MediQ: Question-Asking LLMs and a Benchmark for Reliable Interactive Clinical Reasoning
Paper • 2406.00922 • Published • 2
id int64 0 1.27k | question stringlengths 19 424 | context sequencelengths 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 sequencelengths 0 35 | atomic_facts sequencelengths 0 35 |
|---|---|---|---|---|---|---|---|---|---|---|
0 | The mechanism of action of the medication given blocks cell wall synthesis, which of the following was given? | [
"A 21-year-old sexually active male complains of fever, pain during urination, and inflammation and pain in the right knee.",
"A culture of the joint fluid shows a bacteria that does not ferment maltose and has no polysaccharide capsule.",
"The physician orders antibiotic therapy for the patient."
] | 3 | {
"A": "Gentamicin",
"B": "Ciprofloxacin",
"C": "Ceftriaxone",
"D": "Trimethoprim"
} | Ceftriaxone | C | {
"gender": "Male",
"age": "21 years old",
"specialties": [
"Internal Medicine",
"Urology"
],
"subspecialties": [
"Infectious Disease",
"General Urology"
],
"specialty_prob": [
0.6,
0.4
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Urology"
} | [
"1. Patient is a 21-year-old male.",
"2. Patient is sexually active.",
"3. Patient complains of fever.",
"4. Patient complains of pain during urination.",
"5. Patient complains of inflammation and pain in the right knee.",
"6. Culture of joint fluid shows a bacteria.",
"7. Bacteria does not ferment malt... | [
"1. A culture of the joint fluid shows a bacteria.",
"2. The bacteria does not ferment maltose.",
"3. The bacteria has no polysaccharide capsule.",
"4. The physician orders antibiotic therapy for the patient."
] | |
1 | Which of the following is the most likely diagnosis? | [
"A 5-year-old girl is brought to the emergency department by her mother because of multiple episodes of nausea and vomiting that last about 2 hours.",
"During this period, she has had 6–8 episodes of bilious vomiting and abdominal pain.",
"The vomiting was preceded by fatigue.",
"The girl feels well between t... | 14 | {
"A": "Cyclic vomiting syndrome",
"B": "Gastroenteritis",
"C": "Hypertrophic pyloric stenosis",
"D": "Gastroesophageal reflux disease"
} | Cyclic vomiting syndrome | A | {
"gender": "Female",
"age": "5 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"General Pediatrics",
"Gastroenterology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Pediatrics"
} | [
"1. A 5-year-old girl is brought to the emergency department by her mother.",
"2. She has had multiple episodes of nausea and vomiting that last about 2 hours.",
"3. During this period, she has had 6–8 episodes of bilious vomiting and abdominal pain.",
"4. The vomiting was preceded by fatigue.",
"5. She fee... | [
"1. The patient has had 6–8 episodes of bilious vomiting and abdominal pain.",
"2. The vomiting was preceded by fatigue.",
"3. The girl feels well between these episodes.",
"4. She has missed several days of school.",
"5. She has been hospitalized 2 times during the past 6 months for dehydration due to simi... | |
2 | Which of the following is the best course of treatment in this patient? | [
"A 40-year-old woman presents with difficulty falling asleep, diminished appetite, and tiredness for the past 6 weeks.",
"She says that, despite going to bed early at night, she is unable to fall asleep.",
"She denies feeling anxious or having disturbing thoughts while in bed.",
"Even when she manages to fall... | 8 | {
"A": "Diazepam",
"B": "Paroxetine",
"C": "Zolpidem",
"D": "Trazodone"
} | Trazodone | D | {
"gender": "Female",
"age": "40 years old",
"specialties": [
"Psychiatry"
],
"subspecialties": [
"Sleep Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Psychiatry"
} | [
"1. Patient is a 40-year-old woman.",
"2. Patient has difficulty falling asleep for the past 6 weeks.",
"3. Patient goes to bed early at night but is unable to fall asleep.",
"4. Patient denies feeling anxious or having disturbing thoughts while in bed.",
"5. Patient wakes up early in the morning and is una... | [
"1. The patient has trouble falling asleep despite going to bed early at night.",
"2. She denies feeling anxious or having disturbing thoughts while in bed.",
"3. Even when she manages to fall asleep, she wakes up early in the morning and is unable to fall back asleep.",
"4. The patient has grown increasingly... | |
3 | Which of the following is the next best step in management? | [
"A 37-year-old female with a history of type II diabetes mellitus presents to the emergency department complaining of blood in her urine, left-sided flank pain, nausea, and fever.",
"She also states that she has pain with urination.",
"Vital signs include: temperature is 102 deg F (39.4 deg C), blood pressure i... | 4 | {
"A": "Obtain an abdominal CT scan",
"B": "Obtain a urine analysis and urine culture",
"C": "Begin intravenous treatment with ceftazidime",
"D": "No treatment is necessary"
} | Obtain a urine analysis and urine culture | B | {
"gender": "Female",
"age": "37 years old",
"specialties": [
"Urology"
],
"subspecialties": [
"General Urology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Urology"
} | [
"1. A 37-year-old female presents to the emergency department.",
"2. She has a history of type II diabetes mellitus.",
"3. She is complaining of blood in her urine, left-sided flank pain, nausea, and fever.",
"4. She also states that she has pain with urination.",
"5. Her temperature is 102 deg F (39.4 deg ... | [
"1. The patient reports pain with urination.",
"2. Vital signs: temperature is 102 deg F (39.4 deg C), blood pressure is 114/82 mmHg, pulse is 96/min, respirations are 18, and oxygen saturation of 97% on room air.",
"3. On physical examination, the patient appears uncomfortable.",
"4. The patient has tenderne... | |
4 | Which of the following should be treated first in this patient? | [
"A 19-year-old boy presents with confusion and the inability to speak properly.",
"The patient's mother says that, a few hours ago, she noticed a change in the way he talked and that he appeared to be in a daze.",
"He then lost consciousness, and she managed to get him to the hospital.",
"She is also concerne... | 9 | {
"A": "Hypoperfusion",
"B": "Hyperglycemia",
"C": "Metabolic acidosis",
"D": "Hypokalemia"
} | Hypoperfusion | A | {
"gender": "Male",
"age": "19",
"specialties": [
"Neurology"
],
"subspecialties": [
"Neurocritical Care"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Neurology"
} | [
"1. Patient is 19 years old.",
"2. Patient presents with confusion and inability to speak properly.",
"3. Patient's mother noticed a change in the way he talked and he appeared to be in a daze a few hours ago.",
"4. Patient lost consciousness and mother managed to get him to the hospital.",
"5. Mother is co... | [
"1. The patient's mother noticed a change in the way he talked and that he appeared to be in a daze.",
"2. The patient lost consciousness.",
"3. The patient's blood pressure is 80/55 mm Hg.",
"4. The patient's pulse is 115/min.",
"5. The patient's temperature is 37.2°C (98.9°F).",
"6. The patient's respir... | |
5 | Which of the following represents the most likely etiology of her anemia. | [
"A 41-year-old woman presents to her primary care physician with complaints of fatigue and weakness.",
"She denies any personal history of blood clots or bleeding problems in her past, but she says that her mother has had to be treated for breast cancer recently and is starting to wear her down.",
"Her past med... | 9 | {
"A": "Vitamin B12 deficiency",
"B": "Folate deficiency",
"C": "Iron deficiency",
"D": "Intravascular hemolysis"
} | Iron deficiency | C | {
"gender": "Female",
"age": "41",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Hematology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is 41 years old.",
"2. Patient complains of fatigue and weakness.",
"3. Patient denies personal history of blood clots or bleeding problems.",
"4. Patient's mother has been treated for breast cancer recently.",
"5. Patient's past medical history includes preeclampsia, hypertension, polycystic ov... | [
"1. Patient denies personal history of blood clots or bleeding problems.",
"2. Patient's mother has been treated for breast cancer recently.",
"3. Patient's past medical history includes preeclampsia, hypertension, polycystic ovarian syndrome, and hypercholesterolemia.",
"4. Patient currently smokes 1 pack of... | |
6 | Which of the following is the most likely primary mechanism underlying this woman's temporal muscle atrophy? | [
"A 59-year-old woman with stage IV lung cancer comes to the physician because of progressively worsening weakness in the past 3 months.",
"She has had a 10.5-kg (23-lb) weight loss during this period.",
"Her BMI is 16 kg/m2.",
"She appears thin and has bilateral temporal wasting."
] | 4 | {
"A": "Cytochrome c-mediated activation of proteases",
"B": "Lipase-mediated degradation of triglycerides",
"C": "TNF-α-mediated activation of caspases",
"D": "Proteasomal degradation of ubiquitinated proteins"
} | Proteasomal degradation of ubiquitinated proteins | D | {
"gender": "Female",
"age": "59 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Medical Oncology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 59-year-old woman has stage IV lung cancer.",
"2. She has experienced progressively worsening weakness in the past 3 months.",
"3. She has lost 10.5 kg (23 lbs) in the past 3 months.",
"4. Her BMI is 16 kg/m2.",
"5. She appears thin.",
"6. She has bilateral temporal wasting."
] | [
"1. She has had a 10.5-kg weight loss during this period.",
"2. The weight loss is equivalent to 23 lbs.",
"3. Her BMI is 16 kg/m2.",
"4. She appears thin.",
"5. She has bilateral temporal wasting."
] | |
7 | Which of the following is the most likely diagnosis? | [
"A 67-year-old man presents to the emergency department with a fever and altered mental status.",
"The patient has a history of Alzheimer dementia and is typically bed bound.",
"His son found him confused with a warm and flushed complexion thus prompting his presentation.",
"The patient has a past medical his... | 12 | {
"A": "Exertional heat stroke",
"B": "Neuroleptic malignant syndrome",
"C": "Non-exertional heat stroke",
"D": "Septic shock"
} | Non-exertional heat stroke | C | {
"gender": "Male",
"age": "67",
"specialties": [
"Internal Medicine",
"Emergency Medicine"
],
"subspecialties": [
"Infectious Disease",
"Neurocritical Care"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 67-year-old man presents to the emergency department with a fever and altered mental status.",
"2. The patient has a history of Alzheimer dementia and is typically bed bound.",
"3. His son found him confused with a warm and flushed complexion thus prompting his presentation.",
"4. The patient has a past... | [
"1. The patient has a history of Alzheimer dementia.",
"2. The patient is typically bed bound.",
"3. The patient has a past medical history of dementia, diabetes, and hypertension.",
"4. The patient typically has a visiting home nurse come to administer medications.",
"5. Prior to examination, the patient i... | |
8 | The most likely cause of this patient's symptoms is associated with which of the following enzymatic reactions? | [
"A 32-year-old man presents to a mission hospital in Cambodia because he has had difficulty walking from his village to the market.",
"He says that he has always been healthy other than occasional infections; however, over the last year he has been having numbness in his hands and feet.",
"Furthermore, he has n... | 5 | {
"A": "Alpha-ketoglutarate dehydrogenase",
"B": "Acyl transferases",
"C": "Glycogen phosphorylase",
"D": "Homocysteine methyltransferase"
} | Alpha-ketoglutarate dehydrogenase | A | {
"gender": "Male",
"age": "32 years old",
"specialties": [
"Neurology"
],
"subspecialties": [
"Neuromuscular Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Physical Medicine and Rehabilitation"
} | [
"1. A 32-year-old man presents to a mission hospital in Cambodia.",
"2. He has had difficulty walking from his village to the market.",
"3. He has always been healthy other than occasional infections.",
"4. Over the last year he has been having numbness in his hands and feet.",
"5. He has noticed weakness, ... | [
"1. He has always been healthy other than occasional infections.",
"2. Over the last year, he has been having numbness in his hands and feet.",
"3. He has noticed weakness, muscle wasting, and pain in his lower extremities.",
"4. After having a poor harvest last year, he and his family have been subsisting on... | |
9 | Which of the following is the best next step in management? | [
"A 60-year-old woman presents to her primary care physician for a wellness checkup.",
"She has a past medical history of hypertension and was discharged from the hospital yesterday after management of a myocardial infarction.",
"She states that sometimes she experiences exertional angina.",
"Her temperature i... | 5 | {
"A": "Atenolol",
"B": "Furosemide",
"C": "Hydrochlorothiazide",
"D": "Nitroglycerin"
} | Atenolol | A | {
"gender": "Female",
"age": "60 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"General Internal Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 60-year-old woman presents to her primary care physician for a wellness checkup.",
"2. She has a past medical history of hypertension.",
"3. She was discharged from the hospital yesterday after management of a myocardial infarction.",
"4. She states that sometimes she experiences exertional angina.",
... | [
"1. The patient has a past medical history of hypertension.",
"2. The patient was discharged from the hospital yesterday after management of a myocardial infarction.",
"3. The patient sometimes experiences exertional angina.",
"4. The patient's temperature is 99.5°F (37.5°C).",
"5. The patient's blood press... | |
10 | When this hormone is produced by the hypothalamus, it has which of the following effects? | [
"A 42-year-old male presents to his primary care physician complaining of abdominal pain.",
"He reports a 5-month history of epigastric pain that improves with meals.",
"He has lost 15 pounds since the pain started.",
"His past medical history is significant for a prolactinoma for which he underwent transphen... | 8 | {
"A": "Decrease production of growth hormone",
"B": "Decrease production of prolactin",
"C": "Decrease production of gastrin",
"D": "Decrease production of thyrotropin-releasing hormone"
} | Decrease production of growth hormone | A | {
"gender": "Male",
"age": "42",
"specialties": [
"Gastroenterology",
"Internal Medicine"
],
"subspecialties": [
"General Gastroenterology",
"Gastroenterology"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 42-year-old male presents to his primary care physician.",
"2. He is complaining of abdominal pain.",
"3. He has a 5-month history of epigastric pain that improves with meals.",
"4. He has lost 15 pounds since the pain started.",
"5. His past medical history is significant for a prolactinoma for which... | [
"1. The patient reports a 5-month history of epigastric pain that improves with meals.",
"2. He has lost 15 pounds since the pain started.",
"3. His past medical history includes a prolactinoma for which he underwent transphenoidal resection.",
"4. He drinks alcohol socially and has a 10 pack-year smoking his... | |
11 | What is the minimum amount of time this patient must exhibit these symptoms in order to meet the diagnostic criteria for dysthymia? | [
"A 28-year-old female reports that, for more days than not over the past 3 years, she has felt \"down\" and, at times, \"mildly depressed.\" Over this period, she also endorses feeling fatigued, difficulty concentrating, and often sleeping more than in the past.",
"The patient denies any manic or hypomanic period... | 3 | {
"A": "2 months",
"B": "6 months",
"C": "2 years",
"D": "5 years"
} | 2 years | C | {
"gender": "Female",
"age": "28",
"specialties": [
"Psychiatry"
],
"subspecialties": [
"General Psychiatry"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Psychiatry"
} | [
"1. Patient is 28 years old.",
"2. Patient has felt \"down\" and \"mildly depressed\" for more days than not over the past 3 years.",
"3. Patient endorses feeling fatigued.",
"4. Patient endorses difficulty concentrating.",
"5. Patient has been sleeping more than in the past.",
"6. Patient denies any mani... | [
"1. The patient denies any manic periods.",
"2. The patient denies any hypomanic periods.",
"3. The patient reports not having any periods of extreme worsening of her depressed mood beyond that described above.",
"4. The patient denies any suicidal ideation."
