Perturbed USMLE Dataset
Collection
MedQA dataset perturbed using knowledge-based synonym replacement technique with BAT • 3 items • Updated • 1
id stringlengths 11 11 | sent1 stringlengths 73 3.89k | sent2 float64 | ending0 stringlengths 1 230 | ending1 stringlengths 1 206 | ending2 stringlengths 1 251 | ending3 stringlengths 1 212 ⌀ | label int64 0 3 |
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train-00000 | A 23-year-old pregnant women at 22 weeks pregnancy presents with burning upon micturition. She states it started 1 day ago and has been worsening despite water consumption more hydrogen oxide and taking vaccinium macrocarpons extract. She otherwise feels well and is followed by a doctor for her pregnancies. Her tempera... | null | Ampicillin | Ceftriaxone | Doxycycline | Nitrofurantoin | 3 |
train-00001 | A 3-month-old baby died suddenly at night while asleep. His mothers noticed that he had died only after she awoke in the morning. No cause of end of life was determined based on the postmortem examinations. Which of the following precautions could have prevented the cardiac death of the baby?. | null | Placing the infant in a supine position on a firm mattress while sleeping | Keeping the infant covered and maintaining a high room temperature | Application of a device to maintain the sleeping position | Avoiding pacifier use during sleep | 0 |
train-00002 | A mothers brings her 3-week-old infants to the pediatrician's office because she is concerned about his feeding habit disturbance. He was born without coexistent conditions and has not had any medical problems up until this effect, long-term. However, for the past 4 days, he has been fussy, is regurgitating all of his ... | null | Abnormal migration of ventral pancreatic bud | Complete failure of proximal duodenum to recanalize | Abnormal hypertrophy of the pylorus | Failure of lateral body folds to move ventrally and fuse in the midline | 0 |
train-00003 | A pulmonary post-mortem examinations specimen from a 58-year-old women who died of acute hypoxic respiratory failure was examined. She had recently undergone peroperative procedures for a fractured trochanters 3 months ago. Initial hospitals course was uncomplicated, and she was discharged to a rehab facility in good n... | null | Thromboembolism | Pulmonary ischemia | Pulmonary hypertension | Pulmonary passive congestion | 0 |
train-00004 | A 20-year-old girls presents with heavy periods for the past several years. She says that her menses “have always been heavy”, and she has experienced easy bruising for as long as she can remember. kinship networks historical aspect is significant for her mother, who had similar problems with bruising easily. The patie... | null | Hemophilia A | Lupus anticoagulant | Protein C deficiency | Von Willebrand disease | 3 |
train-00005 | A 40-year-old zookeeper presents to the emergencies department complaining of severe abdominal burning pain that radiates to her back, and nausea. The burning pains started 2 days ago and slowly increased until she could not tolerate it any longer. Past medical historical aspect is significant for high blood pressure a... | null | Aspirin | Oral contraceptive pills | Scorpion sting | Hypothyroidism | 2 |
train-00006 | A 25-year-old primigravida presents to her physicians for a routine prenatal visit. She is at 34 weeks gestation, as confirmed by an x-ray diagnosis examination. She has no complaints, but notes that the new shoe she bought 2 weeks ago do not fit anymore. The course of her pregnancies has been uneventful and she has be... | null | Bilirubin assessment | Coagulation studies | Leukocyte count with differential | 24-hour urine protein | 3 |
train-00007 | A 3900-g (8.6-lb) males infants is delivered at 39 weeks' pregnancy via spontaneous vaginal delivery. pregnancies and delivery were uncomplicated but a prenatal radiography at 20 weeks showed a defect in the pleuroperitoneal tissues, membrane. Further evaluation of this patients is most likely to show which of the foll... | null | Gastric fundus in the thorax | Pancreatic ring around the duodenum | Hypertrophy of the gastric pylorus | Large bowel in the inguinal canal | 0 |
train-00008 | A 62-year-old women groups presents for a regular check-up. She complains of light headedness and palpitations which occur episodically. Past medical history is significant for a myocardial infarcts 6 months ago and NYHA class II chronic hearts failure. She also was diagnosed with grade I arterial high blood pressure 4... | null | Atenolol | Diltiazem | Propafenone | Digoxin | 3 |
