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medqa_train_918 | medqa | USMLE (step1) | null | Researchers are investigating the mechanism of cell apoptosis and host defense in mice. They have observed that mice with certain gene deletions are not able to fight the induced viral infection. They identify a cell that is able to destroy target cells infected with viruses by exocytosis of granule contents, which ind... | C) CD8+ lymphocytes | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_924 | medqa | USMLE (step2&3) | null | A 17-year-old girl comes to the emergency department with a 5-day history of severe abdominal pain, cramping, nausea, and vomiting. She also has pain with urination. She is sexually active with one male partner, and they use condoms inconsistently. She experienced a burning pain when she last had sexual intercourse 3 d... | D) Pelvic inflammatory disease | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_932 | medqa | USMLE (step2&3) | null | A 39-year-old woman presents to her gynecologist for a routine visit. She has no complaints during this visit. She had an abnormal pap test 6 years ago that showed atypical squamous cells of undetermined significance. The sample was negative for human papillomavirus. On her follow-up Pap test 3 years later, there was n... | B) Cold knife conization | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_935 | medqa | USMLE (step2&3) | null | A 34-year-old man comes to the physician for a routine health maintenance examination. He was diagnosed with HIV 8 years ago. He is currently receiving triple antiretroviral therapy. He is sexually active and uses condoms consistently. He is planning a trip to Thailand with his partner to celebrate his 35th birthday in... | B) Measles, mumps, rubella vaccine | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_938 | medqa | USMLE (step1) | null | A 70-year-old Caucasian women presents to the emergency department complaining of abdominal pain. She is oriented to person but is slow to answer questions and cannot name her location. She is afebrile on exam and endorses mild suprapubic tenderness. Her urine culture was positive for leukocyte esterase and nitrites. S... | C) Trimethoprim-sulfamethoxazole | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_939 | medqa | USMLE (step2&3) | null | A previously healthy 26-year-old man is brought to the emergency department because of extreme agitation and confusion. He is unable to give a clear history. His mother says he returned from a hiking trip 4 weeks ago on which he also explored caves. Over the past few days, he has had generalized fever and malaise with ... | D) Immunoglobulin and vaccination administration | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_946 | medqa | USMLE (step1) | null | A 48-year-old woman with a history of osteoarthritis and hypertension presents to the office complaining of persistent abdominal pain for the last 2 months. She describes the pain as 'burning and achy' that is worse when she eats, which has lead to a weight loss of 4.5 kg (10.0 lb). The patient is currently taking lisi... | A) Chronic NSAID use | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_947 | medqa | USMLE (step2&3) | null | A 52-year-old male patient with chronic alcoholism presents to an ambulatory medical clinic, where the hepatologist elects to perform comprehensive hepatitis B screening, in addition to several other screening and preventative measures. Given the following choices, which serologic marker, if positive, would indicate th... | B) HBsAb | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_949 | medqa | USMLE (step2&3) | null | A 59-year-old man comes to the physician because of a painful, burning red rash on his face and hands, which developed 30 minutes after going outside to do garden work. He wore a long-sleeved shirt and was exposed to direct sunlight for about 10 minutes. The patient is light-skinned and has a history of occasional sunb... | C) Use of demeclocycline | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_952 | medqa | USMLE (step1) | null | A 26-year-old nurse presents 12 hours after she accidentally stuck herself with a blood-contaminated needle. She reported the accident appropriately and now seeks post-exposure prophylaxis. She does not have any complaints at the moment of presentation. Her vital signs include: blood pressure 125/80 mm Hg, heart rate 7... | C) Vm will stay the same, Km will increase | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_953 | medqa | USMLE (step1) | null | A 55-year-old man, who underwent a kidney transplant 2 years ago, presents in septic shock. He is compliant with his immunosuppressive therapy. He does not use any drugs and is sexually active with one male partner. His complete blood count returns as follows: Hemoglobin: 13.7 g/dL, white blood cell count: 4000 cells/m... | B) Decreased phagocytic cell count | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_955 | medqa | USMLE (step1) | null | A 65-year-old man with chronic obstructive lung disease, depression, and type 2 diabetes mellitus comes to the physician with fever, chills, dyspnea, and a productive cough for 5 days. His temperature is 38.8°C (101.8°F) and respirations are 30/min. An x-ray of the chest shows a right lower lobe infiltrate, and sputum ... | A) Multivitamin | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_959 | medqa | USMLE (step1) | null | A 10-month-old boy is brought to the clinic with a history of recurrent episodes of stridor and wheezing. His mother reports that his wheezing is exacerbated by crying, feeding, and flexion of the neck, and is relieved by extension of the neck. Occasionally he vomits after feeding. What is the most likely diagnosis?