] | |
12 | Which of the following is the most appropriate next step in management? | [
"A 42-year-old man is being treated by his female family medicine physician for chronic depression.",
"Recently, he has been scheduling more frequent office visits.",
"He does not report any symptoms or problems with his SSRI medication during these visits.",
"Upon further questioning, the patient confesses t... | 5 | {
"A": "Re-evaluate this patient for borderline personality disorder",
"B": "Ask closed-ended questions and use a chaperone for future visits",
"C": "Immediately tell this patient that you can not continue to treat him and avoid any further communication",
"D": "Increase the dosage of this patient’s SSRI"
} | Ask closed-ended questions and use a chaperone for future visits | B | {
"gender": "Male",
"age": "42",
"specialties": [
"Psychiatry"
],
"subspecialties": [
"General Psychiatry"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Psychiatry"
} | [
"1. A 42-year-old man is being treated by his female family medicine physician.",
"2. The patient has chronic depression.",
"3. The patient has been scheduling more frequent office visits.",
"4. The patient does not report any symptoms or problems with his SSRI medication during these visits.",
"5. Upon fur... | [
"1. He has been scheduling more frequent office visits.",
"2. He does not report any symptoms or problems with his SSRI medication during these visits.",
"3. The patient confesses that he is attracted to her.",
"4. The patient says \"You are the only one in the world who understands me.\"",
"5. The physicia... | |
13 | What is the most likely cause of the gallstone coloring? | [
"A 51-year-old female presents with intermittent right upper quadrant discomfort.",
"The physician suspects she is suffering from biliary colic and recommends surgery.",
"Following surgery, brown stones are removed from the gallbladder specimen."
] | 3 | {
"A": "E. coli infection; beta-glucoronidase release",
"B": "Shigella infection; HMG-CoA reductase release",
"C": "Shigella infection; beta-glucoronidase release",
"D": "Bile supersaturated with cholesterol; beta-glucoronidase release"
} | E. coli infection; beta-glucoronidase release | A | {
"gender": "Female",
"age": "51 years",
"specialties": [
"Gastroenterology",
"Internal Medicine"
],
"subspecialties": [
"General Gastroenterology",
"Gastroenterology"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Surgery"
} | [
"1. A 51-year-old female presents with intermittent right upper quadrant discomfort.",
"2. The physician suspects she is suffering from biliary colic.",
"3. The physician recommends surgery.",
"4. Following surgery, brown stones are removed from the gallbladder specimen."
] | [
"1. The physician suspects the patient is suffering from biliary colic.",
"2. The physician recommends surgery for the patient.",
"3. Brown stones are removed from the gallbladder specimen following surgery."
] | |
14 | What is the most likely cause of his condition? | [
"A 56-year-old man with known coronary artery disease presents to the emergency department complaining of chest discomfort and palpitations for 2 hours.",
"On arrival, the vital signs include blood pressure 122/76 mm Hg, heart rate 180/min, respiratory rate 22/min, temperature 37.0℃ (98.6℉), and blood oxygen satu... | 7 | {
"A": "Monomorphic ventricular tachycardia",
"B": "Mitral regurgitation",
"C": "Third-degree heart block",
"D": "Acute pericarditis"
} | Monomorphic ventricular tachycardia | A | {
"gender": "Male",
"age": "56 years old",
"specialties": [
"Cardiology"
],
"subspecialties": [
"Cardiovascular Disease",
"Clinical Cardiac Electrophysiology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 56-year-old man with known coronary artery disease presents to the emergency department.",
"2. The patient is complaining of chest discomfort and palpitations for 2 hours.",
"3. On arrival, the vital signs include blood pressure 122/76 mm Hg, heart rate 180/min, respiratory rate 22/min, temperature 37.0℃ ... | [
"1. Vital signs on arrival: blood pressure 122/76 mm Hg, heart rate 180/min, respiratory rate 22/min, temperature 37.0℃ (98.6℉), and blood oxygen saturation (SpO2) 98% on room air.",
"2. 12-lead electrocardiogram demonstrated ST-segment elevation in the anterolateral leads.",
"3. Troponin level was 0.8 ng/mL (n... | |
15 | Which of the following is the most likely diagnosis in this patient? | [
"A 16-year-old female high school student is brought to the physician by her parents for her repeated behavioral problems at home and school during the past 10 months.",
"Her teachers describe her behavior as uncooperative and disruptive as she persistently refuses to answer questions, insults her teachers, and a... | 6 | {
"A": "Reactive attachment disorder",
"B": "Conduct disorder",
"C": "Antisocial personality disorder",
"D": "Oppositional defiant disorder"
} | Oppositional defiant disorder | D | {
"gender": "Female",
"age": "16",
"specialties": [
"Psychiatry"
],
"subspecialties": [
"Child and Adolescent Psychiatry"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Psychiatry"
} | [
"1. Patient is a 16-year-old female high school student.",
"2. Patient was brought to the physician by her parents.",
"3. Patient has had repeated behavioral problems for 10 months.",
"4. Patient's teachers describe her behavior as uncooperative and disruptive.",
"5. Patient refuses to answer questions, ins... | [
"1. Her teachers describe her behavior as uncooperative and disruptive.",
"2. She persistently refuses to answer questions.",
"3. She insults her teachers.",
"4. She annoys her classmates on a daily basis.",
"5. Her parents try to address her frequent violations of curfew.",
"6. Attempts at discussing the... | |
16 | Which of the following findings indicates that the cause of shock is cardiogenic? | [
"A 22-year-old man is brought to the emergency room with a penetrating stab injury to his left chest.",
"He appears pale, drowsy, and diaphoretic.",
"His pulse is feeble, systolic blood pressure is 86 mm Hg, the respirations are 22/min with an oxygen saturation of 88% at room air, and the temperature is 36.6°C ... | 6 | {
"A": "Elevated serum creatinine",
"B": "High central venous pressure (CPV)",
"C": "Arterial blood gas (ABG) showing base deficit and metabolic acidosis",
"D": "White blood cell (WBC) count < 4000/mm3"
} | High central venous pressure (CPV) | B | {
"gender": "Male",
"age": "22 years old",
"specialties": [
"Emergency Medicine",
"Cardiology"
],
"subspecialties": [
"General Emergency Medicine",
"Cardiovascular Disease"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Thoracic Surgery"
} | [
"1. A 22-year-old man is brought to the emergency room.",
"2. He has a penetrating stab injury to his left chest.",
"3. He appears pale, drowsy, and diaphoretic.",
"4. His pulse is feeble.",
"5. His systolic blood pressure is 86 mm Hg.",
"6. His respirations are 22/min.",
"7. His oxygen saturation is 88... | [
"1. The patient appears pale, drowsy, and diaphoretic.",
"2. His pulse is feeble.",
"3. Systolic blood pressure is 86 mm Hg.",
"4. The respirations are 22/min.",
"5. Oxygen saturation is 88% at room air.",
"6. The temperature is 36.6°C (98.0°F).",
"7. The jugular vein is distended.",
"8. Chest auscult... | |
17 | Which of the following characteristics best describes the most likely causal pathogen? | [
"A 56-year-old woman is brought to the physician by her husband because of a two-day history of fever, malaise, headaches, and confusion.",
"She recently immigrated from rural China and her immunization status is unknown.",
"Her temperature is 39.1°C (102.4°F).",
"Physical examination shows nuchal rigidity an... | 7 | {
"A": "Gram-negative coccobacillus",
"B": "Gram-positive, lancet-shaped diplococcus",
"C": "Gram-negative diplococcus",
"D": "Gram-positive, facultative intracellular bacillus"
} | Gram-negative coccobacillus | A | {
"gender": "Female",
"age": "56",
"specialties": [
"Internal Medicine",
"Infectious Disease"
],
"subspecialties": [
"Infectious Disease",
"General Infectious Disease"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 56-year-old woman is brought to the physician by her husband.",
"2. She has a two-day history of fever, malaise, headaches, and confusion.",
"3. She recently immigrated from rural China.",
"4. Her immunization status is unknown.",
"5. Her temperature is 39.1°C (102.4°F).",
"6. Physical examination s... | [
"1. She recently immigrated from rural China.",
"2. Her immunization status is unknown.",
"3. Her temperature is 39.1°C (102.4°F).",
"4. Physical examination shows nuchal rigidity and photophobia.",
"5. Cerebrospinal fluid analysis shows a neutrophil count of 1,500/mm3.",
"6. Cerebrospinal fluid cultured ... | |
18 | The pathogen associated with this patient’s condition is also known to cause which of the following? | [
"A 35-year-old male presents to his primary care physician complaining of a one-month history of progressively worsening fatigue.",
"He sought medical attention because this has affected his ability to complete his work as a graduate student.",
"As a child, he was hospitalized for hemolytic uremic syndrome.",
... | 10 | {
"A": "Kaposi’s sarcoma",
"B": "Erythema infectiosum",
"C": "Mononucleosis",
"D": "Croup"
} | Erythema infectiosum | B | {
"gender": "Male",
"age": "35",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Hematology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is a 35-year-old male.",
"2. Patient has a one-month history of progressively worsening fatigue.",
"3. Patient sought medical attention because fatigue has affected his ability to complete his work as a graduate student.",
"4. Patient was hospitalized for hemolytic uremic syndrome as a child.",
... | [
"1. The patient sought medical attention due to an impact on his ability to complete his work as a graduate student.",
"2. As a child, the patient was hospitalized for hemolytic uremic syndrome.",
"3. The patient's past medical history includes diabetes mellitus and obesity.",
"4. The patient takes metformin ... | |
19 | Which of the following is the best treatment for the most likely cause for this patient’s illness? | [
"A 30-year-old man is brought to the doctor's office by his wife.",
"She complains that over the past week there have been 3 episodes where he has fallen asleep while speaking with her.",
"She mentioned that these events began a few months ago and have been increasing in frequency.",
"She also says that his s... | 9 | {
"A": "Modafinil",
"B": "Taking longer naps",
"C": "Continuous positive airway pressure",
"D": "Changing bedtime to earlier in the evening"
} | Modafinil | A | {
"gender": "Male",
"age": "30",
"specialties": [
"Internal Medicine",
"Sleep Medicine"
],
"subspecialties": [
"Sleep Medicine",
"Pulmonary Disease",
"General Sleep Medicine"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.4,
0.4,
0.2
],
"gpt_specialty": "Neurology"
} | [
"1. A 30-year-old man is brought to the doctor's office by his wife.",
"2. The wife complains that over the past week there have been 3 episodes where he has fallen asleep while speaking with her.",
"3. The wife mentions that these events began a few months ago and have been increasing in frequency.",
"4. The... | [
"1. The patient has experienced 3 episodes of falling asleep while speaking over the past week.",
"2. The events of falling asleep began a few months ago and have been increasing in frequency.",
"3. The patient's snoring has reached a point where it affects her ability to sleep next to him.",
"4. The patient ... | |
20 | Which of the following is the best next treatment for this patient? | [
"A 55-year-old homeless man presents to the emergency department acutely confused.",
"The patient was found wandering the streets with an abnormal gait.",
"The patient has a past medical history of alcohol and IV drug abuse.",
"His temperature is 98.5°F (36.9°C), blood pressure is 103/61 mmHg, pulse is 120/mi... | 9 | {
"A": "Folate",
"B": "Magnesium",
"C": "Thiamine",
"D": "Vitamin C"
} | Thiamine | C | {
"gender": "Male",
"age": "55",
"specialties": [
"Emergency Medicine",
"Neurology"
],
"subspecialties": [
"General Emergency Medicine",
"Neurocritical Care"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 55-year-old homeless man presents to the emergency department acutely confused.",
"2. The patient was found wandering the streets with an abnormal gait.",
"3. The patient has a past medical history of alcohol and IV drug abuse.",
"4. His temperature is 98.5°F (36.9°C).",
"5. Blood pressure is 103/61 m... | [
"1. The patient was found wandering the streets with an abnormal gait.",
"2. The patient has a past medical history of alcohol and IV drug abuse.",
"3. His temperature is 98.5°F (36.9°C), blood pressure is 103/61 mmHg, pulse is 120/min, respirations are 16/min, and oxygen saturation is 97% on room air.",