train-00009 | A 35-year-old males presents to his primary care physicians with complaints of seasonal allergic reaction. He has been using intranasal vasoconstrictor drug several times per day for several weeks. What is a likely sequela of the chronic use of topical nasal decongestants?. | null | Epistaxis | Permanent loss of smell | Persistent nasal crusting | Persistent congestion | 3 |
train-00010 | A 46-year-old women comes to the physicians because of a 2-week historical aspects of diplopia, monocular and ocular burning pain when reading the newspapers. She also has a 3-month historical aspects of amenorrhea, hot flashes, and increased sweating. She research report that she has been overweight all her adults lif... | null | Granulomatous inflammation of the cavernous sinus | Abnormal communication between the cavernous sinus and the internal carotid artery | Glycosaminoglycan accumulation in the orbit | Sympathetic hyperactivity of levator palpebrae superioris
" | 2 |
train-00011 | A 1-year-old boy presents to the emergencies department with weakness and a change in his behaviors. His step-parent state that they first noticed the change in his processes, acceptance this morning and it has been getting worse. They noticed the clients was initially weak in his upper body and arms, but now he won’t ... | null | Autoantibodies against the presynaptic voltage-gated calcium channels | Autoimmune demyelination of peripheral nerves | Blockade of presynaptic acetylcholine release at the neuromuscular junction | Lower motor neuron destruction in the anterior horn | 2 |
train-00012 | A 9-month-old females is brought to the emergencies department after experiencing a tonic clonic seizure. She was born at home and was normal at childbirths according to her parental ages. Since then, they have noticed that she does not appear to be achieving developmental milestones as quickly as her siblings, and oft... | null | Anticipation | Multiple gene mutations | Pleiotropy | Variable expressivity | 2 |
train-00013 | A 23-year-old man comes to the physicians for evaluation of decreased hearing, dizziness, and ringing in his right ear for the past 6 months. Physical examination shows multiple soft, yellow plaques and papules on his arms, chest, and back. There is sensorineural audition loss and weakness of facial tissue, muscle bila... | null | Neural tube | Surface ectoderm | Neural crest | Notochord | 2 |
train-00014 | A 62-year-old women comes to the physicians because of coughing and lassitude during the past 2 years. In the morning, the coughs is productive of whites phlegm. She becomes short of breath ambulation up a flight of stairs. She has high blood pressure and dyslipidemia. She has recently retired from working as a nurses,... | null | Chronic decrease in pulmonary compliance | Local accumulation of kinins | Progressive obstruction of expiratory airflow | Incremental loss of functional residual capacity
" | 2 |
train-00015 | A 68-year-old man presents to the emergencies department with leg radiating pain. He states that the pains, splitting started suddenly while he was ambulation outside. The patients has a past medical aspects, historical of diabetes, hypertension, obesity, and atrial fibrillation. His temperatures is 99.3°F (37.4°C), bl... | null | Graded exercise and aspirin | Heparin drip | Surgical thrombectomy | Tissue plasminogen activator | 1 |
train-00016 | A 76-year-old African American man presents to his primary care provider complaining of urinary occurrence. He wakes up 3-4 times per night to urinate while he previously only had to wake up once per night. He also complains of post-void dribbling and difficulty initiating a river of urine. He denies any difficulty mai... | null | Hydrochlorothiazide | Midodrine | Oxybutynin | Tamsulosin | 3 |
train-00017 | A 68-year-old man comes to the physicians because of recurrent episodes of nausea and abdominal discomfort for the past 4 months. The discomfort is located in the upper abdomens and sometimes occurs after eating, especially after a big times, meal. He has tried to go for a walk after times, dinner to help with digestio... | null | Esophagogastroduodenoscopy | Hydrogen breath test | Cardiac stress test | Abdominal ultrasonography of the right upper quadrant | 2 |
train-00018 | A 27-year-old females presents to general medical clinic for a routine checkup. She has a genetic diseases marked by a mutations in a level, chloride ion transporter. She has a historical aspects of chronic bronchitides. She has a brothers with a similar aspects, historical of infestations and infections as well as sub... | null | It may result in corneal vascularization | It may result in the triad of confusion, ophthalmoplegia, and ataxia | It may be exacerbated by excessive ingestion of raw eggs | It may manifest itself as a prolonged PT | 3 |