A... | B) Double aortic arch | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_969 | medqa | USMLE (step2&3) | null | A 2-day old male newborn delivered vaginally at 36 weeks to a 29-year-old woman, gravida 3, para 2, has generalized convulsions lasting 2 minutes. Previous to the event, he had difficulty feeding and was lethargic. Pregnancy and delivery were uncomplicated. Apgar scores were 7 and 8 at 1 and 5 minutes, respectively. Pr... | A) Congenital toxoplasmosis | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_970 | medqa | USMLE (step1) | null | A 34-year-old woman makes an appointment with her gynecologist because she has been having foul smelling vaginal discharge. She says that the symptoms started about a week ago, but she can't think of any particular trigger associated with the onset of symptoms. She says that otherwise she has not experienced any pain o... | C) Oxidase-negative, facultative anaerobe | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_971 | medqa | USMLE (step2&3) | null | A previously healthy 2-year-old girl is brought to the physician by her mother after she noticed multiple painless, nonpruritic papules on her abdomen. The child attends daycare three times per week, and this past week one child was reported to have similar lesions. Her immunizations are up-to-date. Her brother had chi... | B) Molluscum contagiosum | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_976 | medqa | USMLE (step1) | null | A 65-year-old alcoholic male had been taken to the emergency room after he was found unconscious covered in vomitus. After regaining consciousness, he complained of a constant productive cough with foul-smelling sputum for the past few weeks. A chest x-ray(Image A) was taken and the patient was treated accordingly. The... | A) Gram-positive bacilli, motile, spore-forming, obligate anaerobe | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_989 | medqa | USMLE (step2&3) | null | A 23-year-old female presents to the emergency department with right lower abdominal pain that began suddenly one hour ago. She is writhing in discomfort and has vomited twice since arrival. She has no chronic medical conditions, but states she has had chlamydia two or three times in the past. Her abdomen is firm, and ... | C) Transvaginal ultrasound | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_993 | medqa | USMLE (step1) | null | A 41-year-old male with a history of pneumocystis jiroveci pneumonia is found to have multiple ring-enhancing lesions on brain CT. Which of the following is most likely responsible for this patient's abnormal scan?
A) Neoplasm
B) Bacteria
C) Virus
D) Protozoa | D) Protozoa | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_997 | medqa | USMLE (step1) | null | A 24-year-old woman presents to her primary care doctor with a lesion on her labia. She first noticed the lesion 2 days ago. It is not painful. She denies vaginal discharge or dysuria. She has no past medical history and takes no medications. She has had 4 sexual partners in the past 8 months and uses the pull-out meth... | C) Motile and helical-shaped bacteria | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_998 | medqa | USMLE (step1) | null | A 70-year-old man presents with fever, headache, and vomiting. He says that symptoms onset acutely 2 days ago and have not improved. He also reports associated weakness and chills. Past medical history is significant for occasional heartburn. His temperature is 39.4°C (103.0°F), the pulse rate is 124/min, the blood pre... | A) Ampicillin | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1000 | medqa | USMLE (step2&3) | null | A 66-year-old white man comes to the physician because of a 10-day history of fatigue and lower leg swelling. Over the past 6 months, he has had a 3.6-kg (8-lb) weight loss. He has chronic bronchitis and uses an albuterol inhaler as needed. He has smoked one pack of cigarettes daily for 44 years and drinks one alcoholi... | B) Membranous nephropathy | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1007 | medqa | USMLE (step1) | null | A 44-year-old Caucasian male presents with a fever, recent weight loss, and a cough productive of bloody sputum. A chest X-ray and CT scan were performed, revealing cavities near the apex of his lungs. The patient is started on rifampin, isoniazid, ethambutol and pyrazinamide. Formation of the cavities in the patient's... | A) TH1 cells | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1009 | medqa | USMLE (step2&3) | null | A 58-year-old chronic smoker known to have chronic bronchitis for the last 20 years presents to his physician for a scheduled follow-up visit. He mentions that over the last month he has been having difficulty breathing, especially after climbing stairs. He also says that he has had similar episodes in the past, which ... | A) Diltiazem | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1010 | medqa | USMLE (step1) | null | A 70-year-old man presents to the clinic with right-sided chest pain and difficulty