"4. ... | |
21 | Which of the following is the most likely initial step in the pathogenesis of this patient's coronary condition? | [
"A 61-year-old woman is brought to the emergency department because of crushing substernal chest pain at rest for the past 2 hours.",
"She is diaphoretic.",
"Her temperature is 37.5°C (99.5°F), pulse is 110/min, respirations are 21/min, and blood pressure is 115/65 mm Hg.",
"An ECG shows ST elevation in I, aV... | 5 | {
"A": "Intimal monocyte infiltration",
"B": "Platelet activation",
"C": "Endothelial cell dysfunction",
"D": "Fibrous plaque formation"
} | Endothelial cell dysfunction | C | {
"gender": "Female",
"age": "61 years old",
"specialties": [
"Cardiology",
"Internal Medicine"
],
"subspecialties": [
"Cardiovascular Disease",
"General Cardiology"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 61-year-old woman is brought to the emergency department.",
"2. She has crushing substernal chest pain at rest for the past 2 hours.",
"3. She is diaphoretic.",
"4. Her temperature is 37.5°C (99.5°F).",
"5. Her pulse is 110/min.",
"6. Her respirations are 21/min.",
"7. Her blood pressure is 115/65... | [
"1. She is diaphoretic.",
"2. Her temperature is 37.5°C (99.5°F).",
"3. Her pulse is 110/min.",
"4. Her respirations are 21/min.",
"5. Her blood pressure is 115/65 mm Hg.",
"6. An ECG shows ST elevation in I, aVL, and V2–V4.",
"7. Coronary angiography shows an 80% stenosis in the left anterior descendin... | |
22 | What is the most likely etiology of this patient’s presentation? | [
"A 4-year-old boy presents to the office with his mother.",
"She states that the patient has been complaining of pain in his scrotum with swelling, abdominal pain, and nausea for the last 2 or 3 days.",
"On exam, the abdomen is soft and nontender to palpation.",
"The right scrotal sac is mildly enlarged witho... | 7 | {
"A": "Patent processus vaginalis",
"B": "Collection of fluid in the tunica vaginalis",
"C": "Infection of the epididymis",
"D": "Neoplasm of the testicle"
} | Patent processus vaginalis | A | {
"gender": "Male",
"age": "4 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Urology",
"General Pediatrics"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Pediatrics"
} | [
"1. A 4-year-old boy presents to the office with his mother.",
"2. The patient has been complaining of pain in his scrotum with swelling, abdominal pain, and nausea for the last 2 or 3 days.",
"3. On exam, the abdomen is soft and nontender to palpation.",
"4. The right scrotal sac is mildly enlarged without e... | [
"1. The patient has been complaining of pain in his scrotum with swelling, abdominal pain, and nausea for the last 2 or 3 days.",
"2. On exam, the abdomen is soft and nontender to palpation.",
"3. The right scrotal sac is mildly enlarged without erythema.",
"4. A tender mass is palpated in the right scrotal a... | |
23 | What is the most likely diagnosis? | [
"A 59-year-old man presents to his primary care physician, accompanied by his wife, who requests treatment for his “chronic pessimism.” The patient admits to feeling tired and “down” most of the time for the past several years but insists that it is “just part of getting old.” His wife believes that he has become m... | 7 | {
"A": "Adjustment disorder with depressive features",
"B": "Bipolar disorder",
"C": "Cyclothymia",
"D": "Dysthymia"
} | Dysthymia | D | {
"gender": "Male",
"age": "59 years old",
"specialties": [
"Psychiatry"
],
"subspecialties": [
"General Psychiatry"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Psychiatry"
} | [
"1. A 59-year-old man presents to his primary care physician.",
"2. He is accompanied by his wife.",
"3. His wife requests treatment for his “chronic pessimism.”",
"4. The patient admits to feeling tired and “down” most of the time for the past several years.",
"5. He insists that it is “just part of gettin... | [
"1. The patient and his wife cannot identify any stressors or triggering events.",
"2. He has continued to work as a librarian at a nearby college.",
"3. He spends time with friends on the weekends.",
"4. He sleeps 7 hours per night.",
"5. He eats 3 meals per day.",
"6. He denies suicidal ideation.",
"7... | |
24 | What is the most likely explanation for the patient’s presentation? | [
"A 17-month-old girl was brought to the emergency department by her mom following a fall.",
"The mom reports that the patient was playing in the playground when she tripped and fell onto the mulch.",
"She had an uncomplicated birth history and has been meeting developmental goals except for language delay, for ... | 6 | {
"A": "Child abuse",
"B": "Defective type 1 collagen gene",
"C": "Low levels of phosphate",
"D": "Low levels of vitamin D"
} | Defective type 1 collagen gene | B | {
"gender": "Female",
"age": "17 months",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Child Abuse Pediatrics",
"Pediatric Emergency Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Pediatrics"
} | [
"1. A 17-month-old girl was brought to the emergency department by her mom.",
"2. The mom reports that the patient was playing in the playground when she tripped and fell onto the mulch.",
"3. She had an uncomplicated birth history.",
"4. She has been meeting developmental goals except for language delay.",
... | [
"1. The patient was playing in the playground when she tripped and fell onto the mulch.",
"2. The patient had an uncomplicated birth history.",
"3. The patient has been meeting developmental goals except for language delay.",
"4. The patient is to receive a hearing test for further evaluation next week.",
"... | |
25 | Which of the following is the most likely diagnosis? | [
"ِA 62-year-old man comes to the emergency department because of colicky pain in the lower abdomen and abdominal distension for the past 12 hours.",
"He has chronic constipation for which he takes lactulose and senna laxatives.",
"His temperature is 37.1°C (98.7°F), blood pressure is 110/60 mm Hg and pulse is 8... | 5 | {
"A": "Infectious colitis",
"B": "Bowel adhesions",
"C": "Volvulus",
"D": "Acute diverticulitis"
} | Volvulus | C | {
"gender": "Male",
"age": "62 years old",
"specialties": [
"General Surgery",
"Surgery"
],
"subspecialties": [
"General Surgery"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Surgery"
} | [
"1. A 62-year-old man comes to the emergency department.",
"2. He has colicky pain in the lower abdomen and abdominal distension for the past 12 hours.",
"3. He has chronic constipation for which he takes lactulose and senna laxatives.",
"4. His temperature is 37.1°C (98.7°F).",
"5. His blood pressure is 11... | [
"1. He has chronic constipation.",
"2. He takes lactulose and senna laxatives.",
"3. His temperature is 37.1°C (98.7°F).",
"4. His blood pressure is 110/60 mm Hg.",
"5. His pulse is 85/min.",
"6. On physical examination, there is diffuse abdominal distension.",
"7. On physical examination, there is tend... | |
26 | The addition of this drug is most likely to increase the risk of which of the following adverse effects?" | [
"A 73-year-old African American man comes to the physician for a routine health maintenance examination.",
"He has type 2 diabetes mellitus, hypertension, hypercholesterolemia, and coronary artery disease.",
"His current medications include metformin, hydrochlorothiazide, amlodipine, rosuvastatin, isosorbide mo... | 7 | {
"A": "Hepatotoxicity",
"B": "Hyperkalemia",
"C": "Cutaneous flushing",
"D": "Hyperuricemia"
} | Hepatotoxicity | A | {
"gender": "Male",
"age": "73",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Geriatric Medicine",
"General Internal Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Preventive Medicine"
} | [
"1. A 73-year-old African American man comes to the physician for a routine health maintenance examination.",
"2. He has type 2 diabetes mellitus, hypertension, hypercholesterolemia, and coronary artery disease.",
"3. His current medications include metformin, hydrochlorothiazide, amlodipine, rosuvastatin, isos... | [
"1. He has type 2 diabetes mellitus.",
"2. He has hypertension.",
"3. He has hypercholesterolemia.",
"4. He has coronary artery disease.",
"5. His current medications include metformin.",
"6. His current medications include hydrochlorothiazide.",
"7. His current medications include amlodipine.",
"8. H... | |
27 | Which of the following is the next best diagnostic step? | [
"A 15-year-old girl is brought to the clinic by her mother because she is worried the patient has not yet had her period.",
"The patient’s older sister had her first period at age 14.",
"The mother had her first period at age 13.",
"The patient reports she is doing well in school and is on the varsity basketb... | 10 | {
"A": "CYP17 gene work-up",
"B": "Estrogen levels",
"C": "Gonadotrophin-releasing hormone stimulation test",
"D": "Karotype"
} | Karotype | D | {
"gender": "Female",
"age": "15 years old",
"specialties": [
"Pediatrics",
"Obstetrics and Gynecology"
],
"subspecialties": [
"Pediatric Endocrinology",
"Pediatric Gynecology"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Pediatrics"
} | [
"1. Patient is 15 years old.",
"2. Patient's mother brought her to the clinic.",
"3. Patient's mother is worried because patient has not had her period.",
"4. Patient's older sister had her first period at age 14.",
"5. Patient's mother had her first period at age 13.",
"6. Patient reports she is doing we... | [
"1. The patient’s older sister had her first period at age 14.",
"2. The mother had her first period at age 13.",
"3. The patient reports she is doing well in school and is on the varsity basketball team.",
"4. Her medical history is significant for asthma and atopic dermatitis.",
"5. Her medications includ... | |
28 | Further evaluation is most likely to show which of the following findings? | [
"A 15-month-old girl is brought to the physician by her mother for grossly bloody diarrhea for 2 days.",
"The girl has had a few episodes of blood-tinged stools over the past 3 weeks.",
"She has not had pain, nausea, or vomiting.",
"She is at the 55th percentile for height and 55th percentile for weight.",
... | 8 | {
"A": "Neutrophil infiltrated crypts on colonic biopsy",
"B": "Absent ganglionic cells on rectal suction biopsy",
"C": "Target sign on abdominal ultrasound",
"D": "Ectopic gastric mucosa on Technetium-99m pertechnetate scan"
} | Ectopic gastric mucosa on Technetium-99m pertechnetate scan | D | {
"gender": "Female",
"age": "15 months",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Gastroenterology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Pediatrics"
} | [
"1. A 15-month-old girl is brought to the physician by her mother.",
"2. She has had grossly bloody diarrhea for 2 days.",
"3. She has had a few episodes of blood-tinged stools over the past 3 weeks.",
"4. She has not had pain, nausea, or vomiting.",
"5. She is at the 55th percentile for height.",
"6. She... | [
"1. The girl has had a few episodes of blood-tinged stools over the past 3 weeks.",
"2. She has not had pain, nausea, or vomiting.",
"3. She is at the 55th percentile for height and 55th percentile for weight.",
"4. Examination shows conjunctival pallor.",
"5. The abdomen is soft and nontender.",
"6. Ther... | |
29 | Which of the following is the most likely underlying cause of this patient's findings? | [
"A 3855-g (8-lb 8-oz) newborn is examined shortly after birth.",
"She was delivered at 40 weeks' gestation by cesarean delivery because of breech presentation.",
"Pregnancy was otherwise uncomplicated.",
"Physical examination shows asymmetric thigh creases.",
"The left leg is shorter than the right leg and ... | 5 | {
"A": "Fracture of the femoral neck",
"B": "Inflammation of the hip synovium",
"C": "Abnormal development of the acetabulum",
"D": "Displacement of the femoral epiphysis"
} | Abnormal development of the acetabulum | C | {
"gender": "Not specified",
"age": "Newborn",
"specialties": [
"Orthopaedic Surgery"
],
"subspecialties": [
"General Orthopaedic Surgery",
"Pediatric Orthopaedic Surgery"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Orthopaedic Surgery"
} | [
"1. A 3855-g newborn was examined shortly after birth.",
"2. The newborn was delivered at 40 weeks' gestation.",
"3. The newborn was delivered by cesarean delivery.",
"4. The cesarean delivery was due to breech presentation.",
"5. The pregnancy was otherwise uncomplicated.",
"6. Physical examination showe... | [
"1. She was delivered at 40 weeks' gestation.",
"2. The delivery was by cesarean delivery.",
"3. The reason for the cesarean delivery was breech presentation.",
"4. The pregnancy was otherwise uncomplicated.",
"5. Physical examination shows asymmetric thigh creases.",
"6. The left leg is shorter than the ... | |
