surgery.",
"3. Physical examination of the right shoulder shows decreased sensation to pinprick and light touch over the lateral shoulder.",
"4. There is n... | [
"1. Physical examination of the right shoulder shows decreased sensation to pinprick.",
"2. Physical examination of the right shoulder shows decreased sensation to light touch over the lateral shoulder.",
"3. There is normal passive range of motion of the shoulder.",
"4. She has difficulty externally rotating... | |
219 | Which of the following antibodies is most likely responsible for this patient’s condition? | [
"A 25-year-old man presents to his primary care physician with complaints of coughing up blood in his sputum and dark-colored urine for 1 week.",
"There are streaks of blood intermixed with phlegm.",
"He also expresses concerns about his urine being grossly dark brown.",
"He denies any history of major bleedi... | 9 | {
"A": "Anti-neutrophil cytoplasmic antibody (c-ANCA)",
"B": "Anti-phospholipid antibody",
"C": "Anti-glomerular basement membrane antibody (anti-GBM)",
"D": "Anti-dsDNA antibody"
} | Anti-glomerular basement membrane antibody (anti-GBM) | C | {
"gender": "Male",
"age": "25 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Nephrology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 25-year-old man presents to his primary care physician with complaints of coughing up blood in his sputum and dark-colored urine for 1 week.",
"2. There are streaks of blood intermixed with phlegm.",
"3. He also expresses concerns about his urine being grossly dark brown.",
"4. He denies any history of ... | [
"1. Streaks of blood intermixed with phlegm",
"2. Concerns about urine being grossly dark brown",
"3. Denial of history of major bleeding from minor injuries",
"4. Not taking any medications",
"5. Family history negative for bleeding disorders",
"6. Vital signs: blood pressure 160/100 mm Hg, pulse 88/min,... | |
220 | Of the steps leading to the formation of this structure, which occurs first? | [
"The lung of a 45-year-old Caucasian male who died from Mycobacterium tuberculosis infection reveals the following at autopsy (Image A)."
] | 1 | {
"A": "Th1 cell activation",
"B": "Bacterium-mediated inhibition of phagosome-lysosome fusion",
"C": "Formation of epithelioid cells",
"D": "Formation of giant cells"
} | Bacterium-mediated inhibition of phagosome-lysosome fusion | B | {
"gender": "Male",
"age": "45 years old",
"specialties": [
"Pathology"
],
"subspecialties": [
"Medical Microbiology Pathology",
"General Pathology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Pathology"
} | [
"1. The lung belongs to a 45-year-old Caucasian male.",
"2. The cause of death was Mycobacterium tuberculosis infection.",
"3. Autopsy was performed on the lung.",
"4. Image A was taken during the autopsy."
] | [
"1. The lung belongs to a 45-year-old Caucasian male.",
"2. The male died from Mycobacterium tuberculosis infection.",
"3. The autopsy revealed specific findings in the lung."
] | |
221 | Which of the following recommendations is most appropriate at this time? | [
"A 57-year-old man comes to the physician because of a 3-month history of bloating and nausea after eating food.",
"He has also had episodic abdominal pain during this period.",
"He has osteoarthritis of the left knee.",
"There is no family history of serious illness.",
"He has smoked one pack of cigarettes... | 17 | {
"A": "Avoid drinking alcohol for the next 2 weeks",
"B": "Begin prophylactic steroid therapy for anaphylaxis",
"C": "Check liver enzymes in 2 weeks",
"D": "Perform urea breath test in 2 weeks"
} | Avoid drinking alcohol for the next 2 weeks | A | {
"gender": "Male",
"age": "57 years old",
"specialties": [
"Gastroenterology"
],
"subspecialties": [
"General Gastroenterology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 57-year-old man comes to the physician.",
"2. He has a 3-month history of bloating and nausea after eating food.",
"3. He has had episodic abdominal pain during this period.",
"4. He has osteoarthritis of the left knee.",
"5. There is no family history of serious illness.",
"6. He has smoked one pac... | [
"1. He has episodic abdominal pain.",
"2. He has osteoarthritis of the left knee.",
"3. There is no family history of serious illness.",
"4. He has smoked one pack of cigarettes daily for 21 years.",
"5. He drinks two to three beers daily.",
"6. Current medications include ibuprofen.",
"7. He is allergi... | |
222 | Which of the following would be the best next step in the management of this patient? | [
"A 72-year-old man presents to his physician’s office with difficulty breathing and chronic fatigue.",
"Over the past few months, he has felt that it is difficult to retain his energy throughout the day.",
"He is disturbed because he has to skip many social events because of his inability to participate.",
"H... | 7 | {
"A": "Colonoscopy",
"B": "Vitamin B12 levels",
"C": "Endoscopy",
"D": "Iron supplementation"
} | Colonoscopy | A | {
"gender": "Male",
"age": "72 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Pulmonary Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 72-year-old man presents to his physician's office with difficulty breathing and chronic fatigue.",
"2. Over the past few months, he has felt that it is difficult to retain his energy throughout the day.",
"3. He is disturbed because he has to skip many social events because of his inability to participat... | [
"1. Over the past few months, he has felt that it is difficult to retain his energy throughout the day.",
"2. He is disturbed because he has to skip many social events because of his inability to participate.",
"3. He also says that lately, he has had difficulty catching his breath after walking for just a few ... | |
223 | What is the most likely injury? | [
"A 17-year-old rugby player limped into the emergency room and says he “rolled his ankle” while running during a game.",
"You conclude that the mechanism involved ankle plantar flexion and inversion.",
"There is no medial or lateral malleolus point tenderness.",
"Anterior drawer test of the ankle is positive.... | 5 | {
"A": "Anterior talofibular ligament (ATFL) sprain",
"B": "Deltoid ligament sprain",
"C": "Tibia fracture",
"D": "Fibula fracture"
} | Anterior talofibular ligament (ATFL) sprain | A | {
"gender": "Not specified",
"age": "17 years old",
"specialties": [
"Orthopaedic Surgery"
],
"subspecialties": [
"Orthopaedic Sports Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Orthopaedic Surgery"
} | [
"1. A 17-year-old rugby player limped into the emergency room.",
"2. The player said he \"rolled his ankle\" while running during a game.",
"3. The mechanism involved ankle plantar flexion and inversion.",
"4. There is no medial or lateral malleolus point tenderness.",
"5. Anterior drawer test of the ankle ... | [
"1. Mechanism involved ankle plantar flexion and inversion.",
"2. No medial or lateral malleolus point tenderness.",
"3. Anterior drawer test of the ankle is positive.",
"4. Talar tilt test is negative."
] | |
224 | Which of the following statements concerning positive predictive value (PPV) is correct? | [] | 0 | {
"A": "PPV is the proportion of tests that are true positives; if disease prevalence is low, then PPV will be low.",
"B": "PPV is the proportion of tests that are true positives; disease prevalence has no effect on PPV.",
"C": "PPV is the proportion of tests that are false positives; if disease prevalence is low... | PPV is the proportion of tests that are true positives; if disease prevalence is low, then PPV will be low. | A | {
"gender": "study",
"age": "study",
"specialties": [
"Pathology"
],
"subspecialties": [
"General Pathology",
"Clinical Informatics"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Pathology"
} | [] | [] | |
225 | The organism that is most likely responsible for this patient's symptoms has which of the following structures? | [
"A 32-year-old man presents to the emergency department with fever, weight loss, and right upper quadrant pain.",
"He says that he started experiencing nausea and fatigue after he returned from a honeymoon trip to Asia with his wife.",
"Notably, she is 5 months pregnant with their first child.",
"On presentat... | 7 | {
"A": "Enveloped dsDNA virus",
"B": "Enveloped (-) RNA virus",
"C": "Enveloped (+) RNA virus",
"D": "Non-enveloped (+) RNA hepevirus"
} | Non-enveloped (+) RNA hepevirus | D | {
"gender": "Male",
"age": "32 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Infectious Disease",
"Gastroenterology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 32-year-old man presents to the emergency department.",
"2. He has fever, weight loss, and right upper quadrant pain.",
"3. He started experiencing nausea and fatigue after returning from a honeymoon trip to Asia with his wife.",
"4. His wife is 5 months pregnant with their first child.",
"5. On prese... | [
"1. The patient started experiencing nausea and fatigue after returning from a honeymoon trip to Asia with his wife.",
"2. The patient's wife is 5 months pregnant with their first child.",
"3. On presentation, the patient's temperature is 100.8°F (38.2°C).",
"4. On presentation, the patient's blood pressure i... | |
226 | What medication should be administered to this patient? | [
"A 59-year-old man presents to the emergency room with shortness of breath and swelling of his feet and legs.",
"He denies any past medical problems, surgeries, medications, or illicit drug use.",
"He reports drinking a few beers each night.",
"He is diagnosed with a first episode of congestive heart failure ... | 11 | {
"A": "Flumazenil",
"B": "Benzodiazepines",
"C": "Dantrolene",
"D": "Fomepizole"
} | Benzodiazepines | B | {
"gender": "Male",
"age": "59",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Cardiology",
"Cardiovascular Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 59-year-old man presents to the emergency room with shortness of breath and swelling of his feet and legs.",
"2. He denies any past medical problems, surgeries, medications, or illicit drug use.",
"3. He reports drinking a few beers each night.",
"4. He is diagnosed with a first episode of congestive he... | [
"1. The patient denies any past medical problems, surgeries, medications, or illicit drug use.",
"2. The patient reports drinking a few beers each night.",
"3. The patient is diagnosed with a first episode of congestive heart failure and is admitted to the hospital.",
"4. The nurse notices that the patient's ... | |
227 | Which of the following is the most likely diagnosis in this patient? | [
"A 49-year-old woman otherwise healthy presents to the outpatient department with swelling of the neck.",
"Family history is negative for any thyroid disorders.",
"Physical examination shows a nontender thyroid gland with a nodule on the right side.",
"The thyroid gland is mobile on deglutition.",
"Cervical... | 6 | {
"A": "Follicular carcinoma",
"B": "Papillary carcinoma",
"C": "Anaplastic carcinoma",
"D": "Follicular adenoma"
} | Papillary carcinoma | B | {
"gender": "Female",
"age": "49 years old",
"specialties": [
"Otolaryngology",
"Internal Medicine",
"ENT (Otolaryngology)"
],
"subspecialties": [
"General Otolaryngology",
"Endocrinology, Diabetes, and Metabolism"
],
"specialty_prob": [
0.6,
0.2,
0.2
],
"subspecialty_p... | [
"1. A 49-year-old woman is presenting to the outpatient department.",
"2. The woman is otherwise healthy.",
"3. Family history is negative for any thyroid disorders.",
"4. Physical examination shows a nontender thyroid gland.",
"5. There is a nodule on the right side of the thyroid gland.",
"6. The thyroi... | [
"1. Family history is negative for any thyroid disorders.",
"2. Physical examination shows a nontender thyroid gland with a nodule on the right side.",
"3. The thyroid gland is mobile on deglutition.",
"4. Cervical lymphadenopathy is present.",
"5. Fine needle aspiration and cytology show empty appearing nu... | |
228 | Which of the following is the most appropriate pharmacotherapy? | [
"A 33-year-old woman comes to the physician because of a 2-year history of intermittent episodes of pain in all her fingers bilaterally.",
"The episodes are worse during the winter.",
"The fingers become white when exposed to cold weather, then severely painful and numb once they warm up.",
"She has started w... | 14 | {
"A": "Oral aspirin",
"B": "Oral nifedipine",
"C": "Oral epoprostenol",
"D": "Oral prednisone"
} | Oral nifedipine | B | {
"gender": "Female",
"age": "33 years old",
"specialties": [
"Rheumatology"
],
"subspecialties": [
"General Rheumatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is a 33-year-old woman.",
"2. Patient has a 2-year history of intermittent episodes of pain in all her fingers bilaterally.",
"3. Episodes are worse during the winter.",
"4. Fingers become white when exposed to cold weather, then severely painful and numb once they warm up.",