breathing for the past 10 days. When it began, the pain was mild, but as time went on, it increased to a level at which the man found it difficult to breathe. Two years ago, he was diagnosed with clear cell carcinoma of the kidney. Vita... | D) Pleural effusion | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1011 | medqa | USMLE (step2&3) | null | A 1-month-old boy is brought in by his mother for episodes of “not breathing.” She reports noticing that the patient will occasionally stop breathing while he’s sleeping, and that these episodes have been occurring more frequently. The patient was born at 32 weeks due to placental insufficiency. He was in the neonatal ... | B) Impaired erythropoietin production | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1013 | medqa | USMLE (step2&3) | null | A 32-year-old man comes to the emergency department because of sharp chest pain for 3 days. The pain is retrosternal, 8 out of 10 in intensity, increases with respiration, and decreases while sitting upright and leaning forward. He has nausea and myalgia. He has not had fever or a cough. He has asthma and was treated f... | C) Cardiac tamponade | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1014 | medqa | USMLE (step2&3) | null | A 48-year-old man comes to the physician because of a 2-day history of an itchy rash. He has no history of skin problems. He had an upper respiratory infection 4 days ago that resolved with acetaminophen and over-the-counter cold medication. He has type I diabetes mellitus well-controlled with insulin. He was also diag... | D) Cutaneous mast cell activation | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1024 | medqa | USMLE (step1) | null | A 25-year-old woman comes to the physician because of a 2-day history of a burning sensation when urinating and increased urinary frequency. She is concerned about having contracted a sexually transmitted disease. Physical examination shows suprapubic tenderness. Urinalysis shows a negative nitrite test and positive le... | D) Staphylococcus saprophyticus | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1028 | medqa | USMLE (step1) | null | A 1-year-old immigrant girl presents to her pediatrician for a routine well-child check. She has not received any recommended vaccines since birth. She attends daycare and remains healthy despite her daily association with several other children for the past 3 months at a home daycare facility. Which of the following p... | A) Herd immunity | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1029 | medqa | USMLE (step1) | null | A pharmaceutical company has modified one of its existing antibiotics to have an improved toxicity profile. The new antibiotic blocks protein synthesis by first entering the cell and then binding to active ribosomes. The antibiotic mimics the structure of aminoacyl-tRNA. The drug is covalently bonded to the existing gr... | D) P site | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1046 | medqa | USMLE (step2&3) | null | A 28-year-old man presents to his primary care provider complaining of intermittent stomach pain, non-bloody diarrhea, and weight loss for the last 3 months. He has occasional abdominal pain and fever. This condition makes studying difficult. He has tried omeprazole and dietary changes with no improvement. Past medical... | C) Whipple’s disease | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1053 | medqa | USMLE (step2&3) | null | A 71-year-old man comes to the physician because of a 2-week history of fatigue and a cough productive of a blood-tinged phlegm. Over the past month, he has had a 5.0-kg (11-lb) weight loss. He has hypertension and type 2 diabetes mellitus. Eight months ago, he underwent a kidney transplantation. The patient does not s... | C) Trimethoprim/sulfamethoxazole | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1055 | medqa | USMLE (step1) | null | A 45-year-old male patient with a history of recurrent nephrolithiasis and chronic lower back pain presents to the ER with severe, sudden-onset, upper abdominal pain. The patient is febrile, hypotensive, and tachycardic, and is rushed to the OR for exploratory laporotomy. Surgery reveals that the patient has a perforat... | A) A gastrin-secreting tumor of the pancreas | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1058 | medqa | USMLE (step2&3) | null | A 23-year-old woman presents to her physician requesting the chickenpox vaccine. She is also complaining of nausea, malaise, and moderate weight gain. She developed these symptoms gradually over the past 2 weeks. She reports no respiratory or cardiovascular disorders. Her last menstruation was about 6 weeks ago. She ha... | C) Confirm pregnancy with serum beta-hCG and if positive, postpone administration of the vaccine until after completion of the pregnancy. | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1063 | medqa | USMLE (step1) | null | A 5-year-old African American female has experienced recurrent respiratory infections. To determine how well her cell-mediated