30 | Which of the following is the most likely cause of this patient's anemia? | [
"A 27-year-old G1P0 woman at 9 weeks estimated gestational age presents for a prenatal visit.",
"She has no current complaints and takes no medications.",
"She is vegetarian and emigrated from Nepal 7 years ago.",
"She does not use tobacco, alcohol or recreational drugs.",
"The patient’s vital signs include... | 6 | {
"A": "Vitamin B12 deficiency",
"B": "Zinc deficiency",
"C": "Gestational anemia",
"D": "Thalassemia trait"
} | Thalassemia trait | D | {
"gender": "Female",
"age": "27 years old",
"specialties": [
"Obstetrics and Gynecology"
],
"subspecialties": [
"Gestational anemia",
"General Obstetrics and Gynecology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Obstetrics and Gynecology"
} | [
"1. Patient is a 27-year-old G1P0 woman.",
"2. Patient is at 9 weeks estimated gestational age.",
"3. Patient has no current complaints.",
"4. Patient takes no medications.",
"5. Patient is vegetarian.",
"6. Patient emigrated from Nepal 7 years ago.",
"7. Patient does not use tobacco, alcohol or recreat... | [
"1. The patient has no current complaints.",
"2. The patient takes no medications.",
"3. The patient is vegetarian.",
"4. The patient emigrated from Nepal 7 years ago.",
"5. The patient does not use tobacco.",
"6. The patient does not use alcohol.",
"7. The patient does not use recreational drugs.",
"... | |
31 | What will be the change in the kinetics of the reaction catalyzed by carbonic anhydrase under the influence of acetazolamide? | [
"A 31-year-old woman presents to your clinic with a persistent headache.",
"She reports she has suffered from headaches since the age of 27 when she gained 12 kg (26.4 lb) after the birth of her second child.",
"The headache is generalized and throbbing in nature.",
"It worsens in the morning and is aggravate... | 10 | {
"A": "Activation energy (Ea) will increase",
"B": "Activation energy (Ea) will decrease",
"C": "Free energy (G) of the reactants will increase",
"D": "Increase reaction free energy change (∆G) by increasing free energy (G) of reactants and decreasing G of products"
} | Activation energy (Ea) will increase | A | {
"gender": "Female",
"age": "31 years old",
"specialties": [
"Neurology"
],
"subspecialties": [
"General Neurology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Neurology"
} | [
"1. Patient is a 31-year-old woman.",
"2. Patient has suffered from headaches since the age of 27.",
"3. Patient gained 12 kg (26.4 lb) after the birth of her second child.",
"4. Headache is generalized and throbbing in nature.",
"5. Headache worsens in the morning.",
"6. Headache is aggravated with cough... | [
"1. The patient has suffered from headaches since the age of 27.",
"2. The headaches started after she gained 12 kg (26.4 lb) after the birth of her second child.",
"3. The headache is generalized and throbbing in nature.",
"4. It worsens in the morning and is aggravated with coughing, laughing, and sneezing.... | |
32 | Which of the following is the most likely cause of this patient's symptoms? | [
"A 55-year-old man comes to the emergency department because of a dry cough and severe chest pain beginning that morning.",
"Two months ago, he was diagnosed with inferior wall myocardial infarction and was treated with stent implantation of the right coronary artery.",
"He has a history of hypertension and hyp... | 9 | {
"A": "Cardiac tamponade",
"B": "Constrictive pericarditis",
"C": "Reinfarction",
"D": "Dressler syndrome"
} | Dressler syndrome | D | {
"gender": "Male",
"age": "55 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Pulmonary Disease",
"Cardiovascular Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. A 55-year-old man comes to the emergency department.",
"2. He has a dry cough and severe chest pain beginning that morning.",
"3. Two months ago, he was diagnosed with inferior wall myocardial infarction.",
"4. He was treated with stent implantation of the right coronary artery.",
"5. He has a history o... | [
"1. Two months ago, he was diagnosed with inferior wall myocardial infarction.",
"2. He was treated with stent implantation of the right coronary artery.",
"3. He has a history of hypertension.",
"4. He has a history of hypercholesterolemia.",
"5. His medications include aspirin.",
"6. His medications inc... | |
33 | Which of the following is the most appropriate treatment for this patient’s condition? | [
"A 27-year-old man presents to the physician with concern for pain in both of his knees that he is unable to attribute to any activities that he has recently performed.",
"He had an acute episode of diarrhea 2 weeks ago, prior to the onset of symptoms.",
"He has also been experiencing a burning sensation during... | 6 | {
"A": "Acetaminophen",
"B": "Allopurinol",
"C": "Indomethacin",
"D": "Leflunomide"
} | Indomethacin | C | {
"gender": "Male",
"age": "27",
"specialties": [
"Orthopaedic Surgery"
],
"subspecialties": [
"Orthopaedic Sports Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Orthopaedic Surgery"
} | [
"1. Patient is 27 years old.",
"2. Patient has pain in both knees.",
"3. Patient cannot attribute pain to any recent activities.",
"4. Patient had an acute episode of diarrhea 2 weeks ago.",
"5. Patient has burning sensation during urination for the past week.",
"6. Patient has noticed eyes occasionally f... | [
"1. He had an acute episode of diarrhea 2 weeks ago.",
"2. He has been experiencing a burning sensation during urination for the past week.",
"3. He has noticed that his eyes occasionally feel irritated and painful, leading to bouts of blurry vision.",
"4. On physical examination, the patient is afebrile.",
... | |
34 | Of the following organisms, infection with which one is most consistent with her symptoms? | [
"A 22-year old active duty soldier presents to your clinic with complaints of intense fatigue, fevers, abdominal pain, and a nonproductive cough.",
"Her symptoms began a few days ago, but she returned from a tour of duty in Malawi and Mozambique four weeks ago.",
"She endorses sleeping outside, using minimal bu... | 7 | {
"A": "Plasmodium falciparum",
"B": "Schistosoma mansoni",
"C": "Mycobacterium tuberculosis",
"D": "Trypanosoma brucei rhodesiense"
} | Schistosoma mansoni | B | {
"gender": "Not specified",
"age": "22 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Infectious Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is 22-year old active duty soldier.",
"2. Patient presents with complaints of intense fatigue, fevers, abdominal pain, and a nonproductive cough.",
"3. Symptoms began a few days ago.",
"4. Patient returned from a tour of duty in Malawi and Mozambique four weeks ago.",
"5. Patient endorses sleepi... | [
"1. Her symptoms began a few days ago",
"2. She returned from a tour of duty in Malawi and Mozambique four weeks ago",
"3. She endorses sleeping outside",
"4. She endorses using minimal bug spray",
"5. She endorses swimming in rivers during her tour",
"6. On physical exam, her temperature is 101.5",
"7.... | |
35 | Which of the following best describes the mechanism of action of the drug that is most likely responsible for this patient's symptoms? | [
"A 72-year-old man comes to the emergency room because of a 4-day history of progressively worsening pain and swelling on the right side of his face.",
"The patient was diagnosed with multiple myeloma 8 months ago and is currently undergoing treatment.",
"His vital signs are within normal limits.",
"Physical ... | 5 | {
"A": "Cross-linking DNA at guanine",
"B": "Inhibition of proteosome activity",
"C": "Stimulation of PTH receptor",
"D": "Binding to hydroxyapatite"
} | Binding to hydroxyapatite | D | {
"gender": "Male",
"age": "72 years old",
"specialties": [
"Otolaryngology"
],
"subspecialties": [
"General Otolaryngology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Otolaryngology"
} | [
"1. A 72-year-old man comes to the emergency room.",
"2. He has a 4-day history of progressively worsening pain and swelling on the right side of his face.",
"3. He was diagnosed with multiple myeloma 8 months ago.",
"4. He is currently undergoing treatment.",
"5. His vital signs are within normal limits.",... | [
"1. The patient was diagnosed with multiple myeloma 8 months ago.",
"2. The patient is currently undergoing treatment.",
"3. His vital signs are within normal limits.",
"4. Physical exam shows erythema and swelling over the right cheek and mandible.",
"5. An orofacial fistula is present."
] | |
36 | Which of the following is the most important risk factor for the development of this condition? | [
"A 12-month-old girl is brought to the physician because she is unable to sit and has not learned how to crawl.",
"She keeps her hips and elbows flexed and her parents have to use considerable force to passively extend her joints.",
"She attained neck control at 4 months and could roll from front to back at 5 m... | 14 | {
"A": "Premature birth",
"B": "Congenital rubella infection",
"C": "Congenital CMV infection",
"D": "Advanced maternal age"
} | Premature birth | A | {
"gender": "Female",
"age": "12 months",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Developmental"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Pediatrics"
} | [
"1. Patient is a 12-month-old girl.",
"2. Patient is unable to sit and has not learned how to crawl.",
"3. Patient keeps hips and elbows flexed and parents have to use considerable force to passively extend her joints.",
"4. Patient attained neck control at 4 months and could roll from front to back at 5 mont... | [
"1. She keeps her hips and elbows flexed and her parents have to use considerable force to passively extend her joints.",
"2. She attained neck control at 4 months and could roll from front to back at 5 months of age.",
"3. She does not engage in play, reach for toys, or maintain eye contact.",
"4. She babble... | |
37 | What is the most likely diagnosis? | [
"A 31-year-old male presents with a 2-day history of watery diarrhea that began 8 days after his arrival from Africa.",
"None of the other members of his family became ill.",
"He reports symptoms of malaise, anorexia, and abdominal cramps followed by watery diarrhea.",
"He denies tenesmus, urgency, and bloody... | 7 | {
"A": "Giardiasis",
"B": "Irritable bowel syndrome (IBS)",
"C": "Traveler’s diarrhea due to Norovirus",
"D": "Traveler’s diarrhea due to ETEC"
} | Traveler’s diarrhea due to ETEC | D | {
"gender": "Male",
"age": "31",
"specialties": [
"Infectious Disease"
],
"subspecialties": [
"General Infectious Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is a 31-year-old male.",
"2. Patient has a 2-day history of watery diarrhea.",
"3. Patient's diarrhea began 8 days after his arrival from Africa.",
"4. None of the other members of his family became ill.",
"5. Patient reports symptoms of malaise, anorexia, and abdominal cramps.",
"6. Patient d... | [
"1. None of the other members of his family became ill.",
"2. He reports symptoms of malaise, anorexia, and abdominal cramps followed by watery diarrhea.",
"3. He denies tenesmus, urgency, and bloody diarrhea.",
"4. His temperature is 98.6°F (37°C).",
"5. His respiratory rate is 15/min.",
"6. His pulse is... | |
38 | Which of the following is the primary cause of the patient’s lab results? | [
"A 46-year-old woman presents to the emergency department with progressive dyspnea and chest pain.",
"She reports that her symptoms started 1 week ago and have gotten progressively worse.",
"The chest pain is left-sided and is exacerbated by coughing or deep breaths.",
"She also endorses a 6-month history of ... | 14 | {
"A": "Hematologic malignancy",
"B": "Immune-mediated destruction",
"C": "Mechanical shearing",
"D": "Viral infection"
} | Immune-mediated destruction | B | {
"gender": "Female",
"age": "46",
"specialties": [
"Internal Medicine",
"Pulmonary Disease"
],
"subspecialties": [
"Pulmonary Disease",
"General Pulmonary Disease"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. Patient is a 46-year-old woman.",
"2. Patient presents to the emergency department with progressive dyspnea and chest pain.",
"3. Symptoms started 1 week ago and have gotten progressively worse.",
"4. Chest pain is left-sided and is exacerbated by coughing or deep breaths.",
"5. Patient has a 6-month hi... | [
"1. Symptoms started 1 week ago",
"2. Symptoms have gotten progressively worse",
"3. Chest pain is left-sided",
"4. Chest pain is exacerbated by coughing or deep breaths",
"5. 6-month history of joint pains involving knees, elbows, and digits",
"6. No significant medical or surgical history",
"7. Takes ... | |
39 | The cell type responsible for the regeneration of the patient's alveolar epithelium is also functions in: | [
"A 48-year-old patient is recovering from acute lung injury following a diffuse pulmonary viral infection."