"5. Patient has sta... | [
"1. The episodes are worse during the winter.",
"2. The fingers become white when exposed to cold weather.",
"3. The fingers then become severely painful and numb once they warm up.",
"4. She has started wearing gloves at all times to prevent these episodes.",
"5. She has generalized anxiety disorder.",
"... | |
229 | Which of the following is the most appropriate next step in management? | [
"A 43-year-old man comes to the physician because of redness and swelling of his right leg.",
"He reports that it is very painful to touch.",
"He has had fever and chills.",
"He has no chest pain or shortness of breath.",
"He has a history of type 2 diabetes mellitus and underwent saphenous vein stripping a... | 12 | {
"A": "Oral cephalexin therapy",
"B": "Intravenous cefazolin therapy",
"C": "Intravenous ciprofloxacin therapy",
"D": "Subcutaneous heparin injection"
} | Intravenous cefazolin therapy | B | {
"gender": "Male",
"age": "43 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Infectious Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 43-year-old man comes to the physician.",
"2. He has redness and swelling of his right leg.",
"3. It is very painful to touch.",
"4. He has had fever and chills.",
"5. He has no chest pain or shortness of breath.",
"6. He has a history of type 2 diabetes mellitus.",
"7. He underwent saphenous vein... | [
"1. He reports that it is very painful to touch.",
"2. He has had fever and chills.",
"3. He has no chest pain or shortness of breath.",
"4. He has a history of type 2 diabetes mellitus.",
"5. He underwent saphenous vein stripping and ligation in his right leg 3 years ago.",
"6. He works as a security gua... | |
230 | Of the following options, which is the next best step in patient management? | [
"A 52-year-old thoracic surgeon presents to his primary care physician with an eczematous dermatitis overlying his hands and forearms.",
"He notes that he has recently started using a new type of surgical gloves.",
"He notes that he washes his hands frequently, but he has never had issues with skin irritation b... | 4 | {
"A": "Patch testing",
"B": "KOH examination",
"C": "Skin biopsy",
"D": "Radioallergosorbent test"
} | Patch testing | A | {
"gender": "Male",
"age": "52",
"specialties": [
"Dermatology"
],
"subspecialties": [
"General Dermatology",
"Micrographic Dermatologic Surgery"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Dermatology"
} | [
"1. A 52-year-old thoracic surgeon presents to his primary care physician.",
"2. He has an eczematous dermatitis overlying his hands and forearms.",
"3. He recently started using a new type of surgical gloves.",
"4. He washes his hands frequently.",
"5. He has never had issues with skin irritation before.",... | [
"1. The patient has recently started using a new type of surgical gloves.",
"2. The patient washes his hands frequently.",
"3. The patient has never had issues with skin irritation before.",
"4. On physical examination, there are erythematous plaques on the patient's bilateral hands and dorsal forearms.",
"... | |
231 | What is the most likely diagnosis? | [
"A 43-year-old woman presents to a new primary care physician complaining of anxiety.",
"She has been worrying non-stop recently about the possibility that her husband will lose his job as a teacher.",
"Her husband, who is present, assures the physician that his job is entirely secure and states that she has \"... | 7 | {
"A": "Social phobia",
"B": "Agoraphobia",
"C": "Posttraumatic stress disorder",
"D": "Generalized anxiety disorder"
} | Generalized anxiety disorder | D | {
"gender": "Female",
"age": "43",
"specialties": [
"Psychiatry"
],
"subspecialties": [
"General Psychiatry"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Psychiatry"
} | [
"1. Patient is a 43-year-old female.",
"2. Patient is presenting to a new primary care physician with anxiety.",
"3. Patient's husband is present and states that she has \"fretted\" for their entire marriage.",
"4. Patient worries excessively about everyday tasks, such as catching the train on time and whethe... | [
"1. She has been worrying non-stop recently about the possibility of her husband losing his job as a teacher.",
"2. Her husband assures the physician that his job is entirely secure.",
"3. Her husband states that she has \"fretted\" for their entire marriage.",
"4. The exact topic causing her anxiety varies o... | |
232 | A biopsy of one of these areas of affected thyroid tissue is most likely to show which of the following? | [
"A 60-year-old woman comes to the physician because of palpitations and a 5.4-kg (11.9-lb) weight loss over the past 3 months.",
"She appears anxious.",
"Her pulse is 104/min and blood pressure is 148/101 mm Hg.",
"Physical examination shows warm skin, mild tremor, and an enlarged thyroid gland.",
"A thyroi... | 5 | {
"A": "Sheets of parafollicular cells surrounded by amyloid stroma",
"B": "Follicle destruction with lymphocytic infiltrate and germinal center formation",
"C": "Patches of enlarged follicular cells distended with colloid",
"D": "Crowded follicular cells with scalloped colloid"
} | Patches of enlarged follicular cells distended with colloid | C | {
"gender": "Female",
"age": "60 years old",
"specialties": [
"Endocrinology, Diabetes, and Metabolism",
"Internal Medicine"
],
"subspecialties": [
"General Endocrinology",
"Endocrinology, Diabetes, and Metabolism"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0... | [
"1. A 60-year-old woman comes to the physician.",
"2. She has experienced a 5.4-kg (11.9-lb) weight loss over the past 3 months.",
"3. She appears anxious.",
"4. Her pulse is 104/min.",
"5. Her blood pressure is 148/101 mm Hg.",
"6. Physical examination shows warm skin, mild tremor, and an enlarged thyroi... | [
"1. She appears anxious.",
"2. Her pulse is 104/min.",
"3. Her blood pressure is 148/101 mm Hg.",
"4. Physical examination shows warm skin.",
"5. Physical examination shows mild tremor.",
"6. Physical examination shows an enlarged thyroid gland.",
"7. A thyroid scintigraphy scan shows several focal area... | |
233 | This patient is most likely experiencing toxicity from which of the following substances?" | [
"A 47-year-old man is brought to the emergency department 1 hour after his neighbor found him collapsed on his front porch in a pool of vomitus.",
"On arrival, he is oriented only to self.",
"His pulse is 103/min and respirations are 30/min.",
"Neurologic examination shows muscle spasms in the arms and jaw.",... | 6 | {
"A": "Methanol",
"B": "Ethylene glycol",
"C": "Parathion",
"D": "Aspirin"
} | Ethylene glycol | B | {
"gender": "Male",
"age": "47 years old",
"specialties": [
"Emergency Medicine"
],
"subspecialties": [
"Medical Toxicology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 47-year-old man is brought to the emergency department.",
"2. His neighbor found him collapsed on his front porch in a pool of vomitus 1 hour prior.",
"3. On arrival, he is oriented only to self.",
"4. His pulse is 103/min.",
"5. Respirations are 30/min.",
"6. Neurologic examination shows muscle spa... | [
"1. On arrival, the patient is oriented only to self.",
"2. The patient's pulse is 103/min.",
"3. The patient's respirations are 30/min.",
"4. Neurologic examination shows muscle spasms in the arms and jaw.",
"5. Serum studies show: Na+ 137 mEq/L, Cl- 99 mEq/L, HCO3- 8 mEq/L, Osmolality 328 mOsm/kg.",
"6.... | |
234 | Which of the following is the most probable cause of his complaints? | [
"A 13-year-old boy presents to the clinic for evaluation of pain, swelling, and redness in the left knee.",
"This began a month ago and has been progressively worsening.",
"He thinks his pain is due to playing soccer.",
"He is frustrated that the pain does not respond to Tylenol.",
"History is non-contribut... | 9 | {
"A": "Osteomyelitis",
"B": "Osteosarcoma",
"C": "Ewing’s sarcoma",
"D": "Chondrosarcoma"
} | Osteosarcoma | B | {
"gender": "Male",
"age": "13 years old",
"specialties": [
"Orthopaedic Surgery"
],
"subspecialties": [
"Orthopaedic Sports Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Orthopaedic Surgery"
} | [
"1. A 13-year-old boy presents to the clinic for evaluation of pain, swelling, and redness in the left knee.",
"2. This began a month ago and has been progressively worsening.",
"3. He thinks his pain is due to playing soccer.",
"4. He is frustrated that the pain does not respond to Tylenol.",
"5. History i... | [
"1. The symptoms began a month ago.",
"2. The symptoms have been progressively worsening.",
"3. The patient attributes the pain to playing soccer.",
"4. The patient is frustrated that the pain does not respond to Tylenol.",
"5. The patient's medical history is non-contributory.",
"6. The vital signs are u... | |
235 | Which of the following is the most likely explanation for this patient’s clinical findings? | [
"A 55-year-old woman presents to the emergency department because of palpitations and generalized weakness.",
"She has a history of type 2 diabetes, for which she has been receiving medication for the past 15 years.",
"Consequently, her recent medical history involves diabetic retinopathy as well as end-stage r... | 8 | {
"A": "Skipped dialysis appointment",
"B": "Insulin supplementation",
"C": "Administration of α-agonist",
"D": "Alkalosis"
} | Skipped dialysis appointment | A | {
"gender": "Female",
"age": "55",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Cardiology",
"Cardiovascular Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 55-year-old woman presents to the emergency department because of palpitations and generalized weakness.",
"2. She has a history of type 2 diabetes, for which she has been receiving medication for the past 15 years.",
"3. Her recent medical history involves diabetic retinopathy.",
"4. Her recent medical... | [
"1. She has a history of type 2 diabetes.",
"2. She has been receiving medication for the past 15 years.",
"3. Her recent medical history involves diabetic retinopathy.",
"4. Her recent medical history involves end-stage renal disease.",
"5. She is advised dialysis.",
"6. She does not attend her regular d... | |
236 | Based on Ranson’s Criteria, what is this patient’s overall risk of mortality, assuming all other relevant factors are negative? | [
"A 59-year-old man presents to the emergency department with diffuse abdominal pain that radiates to his back, nausea, and vomiting.",
"The vital signs include: temperature 36.7°C (98.0°F), blood pressure 126/74 mm Hg, heart rate 74/min, and respiratory rate 14/min.",
"The laboratory evaluation on admission is ... | 4 | {
"A": "20%",
"B": "40%",
"C": "80%",
"D": "100%"
} | 20% | A | {
"gender": "Male",
"age": "59",
"specialties": [
"Gastroenterology",
"Internal Medicine"
],
"subspecialties": [
"General Gastroenterology",
"Gastroenterology"
],
"specialty_prob": [
0.6,
0.4
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Emergency Medicine... | [
"1. A 59-year-old man presents to the emergency department with diffuse abdominal pain that radiates to his back, nausea, and vomiting.",
"2. The vital signs include: temperature 36.7°C (98.0°F), blood pressure 126/74 mm Hg, heart rate 74/min, and respiratory rate 14/min.",
"3. The laboratory evaluation on admi... | [
"1. Vital signs: temperature 36.7°C (98.0°F), blood pressure 126/74 mm Hg, heart rate 74/min, respiratory rate 14/min.",
"2. Laboratory evaluation on admission: serum glucose 241 mg/dL, aspartate aminotransferase (AST) 321 IU/dL, leukocyte count 21,200/mL.",
"3. Patient admitted to intensive care unit.",
"4. ... | |
237 | What is the most likely diagnosis? | [
"A 68-year-old male presents to your office for his annual physical exam.",
"He has no complaints at this time and his chronic hypertension is well controlled.",
"You notice a .5cm papule on the patient's eyelid that has a pink pearly appearance, rolled borders, and overlying telangiectasias.",
"On further qu... | 6 | {
"A": "Squamous cell carcinoma",
"B": "Keratoacanthoma",
"C": "Verrucous carcinoma",
"D": "Basal cell carcinoma"
} | Basal cell carcinoma | D | {
"gender": "Male",
"age": "68",
"specialties": [
"Dermatology"
],
"subspecialties": [
"General Dermatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Dermatology"
} | [
"1. A 68-year-old male presents to your office for his annual physical exam.",
"2. He has no complaints at this time.",
"3. His chronic hypertension is well controlled.",
"4. You notice a .5cm papule on the patient's eyelid.",
"5. The papule has a pink pearly appearance.",
"6. The papule has rolled border... | [
"1. The patient has no complaints at this time.",
"2. The patient's chronic hypertension is well controlled.",
"3. There is a .5cm papule on the patient's eyelid.",
"4. The papule has a pink pearly appearance.",
"5. The papule has rolled borders.",