immunity is performing, a Candida skin injection is administered. After 48 hours, there is no evidence of induration at the injection site. Of the following cell types, which one would have med... | B) T-cells | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1067 | medqa | USMLE (step1) | null | A group of microbiological investigators is studying bacterial DNA replication in E. coli colonies. While the cells are actively proliferating, the investigators stop the bacterial cell cycle during S phase and isolate an enzyme involved in DNA replication. An assay of the enzyme's exonuclease activity determines that ... | C) DNA polymerase I | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1069 | medqa | USMLE (step1) | null | An investigator is studying the outcomes of a malaria outbreak in an endemic region of Africa. 500 men and 500 women with known malaria exposure are selected to participate in the study. Participants with G6PD deficiency are excluded from the study. The clinical records of the study subjects are reviewed and their peri... | D) Glutamic acid substitution in the β-globin chain | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1070 | medqa | USMLE (step1) | null | A 45-year-old man comes to his primary care provider for a routine visit. The patient mentions that while he was cooking 5 days ago, he accidentally cut himself with a meat cleaver and lost the skin at the tip of his finger. After applying pressure and ice, the bleeding stopped and he did not seek treatment. The patien... | B) Deposition of type III collagen | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1071 | medqa | USMLE (step1) | null | An otherwise healthy 56-year-old woman comes to the physician because of a 3-year history of intermittent upper abdominal pain. She has had no nausea, vomiting, or change in weight. Physical examination shows no abnormalities. Laboratory studies are within normal limits. Abdominal ultrasonography shows a hyperechogenic... | C) Gallbladder carcinoma | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1075 | medqa | USMLE (step1) | null | A 31-year-old man comes to the physician because of a 2-day history of nausea, abdominal discomfort, and yellow discoloration of the eyes. Six weeks ago, he had an episode of fever, joint pain, swollen lymph nodes, and an itchy rash on his trunk and extremities that persisted for 1 to 2 days. He returned from a backpac... | A) Hepatitis B | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1076 | medqa | USMLE (step2&3) | null | A 49-year-old woman comes to the physician because of difficulty walking and dizziness for the past 2 weeks. She has also had fatigue, heartburn, and diarrhea for 4 months. The stools are foul-smelling and do not flush easily. Over the past 4 months, she has had a 2.2-kg (5-lb) weight loss. Her only medication is an ov... | A) Inactivation of pancreatic enzymes | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1081 | medqa | USMLE (step1) | null | An otherwise healthy 17-year-old girl comes to the physician because of multiple patches on her face, hands, abdomen, and feet that are lighter than the rest of her skin. The patches began to appear 3 years ago and have been gradually increasing in size since. There is no associated itchiness, redness, numbness, or pai... | D) Autoimmune destruction of melanocytes | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1082 | medqa | USMLE (step1) | null | A 9-year-old boy is brought to the emergency department by his parents after a 2-day history of fever, productive cough, and severe dyspnea. The parents report that the boy had no health problems at birth but developed respiratory problems as an infant that have continued throughout his life, including recurrent pulmon... | A) Adenovirus | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1085 | medqa | USMLE (step1) | null | A 45-year-old male presents to his primary care physician complaining of drainage from his left great toe. He has had an ulcer on his left great toe for over eight months. He noticed increasing drainage from the ulcer over the past week. His past medical history is notable for diabetes mellitus on insulin complicated b... | A) Otitis externa | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1089 | medqa | USMLE (step1) | null | An HIV-positive patient with a CD4+ count of 45 is receiving recommended first-line treatment for a case of cytomegalovirus retinitis. Coadministration with which of the following agents would be most likely to precipitate a deficiency of neutrophils in this patient?
A) Foscarnet
B) Zidovudine
C) Efavirenz
D) Raltegra... | B) Zidovudine | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1090 | medqa | USMLE (step1) | null | An investigator studying the immunologic profile of various cells notices that the blood of a test subject agglutinates upon addition of a serum containing antibodies against P blood group antigens. Infection with which of the following pathogens would most likely be prevented by these antibodies?