] | 1 | {
"A": "Protease release",
"B": "Phagocytosis",
"C": "Surfactant secretion",
"D": "Recruitment of neutrophils"
} | Surfactant secretion | C | {
"gender": "Not specified",
"age": "48 years old",
"specialties": [
"Pulmonary Disease"
],
"subspecialties": [
"General Pulmonary Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is 48 years old.",
"2. Patient is recovering from acute lung injury.",
"3. Patient had a diffuse pulmonary viral infection."
] | [
"1. The patient is 48 years old.",
"2. The patient is recovering from acute lung injury.",
"3. The acute lung injury is following a diffuse pulmonary viral infection."
] | |
40 | Which of the following is the most appropriate next step in management?" | [
"A 36-year-old woman comes to the physician because of fatigue for 4 months.",
"She is unable to do her chores and complains of excessive sleepiness during the day.",
"She has generalized itching.",
"She has not had abdominal pain, fever, or weight loss.",
"She has had chronic low back pain for 6 years.",
... | 10 | {
"A": "Liver biopsy",
"B": "Atorvastatin",
"C": "Cholestyramine",
"D": "Ursodeoxycholic acid"
} | Ursodeoxycholic acid | D | {
"gender": "Female",
"age": "36",
"specialties": [
"Internal Medicine",
"Hepatology"
],
"subspecialties": [
"Gastroenterology",
"General Hepatology"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 36-year-old woman comes to the physician because of fatigue for 4 months.",
"2. She is unable to do her chores and complains of excessive sleepiness during the day.",
"3. She has generalized itching.",
"4. She has not had abdominal pain, fever, or weight loss.",
"5. She has had chronic low back pain f... | [
"1. She is unable to do her chores and complains of excessive sleepiness during the day.",
"2. She has generalized itching.",
"3. She has not had abdominal pain, fever, or weight loss.",
"4. She has had chronic low back pain for 6 years.",
"5. Her current medications include acetaminophen and vitamin supple... | |
41 | Which of the following arterial blood findings for the partial pressure of oxygen (PaO2), oxygen saturation (SaO2), and oxygen concentration (CaO2) are expected in this patient? | [
"A 40-year-old woman presents to the physician with complaints of frequent headaches and fatigue for a month.",
"Her headaches are mild and occur at random times.",
"They are relieved by over the counter analgesics.",
"Furthermore, she feels tired most of the time and sometimes gets short of breath with exert... | 10 | {
"A": "Normal PaO2, normal SaO2, normal CaO2",
"B": "Low PaO2, low SaO2, low CaO2",
"C": "Low PaO2, normal SaO2, normal CaO2",
"D": "Normal PaO2, normal SaO2, low CaO2"
} | Normal PaO2, normal SaO2, low CaO2 | D | {
"gender": "Female",
"age": "40",
"specialties": [
"Internal Medicine",
"Pulmonary Disease"
],
"subspecialties": [
"Pulmonary Disease",
"General Pulmonary Disease"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Neurology"
} | [
"1. Patient is a 40-year-old woman.",
"2. Patient has been experiencing frequent headaches and fatigue for a month.",
"3. Headaches are mild and occur at random times.",
"4. Headaches are relieved by over the counter analgesics.",
"5. Patient feels tired most of the time.",
"6. Patient sometimes gets shor... | [
"1. Her headaches are mild.",
"2. Her headaches occur at random times.",
"3. Her headaches are relieved by over the counter analgesics.",
"4. She feels tired most of the time.",
"5. She sometimes gets short of breath with exertion.",
"6. She denies low mood.",
"7. She denies loss of interest.",
"8. Sh... | |
42 | What is the most logical diagnostic test for this patient? | [
"A 25-year-old woman complains of dyspnea and mild chest pain on exertion, which increases gradually with continued exertion.",
"She had similar symptoms last year and her medical record included the following arterial blood gas findings: | pH 7.51 | pO2 77 mm Hg | pCO2 32 mm Hg | An ECG last year demonstrated a... | 5 | {
"A": "Echocardiography",
"B": "Holter monitoring",
"C": "Lung biopsy",
"D": "Transbronchial biopsy"
} | Echocardiography | A | {
"gender": "Female",
"age": "25",
"specialties": [
"Cardiology",
"Internal Medicine"
],
"subspecialties": [
"Pulmonary Disease",
"General Cardiology",
"Adult Congenital Heart Disease",
"Echocardiography"
],
"specialty_prob": [
0.6,
0.4
],
"subspecialty_prob": [
0.4,
0.2,
0.2,
0.2
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is a 25-year-old woman.",
"2. Patient complains of dyspnea and mild chest pain on exertion, which increases gradually with continued exertion.",
"3. Patient had similar symptoms last year.",
"4. Medical record included arterial blood gas findings of pH 7.51, pO2 77 mm Hg, and pCO2 32 mm Hg.",
"5... | [
"1. She had similar symptoms last year",
"2. Her medical record included the following arterial blood gas findings: pH 7.51, pO2 77 mm Hg, pCO2 32 mm Hg",
"3. An ECG last year demonstrated a right axis deviation",
"4. The current chest X-ray showed enlarged pulmonary arteries but no parenchymal infiltrates",
... | |
43 | Which of the following is the most likely diagnosis? | [
"A 4-year-old boy is brought to the physician because of a progressive rash for 2 days.",
"The rash started behind the ears and now involves the trunk and extremities.",
"Over the past 4 days, he has had mild sore throat, red, itchy eyes, and headache.",
"He was born at term and has been healthy except for re... | 12 | {
"A": "Rubella",
"B": "Allergic drug reaction",
"C": "Scarlet fever",
"D": "Erythema infectiosum"
} | Rubella | A | {
"gender": "Male",
"age": "4 years old",
"specialties": [
"Pediatrics",
"Dermatology"
],
"subspecialties": [
"General Pediatrics",
"Pediatric Dermatology"
],
"specialty_prob": [
0.6,
0.4
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Dermatology"
} | [
"1. Patient is a 4-year-old boy.",
"2. Patient has had a progressive rash for 2 days.",
"3. Rash started behind the ears and now involves the trunk and extremities.",
"4. Patient has had mild sore throat, red, itchy eyes, and headache for 4 days.",
"5. Patient was born at term and has had recurrent episodes... | [
"1. The rash started behind the ears.",
"2. The rash now involves the trunk and extremities.",
"3. Over the past 4 days, the patient has had a mild sore throat.",
"4. Over the past 4 days, the patient has had red, itchy eyes.",
"5. Over the past 4 days, the patient has had a headache.",
"6. The patient wa... | |
44 | Which of the following should be monitored as the patient continues treatment? | [
"A 66-year-old man presents to the office complaining of fatigue.",
"He reports that for the past year he has been experiencing a progressive decrease in energy.",
"This week he began having some difficulty breathing while climbing the stairs.",
"He denies chest pain or palpitations.",
"He has no other chro... | 9 | {
"A": "Creatinine",
"B": "Fecal leukocytes",
"C": "Neutrophil count",
"D": "Peak flow"
} | Neutrophil count | C | {
"gender": "Male",
"age": "66 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Nephrology",
"Geriatric Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 66-year-old man presents to the office complaining of fatigue.",
"2. He reports that for the past year he has been experiencing a progressive decrease in energy.",
"3. This week he began having some difficulty breathing while climbing the stairs.",
"4. He denies chest pain or palpitations.",
"5. He ha... | [
"1. Patient reports progressive decrease in energy for the past year.",
"2. Patient began having difficulty breathing while climbing stairs this week.",
"3. Patient denies chest pain or palpitations.",
"4. Patient has no other chronic medical conditions.",
"5. Patient has had no prior surgeries.",
"6. Pat... | |
45 | The molecular structure of the drug most likely recommended by the physician closely resembles a drug used to treat which of the following conditions? | [
"A 15-year-old girl comes to the physician for a follow-up evaluation.",
"She has multiple erythematous pustules and nodules over her face, for which she has received erythromycin and topical benzoyl peroxide.",
"She is concerned that the therapy is ineffective.",
"The physician recommends a drug on the condi... | 4 | {
"A": "EGFR-positive non-small cell lung cancer",
"B": "Acute promyelocytic leukemia",
"C": "BRAF-positive metastatic melanoma",
"D": "Choriocarcinoma"
} | Acute promyelocytic leukemia | B | {
"gender": "Female",
"age": "15 years old",
"specialties": [
"Internal Medicine",
"Pediatrics"
],
"subspecialties": [
"Medical Oncology",
"Pediatric Hematology"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 15-year-old girl comes to the physician for a follow-up evaluation.",
"2. She has multiple erythematous pustules and nodules over her face.",
"3. She has received erythromycin and topical benzoyl peroxide.",
"4. She is concerned that the therapy is ineffective.",
"5. The physician recommends a drug.",... | [
"1. The patient has multiple erythematous pustules and nodules over her face.",
"2. The patient has received erythromycin and topical benzoyl peroxide for her condition.",
"3. The patient is concerned that the therapy is ineffective.",
"4. The physician recommends a drug for the patient.",
"5. The physician... | |
46 | A biopsy of one of this lesion would most likely reveal which of the following? | [
"A 62-year-old female presents to her primary care provider complaining of a mass near her right jaw.",
"She reports that the mass is painless and has grown very slowly over the past six months.",
"She initially did not see a physician due to being very busy at her work as a lawyer.",
"However, she reports th... | 10 | {
"A": "Cystic configurations of anaplastic squamous and mucoid cells",
"B": "Non-infiltrative clusters of epithelial and mesenchymal cells",
"C": "Epithelial cells with dense lymphoid stroma and germinal centers",
"D": "Uniform spindle cells with scant cytoplasm and cigar-shaped nuclei"
} | Cystic configurations of anaplastic squamous and mucoid cells | A | {
"gender": "Female",
"age": "62 years old",
"specialties": [
"Pathology"
],
"subspecialties": [
"Dermatopathology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Otolaryngology"
} | [
"1. Patient is a 62-year-old female.",
"2. Patient presents with a mass near her right jaw.",
"3. Mass is painless and has grown slowly over the past six months.",
"4. Patient initially did not see a physician due to being very busy at her work as a lawyer.",
"5. Patient noticed some right-sided facial weak... | [
"1. The mass is painless.",
"2. The mass has grown very slowly over the past six months.",
"3. She initially did not see a physician due to being very busy at her work as a lawyer.",
"4. She noticed some right-sided facial weakness in the past week.",
"5. Her past medical history is notable for Hodgkins lym... | |
47 | Which of the following additional findings would most likely be present in this patient? | [
"A 29-year-old woman presents with low-grade fever, rash, and joint pain.",
"She says her symptoms started gradually about 3 months ago and have progressively worsened.",
"The patient describes her rash as pruritic, flat, and localized to her face.",
"She reports a different type of rash on her shoulders and ... | 13 | {
"A": "Swelling and proliferation of endothelial and mesangial cells in portions of each glomerulus with neutrophil infiltration",
"B": "Immunologically mediated destruction of the salivary glands",
"C": "Abnormal accumulation of fibrous tissue in the skin and multiple organs",
"D": "Amyloid deposits within the myocardium between the muscle fibers"
} | Swelling and proliferation of endothelial and mesangial cells in portions of each glomerulus with neutrophil infiltration | A | {
"gender": "Female",
"age": "29",
"specialties": [
"Rheumatology"
],
"subspecialties": [
"General Rheumatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is a 29-year-old woman.",
"2. Patient has low-grade fever, rash, and joint pain.",
"3. Symptoms started gradually about 3 months ago and have progressively worsened.",
"4. Rash is pruritic, flat, and localized to her face.",
"5. Different type of rash on her shoulders and arms that are aggravate... | [
"1. Symptoms started gradually about 3 months ago",
"2. Symptoms have progressively worsened",
"3. Rash is pruritic, flat, and localized to her face",
"4. Different type of rash on shoulders and arms aggravated by sunlight",
"5. Joint pain is moderate, dull, and aching in character",
"6. Joint pain mainly... | |
48 | The child likely has: | [
"A 3-year-old Cuban-American male has a history of recurrent Pseudomonas and Candida infections.",
"Laboratory analysis reveals no electrolyte abnormalities.",
"Examination of his serum shows decreased levels of IgG and CT scan reveals the absence of a thymus."