train-00019 | A previously healthy 36-year-old man comes to the physicians for a yellow discoloration of his skin and dark-colored urinary levels for 2 weeks. He does not drink any alcohol. Physical examination shows hemolytic jaundices. Abdominal and neurologic examinations show no hypoplasia. serum, blood studies show increased le... | null | Bullous changes of the lung bases on chest CT | Beading of intra- and extrahepatic bile ducts on ERCP | Myocardial iron deposition on cardiovascular MRI | Dark corneal ring on slit-lamp examination | 0 |
train-00020 | A 69-year-old males presents to the emergencies room with back pain, splitting. He has a aspect, historical of personalities disorder and secondary prostates neoplasm, malignant and was not a candidate for surgical resection. He began drug therapy but discontinued due to unremitting nausea. He denies any bowel or bladd... | null | The most likely diagnosis is cauda equina syndrome and steroids should be started prior to MRI | The most likely diagnosis is cauda equina syndrome and steroids should be started after to MRI | The most likely diagnosis is cauda equina syndrome and the patient should be rushed to radiation | The most likely diagnosis is conus medullaris syndrome and steroids should be started prior to MRI | 0 |
train-00021 | An clinical investigator is studying the physiology of the lateral nucleus of the area, preoptico-hypothalamic in an experimental animals. Using a viral vector, the genetic material encoding chloride-conducting channelrhodopsin are injected into this nucleus. Photostimulation of the channels causality complete inhibiti... | null | Hypothermia | Hyperthermia | Polydipsia | Anorexia | 3 |
train-00022 | A 52-year-old women's groups comes to the physicians because of a 6-month historical aspects of generalized fatigue, low-grade fever, and a 10-kg (22-lb) weight loss. Physical examination shows generalized pallors and spleen, enlarged. Her eryhem concentration is 7.5 g/dL and white blood cell count is 41,800/mm3. leuko... | null | Cytokine-independent activation of the JAK-STAT pathway | Loss of function of the APC gene | Altered expression of the retinoic acid receptor gene | Unregulated expression of the ABL1 gene | 3 |
train-00023 | A 42-year-old women's group is in the hospitals recovering from a cholecystectomies performed 3 days ago that was complicated by cholangitides. She is being treated with IV piperacillin-tazobactam. She calls the nursing personnel to her room because she says that her hearts is racing. She also demands that someone come... | null | Acute cholangitis | Alcoholic hallucinosis | Delirium tremens | Hepatic encephalopathy | 2 |
train-00024 | A 48-year-old women groups comes to the emergencies department because of a photosensitive blistering rash, skin on her hands, forearms, and faces for 3 weeks. The lesions are not itchy. She has also noticed that her urine has been dark brown in colors recently. Twenty years ago, she was successfully treated for Coats ... | null | Pursue liver transplantation | Begin oral thalidomide therapy | Begin phlebotomy therapy | Begin oral hydroxychloroquine therapy | 2 |
train-00025 | A 53-year-old man comes to the emergencies department because of severe right-sided flank splitting pain for 3 hours. The pain, radiating is colicky, radiates towards his right groin, and he describes it as 8/10 in intensity. He has vomited once. He has no historical aspects of similar episodes in the past. Last year, ... | null | Urinary pH: 7.3 | Urinary pH: 4.7 | Positive nitrites test | Largely positive urinary protein | 1 |
train-00026 | A 5-year-old women's groups is brought to the clinic by her mothers for excessive animal fur postnatal growth. Her mothers report that for the past 2 months she has noticed lanugo at the axillary and pubic areas. She denies any step-parent families aspects, historical of precocious puberties and summary report that her... | null | Granulosa cell tumor | Idiopathic precocious puberty | McCune-Albright syndrome | Sertoli-Leydig tumor | 0 |
train-00027 | A 16-year-old boy is brought to the physicians by his mothers because she is worried about his acceptance processes. Yesterday, he was expelled from secondary schools for repeatedly skipping classes. Over the past 2 months, he was suspended 3 times for bullying, workplace and aggressive acceptance processes towards his... | null | Acting out | Projection | Passive aggression | Regression | 0 |