"6. The papule has overlying telangiectasias.",
"7. The... | |
238 | Which of the following is the most appropriate next step in management? | [
"A 67-year-old woman is brought to the emergency room after complaining of back pain with a gradual loss of sensation in her lower extremities.",
"She was recently diagnosed with radiosensitive metastatic breast cancer and was scheduled to receive chemotherapy and palliative surgery.",
"Her temperature is 99.0°... | 8 | {
"A": "Biopsy",
"B": "Chemotherapy",
"C": "Radiation therapy",
"D": "Surgical decompression"
} | Radiation therapy | C | {
"gender": "Female",
"age": "67 years old",
"specialties": [
"Neurological Surgery",
"Neurology"
],
"subspecialties": [
"General Neurological Surgery",
"Neurosurgery"
],
"specialty_prob": [
0.6,
0.4
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Neurology"... | [
"1. A 67-year-old woman is brought to the emergency room.",
"2. She is complaining of back pain with a gradual loss of sensation in her lower extremities.",
"3. She was recently diagnosed with radiosensitive metastatic breast cancer.",
"4. She was scheduled to receive chemotherapy and palliative surgery.",
... | [
"1. Patient diagnosed with radiosensitive metastatic breast cancer",
"2. Scheduled to receive chemotherapy and palliative surgery",
"3. Temperature is 99.0°F (37.2°C)",
"4. Blood pressure is 133/81 mmHg",
"5. Pulse is 82/min",
"6. Respirations are 15/min",
"7. Oxygen saturation is 98% on room air",
"8... | |
239 | What is the most likely diagnosis for this patient? | [
"An obese 50-year-old woman presents to the emergency department of a rural hospital due to chest pain for the last 12 hours.",
"The pain is substernal, crushing in nature, radiating into her neck, and accompanied by profuse sweating.",
"Her history is significant for hypertension, and she admits poor complianc... | 11 | {
"A": "Acute pericarditis",
"B": "Left ventricular free wall rupture",
"C": "Papillary muscle rupture",
"D": "Pulmonary embolism"
} | Left ventricular free wall rupture | B | {
"gender": "Female",
"age": "50",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Cardiovascular Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. Patient is a 50-year-old woman.",
"2. Patient is obese.",
"3. Patient presents to the emergency department of a rural hospital.",
"4. Patient has had chest pain for the last 12 hours.",
"5. Pain is substernal, crushing in nature, radiating into her neck, and accompanied by profuse sweating.",
"6. Pati... | [
"1. The pain is substernal",
"2. The pain is crushing in nature",
"3. The pain is radiating into her neck",
"4. The pain is accompanied by profuse sweating",
"5. Her history is significant for hypertension",
"6. She admits poor compliance with her medications",
"7. An ECG done at the clinic confirmed th... | |
240 | Which of the following is responsible for the exact mechanism of diapedesis that allows for inflammatory cells to enter the tissue space of this patient? | [
"A 20-year-old woman presents to the emergency department with painful swelling in the middle of her neck for the past 3 days.",
"She is not experiencing pain during swallowing, difficulty in breathing, or changes in her voice.",
"On examination, a red, 5 x 5 cm, exquisitely tender, non-pulsatile, fluctuating m... | 4 | {
"A": "Adhesion",
"B": "Margination",
"C": "Transmigration and chemotaxis",
"D": "Rolling"
} | Transmigration and chemotaxis | C | {
"gender": "Female",
"age": "20 years old",
"specialties": [
"Internal Medicine",
"Emergency Medicine"
],
"subspecialties": [
"Rheumatology",
"General Emergency Medicine"
],
"specialty_prob": [
0.6,
0.4
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Emerge... | [
"1. A 20-year-old woman presents to the emergency department.",
"2. She has had painful swelling in the middle of her neck for the past 3 days.",
"3. She is not experiencing pain during swallowing, difficulty in breathing, or changes in her voice.",
"4. On examination, a red, 5 x 5 cm, exquisitely tender, non... | [
"1. The patient is not experiencing pain during swallowing.",
"2. The patient is not experiencing difficulty in breathing.",
"3. The patient is not experiencing changes in her voice.",
"4. On examination, a red, 5 x 5 cm mass is present in the midline on the anterior aspect of the neck.",
"5. The mass is ex... | |
241 | Which of the following treatment strategies would be most appropriate for this patient? | [
"A 45-year-old G2P2 presents with episodes of urgency accompanied by an involuntary passage of urine.",
"These symptoms take place during the day and night.",
"The symptoms are not linked with physical exertion, laughing, or coughing.",
"Her occupation does not involve weight lifting, but she says that someti... | 17 | {
"A": "Instillation of the urethral mesh sling",
"B": "Topical estrogen therapy",
"C": "Augmentation cystoplasty",
"D": "Start her on a muscarinic antagonist"
} | Start her on a muscarinic antagonist | D | {
"gender": "Not specified",
"age": "45 years old",
"specialties": [
"Urology"
],
"subspecialties": [
"Female Pelvic Medicine and Reconstructive Surgery"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Urology"
} | [
"1. Patient is 45 years old.",
"2. Patient is G2P2.",
"3. Patient has episodes of urgency accompanied by an involuntary passage of urine.",
"4. Symptoms take place during the day and night.",
"5. Symptoms are not linked with physical exertion, laughing, or coughing.",
"6. Patient's occupation does not inv... | [
"1. Symptoms occur during the day and night.",
"2. Symptoms are not linked with physical exertion, laughing, or coughing.",
"3. Occupation does not involve weight lifting, but is sometimes stressful.",
"4. Denies any other genitourinary symptoms.",
"5. Had 1 vaginal delivery and 1 cesarean section.",
"6. ... | |
242 | The patient's symptoms are most likely caused by disruption of which of the following steps in protein synthesis? | [
"A 4-year-old girl is brought to the physician with progressively worsening fever, malaise, and a sore throat.",
"Her parents say “Our daughter has not received vaccinations because her body has to learn how to fight infections.” Her temperature is 38.5˚C (101.3 F).",
"Physical examination shows marked cervical... | 4 | {
"A": "Folding of completed proteins",
"B": "Translocation of the ribosome along the mRNA",
"C": "Binding of tRNA to the A site",
"D": "Release of completed protein from ribosome"
} | Translocation of the ribosome along the mRNA | B | {
"gender": "Female",
"age": "4 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Infectious Diseases"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Pediatrics"
} | [
"1. A 4-year-old girl is brought to the physician.",
"2. She has progressively worsening fever, malaise, and a sore throat.",
"3. Her parents say she has not received vaccinations because her body has to learn how to fight infections.",
"4. Her temperature is 38.5˚C (101.3 F).",
"5. Physical examination sho... | [
"1. Her parents say \"Our daughter has not received vaccinations because her body has to learn how to fight infections.\"",
"2. Her temperature is 38.5˚C (101.3 F).",
"3. Physical examination shows marked cervical lymphadenopathy.",
"4. There are gray-white membranes over the tonsils and posterior pharynx tha... | |
243 | Which of the following therapies would have been first line for improving this patient’s symptoms early in the course of this disease? | [
"A 56-year-old man presents to his family physician for issues with his back that have persisted since he was in his 20’s.",
"For the last 6 months, his neck has been very stiff and he has been unable to tilt his head backwards.",
"He also has severe kyphosis and feels limited in his range of motion.",
"He tr... | 9 | {
"A": "Infliximab",
"B": "Indomethacin",
"C": "Methotrexate",
"D": "Sulfasalazine"
} | Indomethacin | B | {
"gender": "Male",
"age": "56",
"specialties": [
"Orthopaedic Surgery"
],
"subspecialties": [
"Orthopaedic Sports Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Physical Medicine and Rehabilitation"
} | [
"1. Patient is 56 years old.",
"2. Patient has had back issues since his 20's.",
"3. Patient has had a stiff neck for the last 6 months.",
"4. Patient has severe kyphosis.",
"5. Patient has limited range of motion.",
"6. Patient tries to get 8 hours of sleep each night.",
"7. Patient has no pain on acti... | [
"1. His neck has been very stiff for the last 6 months.",
"2. He has been unable to tilt his head backwards.",
"3. He has severe kyphosis.",
"4. He feels limited in his range of motion.",
"5. He tries to get at least 8 hours of sleep each night.",
"6. He rarely feels rested despite getting 8 hours of slee... | |
244 | What is the most likely cause of this patient’s cervicitis? | [
"A 24-year-old woman visits the health services of her university for vaginal itching, dysuria, pelvic discomfort, and foul-smelling vaginal discharge.",
"She states this is the eighth time she has had such symptoms within the last year, for which she and her sexual partners have received multiple courses of doxy... | 4 | {
"A": "Chlamydia trachomatis",
"B": "Mycoplasma hominis",
"C": "Mycoplasma genitalium",
"D": "Neisseria gonorrhoeae"
} | Mycoplasma genitalium | C | {
"gender": "Female",
"age": "24 years old",
"specialties": [
"Obstetrics and Gynecology"
],
"subspecialties": [
"General Obstetrics and Gynecology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Obstetrics and Gynecology"
} | [
"1. A 24-year-old woman visited the health services of her university.",
"2. She had vaginal itching, dysuria, pelvic discomfort, and foul-smelling vaginal discharge.",
"3. This was the eighth time she had these symptoms in the last year.",
"4. She and her sexual partners had received multiple courses of doxy... | [
"1. The patient has experienced similar symptoms eight times in the past year.",
"2. The patient and her sexual partners have received multiple courses of doxycycline and ceftriaxone or azithromycin and ceftriaxone.",
"3. A pelvic examination revealed mucopurulent cervical discharge.",
"4. The cervical discha... | |
245 | Which of the following is the most appropriate next step in management? | [
"A previously healthy 11-month-old boy is brought to the emergency department for the evaluation of abdominal pain and vomiting.",
"His mother states that over the past 6 hours he has been having intermittent episodes of inconsolable crying, during which he “grabs his abdomen and draws up his legs.” These episode... | 10 | {
"A": "Air enema",
"B": "Appendectomy",
"C": "Technetium-99m pertechnetate scan",
"D": "Pyloromyotomy"
} | Air enema | A | {
"gender": "Male",
"age": "11 months",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"General Pediatrics",
"Pediatric Surgery"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Pediatrics"
} | [
"1. A previously healthy 11-month-old boy is brought to the emergency department for the evaluation of abdominal pain and vomiting.",
"2. His mother states that over the past 6 hours he has been having intermittent episodes of inconsolable crying, during which he “grabs his abdomen and draws up his legs.”",
"3.... | [
"1. His mother reports intermittent episodes of inconsolable crying over the past 6 hours.",
"2. During the episodes, he grabs his abdomen and draws up his legs.",
"3. The episodes are accompanied by nonbloody, nonbilious vomiting and reddish, mucoid bowel movements.",
"4. He appears sleepy.",
"5. His tempe... | |
246 | Which of the following best explains the findings in this patient? | [
"A 68-year-old man comes to the physician because of a 4-month history of bad breath and progressive difficulty swallowing solid food.",
"Physical examination shows no abnormalities.",
"An upper endoscopy is performed and a photomicrograph of a biopsy specimen obtained from the mid-esophagus is shown."
] | 3 | {
"A": "Atrophy and fibrosis of the esophageal smooth muscle",
"B": "Metaplastic transformation of esophageal mucosa",
"C": "Neoplastic proliferation of squamous epithelium",
"D": "Eosinophilic infiltration of the esophageal walls\n\""
} | Neoplastic proliferation of squamous epithelium | C | {
"gender": "Male",
"age": "68 years old",
"specialties": [
"Gastroenterology"
],
"subspecialties": [
"General Gastroenterology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Otolaryngology"
} | [
"1. A 68-year-old man comes to the physician.",
"2. He has a 4-month history of bad breath.",
"3. He has progressive difficulty swallowing solid food.",
"4. Physical examination shows no abnormalities.",
"5. An upper endoscopy is performed.",
"6. A photomicrograph of a biopsy specimen is obtained from the... | [
"1. Physical examination shows no abnormalities.",
"2. An upper endoscopy is performed.",
"3. A photomicrograph of a biopsy specimen is obtained from the mid-esophagus."