] | 3 | {
"A": "Severe combined immunodeficiency syndrome",
"B": "DiGeorge syndrome",
"C": "Isolated IgA deficiency",
"D": "Common variable immunodeficiency"
} | Severe combined immunodeficiency syndrome | A | {
"gender": "Male",
"age": "3 years old",
"specialties": [
"Pediatrics",
"Allergy and Immunology"
],
"subspecialties": [
"Immunology",
"Immunology and Allergy",
"General Allergy and Immunology"
],
"specialty_prob": [
0.6666666666666666,
0.3333333333333333
],
"subspecialty_prob": [
0.3333333333333333,
0.3333333333333333,
0.3333333333333333
],
"gpt_specialty": "Allergy and Immunology"
} | [
"1. Patient is a 3-year-old Cuban-American male.",
"2. Patient has a history of recurrent Pseudomonas and Candida infections.",
"3. Laboratory analysis reveals no electrolyte abnormalities.",
"4. Examination of patient's serum shows decreased levels of IgG.",
"5. CT scan reveals the absence of a thymus."
] | [
"1. Laboratory analysis reveals no electrolyte abnormalities.",
"2. Examination of his serum shows decreased levels of IgG.",
"3. CT scan reveals the absence of a thymus."
] | |
49 | Which of the following is the most likely underlying cause of the patient's condition?" | [
"A 7-year-old girl is brought to the physician for evaluation of recurrent epistaxis.",
"Her mother reports that she bruises easily while playing.",
"Her pulse is 89/min and blood pressure is 117/92 mm Hg.",
"Examination shows multiple bruises in the upper and lower extremities.",
"Laboratory studies show: ... | 6 | {
"A": "Glycoprotein Ib deficiency",
"B": "Vitamin K deficiency",
"C": "Von Willebrand factor deficiency",
"D": "ADAMTS13 deficiency"
} | Glycoprotein Ib deficiency | A | {
"gender": "Female",
"age": "7 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"Pediatric Hematology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Otolaryngology"
} | [
"1. A 7-year-old girl is brought to the physician for evaluation of recurrent epistaxis.",
"2. Her mother reports that she bruises easily while playing.",
"3. Her pulse is 89/min.",
"4. Her blood pressure is 117/92 mm Hg.",
"5. Examination shows multiple bruises in the upper and lower extremities.",
"6. L... | [
"1. Her mother reports that she bruises easily while playing.",
"2. Her pulse is 89/min.",
"3. Her blood pressure is 117/92 mm Hg.",
"4. Examination shows multiple bruises in the upper and lower extremities.",
"5. Platelet count is 100,000/mm3.",
"6. Prothrombin time is 12 seconds.",
"7. Partial thrombo... | |
50 | Which of the following is the most likely diagnosis? | [
"A 38-year-old woman comes to the emergency department because of progressive headache, blurry vision, and nausea for 1 day.",
"Four days ago, she was diagnosed with a right middle ear infection.",
"She appears lethargic.",
"Her temperature is 39.1°C (102.3°F), and blood pressure is 148/95 mm Hg.",
"Ophthal... | 8 | {
"A": "Cerebral venous thrombosis",
"B": "Hypertensive emergency",
"C": "Subarachnoid hemorrhage",
"D": "Viral meningitis"
} | Cerebral venous thrombosis | A | {
"gender": "Female",
"age": "38",
"specialties": [
"Neurology"
],
"subspecialties": [
"Vascular Neurology",
"Neurology with Special Qualification in Child Neurology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.5,
0.5
],
"gpt_specialty": "Neurology"
} | [
"1. A 38-year-old woman comes to the emergency department.",
"2. She has progressive headache, blurry vision, and nausea for 1 day.",
"3. Four days ago, she was diagnosed with a right middle ear infection.",
"4. She appears lethargic.",
"5. Her temperature is 39.1°C (102.3°F).",
"6. Her blood pressure is ... | [
"1. Four days ago, she was diagnosed with a right middle ear infection.",
"2. She appears lethargic.",
"3. Her temperature is 39.1°C (102.3°F).",
"4. Her blood pressure is 148/95 mm Hg.",
"5. Ophthalmologic examination shows bilateral swelling of the optic disc.",
"6. The corneal reflex in the right eye i... | |
51 | Which of the following features are not associated of Waardenburg’s syndrome? | [
"A 35-year-old female presents to your office for a routine physical.",
"She informs you that she is pregnant, and that the father of her child has Waardenburg’s syndrome.",
"She asks you about common findings in Waardenburg’s syndrome."
] | 3 | {
"A": "Heterochromia",
"B": "Conductive hearing loss",
"C": "Lateral displacement of inner canthi",
"D": "Broad nasal root"
} | Conductive hearing loss | B | {
"gender": "Female",
"age": "35",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"General Pediatrics",
"Clinical Genetics and Genomics"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6666666666666666,
0.3333333333333333
],
"gpt_specialty": "Medical Genetics and Genomics"
} | [
"1. A 35-year-old female presents to your office for a routine physical.",
"2. She informs you that she is pregnant.",
"3. The father of her child has Waardenburg's syndrome.",
"4. She asks you about common findings in Waardenburg's syndrome."
] | [
"1. The woman is pregnant.",
"2. The father of her child has Waardenburg’s syndrome.",
"3. She is asking about common findings in Waardenburg’s syndrome."
] | |
52 | Which of the following is the most likely underlying mechanism of this patient's fall? | [
"A 4-year-old boy is brought to the emergency department for evaluation after falling.",
"He has fallen multiple times in the last year.",
"His parents report that he did not walk until he was 18 months old.",
"Examination shows a mildly swollen right ankle with no tenderness over the medial or lateral malleo... | 6 | {
"A": "Loss of the ATM protein",
"B": "Absence of dystrophin protein",
"C": "Arylsulfatase A deficiency",
"D": "SMN1 gene defect"
} | Absence of dystrophin protein | B | {
"gender": "Male",
"age": "4 years old",
"specialties": [
"Pediatrics"
],
"subspecialties": [
"General Pediatrics",
"Pediatric Emergency Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6666666666666666,
0.3333333333333333
],
"gpt_specialty": "Pediatrics"
} | [
"1. A 4-year-old boy is brought to the emergency department for evaluation after falling.",
"2. He has fallen multiple times in the last year.",
"3. His parents report that he did not walk until he was 18 months old.",
"4. Examination shows a mildly swollen right ankle with no tenderness over the medial or la... | [
"1. He has fallen multiple times in the last year.",
"2. His parents report that he did not walk until he was 18 months old.",
"3. Examination shows a mildly swollen right ankle with no tenderness over the medial or lateral malleolus.",
"4. Range of motion is full with mild pain in the right ankle.",
"5. He... | |
53 | Administering succinylcholine during this procedure would most likely result in which of the following complications? | [
"A 25-year-old man is brought to the emergency department with second- and third-degree burns covering 30% of the surface area of his body.",
"He is alert and active.",
"He has no personal or family history of serious illness.",
"His temperature is 36.5°C (97.7°F), pulse is 62/min, respirations are 18/min, an... | 10 | {
"A": "Prolonged muscle weakness",
"B": "Malignant hyperthermia",
"C": "Cardiac arrhythmia",
"D": "Respiratory depression"
} | Cardiac arrhythmia | C | {
"gender": "Male",
"age": "25 years old",
"specialties": [
"Anesthesiology"
],
"subspecialties": [
"General Anesthesiology",
"Pain Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6666666666666666,
0.3333333333333333
],
"gpt_specialty": "Anesthesiology"
} | [
"1. A 25-year-old man is brought to the emergency department.",
"2. He has second- and third-degree burns covering 30% of the surface area of his body.",
"3. He is alert and active.",
"4. He has no personal or family history of serious illness.",
"5. His temperature is 36.5°C (97.7°F).",
"6. His pulse is ... | [
"1. The patient is alert and active.",
"2. The patient has no personal or family history of serious illness.",
"3. The patient's temperature is 36.5°C (97.7°F).",
"4. The patient's pulse is 62/min.",
"5. The patient's respirations are 18/min.",
"6. The patient's blood pressure is 105/70 mm Hg.",
"7. Pul... | |
54 | What ausculatory finding would explain the mechanism by which her more recent complaint occurred? | [
"A 32-year-old woman presents to the emergency department with 2 hours of left-sided weakness.",
"Her husband reports that she had been complaining of pain and swelling in her right calf for several weeks prior to this event.",
"The couple had recently returned from a vacation in Europe."
] | 3 | {
"A": "Holosystolic murmur radiating to the axilla",
"B": "Wide, fixed splitting of S2",
"C": "Crescendo-decrescendo murmur heard loudest at the right second intercostal space",
"D": "An S2 that splits during expiration"
} | Wide, fixed splitting of S2 | B | {
"gender": "Female",
"age": "32",
"specialties": [
"Internal Medicine",
"Neurology"
],
"subspecialties": [
"Neurology",
"Vascular Neurology"
],
"specialty_prob": [
0.6666666666666666,
0.3333333333333333
],
"subspecialty_prob": [
0.6666666666666666,
0.3333333333333333
],
"gpt_specialty": "Neurology"
} | [
"1. A 32-year-old woman presents to the emergency department.",
"2. She has had left-sided weakness for 2 hours.",
"3. Her husband reports she had been complaining of pain and swelling in her right calf for several weeks prior to this event.",
"4. The couple had recently returned from a vacation in Europe."
] | [
"1. The patient's husband reported her complaints of pain and swelling in her right calf.",
"2. The pain and swelling had been ongoing for several weeks before the event.",
"3. The couple had recently returned from a vacation in Europe."