A) Parvovirus B19
B)... | A) Parvovirus B19 | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1092 | medqa | USMLE (step1) | null | A 25-year-old woman has dysuria, pyuria, increased frequency of urination, and fever of 1-day duration. She is sexually active. Urine cultures show gram-positive bacteria in clusters that are catalase-positive and coagulase-negative. The patient is started on trimethoprim-sulfamethoxazole. Which of the following charac... | D) Resistance to novobiocin | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1096 | medqa | USMLE (step2&3) | null | A 22-year-old primigravid woman comes to the physician for her initial prenatal visit at 12 weeks' gestation. She has had generalized fatigue and shortness of breath over the past 2 months. She has also had a tingling sensation in her toes for the past month. Three years ago, she was treated for gonorrhea. She follows ... | B) Vitamin B12 supplementation | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1099 | medqa | USMLE (step2&3) | null | Three days after undergoing coronary bypass surgery, a 67-year-old man becomes unresponsive and hypotensive. He is intubated, mechanically ventilated, and a central line is inserted. Vasopressin and noradrenaline infusions are begun. A Foley catheter is placed. Six days later, he has high unrelenting fevers. He is curr... | A) Central line-associated blood stream infection | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1104 | medqa | USMLE (step2&3) | null | A 7-year-old boy is brought to the physician for the evaluation of sore throat for the past 2 days. During this period, he has had intermittent nausea and has vomited once. The patient has no cough, hoarseness, or rhinorrhea. He had similar symptoms at the age of 5 years that resolved spontaneously. He is otherwise hea... | D) Obtain throat culture
" | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1106 | medqa | USMLE (step1) | null | A 2-year-old girl is brought to the physician by her parents because of clumsiness and difficulty walking. She began to walk at 12 months and continues to have difficulty standing still without support. She also appears to have difficulty grabbing objects in front of her. Over the past year, she has had 5 episodes of s... | B) Conjunctival telangiectasias | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1115 | medqa | USMLE (step1) | null | A 55-year-old man comes to the physician because of fever, fatigue, dry cough, headache, and myalgia over the past week. Two days ago, he developed several painful oral lesions and difficulty swallowing. He underwent kidney transplantation 3 years ago. His temperature is 38.2°C (100.7°F). Physical examination shows bil... | B) Histoplasma capsulatum | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1124 | medqa | USMLE (step2&3) | null | A 70-year-old woman comes to the physician for the evaluation of loss of urine for the last several months. She loses small amounts of urine without warning after coughing or sneezing. She also sometimes forgets the names of her relatives. She is retired and lives at an assisted-living facility. She has type 2 diabetes... | B) Urethral hypermobility | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1125 | medqa | USMLE (step2&3) | null | A 78-year-old man is brought to the emergency department because of a 3-week history of productive cough, swelling of the legs and feet, and fatigue. He has had progressive dyspnea on exertion for the past 2 months. Twelve years ago, he received a porcine valve replacement for severe mitral valve regurgitation. He has ... | C) Valve degeneration | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1129 | medqa | USMLE (step2&3) | null | A 25-year-old college student is diagnosed with acute myelogenous leukemia after presenting with a 3-week history of fever, malaise, and fatigue. He has a history of type 1 diabetes mellitus, multiple middle ear infections as a child, and infectious mononucleosis in high school. He currently smokes 1 pack of cigarettes... | C) Allopurinol | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1137 | medqa | USMLE (step1) | null | A 21-year-old man presents to a physician because of extreme fatigue, palpitations, fever, and weight loss. He developed these symptoms gradually over the past 3 months. His blood pressure is 110/80 mm Hg, heart rate is 109/min, respiratory rate is 17/min, and temperature is 38.1°C (100.6°F). The patient is emaciated a... | C) Chronic intravenous drug usage | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1147 | medqa | USMLE (step2&3) | null | A 28-year-old woman comes to the physician with a history of bright red blood in her stools for 3 days. She has defecated once per day. She does not have fever, pain on defecation, or abdominal pain. She was treated for a urinary tract infection with levofloxacin around 3 months ago. Menses occur at regular intervals o... | A) Docusate therapy | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1148 | medqa | USMLE (step1) | null | A 73-year-old female with no past medical history is hospitalized after she develops a fever associated with increasing shortness of breath. She states that 1 week prior, she had a cold which seemed to be resolving. Yesterday, however, she noticed that she started to feel feverish, measured her temperature to be 101.5°... | D) Protein-rich fluid | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1154 | medqa | USMLE (step1) | null | A 46-year-old man comes to the physician because of a 1-week history of headache, muscle pain, and recurrent fever spikes that occur without a noticeable rhythm. Two weeks ago, he returned from a 5-week-long world trip during which he climbed several mountains in India, Africa, and Appalachia. Chemoprophylaxis with chl... | B) Plasmodium falciparum | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1159 | medqa | USMLE (step1) | null | An infectious disease chairperson of a large hospital determines