] | |
247 | Which of the following is the most appropriate next step in diagnosis? | [
"A 43-year-old woman comes to the physician because of a 2-month history of progressive muscle pain and stiffness that worsens with exercise.",
"She also has difficulty climbing stairs, getting out of chairs, and putting things on shelves or in cupboards.",
"She has had constipation, occasional headaches, and a... | 9 | {
"A": "Serum TSH levels",
"B": "Acetylcholine receptor antibody testing",
"C": "Serum potassium levels",
"D": "Temporal artery biopsy"
} | Serum TSH levels | A | {
"gender": "Female",
"age": "43 years old",
"specialties": [
"Rheumatology",
"Neurology"
],
"subspecialties": [
"General Rheumatology",
"Neuromuscular Medicine"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Internal Medicin... | [
"1. Patient is a 43-year-old woman.",
"2. Patient has a 2-month history of progressive muscle pain and stiffness that worsens with exercise.",
"3. Patient has difficulty climbing stairs, getting out of chairs, and putting things on shelves or in cupboards.",
"4. Patient has had constipation, occasional headac... | [
"1. She has difficulty climbing stairs.",
"2. She has difficulty getting out of chairs.",
"3. She has difficulty putting things on shelves or in cupboards.",
"4. She has had constipation.",
"5. She has occasional headaches.",
"6. She has had a 9-kg (20-lb) weight gain during the past year.",
"7. She has... | |
248 | Which of the following genetic principles is most likely responsible for this patient's condition? | [
"A 34-year-old woman comes to the physician because of a rapidly growing lump in her right breast.",
"Eight months ago, she underwent excision of a liposarcoma from the dorsum of her right forearm.",
"Her brother was diagnosed with osteosarcoma of the maxilla at the age of 22 years.",
"Her mother died at the ... | 7 | {
"A": "Loss of heterozygosity in tumor suppressor gene",
"B": "Methylation of a previously normal gene copy",
"C": "Oncogenic transformation of a previously normal gene",
"D": "Chronic exposure to carcinogenic material"
} | Loss of heterozygosity in tumor suppressor gene | A | {
"gender": "Female",
"age": "34",
"specialties": [
"Internal Medicine",
"General Surgery",
"Obstetrics and Gynecology"
],
"subspecialties": [
"Medical Oncology",
"Surgical Oncology",
"Gynecologic Oncology"
],
"specialty_prob": [
0.6,
0.2,
0.2
],
"subspecialty_prob"... | [
"1. A 34-year-old woman comes to the physician.",
"2. She has a rapidly growing lump in her right breast.",
"3. Eight months ago, she underwent excision of a liposarcoma from the dorsum of her right forearm.",
"4. Her brother was diagnosed with osteosarcoma of the maxilla at the age of 22 years.",
"5. Her m... | [
"1. Eight months ago, she underwent excision of a liposarcoma from the dorsum of her right forearm.",
"2. Her brother was diagnosed with osteosarcoma of the maxilla at the age of 22 years.",
"3. Her mother died at the age of 43 years from complications of acute myeloid leukemia.",
"4. She has smoked a pack of... | |
249 | Which of the following is the most appropriate next step in management? | [
"A 31-year-old woman comes to the doctor because of episodic nosebleeds and gingival bleeding for the past 2 weeks.",
"She has no history of serious illness and takes no medications.",
"She is sexually active with two male partners and uses condoms inconsistently.",
"Vital signs are within normal limits.",
... | 9 | {
"A": "Blood cultures",
"B": "D-dimer testing",
"C": "Hepatitis C antibody testing",
"D": "Anti-platelet antibody testing"
} | Hepatitis C antibody testing | C | {
"gender": "Female",
"age": "31 years old",
"specialties": [
"Hematology",
"Internal Medicine"
],
"subspecialties": [
"General Hematology",
"Hematology"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is a 31-year-old woman.",
"2. Patient has had episodic nosebleeds and gingival bleeding for the past 2 weeks.",
"3. Patient has no history of serious illness.",
"4. Patient takes no medications.",
"5. Patient is sexually active with two male partners.",
"6. Patient uses condoms inconsistently.... | [
"1. She has no history of serious illness and takes no medications.",
"2. She is sexually active with two male partners and uses condoms inconsistently.",
"3. Vital signs are within normal limits.",
"4. Examination shows punctate, non-blanching macules on the chest.",
"5. The remainder of the examination sh... | |
250 | Which of the following is the most likely diagnosis? | [
"A 40-year-old woman presents to the clinic for hair loss.",
"She was in her usual state of health until earlier this month when she started noticing more and more hair on her pillow in the morning.",
"The problem has only been getting worse since then; she's even started pulling out clumps of hair when she sha... | 6 | {
"A": "Alopecia areata",
"B": "Secondary syphilis",
"C": "Tinea capitis",
"D": "Trichotillomania"
} | Alopecia areata | A | {
"gender": "Female",
"age": "40 years old",
"specialties": [
"Dermatology"
],
"subspecialties": [
"General Dermatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Dermatology"
} | [
"1. A 40-year-old woman presents to the clinic for hair loss.",
"2. She was in her usual state of health until earlier this month.",
"3. She started noticing more and more hair on her pillow in the morning.",
"4. The problem has only been getting worse since then.",
"5. She's even started pulling out clumps... | [
"1. She was in her usual state of health until earlier this month.",
"2. She started noticing more and more hair on her pillow in the morning.",
"3. The problem has only been getting worse since then.",
"4. She's even started pulling out clumps of hair when she shampoos in the morning.",
"5. She has no othe... | |
251 | Which of the following is the most likely karyotype abnormality in this infant? | [
"A 2-day-old girl born at 32 weeks gestation to a 42-year-old woman is being examined by a resident.",
"The examination reveals a very small head circumference with low set ears, a prominent occiput, and a comparatively small mandible.",
"A picture of the infant’s fist is given below.",
"A bilateral foot defo... | 4 | {
"A": "47, XXX",
"B": "Trisomy 21",
"C": "Trisomy 18",
"D": "47, XXY"
} | Trisomy 18 | C | {
"gender": "Female",
"age": "2 days old",
"specialties": [
"Pediatrics",
"Medical Genetics and Genomics"
],
"subspecialties": [
"Neonatal",
"Clinical Genetics and Genomics"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Medi... | [
"1. A 2-day-old girl was born at 32 weeks gestation.",
"2. The girl's mother is 42 years old.",
"3. The girl is being examined by a resident.",
"4. The examination reveals a very small head circumference.",
"5. The examination reveals low set ears.",
"6. The examination reveals a prominent occiput.",
"7... | [
"1. The examination reveals a very small head circumference.",
"2. The examination reveals low set ears.",
"3. The examination reveals a prominent occiput.",
"4. The examination reveals a comparatively small mandible.",
"5. A picture of the infant’s fist is given below.",
"6. A bilateral foot deformity is... | |
252 | This patient's cognitive symptoms are most likely the result of which of the following neuropathologic changes? | [
"A 44-year-old male is brought to the physician by his father.",
"Over the past year, the patient has become progressively forgetful and withdrawn.",
"He frequently has trouble remembering names of acquaintances, and has been requiring increasing amounts of assistance with getting dressed, cooking, and personal... | 6 | {
"A": "Intracellular aggregations of alpha-synuclein",
"B": "Multifocal deposition of excess copper",
"C": "Synaptic build-up of abnormal prion protein",
"D": "Extracellular accumulation of amyloid plaques"
} | Extracellular accumulation of amyloid plaques | D | {
"gender": "Male",
"age": "44",
"specialties": [
"Neurology"
],
"subspecialties": [
"General Neurology",
"Neurology with Special Qualification in Child Neurology",
"Neurodevelopmental Disabilities"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6,
0.2,
0.2
],
... | [
"1. A 44-year-old male is brought to the physician by his father.",
"2. Over the past year, the patient has become progressively forgetful and withdrawn.",
"3. He frequently has trouble remembering names of acquaintances.",
"4. He has been requiring increasing amounts of assistance with getting dressed, cooki... | [
"1. The patient has become progressively forgetful over the past year.",
"2. The patient has become progressively withdrawn over the past year.",
"3. The patient frequently has trouble remembering names of acquaintances.",
"4. The patient has been requiring increasing amounts of assistance with getting dresse... | |
253 | Which of the following is the most likely diagnosis? | [
"A previously healthy 75-year-old man comes to the physician with a 6-month history of fatigue, weight loss, and abdominal pain.",
"He drinks 2 oz of alcohol on the weekends and does not smoke.",
"He is retired but previously worked in a factory that produces plastic pipes.",
"Abdominal examination shows righ... | 5 | {
"A": "Cavernous hemangioma",
"B": "Kaposi sarcoma",
"C": "Angiosarcoma",
"D": "Cholangiocarcinoma\n\""
} | Angiosarcoma | C | {
"gender": "Male",
"age": "75 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Gastroenterology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 75-year-old man comes to the physician.",
"2. He has a 6-month history of fatigue, weight loss, and abdominal pain.",
"3. He drinks 2 oz of alcohol on the weekends.",
"4. He does not smoke.",
"5. He previously worked in a factory that produces plastic pipes.",
"6. Abdominal examination shows right u... | [
"1. He drinks 2 oz of alcohol on the weekends.",
"2. He does not smoke.",
"3. He is retired.",
"4. He previously worked in a factory that produces plastic pipes.",
"5. Abdominal examination shows right upper quadrant tenderness.",
"6. The liver edge is palpable 2 cm below the ribs.",
"7. A liver biopsy ... | |
254 | Which of the following muscles is responsible for the displacement of this segment? | [
"A 28-year-old man is brought to the emergency department 20 minutes after being involved in a bicycling accident.",
"He complains of severe pain over the front of his right shoulder.",
"He refuses to move his right arm.",
"Physical examination shows supraclavicular swelling and bruising.",
"The shoulder's ... | 6 | {
"A": "Trapezius",
"B": "Subclavius",
"C": "Pectoralis major",
"D": "Sternocleidomastoid"
} | Sternocleidomastoid | D | {
"gender": "Male",
"age": "28 years old",
"specialties": [
"Orthopaedic Surgery"
],
"subspecialties": [
"Orthopaedic Sports Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Orthopaedic Surgery"
} | [
"1. A 28-year-old man is brought to the emergency department.",
"2. He was involved in a bicycling accident 20 minutes prior.",
"3. He complains of severe pain over the front of his right shoulder.",
"4. He refuses to move his right arm.",
"5. Physical examination shows supraclavicular swelling and bruising... | [
"1. Patient complains of severe pain over the front of his right shoulder.",
"2. Patient refuses to move his right arm.",
"3. Physical examination shows supraclavicular swelling and bruising.",
"4. Shoulder's range of motion is limited by pain.",
"5. X-ray of the shoulder shows a fracture of the middle thir... | |
255 | Echocardiography of this patient will most likely show which of the following? | [
"A 49-year-old woman presents to her oncologist with progressive difficulty breathing at rest, decreased exercise tolerance, and ankle swelling bilaterally for the past 2 weeks.",
"She was diagnosed with breast cancer 4 years ago which was treated with radical mastectomy, radiation, and aggressive chemotherapy.",... | 10 | {
"A": "Rapid early diastolic filling and impaired late diastolic filling",
"B": "Impairment of both early and late diastolic filling with respiratory variation of ventricular filling",
"C": "Abnormal myocardial texture, and restrictive diastolic dysfunction",
"D": "Dilated left and/or right ventricle and low e... | Impairment of both early and late diastolic filling with respiratory variation of ventricular filling | B | {
"gender": "Female",
"age": "49",
"specialties": [
"Cardiology"
],
"subspecialties": [
"General Cardiology",
"Congestive Heart Failure and Transplant Cardiology",
"Congestive Heart Failure/Cardiomyopathy"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6,
0.2,
0.2... | [
"1. A 49-year-old woman presents to her oncologist with progressive difficulty breathing at rest, decreased exercise tolerance, and ankle swelling bilaterally for the past 2 weeks.",
"2. She was diagnosed with breast cancer 4 years ago which was treated with radical mastectomy, radiation, and aggressive chemother... | [
"1. Diagnosed with breast cancer 4 years ago",
"2. Treated with radical mastectomy, radiation, and aggressive chemotherapy",
"3. Does not smoke or drink alcohol",
"4. Family history positive for breast cancer in elder sister",
"5. Blood pressure 85/50 mm Hg",
"6. Temperature 36.7°C (98.1°F)",
"7. Regula... | |
256 | Which of the following is the most likely diagnosis? | [
"A 5-year-old boy is brought to the physician because of high-grade fever and generalized fatigue for 5 days.",
"Two days ago, he developed a rash on his trunk.",
"He returned from a family hiking trip to Montana 1 week ago.",
"His immunization records are unavailable.",
"His temperature is 39.8°C (103.6°F)... | 11 | {
"A": "Staphylococcal scalded skin syndrome",
"B": "Juvenile idiopathic arthritis",
"C": "Granulomatosis with polyangiitis",
"D": "Kawasaki disease\n\""
} | Kawasaki disease
" | D | {
"gender": "Male",
"age": "5 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"General Pediatrics",
"Pediatric Infectious Diseases"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Pediatrics"
} | [
"1. A 5-year-old boy is brought to the physician.",
"2. He has had high-grade fever and generalized fatigue for 5 days.",
"3. Two days ago, he developed a rash on his trunk.",
"4. He returned from a family hiking trip to Montana 1 week ago.",
"5. His immunization records are unavailable.",
"6. His tempera... | [
"1. Two days ago, he developed a rash on his trunk.",
"2. He returned from a family hiking trip to Montana 1 week ago.",
"3. His immunization records are unavailable.",
"4. His temperature is 39.8°C (103.6°F), pulse is 111/min, and blood pressure is 96/60 mm Hg.",
"5. Examination shows injection of the conj... | |
257 | This patient’s condition is likely due to a lesion in which of the following locations? | [
"A 61-year-old female presents to the emergency room for a headache and vision loss.",
"She reports a 3-hour history of acute-onset dull headache.",
"She also says she cannot see out of part of her eye.",