] | |
55 | Which of the following hormones most likely is the cause of the postprandial aggravation of this patient's symptoms? | [
"A 41-year-old woman presents with pain in her abdomen for the last couple of hours.",
"She says pain is intermittent and localized to the right hypochondriac region.",
"She admits to eating fatty foods this morning before the pain started.",
"She also complains of nausea but has not vomited yet.",
"She des... | 9 | {
"A": "Somatostatin",
"B": "Cholecystokinin",
"C": "Gastrin",
"D": "Secretin"
} | Cholecystokinin | B | {
"gender": "Female",
"age": "41 years old",
"specialties": [
"Gastroenterology"
],
"subspecialties": [
"General Gastroenterology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Surgery"
} | [
"1. Patient is a 41-year-old woman.",
"2. Patient has been experiencing pain in her abdomen for the last couple of hours.",
"3. Pain is intermittent and localized to the right hypochondriac region.",
"4. Patient admits to eating fatty foods this morning before the pain started.",
"5. Patient also complains ... | [
"1. Pain is intermittent",
"2. Pain is localized to the right hypochondriac region",
"3. Ate fatty foods this morning before the pain started",
"4. Complains of nausea",
"5. Has not vomited yet",
"6. Episodes with similar symptoms in the past after a fatty meal were less severe",
"7. Past medical histor... | |
56 | Which of the following is the most likely causal pathogen? | [
"A 53-year-old man comes to the physician because of a 1-day history of fever and chills, severe malaise, and cough with yellow-green sputum.",
"He works as a commercial fisherman on Lake Superior.",
"Current medications include metoprolol and warfarin.",
"His temperature is 38.5°C (101.3°F), pulse is 96/min,... | 6 | {
"A": "Pseudomonas aeruginosa",
"B": "Streptococcus pyogenes",
"C": "Haemophilus influenzae",
"D": "Streptococcus pneumoniae"
} | Streptococcus pneumoniae | D | {
"gender": "Male",
"age": "53 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Pulmonary Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 53-year-old man comes to the physician.",
"2. He has a 1-day history of fever and chills, severe malaise, and cough with yellow-green sputum.",
"3. He works as a commercial fisherman on Lake Superior.",
"4. His current medications include metoprolol and warfarin.",
"5. His temperature is 38.5°C (101.3... | [
"1. He works as a commercial fisherman on Lake Superior.",
"2. Current medications include metoprolol and warfarin.",
"3. His temperature is 38.5°C (101.3°F).",
"4. His pulse is 96/min.",
"5. His respirations are 26/min.",
"6. His blood pressure is 98/62 mm Hg.",
"7. Examination shows increased fremitus... | |
57 | Which of the following is the most appropriate antibiotic to pair with the tamsulosin? | [
"A 46-year-old man presents to his physician because of persistent pelvic and scrotal pain for the past month.",
"He also has had occasional fevers, chills, dysuria, and increased urinary frequency over the last few months.",
"He was prescribed trimethoprim and sulfamethoxazole for the urinary symptoms, but he ... | 12 | {
"A": "Cefepime",
"B": "Gentamicin",
"C": "Levofloxacin",
"D": "Trimethoprim and sulfamethoxazole"
} | Levofloxacin | C | {
"gender": "Male",
"age": "46 years old",
"specialties": [
"Urology"
],
"subspecialties": [
"General Urology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Urology"
} | [
"1. Patient is 46 years old.",
"2. Patient has persistent pelvic and scrotal pain for the past month.",
"3. Patient has occasional fevers, chills, dysuria, and increased urinary frequency over the last few months.",
"4. Patient was prescribed trimethoprim and sulfamethoxazole for the urinary symptoms, but sti... | [
"1. The patient has had occasional fevers, chills, dysuria, and increased urinary frequency over the last few months.",
"2. The patient was prescribed trimethoprim and sulfamethoxazole for the urinary symptoms.",
"3. The patient is still having symptoms currently.",
"4. The patient is sexually active with mul... | |
58 | This drug is most likely to result in which of the following laboratory changes? | [
"A 29-year-old woman comes to the emergency department because of progressive numbness and weakness in her right arm and right leg for 1 day.",
"Two months ago, she had blurry vision and headache for a week, which resolved without treatment.",
"She does not smoke or drink alcohol.",
"Her temperature is 37°C (... | 7 | {
"A": "Monocytosis",
"B": "Lymphocytosis",
"C": "Eosinopenia",
"D": "Granulocytopenia"
} | Eosinopenia | C | {
"gender": "Female",
"age": "29",
"specialties": [
"Neurology"
],
"subspecialties": [
"Vascular Neurology",
"Neurology with Special Qualification in Child Neurology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.5,
0.5
],
"gpt_specialty": "Neurology"
} | [
"1. A 29-year-old woman comes to the emergency department.",
"2. She has progressive numbness and weakness in her right arm and right leg for 1 day.",
"3. Two months ago, she had blurry vision and headache for a week, which resolved without treatment.",
"4. She does not smoke or drink alcohol.",
"5. Her tem... | [
"1. Two months ago, she had blurry vision and headache for a week",
"2. The blurry vision and headache resolved without treatment",
"3. She does not smoke or drink alcohol",
"4. Her temperature is 37°C (98.6°F)",
"5. Her pulse is 78/min",
"6. Her respirations are 14/min",
"7. Her blood pressure is 115/7... | |
59 | Which of the following disorders does this patient potentially suffer from? | [
"A 30-year-old male biology graduate student was dismissed from his PhD program after 8 years because he was not able to produce a thesis, claiming that his data was never exactly how he wanted it.",
"He would spend weeks planning out a simple experiment, since everything had to be just right.",
"For many exper... | 4 | {
"A": "Schizoid personality disorder",
"B": "Narcissistic personality disorder",
"C": "Obsessive compulsive personality disorder",
"D": "Paranoid personality disorder"
} | Obsessive compulsive personality disorder | C | {
"gender": "Male",
"age": "30",
"specialties": [
"Psychiatry"
],
"subspecialties": [
"Obsessive compulsive personality disorder"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Psychiatry"
} | [
"1. A 30-year-old male biology graduate student was dismissed from his PhD program after 8 years.",
"2. He was not able to produce a thesis, claiming that his data was never exactly how he wanted it.",
"3. He would spend weeks planning out a simple experiment, since everything had to be just right.",
"4. For ... | [
"1. He spends weeks planning out a simple experiment.",
"2. Everything has to be just right for his experiments.",
"3. He starts over for many experiments because he feels he went out of order in adding reagents to his media for his cells.",
"4. He has had similar problems in his undergraduate courses.",
"5... | |
60 | Which of the following serum markers is most strongly associated with this patient’s condition? | [
"A 62-year-old male presents to his primary care physician complaining of an unintended 10-pound weight loss over the last 4 months.",
"He also reports vague abdominal discomfort, weakness, and occasional yellowing of his skin and eyes.",
"He has a history of cirrhosis secondary to alcohol abuse and hepatitis C... | 4 | {
"A": "Carcinoembryonic antigen (CEA)",
"B": "Cancer antigen 19-9 (CA 19-9)",
"C": "Alpha-fetoprotein (AFP)",
"D": "Beta-human chorionic gonadotropin (ß-HCG)"
} | Alpha-fetoprotein (AFP) | C | {
"gender": "Male",
"age": "62 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Gastroenterology",
"Medical Oncology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.6666666666666666,
0.3333333333333333
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 62-year-old male presents to his primary care physician.",
"2. He has experienced an unintended 10-pound weight loss over the last 4 months.",
"3. He reports vague abdominal discomfort, weakness, and occasional yellowing of his skin and eyes.",
"4. He has a history of cirrhosis secondary to alcohol abus... | [
"1. The patient reports vague abdominal discomfort.",
"2. The patient reports weakness.",
"3. The patient reports occasional yellowing of his skin and eyes.",
"4. The patient has a history of cirrhosis secondary to alcohol abuse.",
"5. The patient has a history of hepatitis C infection.",
"6. Physical exa... | |
61 | This study is best described as which of the following? | [
"A research group designed a study to investigate the epidemiology of syphilis in the United States.",
"The investigators examined the total number of cases of syphilis and genitourinary chlamydia in the United States using a national health survey of a nationally representative sample of US citizens conducted in... | 3 | {
"A": "Single-blind clinical trial",
"B": "Double-blind clinical trial",
"C": "Cross-sectional study",
"D": "Case-control study"
} | Cross-sectional study | C | {
"gender": "study",
"age": "study",
"specialties": [
"Internal Medicine",
"Pathology"
],
"subspecialties": [
"Infectious Disease",
"Medical Microbiology Pathology"
],
"specialty_prob": [
0.6,
0.4
],
"subspecialty_prob": [
0.6,
0.4
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A research group designed a study to investigate the epidemiology of syphilis in the United States.",
"2. The investigators examined the total number of cases of syphilis and genitourinary chlamydia in the United States.",
"3. The investigators used a national health survey of a nationally representative sa... | [
"1. The investigators examined the total number of cases of syphilis in the United States.",
"2. The investigators examined the total number of cases of genitourinary chlamydia in the United States.",
"3. The examination was based on a national health survey.",
"4. The survey was conducted in 2012.",
"5. Th... | |
62 | Which of the following is the best treatment for this patient’s condition while waiting for the ascitic fluid culture results? | [
"A 56-year-old African American male presents with altered mental status, abdominal pain, and a fever of 100.4F.",
"His past medical history is significant for alcohol use and cirrhosis of the liver.",
"Shifting dullness is noted on physical exam.",
"Paracentesis demonstrates serum ascites albumen gradient of... | 4 | {
"A": "Nadolol",
"B": "Cefotaxime",
"C": "Penicillin",
"D": "Gentamicin"
} | Cefotaxime | B | {
"gender": "Male",
"age": "56",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Infectious Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is 56-year-old African American male.",
"2. Patient presents with altered mental status, abdominal pain, and fever of 100.4F.",
"3. Patient has past medical history of alcohol use and cirrhosis of the liver.",
"4. Physical exam reveals shifting dullness.",
"5. Paracentesis demonstrates serum asc... | [
"1. His past medical history includes alcohol use.",
"2. His past medical history includes cirrhosis of the liver.",
"3. Shifting dullness is noted on physical exam.",
"4. Paracentesis demonstrates a serum ascites albumin gradient of 1.3 g/dL.",
"5. The ascitic fluid polymorphonuclear cell count is 280 cell... | |
63 | Which of the following additional findings is most likely in this patient? | [
"A 4-year-old boy who recently emigrated from Ghana is brought to the physician because of a 5-day history of pain and swelling in his hands.",
"He has had similar episodes in the past.",
"The patient appears distressed.",
"His temperature is 38.1°C (100.5°F).",
"Physical examination shows pallor.",
"The ... | 6 | {
"A": "Coronary artery aneurysm",
"B": "Hyperuricemia",
"C": "Thickened heart valves",
"D": "Microhematuria"
} | Microhematuria | D | {
"gender": "Male",
"age": "4 years old",
"specialties": [
"Pediatrics",
"Rheumatology"
],
"subspecialties": [
"Pediatric Rheumatology"
],
"specialty_prob": [
0.6,
0.4
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Pediatrics"
} | [
"1. A 4-year-old boy recently emigrated from Ghana.",
"2. He has a 5-day history of pain and swelling in his hands.",
"3. He has had similar episodes in the past.",
"4. The patient appears distressed.",
"5. His temperature is 38.1°C (100.5°F).",
"6. Physical examination shows pallor.",
"7. The dorsum of... | [
"1. He has had similar episodes in the past.",
"2. The patient appears distressed.",
"3. His temperature is 38.1°C (100.5°F).",
"4. Physical examination shows pallor.",
"5. The dorsum of his hands and fingers are swollen, warm, and tender to palpation."