that the incidence of Clostridioides difficile infections at the hospital is too high. She proposes an initiative to restrict the usage of clindamycin in the hospital to determine if that lowers the incidence of C. difficile infections. She puts in place ... | D) Plan, do, study, act cycle | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1161 | medqa | USMLE (step1) | null | A previously healthy 3-month-old girl is brought to the physician because of fever, irritability, and rash for 3 days. The rash started around the mouth before spreading to the trunk and extremities. Her temperature is 38.6°C (101.5°F). Examination shows a diffuse erythematous rash with flaccid bullae on the neck, flex... | A) Toxin-induced cleavage of desmoglein | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1166 | medqa | USMLE (step1) | null | A 3-year-old boy is brought to the emergency room by his mother with fever and difficulty breathing after receiving the BCG vaccine. He has never had a reaction to a vaccine before. He has a history of 2 salmonella infections over the past 2 years. He was born at 35 weeks’ gestation and spent one day in the neonatal in... | B) Interferon gamma | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1171 | medqa | USMLE (step2&3) | null | A 32-year-old man comes to the physician because of severe burning with urination for the past 3 days. During this period, he has had clear urethral discharge early in the morning. He has no history of serious illness, except for a rash following treatment with erythromycin 20 years ago. The patient takes no medication... | D) Chlamydia trachomatis | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1173 | medqa | USMLE (step1) | null | A 24-year-old woman presents to her gynecologist complaining of mild pelvic discomfort and a frothy, yellowish discharge from her vagina for the past 2 weeks. She also complains of pain during sexual intercourse and sometimes after urination. Her past medical history is noncontributory. She takes oral contraceptives an... | D) Trichomoniasis | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1179 | medqa | USMLE (step1) | null | A previously healthy 9-year-old, Caucasian girl presents to your office with severe abdominal pain. Her mother also mentions that she has been urinating significantly less lately. History from the mother reveals that the girl suffers from acne vulgaris, mild scoliosis, and had a bout of diarrhea 3 days ago after a fami... | D) Shiga-like toxin production from EHEC | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1181 | medqa | USMLE (step1) | null | A 6-month-old girl has a weak cry, poor suck, ptosis, and constipation. Her condition began 2 days ago with a single episode of abundant watery stool and elevated temperature. The child was born at term to a healthy 26-year-old mother with an uneventful antenatal course and puerperium. The infant was exclusively breast... | C) Vegetative form of Clostridium botulinum spores in the patient's colon | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1195 | medqa | USMLE (step1) | null | A 30-year-old patient comes to the emergency room with a chief complaint of left chest pain and a productive cough with purulent sputum for 1 week. He also complains of shortness of breath. He said he had been previously diagnosed with influenza but did not follow the doctor’s instructions. His vitals include: heart ra... | B) Pneumonia | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1198 | medqa | USMLE (step1) | null | A 43-year-old Caucasian male spent the past month on a business trip in the Caribbean. Two weeks following his return, he began experiencing diarrhea, pain in his abdomen, and a headache. He presents to the hospital and is noted to be febrile with prominent rose-colored spots on his chest and abdomen. Following recover... | A) Gallbladder | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1205 | medqa | USMLE (step2&3) | null | A newborn is brought to the emergency department by his parents with violent vomiting. It started about 3 days ago and has slowly gotten worse. He vomits after most feedings but seems to keep some formula down. His mother notes that he is eager to feed between episodes and seems to be putting on weight. Other than an u... | D) Abdominal ultrasound; elongated pyloric channel and muscle hypertrophy | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1206 | medqa | USMLE (step1) | null | A 32-year-old pregnant woman presents to the clinic with complaints of cramping, abdominal pain, and severe watery diarrhea for the past 3 days. She also is nauseous and complains of fever and malaise. She was started on a 7-day course of amoxicillin after being admitted to the hospital for pyelonephritis 5 days ago. T... | D) Oral vancomycin | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1207 | medqa | USMLE (step2&3) | null | A 26-year-old woman (gravida 3 para 1) with no prenatal care delivers a boy at 37 weeks gestation. His Apgar score is 5 at 1 minute and 8 at 5 minutes. His weight is 2.1 kg (4.2 lb) and length is 47 cm (1 ft 7 in). The mother’s history is significant for chronic pyelonephritis, atrial fibrillation, and gastroesophageal... | D) Warfarin | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1210 | medqa | USMLE (step1) | null | A 17-year-old boy comes to the physician because of a nonpruritic rash on his chest for 1 week. He returned from a trip to Puerto Rico 10 days ago. He started using a new laundry detergent after returning. He has type 1 diabetes mellitus controlled with insulin. His mother has Hashimoto thyroiditis, and his sister has ... | B) Increased growth of Malassezia globosa | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1212 | medqa | USMLE (step1) | null | A 34-year-old man comes to the physician for evaluation of a rash on the elbows for several months. A biopsy of the affected area shows a thinned stratum granulosum as well as retained nuclei and spongiotic