"Her past medical history is notable for hypertension, hyperlipidemia, and a prior myocardial infarction.... | 10 | {
"A": "Optic nerve",
"B": "Pituitary gland",
"C": "Parietal lobe",
"D": "Temporal lobe"
} | Temporal lobe | D | {
"gender": "Female",
"age": "61",
"specialties": [
"Neurology"
],
"subspecialties": [
"Neurology with Special Qualification in Child Neurology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Neurology"
} | [
"1. Patient is a 61-year-old female.",
"2. Patient presents to the emergency room for a headache and vision loss.",
"3. Patient has a 3-hour history of acute-onset dull headache.",
"4. Patient cannot see out of part of her eye.",
"5. Patient's past medical history is notable for hypertension, hyperlipidemia... | [
"1. She reports a 3-hour history of acute-onset dull headache.",
"2. She cannot see out of part of her eye.",
"3. Her past medical history includes hypertension, hyperlipidemia, and a prior myocardial infarction.",
"4. She takes enalapril, atorvastatin, aspirin, and metoprolol.",
"5. On exam, she is alert a... | |
258 | Which of the following is the best next step in management? | [
"A 37-year-old G2P1001 presents to her obstetrician’s office at 31 weeks gestation for decreased fetal movement over the last day.",
"She states that although she occasionally feels some movement, it is decreased from baseline.",
"She denies any gush of fluid, vaginal bleeding, or painful contractions.",
"Thi... | 10 | {
"A": "Non-stress test",
"B": "Biophysical profile",
"C": "Contraction stress test",
"D": "Cervical exam"
} | Non-stress test | A | {
"gender": "Female",
"age": "37 years old",
"specialties": [
"Obstetrics and Gynecology"
],
"subspecialties": [
"Biophysical profile"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Obstetrics and Gynecology"
} | [
"1. Patient is 37 years old.",
"2. Patient is G2P1001.",
"3. Patient is 31 weeks gestation.",
"4. Patient has decreased fetal movement over the last day.",
"5. Patient occasionally feels some movement, but it is decreased from baseline.",
"6. Patient denies any gush of fluid, vaginal bleeding, or painful ... | [
"1. The patient occasionally feels some movement, but it is decreased from baseline.",
"2. The patient denies any gush of fluid, vaginal bleeding, or painful contractions.",
"3. The pregnancy has been complicated by gestational diabetes, and the patient was prescribed insulin.",
"4. The patient reports not al... | |
259 | Which of the following is the most likely predisposing factor for this patient’s current condition? | [
"A 59-year-old man is brought to the emergency department by his wife because of fever, chills, night sweats, and generalized fatigue for 2 weeks.",
"His temperature is 39.1°C (102.4°F).",
"He appears ill.",
"Physical examination shows a grade 3/6 mid-diastolic murmur at the left sternal border, and crackles ... | 6 | {
"A": "Periodontal disease",
"B": "Colon cancer",
"C": "Valve replacement",
"D": "Urinary tract infection"
} | Colon cancer | B | {
"gender": "Male",
"age": "59 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Infectious Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 59-year-old man is brought to the emergency department by his wife.",
"2. He has been experiencing fever, chills, night sweats, and generalized fatigue for 2 weeks.",
"3. His temperature is 39.1°C (102.4°F).",
"4. He appears ill.",
"5. Physical examination shows a grade 3/6 mid-diastolic murmur at the... | [
"1. His temperature is 39.1°C (102.4°F).",
"2. He appears ill.",
"3. Physical examination shows a grade 3/6 mid-diastolic murmur at the left sternal border.",
"4. Physical examination shows crackles at both lung bases.",
"5. A transesophageal echocardiography shows a 12 mm vegetation on the aortic valve.",
... | |
260 | What diagnostic test should this patient receive? | [
"A 65-year-old woman presents to her family doctor to reestablish care since her retirement from her corporate job and loss of her employer-sponsored health insurance.",
"She states that she has not had time for regular check-ups.",
"She exercises 3-4 times a week and consumes red meat sparingly.",
"She drank... | 9 | {
"A": "Chest radiograph",
"B": "Colonoscopy",
"C": "Mammography",
"D": "Pelvic ultrasound"
} | Mammography | C | {
"gender": "Female",
"age": "65",
"specialties": [
"Radiology"
],
"subspecialties": [
"General Radiology",
"Diagnostic Radiology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Family Medicine"
} | [
"1. Patient is 65 years old.",
"2. Patient recently retired from a corporate job and lost employer-sponsored health insurance.",
"3. Patient has not had time for regular check-ups.",
"4. Patient exercises 3-4 times a week.",
"5. Patient consumes red meat sparingly.",
"6. Patient drank and smoked cigarette... | [
"1. She has not had time for regular check-ups.",
"2. She exercises 3-4 times a week.",
"3. She consumes red meat sparingly.",
"4. She drank and smoked cigarettes socially with coworkers.",
"5. She never drank or smoked at home or on vacation.",
"6. She wakes up with achy wrists and elbows.",
"7. She su... | |
261 | Which of the following is the most likely explanation for this patient's symptoms?" | [
"A 52-year-old woman comes to the physician because of mild fatigue and dizziness for the past 2 days.",
"She has not been to work since yesterday due to her symptoms.",
"She says she has \"\"very high blood sugar” and has had similar episodes often in the past 2 years, for which she has visited multiple doctor... | 13 | {
"A": "Somatic symptom disorder",
"B": "Unipolar major depression",
"C": "Illness anxiety disorder",
"D": "Impaired glucose homeostasis"
} | Illness anxiety disorder | C | {
"gender": "Female",
"age": "52",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"General Internal Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 52-year-old woman comes to the physician.",
"2. She has mild fatigue and dizziness for the past 2 days.",
"3. She has not been to work since yesterday due to her symptoms.",
"4. She says she has \"very high blood sugar\".",
"5. She has had similar episodes often in the past 2 years.",
"6. She has vi... | [
"1. She has not been to work since yesterday due to her symptoms.",
"2. She says she has \"very high blood sugar” and has had similar episodes often in the past 2 years.",
"3. She has visited multiple doctors around the city for her symptoms.",
"4. She has purchased a home glucose monitoring device, which she... | |
262 | Which of the following is most likely to have prevented this infant's condition?" | [
"A 4800 g (10.6 lb) male newborn is delivered at term to a 35-year-old woman, gravida 1, para 1.",
"Significant lateral neck traction is required during delivery.",
"Apgar scores are 9 and 9 at 1 and 5 minutes, respectively.",
"Vital signs are within normal limits.",
"At rest, his right shoulder is adducted... | 7 | {
"A": "Avoidance of soft cheeses",
"B": "Administration of insulin",
"C": "Abstinence from cocaine",
"D": "Avoidance of cat feces"
} | Administration of insulin | B | {
"gender": "Male",
"age": "Newborn",
"specialties": [
"Obstetrics and Gynecology",
"Pediatrics"
],
"subspecialties": [
"Maternal",
"Neonatal",
"Maternal–Fetal Medicine"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.6,
0.2,
0.2
],
"gpt_specialt... | [
"1. A 4800 g male newborn is delivered at term.",
"2. The mother is 35 years old and gravida 1, para 1.",
"3. Significant lateral neck traction is required during delivery.",
"4. Apgar scores are 9 and 9 at 1 and 5 minutes, respectively.",
"5. Vital signs are within normal limits.",
"6. At rest, the baby'... | [
"1. Significant lateral neck traction is required during delivery.",
"2. Apgar scores are 9 and 9 at 1 and 5 minutes, respectively.",
"3. Vital signs are within normal limits.",
"4. At rest, his right shoulder is adducted and internally rotated.",
"5. The baby cries with passive movement of the arm.",
"6.... | |
263 | Which of the following is the most sensitive test for diagnosing pregnancy at this time? | [
"A 30-year-old woman comes to the physician for evaluation of successful conception.",
"She and her husband are trying to conceive, and they have had frequent sexual intercourse over the past month.",
"Her menstrual cycles occur at regular 28-day intervals, and her last menstrual period began 25 days ago."
] | 3 | {
"A": "Serum testing",
"B": "Transvaginal ultrasound",
"C": "Transabdominal Doppler ultrasound",
"D": "Urine testing"
} | Serum testing | A | {
"gender": "Female",
"age": "30 years old",
"specialties": [
"Obstetrics and Gynecology"
],
"subspecialties": [
"General Obstetrics and Gynecology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Obstetrics and Gynecology"
} | [
"1. A 30-year-old woman comes to the physician for evaluation of successful conception.",
"2. She and her husband are trying to conceive.",
"3. They have had frequent sexual intercourse over the past month.",
"4. Her menstrual cycles occur at regular 28-day intervals.",
"5. Her last menstrual period began 2... | [
"1. She and her husband are trying to conceive.",
"2. They have had frequent sexual intercourse over the past month.",
"3. Her menstrual cycles occur at regular 28-day intervals.",
"4. Her last menstrual period began 25 days ago."
] | |
264 | Which of the following is also most likely associated with the auscultatory findings in this patient? | [
"A 25-year-old healthy man presents to the physician for an annual checkup.",
"He doesn’t have any concerns and feels completely healthy.",
"He recently started a new job and has been working out at a gym regularly.",
"He does not smoke cigarettes, drinks occasionally, and does not use illicit substances.",
... | 6 | {
"A": "Decreased venous return",
"B": "Increased intrapleural pressure",
"C": "Increased right ventricular output",
"D": "Increased systemic blood pressure"
} | Increased right ventricular output | C | {
"gender": "Male",
"age": "25",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"General Internal Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 25-year-old man presents to the physician for an annual checkup.",
"2. He does not have any concerns and feels completely healthy.",
"3. He recently started a new job.",
"4. He has been working out at a gym regularly.",
"5. He does not smoke cigarettes.",
"6. He drinks occasionally.",
"7. He does ... | [
"1. The patient doesn't have any concerns.",
"2. The patient feels completely healthy.",
"3. The patient recently started a new job.",
"4. The patient has been working out at a gym regularly.",
"5. The patient does not smoke cigarettes.",
"6. The patient drinks occasionally.",
"7. The patient does not u... | |
265 | Which of the following will increase the intensity of this patient’s murmur? | [
"A 79-year-old man presents to his primary care physician complaining of progressive shortness of breath on exertion for the past 2 months.",
"He was first aware of having to catch his breath while gardening, and he is now unable to walk up the stairs in his house without stopping.",
"He has had type 2 diabetes... | 5 | {
"A": "Squatting",
"B": "Standing up from a sitting position",
"C": "Diuretics",
"D": "Volume depletion"
} | Squatting | A | {
"gender": "Male",
"age": "79 years old",
"specialties": [
"Cardiology"
],
"subspecialties": [
"General Cardiology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is 79 years old.",
"2. Patient is complaining of progressive shortness of breath on exertion for the past 2 months.",
"3. Patient first noticed shortness of breath while gardening.",
"4. Patient is unable to walk up stairs without stopping.",
"5. Patient has type 2 diabetes mellitus for 30 years... | [
"1. He first noticed difficulty catching his breath while gardening.",
"2. He is unable to walk up the stairs in his house without stopping.",
"3. He has had type 2 diabetes mellitus for 30 years.",
"4. He takes metformin and sitagliptin for his diabetes.",
"5. His blood pressure is 110/50 mm Hg.",
"6. Hi... | |
266 | Which of the following is the best prophylactic treatment for this patient’s most likely diagnosis? | [
"A 47-year-old woman presents with intermittent throbbing headaches.",
"She says that she has had at least 1–2 every week for the last 3 months.",
"She describes the pain as severe, pulsatile, and localized to the right frontotemporal and periorbital areas.",
"She says the headaches usually last for several h... | 10 | {
"A": "Amitriptyline",
"B": "Valproic acid",
"C": "Propranolol",
"D": "Ibuprofen"
} | Valproic acid | B | {
"gender": "Female",
"age": "47 years old",
"specialties": [
"Neurology"
],
"subspecialties": [
"Headache Medicine",
"Vascular Neurology",
"General Neurology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6,
0.2,
0.2
],
"gpt_specialty": "Neurology"
} | [
"1. Patient is a 47-year-old woman.",
"2. Patient has had intermittent throbbing headaches for the last 3 months, 1-2 per week.",
"3. Pain is severe, pulsatile, and localized to the right frontotemporal and periorbital areas.",
"4. Headaches usually last for several hours and are made worse by the presence of... | [
"1. The patient reports having at least 1–2 headaches every week for the last 3 months.",
"2. She describes the pain as severe, pulsatile, and localized to the right frontotemporal and periorbital areas.",
"3. The headaches usually last for several hours and are exacerbated by the presence of light.",
"4. She... | |
267 | What conditions can the given test predict? | [
"A 37-year-old 11-week primigravida will soon undergo a prenatal evaluation.",
"The doctor wants to exclude chromosomal abnormalities with a test.",
"He tells her that the test includes extracting a blood sample to determine the chances of having certain genetic conditions.",
"This process involves analyzing ... | 4 | {
"A": "Trisomy 21, Ebstein anomaly",
"B": "Trisomy 21, trisomy 13, trisomy 18, fetal sex",
"C": "Trisomy 21, trisomy 13, spina bifida",
"D": "Trisomy 21, spina bifida"
} | Trisomy 21, trisomy 13, trisomy 18, fetal sex | B | {
"gender": "Not specified",
"age": "37 years old",
"specialties": [
"Obstetrics and Gynecology"
],
"subspecialties": [
"Maternal"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Obstetrics and Gynecology"
} | [
"1. A 37-year-old 11-week primigravida will soon undergo a prenatal evaluation.",
"2. The doctor wants to exclude chromosomal abnormalities with a test.",
"3. The test includes extracting a blood sample.",
"4. The blood sample is used to determine the chances of having certain genetic conditions.",
"5. This... | [
"1. The doctor wants to exclude chromosomal abnormalities with a test.",
"2. The test includes extracting a blood sample.",
"3. The blood sample is used to determine the chances of having certain genetic conditions.",
"4. The process involves analyzing fetal DNA in the mother’s blood."