] | |
64 | Which of the following is the most likely explanation for the laboratory findings in this patient? | [
"A 47-year-old woman is admitted to the hospital because of a 2-week history of low-grade fever, fatigue, and a 3-kg (6.6-lb) weight loss.",
"Her temperature is 38°C (100.4°F).",
"Physical examination shows pallor and a cardiac murmur.",
"Her serum creatinine is 1.8 mg/dL.",
"Urinalysis shows red cell casts... | 8 | {
"A": "Occlusion of renal arteries by cholesterol crystals",
"B": "Deposition of antigen-antibody complexes",
"C": "Intravascular fragmentation of red blood cells",
"D": "Hypersensitivity to penicillin haptens"
} | Deposition of antigen-antibody complexes | B | {
"gender": "Female",
"age": "47 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Infectious Disease",
"General Internal Medicine",
"Rheumatology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
0.4,
0.4,
0.2
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 47-year-old woman is admitted to the hospital.",
"2. She has a 2-week history of low-grade fever, fatigue, and a 3-kg (6.6-lb) weight loss.",
"3. Her temperature is 38°C (100.4°F).",
"4. Physical examination shows pallor and a cardiac murmur.",
"5. Her serum creatinine is 1.8 mg/dL.",
"6. Urinalysis... | [
"1. Her temperature is 38°C (100.4°F).",
"2. Physical examination shows pallor and a cardiac murmur.",
"3. Her serum creatinine is 1.8 mg/dL.",
"4. Urinalysis shows red cell casts and 2+ protein.",
"5. A CT scan of the abdomen with contrast shows no abnormalities.",
"6. Despite appropriate medical therapy... | |
65 | Which of the following nerve roots is most likely to be affected in this patient? | [
"A 36-year-old woman comes to the physician because of a 2-month history of progressively worsening lower back pain and weakness in the lower extremities.",
"The pain is worse with movement and improves with lying down on a flat surface.",
"She was diagnosed with pulmonary tuberculosis 6 months ago and is curre... | 6 | {
"A": "S2",
"B": "S1",
"C": "L3",
"D": "L4"
} | L4 | D | {
"gender": "Female",
"age": "36",
"specialties": [
"Neurology",
"Orthopaedic Surgery"
],
"subspecialties": [
"General Neurology",
"Neurology with Special Qualification in Child Neurology",
"Orthopaedic Sports Medicine"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.4,
0.4,
0.2
],
"gpt_specialty": "Neurology"
} | [
"1. A 36-year-old woman comes to the physician.",
"2. She has a 2-month history of progressively worsening lower back pain and weakness in the lower extremities.",
"3. The pain is worse with movement and improves with lying down on a flat surface.",
"4. She was diagnosed with pulmonary tuberculosis 6 months a... | [
"1. The pain is worse with movement.",
"2. The pain improves with lying down on a flat surface.",
"3. She was diagnosed with pulmonary tuberculosis 6 months ago.",
"4. She is currently taking isoniazid and rifampin.",
"5. Physical examination shows sensory loss over the lateral aspect of the mid-thigh, pate... | |
66 | Arterial blood gas analysis on room air shows: | pH 7.56 | PCO2 40 mm Hg | PO2 94 mm Hg | HCO3- 30 mEq/L | Measurement of which of the following is the most appropriate next step in diagnosis?" | [
"A 24-year-old primigravid woman at 8 weeks' gestation is brought to the emergency department because of a 5-day history of nausea and vomiting.",
"She has not been able to tolerate much food or drink.",
"Her symptoms are worse in the morning.",
"She has tried multiple oral antiemetics with limited relief.",
... | 8 | {
"A": "Serum osmolal gap",
"B": "Serum anion gap",
"C": "Urine albumin to urine creatinine ratio",
"D": "Urine chloride concentration"
} | Urine chloride concentration | D | {
"gender": "Female",
"age": "24 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Gastroenterology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Emergency Medicine"
} | [
"1. Patient is a 24-year-old primigravid woman.",
"2. Patient is 8 weeks' gestation.",
"3. Patient has a 5-day history of nausea and vomiting.",
"4. Patient has not been able to tolerate much food or drink.",
"5. Symptoms are worse in the morning.",
"6. Patient has tried multiple oral antiemetics with lim... | [
"1. She has not been able to tolerate much food or drink.",
"2. Her symptoms are worse in the morning.",
"3. She has tried multiple oral antiemetics with limited relief.",
"4. She has not had fevers, chills, abdominal pain, urinary symptoms, or diarrhea.",
"5. She appears tired.",
"6. Her temperature is 3... | |
67 | Which of the following is the most appropriate recommendation at this time? | [
"A 34-year-old pregnant woman, gravida 2, para 0, at 28 weeks of gestation presents to the physician for a prenatal visit.",
"She has not had regular prenatal care.",
"Her most recent abdominal ultrasound was at 20 weeks of gestation, and it confirmed accurate fetal dates and appropriate fetal development.",
... | 14 | {
"A": "Hepatitis A vaccination",
"B": "Plan to formula feed the newborn",
"C": "Start combination therapy with interferon α and ribavirin",
"D": "Undergo liver biopsy"
} | Hepatitis A vaccination | A | {
"gender": "Female",
"age": "34 years old",
"specialties": [
"Obstetrics and Gynecology"
],
"subspecialties": [
"General Obstetrics and Gynecology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Obstetrics and Gynecology"
} | [
"1. A 34-year-old pregnant woman presents to the physician for a prenatal visit.",
"2. She is gravida 2, para 0, and 28 weeks of gestation.",
"3. She has not had regular prenatal care.",
"4. Her most recent abdominal ultrasound was at 20 weeks of gestation.",
"5. The ultrasound confirmed accurate fetal date... | [
"1. She has not had regular prenatal care.",
"2. Her most recent abdominal ultrasound was at 20 weeks of gestation, and it confirmed accurate fetal dates and appropriate fetal development.",
"3. She takes levothyroxine for hypothyroidism.",
"4. She used to work as a nurse before she emigrated from Brazil 13 y... | |
68 | Which of the following does this screening test detect? | [
"A 36-year-old man presents with a 3-week history of fever, enlarged lymph nodes, fatigue, and a dry cough.",
"The patient’s wife says she has noticed that he lost a lot of weight over the last 6 months and seems very pale.",
"Over the last week, he has noticed a worsening non-productive cough and night sweats.... | 6 | {
"A": "Anti-HCV antigen",
"B": "Lactic dehydrogenase",
"C": "p24 antigen",
"D": "CCR5 mutation"
} | p24 antigen | C | {
"gender": "Male",
"age": "36 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Infectious Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. Patient is 36 years old.",
"2. Patient has a 3-week history of fever, enlarged lymph nodes, fatigue, and a dry cough.",
"3. Patient's wife has noticed weight loss and paleness over the last 6 months.",
"4. Patient has a worsening non-productive cough and night sweats over the last week.",
"5. Patient's ... | [
"1. The patient has lost a lot of weight over the last 6 months.",
"2. The patient seems very pale.",
"3. Over the last week, the patient has noticed a worsening non-productive cough and night sweats.",
"4. The patient's blood count shows anemia.",
"5. The patient's blood count shows low lymphocyte count.",... | |
69 | Laboratory studies show: | Hemoglobin 9 g/dL | Leukocyte count 1,500/mm3 | Percent segmented neutrophils 50% | Platelet count 85,000/mm3 | To reduce the likelihood of complications, it is most appropriate to administer which of the following? | [
"Seven days after initiation of induction chemotherapy for acute myeloid leukemia, a 56-year-old man develops leukopenia.",
"He feels well.",
"He has no history of serious cardiopulmonary disease.",
"His temperature is 36.7°C (98.1°F), blood pressure is 110/65 mm Hg, pulse is 72/min, and respiratory rate is 1... | 5 | {
"A": "Ciprofloxacin",
"B": "Granulocyte colony-stimulating factor",
"C": "Vancomycin",
"D": "No pharmaco-prophylaxis at this time"
} | Ciprofloxacin | A | {
"gender": "Male",
"age": "56 years old",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Hematology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Internal Medicine"
} | [
"1. A 56-year-old man developed leukopenia seven days after initiation of induction chemotherapy for acute myeloid leukemia.",
"2. He feels well.",
"3. He has no history of serious cardiopulmonary disease.",
"4. His temperature is 36.7°C (98.1°F).",
"5. His blood pressure is 110/65 mm Hg.",
"6. His pulse ... | [
"1. He feels well.",
"2. He has no history of serious cardiopulmonary disease.",
"3. His temperature is 36.7°C (98.1°F).",
"4. His blood pressure is 110/65 mm Hg.",
"5. His pulse is 72/min.",
"6. His respiratory rate is 14/min.",
"7. Examination of the skin reveals no abnormalities.",
"8. Examination ... | |
70 | Which of the following drugs most likely caused prolonged muscle paralysis in this patient? | [
"A 40-year-old man undergoes an elective cholecystectomy for repeated attacks of cholelithiasis over the last 5 years.",
"In the operating room, rapid sequence intubation is performed using a certain muscle relaxant to prevent aspiration of gastric contents.",
"During the procedure, atracurium is administered t... | 4 | {
"A": "Midazolam",
"B": "Pancuronium",
"C": "Succinylcholine",
"D": "Tubocurarine"
} | Succinylcholine | C | {
"gender": "Male",
"age": "40",
"specialties": [
"Anesthesiology"
],
"subspecialties": [
"General Anesthesiology"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Anesthesiology"
} | [
"1. A 40-year-old man underwent an elective cholecystectomy.",
"2. The man had repeated attacks of cholelithiasis over the last 5 years.",
"3. Rapid sequence intubation was performed using a certain muscle relaxant to prevent aspiration of gastric contents.",
"4. Atracurium was administered to maintain muscle... | [
"1. Rapid sequence intubation is performed in the operating room.",
"2. A muscle relaxant is used to prevent aspiration of gastric contents during rapid sequence intubation.",
"3. Atracurium is administered during the procedure to maintain muscle relaxation.",
"4. 1.5 hours after the operation, neostigmine is... | |
71 | The most likely pathology underlying this patient's symptoms is derived from which of the following embryonic layers? | [
"A 12-year-old boy is brought to the emergency department by ambulance after he was struck by a car while crossing the road.",
"He is found to have a femur fracture and multiple bruises on presentation, but he is alert and hemodynamically stable.",
"He says that the car \"came out of nowhere\" and that he has h... | 7 | {
"A": "Mesoderm",
"B": "Neural crest",
"C": "Neuroectoderm",
"D": "Surface ectoderm"
} | Surface ectoderm | D | {
"gender": "Male",
"age": "12 years old",
"specialties": [
"Neurology",
"Pediatrics"
],
"subspecialties": [
"Neurodevelopmental Disabilities",
"Pediatric Emergency Medicine"
],
"specialty_prob": [
0.8,
0.2
],
"subspecialty_prob": [
0.8,
0.2
],
"gpt_specialty": "Surgery"
} | [
"1. A 12-year-old boy was brought to the emergency department by ambulance.",
"2. He was struck by a car while crossing the road.",
"3. He has a femur fracture and multiple bruises on presentation.",
"4. He is alert and hemodynamically stable.",
"5. He says the car \"came out of nowhere\" and he has had mul... | [
"1. He is found to have a femur fracture on presentation.",
"2. He is found to have multiple bruises on presentation.",
"3. He is alert on presentation.",
"4. He is hemodynamically stable on presentation.",
"5. He says that the car \"came out of nowhere\".",
"6. He has had multiple similar near misses in ... | |
72 | Which of the following is most likely to be the underlying cause for the fracture in this patient? | [
"A 40-year-old man presents with left hip pain.",
"He says that symptoms started a month ago and have progressively worsened.",
"He says the pain has rendered him unable to report to work for the last 2 weeks.",
"The pain was initially 4/10 in intensity, dull with no radiation and was aggravated to 5/10 in in... | 13 | {
"A": "Trauma",
"B": "Chronic steroid use",
"C": "Metastatic lesion",
"D": "Sciatica"
} | Chronic steroid use | B | {
"gender": "Male",
"age": "40",
"specialties": [
"Orthopaedic Surgery"
],
"subspecialties": [
"Orthopaedic Sports Medicine"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Orthopaedic Surgery"
} | [
"1. Patient is a 40-year-old man.",
"2. Patient presents with left hip pain.",
"3. Symptoms started a month ago and have progressively worsened.",
"4. Pain has rendered him unable to report to work for the last 2 weeks.",
"5. Pain initially 4/10 in intensity, dull with no radiation.",
"6. Pain aggravated ... | [
"1. Symptoms started a month ago",
"2. Symptoms have progressively worsened",
"3. Pain has rendered him unable to report to work for the last 2 weeks",
"4. Pain was initially 4/10 in intensity",
"5. Pain was dull with no radiation",
"6. Pain was aggravated to 5/10 in intensity upon weight-bearing",
"7. ... | |
73 | Where was the thoracentesis needle most likely placed? | [
"A 78-year-old woman with a history of breast cancer, status-post bilateral mastectomy, presents to the emergency department with progressive difficulty breathing, worsening fatigue, and 5 pounds of unintended weight loss over the past month.",
"A portable chest x-ray reveals a massive right pleural effusion.",
... | 4 | {
"A": "Lower border of the 10th rib at the right midaxillary line",
"B": "Lower border of the 9th rib at the right midaxillary line",
"C": "Upper border of the 7th rib at the right midclavicular line",
"D": "Upper border of the 10th rib at the right midaxillary line"
} | Lower border of the 10th rib at the right midaxillary line | A | {
"gender": "Female",
"age": "78",
"specialties": [
"Internal Medicine"
],
"subspecialties": [
"Pulmonary Disease"
],
"specialty_prob": [
1
],
"subspecialty_prob": [
1
],
"gpt_specialty": "Radiology"
} | [
"1. A 78-year-old woman presents to the emergency department.",
"2. She has a history of breast cancer and a bilateral mastectomy.",
"3. She has progressive difficulty breathing and worsening fatigue.",
"4. She has lost 5 pounds in the past month.",
"5. A portable chest x-ray reveals a massive right pleural... | [
"1. A portable chest x-ray reveals a massive right pleural effusion.",
"2. The ED resident performs thoracentesis with chest tube placement.",
"3. The patient is admitted to the floor.",
"4. Overnight, the patient requests multiple pain medications for right upper abdominal pain.",
"5. The patient is found ... |
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MediQ: Question-Asking LLMs and a Benchmark for Reliable Interactive Clinical Reasoning
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