clusters of neutrophils in the stratum corneum. This patient's skin findings are most likely associated with whic... | A) Seronegative spondylarthropathy | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1217 | medqa | USMLE (step1) | null | During an experiment conducted to alter the infectivity of common viruses that affect humans, an investigator successfully increases the host range of human immunodeficiency virus (HIV). The new strain of the virus can infect fibroblast-like cells in addition to the usual target of HIV. Which of the following is the mo... | A) Mutation of the gene coding for viral surface glycoproteins | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1219 | medqa | USMLE (step2&3) | null | A 52-year-old man comes to the physician because his skin has been progressively yellowing for the past 4 weeks. He also reports low appetite and difficulty fitting into his pants because of his swollen legs over the past several months. There is no personal or family history of serious illness. He does not smoke and d... | A) Chronic viral hepatitis | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1221 | medqa | USMLE (step1) | null | A 32-year-old man comes to the physician for a follow-up examination 1 week after being admitted to the hospital for oral candidiasis and esophagitis. His CD4+ T lymphocyte count is 180 cells/μL. An HIV antibody test is positive. Genotypic resistance assay shows the virus to be susceptible to all antiretroviral therapy... | C) ↑ ↓ positive | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1222 | medqa | USMLE (step2&3) | null | A 21-year-old U.S. born first year medical student with no prior hospital or healthcare work presents to the physician for a routine physical exam. The patient is HIV negative, denies drug use, and denies sick contacts. The physician places a purified protein tuberculin test in the patient's right forearm intradermally... | C) 72 hours and 16mm diameter | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1226 | medqa | USMLE (step2&3) | null | A 42-year-old woman presents because of a painful mass she first noticed on her neck 1 week ago (see image). The mass has grown over the last few days. She has no history of serious illness and takes no medications. On physical exam, her temperature is 38.0°C (100.4°F), pulse is 86/min, respirations are 12/min, blood p... | D) Warthin-Starry silver stain for Bartonella henselae | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1228 | medqa | USMLE (step1) | null | A 28-year-old man presents with a draining abscess on his left jaw. The patient states that he had a “bad tooth” a few weeks ago which has progressed to his current condition. His vital signs include: blood pressure 110/80 mm Hg, heart rate 85/min, and temperature 37.9°C (100.3°F). On physical examination, the patient ... | D) Gram-positive, branching rod | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1244 | medqa | USMLE (step2&3) | null | A 26-year-old man is brought to the emergency department by his friends because of blurred vision and slurred speech for the past 6 hours. He had some difficulty swallowing his food during lunch and has weakness in both arms. Two weeks ago, he had an upper respiratory infection that resolved spontaneously. He lives ind... | C) Toxin that inhibits ACh release | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1260 | medqa | USMLE (step1) | null | A 22-year-old woman at 30 weeks gestation presents to the obstetrician with the sudden onset of fever, headache, anorexia, fatigue, and malaise. She mentioned that she had eaten ice cream 3 days ago. Blood cultures show gram-positive rods that are catalase-positive and display distinctive tumbling motility in liquid me... | B) Listeriosis | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1264 | medqa | USMLE (step1) | null | A 59-year-old man presents to the emergency room for a fever that has persisted for over 4 days. In addition, he has been experiencing weakness and malaise. His past medical history is significant for a bicuspid aortic valve that was replaced 2 years ago. Physical exam reveals nailbed splinter hemorrhages, tender nodul... | B) Dental procedures | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1265 | medqa | USMLE (step1) | null | A previously healthy 2-year-old boy is brought to the physician by his mother after 2 days of fever, runny nose, hoarseness, and severe, dry cough. He appears restless. His temperature is 38.1°C (100.5°F), and his respiratory rate is 39/min. Examination shows clear rhinorrhea and a barking cough. There is a prolonged i... | C) Parainfluenza virus | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1267 | medqa | USMLE (step2&3) | null | A 32-year-old man presents to the clinic for follow up for treatment of latent tuberculosis. He is a healthcare worker and began isoniazid 3 months ago after a routine PPD yielded a 12-mm induration. He feels otherwise well and attributes this to his vegetarian diet that he has been following for the past 4 years. His ... | B) Pyridoxine supplementation | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1271 | medqa | USMLE (step2&3) | null | An 11-month-old boy is brought to a pediatrician by his parents for evaluation of vomiting and watery diarrhea over the last day. The mother informs the pediatrician that the boy had consumed an apple bought from a fruit vendor on the previous day, but that otherwise there has been no recent change in his diet. There i... | A) Age-appropriate diet | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1273 | medqa | USMLE (step1) | null | A previously healthy 5-year-old boy is brought to the physician because of increasing weakness and a retroauricular rash that started 2 days ago. The rash spread rapidly and involves the trunk and extremities. Last week, he had a mild sore throat, pink eyes, and a headache. His family recently immigrated from Ethiopia.... | A) Togavirus | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1286 | medqa | USMLE (step2&3) | null | A 71-year-old African American man is brought to the emergency department with a worsening productive cough and dyspnea for 2 days. He has had generalized bone pain for 2 months. He was admitted for pyelonephritis last month. He also received outpatient treatment for pneumonia almost 2 months ago. Over the past 2 month... | B) Hypogammaglobulinemia | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1292 | medqa | USMLE (step2&3) | null | A 64-year-old woman has progressively worsening abdominal pain 5 hours after an open valve replacement with cardiopulmonary bypass. The pain is crampy and associated with an urge to defecate. The patient reports having had 2 bloody bowel movements in the last hour. Her operation was complicated by significant intraoper... | A) Decreased blood flow to the splenic flexure | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1299 | medqa | USMLE (step2&3) | null | A 13-year-old boy is brought to a physician with severe fevers and headaches for 3 days. The pain is constant and mainly behind the eyes. He has myalgias, nausea, vomiting, and a rash for one day. Last week, during an academic winter break, he traveled on a tour with his family to several countries, including Brazil, P... | C) Dengue fever | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1300 | medqa | USMLE (step2&3) | null | A 34-year-old male comes to his family physician with complaints of joint pain that has been present for over 7 weeks. Prior to the onset of his arthritis, he recalls having a gastrointestinal infection which caused mild diarrhea and abdominal cramps. He recovered well and had no issues until his joint pain started. A ... | B) Sulfasalazine | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1301 | medqa | USMLE (step2&3) | null | A 22-year-old man presents to the emergency department with a 2-day history of fever and altered mentation. He reports fever without chills and rigors and denies sore throat, abdominal pain, headache, loose stool, burning micturition, or seizures. He has a history of tics and is currently on a low dose of haloperidol. ... | D) Neuroleptic malignant syndrome | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1309 | medqa | USMLE (step2&3) | null | A 56-year-old man who underwent kidney transplantation 6 months ago, presents to the physician because of fever, dyspnea, non-productive cough, and lethargy. He is on no other medications apart from immunosuppressive therapy. On physical examination, the vital signs include: pulse 110/min, blood pressure 126/76 mm Hg, ... | B) Trimethoprim-sulfamethoxazole intravenously | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1313 | medqa | USMLE (step2&3) | null | Five days after admission into the ICU for drug-induced acute kidney injury, a 27-year-old woman develops fever. She is currently on a ventilator and sedatives. Hemodialysis is performed via a catheter placed in the right internal jugular vein. Feeding is via a nasogastric tube. An indwelling urinary catheter shows min... | B) Central catheter-related bacteremia | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1316 | medqa | USMLE (step1) | null | A 35-year-old woman presents to her physician with a complaint of pain and stiffness in her hands. She says that the pain began 6 weeks ago a few days after she had gotten over a minor upper respiratory infection. She admits that the pain is worse in the morning, and she occasionally notes subjective fever but has not ... | D) Prednisone | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1321 | medqa | USMLE (step1) | null | During a humanitarian medical mission in rural Vietnam, a medical resident encounters a 50-year-old man with a year-long history of a pruritic rash on his upper body and face, along with numbness and tingling sensation of both of his palms. He mostly works on his family’s rice farm, where he also takes care of livestoc... | C) Leprosy | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1323 | medqa | USMLE (step2&3) | null | An 87-year-old woman is brought to the emergency department 30 minutes after a fall onto a hardwood floor. She landed on her left side and hit the left side of her head. She did not lose consciousness. She has a mild headache over the left temple and severe left hip pain. She has had nasal congestion, a sore throat, an... | D) Blood loss | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1324 | medqa | USMLE (step1) | null | A 27-year-old male presents with primary complaints of a palpable mass in his scrotum and mild testicular pain. Physical exam reveals an abnormal appearing scrotum around the left testis, as depicted in image A. Which of the following is the most likely etiology of this presentation?
A) Compression of the left renal v... | A) Compression of the left renal vein at the aortic origin of the superior mesenteric artery | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1327 | medqa | USMLE (step2&3) | null | You have been asked to quantify the relative risk of developing bacterial meningitis following exposure to a patient with active disease. You analyze 200 patients in total, half of which are controls. In the trial arm, 30% of exposed patients ultimately contracted bacterial meningitis. In the unexposed group, only 1% c... | A) [30 / (30 + 70)] / [1 / (1 + 99)] | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
medqa_train_1328 | medqa | USMLE (step1) | null | A father brings in his 7-year-old twin sons because they have a diffuse rash. They have several papules, vesicles, pustules, and crusts on their scalps, torso, and limbs. The skin lesions are pruritic. Other than that, the boys appear to be well. The father reports that several children in school have a similar rash. T... | A) Bacterial superinfection of skin lesions | https://huggingface.co/datasets/GBaker/MedQA-USMLE-4-options |
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