] | |
268 | Which of the following is the most likely mechanism of the patient illness? | [
"A 41-year-old man presents with progressive fatigue, pain in the front of the chest, and difficulty breathing with minimal exertion while trying to sleep.",
"He reports having a flu-like illness consisting of fatigue, muscle pain, and cough 10 days ago that resolved spontaneously without seeking a medical help."... | 9 | {
"A": "Rupture of an atherosclerotic plaque in the coronary artery",
"B": "Viral-mediated inflammation with local and systemic immunological activation",
"C": "Infection of the endocardial surface of the heart with microembolization and immune complex deposition",
"D": "Immune-mediated inflammation of the hear... | Viral-mediated inflammation with local and systemic immunological activation | B | {
"gender": "Male",
"age": "41 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Cardiology",
"Cardiovascular Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is a 41-year-old man.",
"2. Patient has progressive fatigue, pain in the front of the chest, and difficulty breathing with minimal exertion while trying to sleep.",
"3. Patient had a flu-like illness consisting of fatigue, muscle pain, and cough 10 days ago that resolved spontaneously without seekin... | [
"1. He had a flu-like illness 10 days ago with fatigue, muscle pain, and cough.",
"2. The flu-like illness resolved spontaneously without seeking medical help.",
"3. He has no past medical history.",
"4. He does not smoke cigarettes or drink alcohol.",
"5. His blood pressure is 100/70 mm Hg.",
"6. His tem... | |
269 | Which of the following public health interventions is most likely to decrease this number? | [
"A group of epidemiologists is studying the rates of cardiac surgeries performed in several Southeast Asian countries compared to the United States.",
"Results show a significant increase in the number of mitral valve replacements performed in Vietnam in adults aged 30–50 years compared to the same age group in t... | 2 | {
"A": "Prompt antibiotic treatment for bacterial pharyngitis",
"B": "Improved access to drug rehabilitation centers",
"C": "Genetic screening program for FBN1 gene mutation",
"D": "Screening echocardiography for prolapsed anterior mitral valve leaflets"
} | Prompt antibiotic treatment for bacterial pharyngitis | A | {
"gender": "study",
"age": "study",
"specialties": [
"Preventive Medicine",
"Internal Medicine"
],
"subspecialties": [
"Public Health and General Preventive Medicine",
"General Internal Medicine",
"Cardiology"
],
"specialty_prob": [
0.6,
0.4
],
"subspecialty_prob": [
0... | [
"1. A group of epidemiologists is studying the rates of cardiac surgeries performed in several Southeast Asian countries compared to the United States.",
"2. Results show a significant increase in the number of mitral valve replacements performed in Vietnam.",
"3. The increase is in adults aged 30–50 years.",
... | [
"1. Results show a significant increase in the number of mitral valve replacements performed in Vietnam.",
"2. The increase is in adults aged 30–50 years.",
"3. The increase is compared to the same age group in the United States."
] | |
270 | Which of the following treatment regimens is most appropriate in this patient? | [
"A 31-year-old male presents to his primary care physician complaining of low back pain and fevers.",
"He reports a four-day history of intermittent fevers, chills, and low back pain.",
"He denies trauma or recent illness.",
"His past medical history is notable for recurrent renal stones, diabetes mellitus, a... | 12 | {
"A": "Ampicillin and gentamicin",
"B": "Ciprofloxacin and trimethroprim-sulfamethoxazole",
"C": "Terazosin",
"D": "Ceftriaxone and doxycycline"
} | Ceftriaxone and doxycycline | D | {
"gender": "Male",
"age": "31",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Infectious Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is a 31-year-old male.",
"2. Patient is complaining of low back pain and fevers.",
"3. Patient has a four-day history of intermittent fevers, chills, and low back pain.",
"4. Patient denies trauma or recent illness.",
"5. Patient's past medical history is notable for recurrent renal stones, diab... | [
"1. He reports a four-day history of intermittent fevers, chills, and low back pain.",
"2. He denies trauma or recent illness.",
"3. His past medical history is notable for recurrent renal stones, diabetes mellitus, and alcohol abuse.",
"4. He takes metformin but admits to missing several doses.",
"5. He ha... | |
271 | Which of the following treatments would be effective for this patient’s most likely condition? | [
"A 12-year-old boy is brought to his pediatrician in order to be medically cleared for playing baseball.",
"On presentation, the boy’s only complaint is that he has never been able to completely keep up with his classmates during gym or on the playground because he feels fatigued and short of breath.",
"A revie... | 6 | {
"A": "Administration of uridine",
"B": "Administration of purine",
"C": "Cobalamin supplementation",
"D": "Folate supplementation"
} | Administration of uridine | A | {
"gender": "Male",
"age": "12 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Sports Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Pediatrics"
} | [
"1. A 12-year-old boy is brought to his pediatrician in order to be medically cleared for playing baseball.",
"2. The boy's only complaint is that he has never been able to completely keep up with his classmates during gym or on the playground because he feels fatigued and short of breath.",
"3. A review of his... | [
"1. The boy complains of feeling fatigued and short of breath during physical activities.",
"2. The boy has hit all his developmental milestones as expected.",
"3. The boy lives with his parents and consumes a diet consisting mostly of fast food and soda.",
"4. Physical exam reveals a thin, pale boy with decr... | |
272 | Which of the following is the most likely cause of this patient's presentation? | [
"A 27-year-old woman presents to her primary care physician for a follow-up appointment.",
"At her previous visit she had missed her previous two menses and also had a blood pressure of 147/100 mmHg.",
"The patient has a past medical history of anxiety, depression, bulimia nervosa and irritable bowel syndrome."... | 8 | {
"A": "Increased mineralocorticoid production",
"B": "Vomiting",
"C": "Increased reabsorption at the collecting duct",
"D": "Decreased renal artery blood flow"
} | Increased mineralocorticoid production | A | {
"gender": "Female",
"age": "27",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Endocrinology, Diabetes, and Metabolism"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 27-year-old woman presents to her primary care physician for a follow-up appointment.",
"2. At her previous visit she had missed her previous two menses and also had a blood pressure of 147/100 mmHg.",
"3. The patient has a past medical history of anxiety, depression, bulimia nervosa and irritable bowel s... | [
"1. The patient missed her previous two menses.",
"2. The patient had a blood pressure of 147/100 mmHg.",
"3. The patient has a past medical history of anxiety, depression, bulimia nervosa, and irritable bowel syndrome.",
"4. The physician prescribed an exercise program for the patient.",
"5. The physician ... | |
273 | Which of the following is most likely to confirm the diagnosis? | [
"A 59-year-old man is brought to the emergency room by his wife.",
"Thirty minutes ago, he was carrying heavy moving boxes from his house to a truck when he felt short of breath and suddenly lost consciousness.",
"His wife states that he fell to the ground and was unresponsive for 15 seconds before he regained ... | 10 | {
"A": "CT angiography",
"B": "Echocardiogram",
"C": "Cardiac enzymes",
"D": "Electroencephalogram\n\""
} | Echocardiogram | B | {
"gender": "Male",
"age": "59",
"specialties": [
"Internal Medicine",
"Cardiology"
],
"subspecialties": [
"Cardiovascular Disease",
"Echocardiogram"
],
"specialty_prob": [
0.6,
0.4
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 59-year-old man is brought to the emergency room by his wife.",
"2. Thirty minutes ago, he was carrying heavy moving boxes from his house to a truck.",
"3. He felt short of breath and suddenly lost consciousness.",
"4. His wife states that he fell to the ground and was unresponsive for 15 seconds before... | [
"1. Thirty minutes ago, he was carrying heavy moving boxes from his house to a truck.",
"2. He felt short of breath and suddenly lost consciousness.",
"3. His wife states that he fell to the ground and was unresponsive for 15 seconds before he regained consciousness.",
"4. He was not confused after this episo... | |
274 | Which of the following is the most appropriate initial step in treatment? | [
"A previously healthy 2-year-old girl is brought to the physician by her mother because of a dry, harsh cough for 2 days that worsens at night.",
"She has also had mild rhinorrhea and fever.",
"Her older brother has asthma and had a cold last week.",
"Immunizations are up-to-date.",
"She appears to be in mi... | 10 | {
"A": "Ceftriaxone",
"B": "Bronchoscopy",
"C": "Chest x-ray",
"D": "Cool mist and dexamethasone"
} | Cool mist and dexamethasone | D | {
"gender": "Female",
"age": "2 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"General Pediatrics",
"Pediatric Pulmonology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Pediatrics"
} | [
"1. Patient is a 2-year-old girl.",
"2. Patient is brought to the physician by her mother.",
"3. Patient has a dry, harsh cough for 2 days that worsens at night.",
"4. Patient has mild rhinorrhea and fever.",
"5. Patient's older brother has asthma and had a cold last week.",
"6. Patient's immunizations ar... | [
"1. She has mild rhinorrhea.",
"2. She has fever.",
"3. Her older brother has asthma.",
"4. Her older brother had a cold last week.",
"5. Her immunizations are up-to-date.",
"6. She appears to be in mild distress.",
"7. Her temperature is 38.1°C (100.5°F).",
"8. Her pulse is 140/min.",
"9. Her respi... | |
275 | Which of the following is the most likely diagnosis? | [
"A 78-year-old man comes to the physician for evaluation of progressive hearing loss in both ears over the past year.",
"He has difficulties understanding conversations in crowded places and when more than one person talks at the same time.",
"He has no dizziness, ear discharge, ringing noise, or ear pain.",
... | 11 | {
"A": "Cerumen impaction",
"B": "Ototoxicity",
"C": "Vestibulocochlear nerve damage",
"D": "Presbycusis"
} | Presbycusis | D | {
"gender": "Male",
"age": "78",
"specialties": [
"Otolaryngology"
],
"subspecialties": [
"General Otolaryngology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Otolaryngology"
} | [
"1. Patient is 78 years old.",
"2. Patient has progressive hearing loss in both ears over the past year.",
"3. Patient has difficulties understanding conversations in crowded places and when more than one person talks at the same time.",
"4. Patient has no dizziness, ear discharge, ringing noise, or ear pain.... | [
"1. He has difficulties understanding conversations in crowded places and when more than one person talks at the same time.",
"2. He has no dizziness, ear discharge, ringing noise, or ear pain.",
"3. He has a history of hypertension, hypercholesterolemia, and type 2 diabetes mellitus.",
"4. Medications includ... | |
276 | Which of the following is the most appropriate next step in management?" | [
"A 35-year-old woman, gravida 3, para 2, at 37 weeks' gestation comes to the physician for a prenatal visit.",
"She feels well.",
"She states that she did not follow up with her gynecologist on a regular basis due to a busy work schedule.",
"Pregnancy and delivery of her first two children were uncomplicated.... | 9 | {
"A": "Induce labor",
"B": "Administration of methyldopa",
"C": "Reassurance",
"D": "Fetal monitoring with continuous cardiotocography"
} | Induce labor | A | {
"gender": "Female",
"age": "35 years old",
"specialties": [
"Obstetrics and Gynecology"
],
"subspecialties": [
"General Obstetrics and Gynecology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Obstetrics and Gynecology"
} | [
"1. A 35-year-old woman is gravida 3, para 2, at 37 weeks' gestation.",
"2. She feels well.",
"3. She did not follow up with her gynecologist on a regular basis due to a busy work schedule.",
"4. Pregnancy and delivery of her first two children were uncomplicated.",
"5. Her blood pressure was 127/75 mm Hg a... | [
"1. She feels well.",
"2. She did not follow up with her gynecologist on a regular basis due to a busy work schedule.",
"3. Pregnancy and delivery of her first two children were uncomplicated.",
"4. Her blood pressure was 127/75 mm Hg at her initial obstetrics appointment.",
"5. Her temperature is 37.2°C (9... | |
277 | Which of the following trinucleotide repeats is found in this disease? | [
"A 31-year-old presents with self-described complaints of being \"fidgety and irritable\" that is unlike his \"calm personality a few years ago\".",
"What is concerning to him is that his father was diagnosed with a similar condition at the age of 38.",
"His father began a progressive decline - losing interest ... | 5 | {
"A": "CAG",
"B": "CTG",
"C": "GAA",
"D": "UGA"
} | CAG | A | {
"gender": "Not specified",
"age": "31 years old",
"specialties": [
"Psychiatry"
],
"subspecialties": [
"General Psychiatry"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Psychiatry"
} | [
"1. A 31-year-old presents with self-described complaints of being \"fidgety and irritable\".",
"2. This is unlike his \"calm personality a few years ago\".",
"3. His father was diagnosed with a similar condition at the age of 38.",
"4. His father began a progressive decline.",
"5. His father's decline incl... | [
"1. His father was diagnosed with a similar condition at the age of 38.",
"2. His father began a progressive decline.",
"3. His father lost interest in his life and family.",
"4. His father became messy.",
"5. His father experienced involuntary movements.",
"6. His father's dementia worsened as he grew ol... | |
278 | This patient's condition is most likely caused by mutation of an oncogene that encodes for a protein involved in which of the following cellular processes? | [
"A 48-year-old woman comes to the physician because of a 3-month history of low-grade fever, unintentional weight loss, night sweats, and a right-sided neck mass.",
"Examination shows pallor.",
"There is a non-tender and immobile right-sided cervical mass and enlarged axillary and inguinal lymph nodes.",
"The... | 6 | {
"A": "Hydrolysis of guanosine triphosphate",
"B": "Upregulation of cytokine receptor binding",
"C": "Transfer of phosphate from ATP to cellular protein",
"D": "Inhibition of programmed cell death"
} | Inhibition of programmed cell death | D | {
"gender": "Female",
"age": "48 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Medical Oncology",
"Hematology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Pathology"
} | [
"1. A 48-year-old woman comes to the physician.",
"2. She has a 3-month history of low-grade fever.",
"3. She has a 3-month history of unintentional weight loss.",
"4. She has a 3-month history of night sweats.",
"5. She has a right-sided neck mass.",
"6. Examination shows pallor.",
"7. There is a non-t... | [
"1. Examination shows pallor.",
"2. There is a non-tender and immobile right-sided cervical mass.",
"3. Enlarged axillary and inguinal lymph nodes are present.",
"4. The liver is palpated 4 cm below the right costal margin.",
"5. The spleen is palpated 3 cm below the left costal margin.",
"6. Histopatholo... | |
279 | What is the mechanism of action of the medication that can treat this patient’s condition? | [
"A 59-year-old man is brought to the emergency department for changes in mental status.",
"His wife noticed that since lunch time today, he has been “zoning out” and forgetting simple things such as where the bathroom is.",
"She decided to call the ambulance as he got uncharacteristically violent during dinner ... | 5 | {
"A": "Antagonist against 5-HT3",
"B": "Long-acting somatostatin analog",
"C": "Mu-opioid receptor agonist",
"D": "Trapping of ammonia in the colon"
} | Trapping of ammonia in the colon | D | {
"gender": "Male",
"age": "59 years old",
"specialties": [
"Neurology",
"Emergency Medicine",
"Internal Medicine"
],
"subspecialties": [
"Neurocritical Care",
"Neurology with Special Qualification in Child Neurology",
"Neurology"
],
"specialty_prob": [
0.6,
0.2,
0.2
... | [
"1. A 59-year-old man is brought to the emergency department for changes in mental status.",
"2. His wife noticed that since lunch time today, he has been “zoning out” and forgetting simple things such as where the bathroom is.",
"3. She decided to call the ambulance as he got uncharacteristically violent durin... | [
"1. His wife noticed that since lunch time today, he has been “zoning out” and forgetting simple things such as where the bathroom is.",
"2. She decided to call the ambulance as he got uncharacteristically violent during dinner when he threw his plate to the floor.",
"3. The patient denies fevers, weight loss, ... | |
280 | Which of the following manifestations is more specific for this patient’s condition? | [
"An otherwise healthy 49-year-old man presents to his primary care doctor for routine screening.",
"He does not have any symptoms and take no medications.",
"He has smoked 15–20 cigarettes daily for the past 9 years.",
"His father died of diabetes complications and his mother has been recently diagnosed with ... | 5 | {
"A": "Kussmaul respiration",
"B": "Unintentional weight loss",
"C": "Acanthosis nigricans",
"D": "Polyurea"
} | Acanthosis nigricans | C | {
"gender": "Male",
"age": "49",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"General Internal Medicine",
"Endocrinology, Diabetes, and Metabolism"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Internal Medicine"
} | [
"1. An otherwise healthy 49-year-old man presents to his primary care doctor for routine screening.",
"2. He does not have any symptoms and take no medications.",
"3. He has smoked 15–20 cigarettes daily for the past 9 years.",
"4. His father died of diabetes complications.",
"5. His mother has been recentl... | [
"1. The patient does not have any symptoms.",
"2. The patient takes no medications.",
"3. The patient has smoked 15–20 cigarettes daily for the past 9 years.",
"4. The patient's father died of diabetes complications.",
"5. The patient's mother has been recently diagnosed with proliferative diabetic retinopa... | |
281 | Which of the following is the most likely site of action of this drug in the kidney? | [
"A 30-year-old woman is brought to the emergency department because of severe headache and vomiting that started after she was hiking in the mountains at high altitude.",
"She normally lives in a city that is close to sea level.",
"Therapy is initiated with a drug that alkalinizes the urine."
] | 3 | {
"A": "Proximal convoluted tubule",
"B": "Ascending loop of Henle",
"C": "Glomerulus",
"D": "Early distal convoluted tubule"
} | Proximal convoluted tubule | A | {
"gender": "Female",
"age": "30 years old",
"specialties": [
"Emergency Medicine",
"Family Medicine",
"Internal Medicine"
],
"subspecialties": [
"Neurocritical Care",
"Pulmonary Disease",
"Sports Medicine"
],
"specialty_prob": [
0.6,
0.2,
0.2
],
"subspecialty_prob"... | [
"1. A 30-year-old woman is brought to the emergency department.",
"2. She has severe headache and vomiting.",
"3. Her symptoms started after she was hiking in the mountains at high altitude.",
"4. She normally lives in a city that is close to sea level.",
"5. Therapy is initiated with a drug that alkalinize... | [
"1. She normally lives in a city.",
"2. The city is close to sea level.",
"3. Therapy is initiated.",
"4. The therapy involves a drug.",
"5. The drug alkalinizes the urine."
] | |
282 | In addition to drawing her blood for viral serologies, which of the following is the most appropriate next step? | [
"A 35-year-old woman comes to employee health services 30 minutes after a work-related incident.",
"She works as a phlebotomist and reports that blood splashed into her right eye when she was drawing blood from a 30-year-old male patient.",
"Immediately following the incident, she flushed her eye with water for... | 8 | {
"A": "Start raltegravir, tenofovir, and emtricitabine",
"B": "Start zidovudine",
"C": "Start tenofovir and emtricitabine",
"D": "Administer hepatitis B immune globulin and vaccine"
} | Start raltegravir, tenofovir, and emtricitabine | A | {
"gender": "Female",
"age": "35 years old",
"specialties": [
"Emergency Medicine"
],
"subspecialties": [
"General Emergency Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 35-year-old woman came to employee health services 30 minutes after a work-related incident.",
"2. She works as a phlebotomist.",
"3. Blood splashed into her right eye when she was drawing blood from a 30-year-old male patient.",
"4. Immediately following the incident, she flushed her eye with water for... | [
"1. She works as a phlebotomist.",
"2. Blood splashed into her right eye when she was drawing blood from a 30-year-old male patient.",
"3. She flushed her eye with water for several minutes immediately following the incident.",
"4. The patient from whom she drew blood was admitted for hemoptysis, weight loss,... | |
283 | Which of the following is the most likely diagnosis? | [
"A 65-year-old Asian woman comes to the physician for a routine health maintenance examination.",
"On questioning, she has had occasional night sweats during the past 2 months.",
"She has not had fevers or weight loss.",
"Seven months ago, she had an acute myocardial infarction and was treated with percutaneo... | 14 | {
"A": "Traumatic subungual hemorrhage",
"B": "Malignant melanoma",
"C": "Onychomycosis",
"D": "Squamous cell carcinoma"
} | Malignant melanoma | B | {
"gender": "Female",
"age": "65 years old",
"specialties": [
"Dermatology"
],
"subspecialties": [
"General Dermatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Dermatology"
} | [
"1. Patient is a 65-year-old Asian woman.",
"2. Patient has had occasional night sweats during the past 2 months.",
"3. Patient has not had fevers or weight loss.",
"4. Patient had an acute myocardial infarction 7 months ago and was treated with percutaneous coronary intervention.",
"5. Patient has hyperten... | [
"1. She has had occasional night sweats during the past 2 months.",
"2. She has not had fevers or weight loss.",
"3. Seven months ago, she had an acute myocardial infarction and was treated with percutaneous coronary intervention.",
"4. She has hypertension, hyperlipidemia, and gastroesophageal reflux disease... | |
284 | Which of the following microorganisms is the most likely cause of this patient’s symptoms? | [
"A 12-year-old girl brought to the clinic by her mother has a 3-day history of fever and sore throat and hematuria since this morning.",
"The patient’s mother says she had a fever up to 39.5℃ (103.1℉) for the last 3 days and a severe sore throat, which has improved slightly.",
"The mother states that she notice... | 10 | {
"A": "Streptococcus pyogenes",
"B": "Adenovirus",
"C": "Escherichia coli O157:H7",
"D": "Proteus mirabilis"
} | Adenovirus | B | {
"gender": "Female",
"age": "12 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Nephrology",
"Pediatric Infectious Diseases"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Pediatrics"
} | [
"1. A 12-year-old girl was brought to the clinic by her mother.",
"2. The patient has a 3-day history of fever and sore throat.",
"3. The patient has had hematuria since this morning.",
"4. The patient's mother says the fever has been up to 39.5℃ (103.1℉) for the last 3 days.",
"5. The patient's mother says... | [
"1. The patient's mother reports a fever up to 39.5℃ (103.1℉) for the last 3 days and a severe sore throat.",
"2. The patient's mother noticed her daughter had red urine today.",
"3. The patient's temperature is 39.3℃ (102.8℉), pulse is 89/min, respiratory rate is 25/min, and blood pressure is 109/69 mm Hg.",
... | |
285 | What physical finding would suggest involvement of the nerve in its course through the parotid gland? | [
"A 73-year-old woman with a past medical history of diabetes, hypertension, and hyperlipidemia presents to the emergency department with swelling in her left neck.",
"The onset was a few months ago.",
"She has lost 6.8 kg (15.0 lb) over the same duration.",
"She denies any fever, night sweats or itching.",
... | 8 | {
"A": "Loss of taste on the left anterior 2/3 of the tongue",
"B": "Hypersensitivity to sound in the left ear",
"C": "Inability to smile on the left side",
"D": "Numbness of the left cheek"
} | Inability to smile on the left side | C | {
"gender": "Female",
"age": "73",
"specialties": [
"Otolaryngology"
],
"subspecialties": [
"General Otolaryngology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Otolaryngology"
} | [
"1. A 73-year-old woman presents to the emergency department with swelling in her left neck.",
"2. The onset of the swelling was a few months ago.",
"3. The woman has lost 6.8 kg (15.0 lb) over the same duration.",
"4. The woman denies any fever, night sweats or itching.",
"5. Physical examination reveals a... | [
"1. The onset of symptoms was a few months ago.",
"2. She has lost 6.8 kg (15.0 lb) over the same duration.",
"3. She denies any fever, night sweats, or itching.",
"4. Physical examination reveals a painless swelling in front of her left ear.",
"5. There is painless lymphadenopathy below the ear.",
"6. Bi... | |
286 | Concurrent treatment with which of the following agents most likely predisposed the patient to this episode? | [
"A 43-year-old man is brought to the emergency department by his wife after a near-syncopal episode.",
"He was doing yard work when he began feeling dizzy and had to lie down.",
"Earlier in the day, he was started on lisinopril.",
"On arrival, he is fully oriented.",
"His pulse is 100/min and blood pressure... | 7 | {
"A": "Ibuprofen",
"B": "Hydrochlorothiazide",
"C": "Lithium",
"D": "Trimethoprim/sulfamethoxazole"
} | Hydrochlorothiazide | B | {
"gender": "Male",
"age": "43 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Cardiology",
"Cardiovascular Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 43-year-old man is brought to the emergency department by his wife.",
"2. He had a near-syncopal episode.",
"3. He was doing yard work when he began feeling dizzy and had to lie down.",
"4. He was started on lisinopril earlier in the day.",
"5. On arrival, he is fully oriented.",
"6. His pulse is 10... | [
"1. He was doing yard work.",
"2. He began feeling dizzy.",
"3. He had to lie down.",
"4. Earlier in the day, he was started on lisinopril.",
"5. On arrival, he is fully oriented.",
"6. His pulse is 100/min.",
"7. His blood pressure is 92/60 mm Hg.",
"8. Serum electrolytes are within normal limits.",
... | |
287 | What additional diagnostic test would be helpful in establishing a diagnosis? | [
"A 4-year-old Caucasian girl previously diagnosed with asthma presents with recurrent sinusitis, otitis media, and clubbing of the nail bed.",
"Family history is significant for a distant cousin with cystic fibrosis.",
"A \"sweat test\" is performed and comes back normal."
] | 3 | {
"A": "Nasal transepithelial potential difference",
"B": "Skeletal survey",
"C": "Complete blood cell count",
"D": "Urinalysis"
} | Nasal transepithelial potential difference | A | {
"gender": "Female",
"age": "4 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Pulmonology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Pediatrics"
} | [
"1. Patient is a 4-year-old Caucasian girl.",
"2. Patient has a previous diagnosis of asthma.",
"3. Patient presents with recurrent sinusitis.",
"4. Patient presents with otitis media.",
"5. Patient has clubbing of the nail bed.",
"6. Patient has a family history of a distant cousin with cystic fibrosis."... | [
"1. Family history is significant for a distant cousin with cystic fibrosis.",
"2. A \"sweat test\" is performed.",
"3. The sweat test comes back normal."
] | |
288 | Which of the following would most likely be positive in this patient? | [
"A 35-year-old woman presents with a complaint of oral ulcers.",
"It is the third recurrence of ulcers in the last 8 months.",
"She is sexually active and complains of dyspareunia.",
"Examination shows the presence of a uveitis."
] | 4 | {
"A": "Anti-double stranded (Ds) DNA",
"B": "HLA-B51",
"C": "ANCA",
"D": "HLA-B27"
} | HLA-B51 | B | {
"gender": "Female",
"age": "35 years old",
"specialties": [
"Rheumatology"
],
"subspecialties": [
"General Rheumatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 35-year-old woman presents with a complaint of oral ulcers.",
"2. It is the third recurrence of ulcers in the last 8 months.",
"3. She is sexually active.",
"4. She complains of dyspareunia.",
"5. Examination shows the presence of a uveitis."
] | [
"1. It is the third recurrence of ulcers",
"2. The ulcers have recurred in the last 8 months",
"3. She is sexually active",
"4. She complains of dyspareunia",
"5. Examination shows the presence of a uveitis"
] | |
289 | What is the most likely cause of this patient’s symptoms? | [
"A 22-year-old female software analyst presents to a medical clinic for evaluation of tingling and numbness in both hands for the past 2 months.",
"Her symptoms are usually aggravated by the end of the work day and absent on most off days.",
"She has been a type I diabetic for 2 years and is currently on insuli... | 5 | {
"A": "Hypothyroidism",
"B": "Acute intermittent porphyria",
"C": "Amyotrophic lateral sclerosis",
"D": "Multiple sclerosis"
} | Hypothyroidism | A | {
"gender": "Female",
"age": "22",
"specialties": [
"Neurology"
],
"subspecialties": [
"Neuromuscular Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Neurology"
} | [
"1. A 22-year-old female software analyst presents to a medical clinic.",
"2. She has tingling and numbness in both hands for the past 2 months.",
"3. Her symptoms are usually aggravated by the end of the work day.",
"4. Her symptoms are absent on most off days.",
"5. She has been a type I diabetic for 2 ye... | [
"1. Her symptoms are usually aggravated by the end of the work day.",
"2. Her symptoms are absent on most off days.",
"3. She has been a type I diabetic for 2 years.",
"4. She is currently on insulin.",
"5. She admits to being sexually active.",
"6. She has had irregular periods for the past 3 months.",
... | |
290 | What is the normal function of the protein that is overexpressed due to the translocation seen in this patient? | [
"A 60-year-old male presents to his primary care physician complaining of fatigue.",
"He reports a six-month history of gradually worsening tiredness.",
"More recently, he has experienced intermittent fevers and night sweats.",
"His temperature is 99.5°F (37.5°C), blood pressure is 115/80 mmHg, pulse is 80/mi... | 6 | {
"A": "Promote cell growth",
"B": "Mediate cell cycle transition to mitosis",
"C": "Mediate cell cycle transition to G2 phase",
"D": "Mediate cell cycle transition to S phase"
} | Mediate cell cycle transition to S phase | D | {
"gender": "Male",
"age": "60",
"specialties": [
"Medical Genetics and Genomics",
"Internal Medicine"
],
"subspecialties": [
"Molecular Genetic Pathology",
"Clinical Genetics and Genomics",
"Hematology"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.6,
... | [
"1. A 60-year-old male presents to his primary care physician.",
"2. He complains of fatigue.",
"3. He has a six-month history of gradually worsening tiredness.",
"4. He has experienced intermittent fevers and night sweats.",
"5. His temperature is 99.5°F (37.5°C).",
"6. His blood pressure is 115/80 mmHg.... | [
"1. The patient reports a six-month history of gradually worsening tiredness.",
"2. The patient has experienced intermittent fevers and night sweats.",
"3. The patient's temperature is 99.5°F (37.5°C).",
"4. The patient's blood pressure is 115/80 mmHg.",
"5. The patient's pulse is 80/min.",
"6. The patien... | |
291 | Which of the following is the most appropriate next step in the management of this patient? | [
"An 8-year-old boy presents with abdominal pain and constipation.",
"The patient’s mother says that the symptoms gradually onset 2 months ago.",
"The patient describes the pain as moderate to severe, gnawing and diffusely localized.",
"No significant past medical history and no current medications.",
"The p... | 12 | {
"A": "Chelation therapy with dimercaptosuccinic acid (succimer)",
"B": "Chelation therapy with dimercaprol",
"C": "Chelation therapy with dimercaprol and calcium disodium edetate (EDTA)",
"D": "Plain abdominal radiographs"
} | Chelation therapy with dimercaprol and calcium disodium edetate (EDTA) | C | {
"gender": "Male",
"age": "8 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Gastroenterology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Pediatrics"
} | [
"1. Patient is 8 years old.",
"2. Patient presents with abdominal pain and constipation.",
"3. Symptoms gradually onset 2 months ago.",
"4. Patient describes pain as moderate to severe, gnawing and diffusely localized.",
"5. No significant past medical history and no current medications.",
"6. Patient liv... | [
"1. The patient's symptoms gradually onset 2 months ago.",
"2. The patient describes the pain as moderate to severe, gnawing, and diffusely localized.",
"3. The patient has no significant past medical history and is not taking any current medications.",
"4. The patient lives in a house built in the 1990s with... | |
292 | Which of the following is the most appropriate next step in management?" | [
"Two days after undergoing a left total hip replacement, a 68-year-old man has increasing shortness of breath and chest pain for 30 minutes.",
"He has type 2 diabetes mellitus and bilateral osteoarthritis of the hips.",
"Prior to admission to the hospital, his medications were metformin and naproxen.",
"His t... | 13 | {
"A": "Administer alteplase",
"B": "Obtain a spiral CT angiogram",
"C": "Obtain an x-ray of the chest",
"D": "Perfom an echocardiography"
} | Obtain a spiral CT angiogram | B | {
"gender": "Male",
"age": "68",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Pulmonary Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. Patient is 68 years old.",
"2. Patient has type 2 diabetes mellitus and bilateral osteoarthritis of the hips.",
"3. Patient's medications prior to admission were metformin and naproxen.",
"4. Patient's temperature is 37.8°C (100°F).",
"5. Patient's pulse is 110/min.",
"6. Patient's respirations are 30... | [
"1. He has type 2 diabetes mellitus.",
"2. He has bilateral osteoarthritis of the hips.",
"3. Prior to admission to the hospital, his medications were metformin and naproxen.",
"4. His temperature is 37.8°C (100°F).",
"5. His pulse is 110/min.",
"6. His respirations are 30/min.",
"7. His blood pressure ... | |
293 | Which of the following is the best next step in management? | [
"An 11-month-old male presents to the emergency department with his father after “passing out” at home.",
"His father reports that the patient started crying after his older brother took a toy away from him.",
"The patient was difficult to soothe and then suddenly stopped breathing.",
"His father reports that... | 10 | {
"A": "Arterial blood gas",
"B": "Echocardiogram",
"C": "Electrocardiogram (ECG)",
"D": "Observation and reassurance"
} | Observation and reassurance | D | {
"gender": "Male",
"age": "11 months",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Cardiology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Pediatrics"
} | [
"1. An 11-month-old male presents to the emergency department with his father.",
"2. His father reports that the patient started crying after his older brother took a toy away from him.",
"3. The patient was difficult to soothe and then suddenly stopped breathing.",
"4. His father reports that his lips turned... | [
"1. The patient started crying after his older brother took a toy away from him.",
"2. The patient was difficult to soothe.",
"3. The patient suddenly stopped breathing.",
"4. The patient's lips turned slightly blue.",
"5. The patient's entire body became limp.",
"6. The episode lasted a few seconds.",
... | |
294 | Which of the following is the most likely diagnosis? | [
"A 27-year-old woman presents to the emergency department for pain in multiple joints.",
"She states that she has had symmetric joint pain that started yesterday and has been worsening.",
"It is affecting her wrists, elbows, and shoulders.",
"She also endorses a subjective fever and some fatigue but denies an... | 11 | {
"A": "Gonococcal arthritis",
"B": "Parvovirus B19",
"C": "Rheumatoid arthritis",
"D": "Transient synovitis"
} | Parvovirus B19 | B | {
"gender": "Female",
"age": "27 years old",
"specialties": [
"Rheumatology"
],
"subspecialties": [
"General Rheumatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 27-year-old woman presents to the emergency department for pain in multiple joints.",
"2. She states that she has had symmetric joint pain that started yesterday and has been worsening.",
"3. It is affecting her wrists, elbows, and shoulders.",
"4. She also endorses a subjective fever and some fatigue b... | [
"1. The patient has symmetric joint pain affecting her wrists, elbows, and shoulders.",
"2. The joint pain started yesterday and has been worsening.",
"3. She endorses a subjective fever and some fatigue.",
"4. The patient denies any other symptoms.",
"5. She works as a schoolteacher and is generally health... | |
295 | Which of the following is the most likely cause of this patient's symptoms? | [
"A 57-year-old man with HIV and GERD comes to the emergency department because of productive cough with malodorous phlegm and night sweats for the past week.",
"He has smoked 1 pack of cigarettes daily for 30 years and he drinks 8–10 beers daily.",
"His temperature is 38.9°C (102.0°F).",
"Physical examination... | 7 | {
"A": "Bronchiectasis",
"B": "Adenocarcinoma in situ",
"C": "Tuberculosis",
"D": "Aspiration pneumonia"
} | Aspiration pneumonia | D | {
"gender": "Male",
"age": "57 years old",
"specialties": [
"Internal Medicine",
"Pulmonary Disease"
],
"subspecialties": [
"Infectious Disease"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 57-year-old man with HIV and GERD comes to the emergency department.",
"2. He has had productive cough with malodorous phlegm and night sweats for the past week.",
"3. He has smoked 1 pack of cigarettes daily for 30 years.",
"4. He drinks 8–10 beers daily.",
"5. His temperature is 38.9°C (102.0°F).",
... | [
"1. He has smoked 1 pack of cigarettes daily for 30 years.",
"2. He drinks 8–10 beers daily.",
"3. His temperature is 38.9°C (102.0°F).",
"4. Physical examination shows coarse crackles and dullness to percussion at the right lung base.",
"5. Scattered expiratory wheezing is heard throughout both lung fields... | |
296 | Which of the following is the most appropriate next step in management? | [
"A 20-year-old woman is brought to the emergency department by her boyfriend for right arm and leg weakness, numbness, and tingling that has been resolving gradually.",
"The symptoms started 4 hours ago after she had an argument with her boyfriend during which she slapped and kicked him.",
"She says she has bee... | 14 | {
"A": "Administer alteplase",
"B": "Provide patient education",
"C": "Prescribe aspirin",
"D": "Start biofeedback therapy\n\""
} | Provide patient education | B | {
"gender": "Female",
"age": "20 years old",
"specialties": [
"Neurology"
],
"subspecialties": [
"Vascular Neurology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Neurology"
} | [
"1. Patient is a 20-year-old woman.",
"2. Patient was brought to the emergency department by her boyfriend.",
"3. Patient has right arm and leg weakness, numbness, and tingling.",
"4. Symptoms have been resolving gradually.",
"5. Symptoms started 4 hours ago after an argument with her boyfriend during which... | [
"1. The symptoms started 4 hours ago after an argument with her boyfriend.",
"2. During the argument, she slapped and kicked him.",
"3. She says she has been limping and cannot use her right arm anymore.",
"4. She has never had similar symptoms in the past.",
"5. She has a history of genital herpes and tric... | |
297 | Which of the following best describes the feelings that the psychiatrist has for the patient? | [
"A 14-year-old female presents to her psychiatrist in hopes that she can find help in dealing with the sexual abuse that occurred in her childhood.",
"While retelling her story of the numerous encounters the patient had with her abuser, the psychiatrist begins to feel protective and parental towards the client, w... | 2 | {
"A": "Countertransference",
"B": "Identification",
"C": "Sublimation",
"D": "Projection"
} | Countertransference | A | {
"gender": "Female",
"age": "14",
"specialties": [
"Psychiatry"
],
"subspecialties": [
"Child and Adolescent Psychiatry"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Psychiatry"
} | [
"1. A 14-year-old female presents to her psychiatrist.",
"2. The patient is seeking help in dealing with sexual abuse that occurred in her childhood.",
"3. The patient is retelling her story of numerous encounters with her abuser.",
"4. The psychiatrist begins to feel protective and parental towards the clien... | [
"1. The patient had numerous encounters with her abuser.",
"2. The psychiatrist feels protective and parental towards the client.",
"3. The psychiatrist wishes he could have somehow helped the young girl."
] | |
298 | Which of the following trinucleotide DNA sequences would initiate protein translation when converted to mRNA? | Note: sequences are written 3'-->5' | [] | 0 | {
"A": "TAC",
"B": "ATC",
"C": "ATT",
"D": "AAA"
} | TAC | A | {
"gender": "study",
"age": "study",
"specialties": [
"Medical Genetics and Genomics",
"Pathology"
],
"subspecialties": [
"General Medical Genetics and Genomics",
"Molecular Genetic Pathology"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gp... | [] | [] | |
299 | Which side-effect is associated with the drug of choice for the treatment of this patient’s condition? | [
"A 47-year-old woman visits the emergency department due to painful, swollen fingers in both of her hands.",
"She has worked as a bus driver for the county school system for the last 20 years.",
"Her past medical history is significant for a transient ischemic attack 5 years ago.",
"She reports that she has l... | 7 | {
"A": "Retinopathy",
"B": "Arterial hypertension",
"C": "Pneumonitis",
"D": "Reactivation of latent tuberculosis"
} | Pneumonitis | C | {
"gender": "Female",
"age": "47 years old",
"specialties": [
"Rheumatology"
],
"subspecialties": [
"General Rheumatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 47-year-old woman visits the emergency department.",
"2. She has painful, swollen fingers in both of her hands.",
"3. She has worked as a bus driver for the county school system for the last 20 years.",
"4. Her past medical history is significant for a transient ischemic attack 5 years ago.",
"5. She ... | [
"1. She has worked as a bus driver for the county school system for the last 20 years.",
"2. Her past medical history is significant for a transient ischemic attack 5 years ago.",
"3. She reports that she has lost weight in the last 2 months although there have been no changes in her diet.",
"4. She also says... |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.