train-00028 | A 63-year-old women groups presents to her primary-care doctor for a 2-month historical aspect of light signal transduction, visual changes, specifically citing the gradual onset of double transduction, visual. Her double phototransduction, visual is present all the long-term effect and does not get better or worse thr... | null | Direct fundoscopy | Intraocular pressures | MR angiography of the head | Temporal artery biopsy | 2 |
train-00029 | An research personnel is studying the modification of newly formed polypeptide in plated eukaryotic cell. After the polypeptide are released from the ribosome, a chemically-tagged gene products, protein attaches covalently to acetate, lysine residues on the peptides chain, forming a modified polypeptides. When a barrel... | null | Glycosylation | Phosphorylation | Carboxylation | Ubiquitination | 3 |
train-00030 | A 38-year-old man presents to his physicians with double ocular vision persisting for a week. When he enters the exam room, the physicians notes that the client has a broad-based gaits. The man’s notification, spousal informs the doctor that he has been an skid row alcoholics for the last 5 years and his index, consume... | null | Decreased α-ketoglutarate dehydrogenase activity in astrocytes | Increased extracellular concentration of glutamate | Increased astrocyte lactate | Breakdown of the blood-brain barrier | 0 |
train-00031 | A 69-year-old man is brought by his son to the emergencies department with weakness in his right arm and leg. The man insists that he is fine and blames his son for "creating panic". Four hours ago the patients was having tea with his persons, married when he suddenly dropped his teacup. He has had difficulty moving hi... | null | Alteplase | Urokinase | Celecoxib | Clopidogrel | 3 |
train-00032 | A 70-year-old man presents to a medical clinic reporting blood in his urinary levels and lower abdominal pains, splitting for the past few days. He is also concerned about urinary prevalence and urgency. He states that he recently completed a cycle of drug therapies for non-Hodgkin malignant lymphoma. Which medication ... | null | Methotrexate | Rituximab | Cyclophosphamide | Prednisone | 2 |
train-00033 | A 27-year-old man presents to the emergencies department after a dog bites and stings. The client was intoxicated and pulled the dog’s tails while it was ingestion. The dog belongs to his acquaintances and is back at his friend’s house currently. Physical exam is notable for a dog sting on the patient’s right arm. The ... | null | Administer amoxicillin-clavulanic acid | Administer trimethoprim-sulfamethoxazole | Close the wound with sutures and discharge the patient | Discharge the patient with outpatient follow up | 0 |
train-00034 | A 19-year-old woman, accompanied by her parents, presents after a one-week aspects, historical of abnormal behavior, delusions, and unusual aggressions. She denies fever, atonic absence seizure or illicit pharmaceutical preparations use. reconstituted family aspect, historical is negative for psychiatric illnesses. She... | null | Intravenous hydration | Paracetamol | Stop risperidone | Switch risperidone to clozapine | 2 |
train-00035 | A 35-year-old women's groups comes to the physicians because of a 1-month aspects, historical of double vision, difficulty climbing stairs, and weakness when trying to brush her animal fur. She progress report that these findings are worse after she exercise, aerobic and disappear after she rest for a few hours. Physic... | null | Myasthenia gravis | Polymyositis | Amyotrophic lateral sclerosis | Multiple sclerosis | 0 |
train-00036 | A 6-year-old males who recently immigrated to the United States from asia, south is admitted to the hospitals with trepopnea. Physical exam reveals a gray pseudomembrane in the patient's oropharynxs along with adenopathies. The patients develops carditis and expires on hospitals day 5. Which of the following would have... | null | Increased CD4+ T cell count | Secretory IgA against viral proteins | Increased IgM preventing bacterial invasion | Circulating IgG against AB exotoxin | 3 |
train-00037 | A 12-year-old boy who recently emigrated from islamic republic of pakistan presents with fever, muscle tissues pain, and weakness of the trunk, abdomen, and leg. The patient’s mothers says that he has not been vaccinated. Physical examination reveals muscle fasciculations, skeletal and flaccid plegia of the lower extre... | null | Posterior horn cells of the spinal cord | Myelin sheath of neurons | Muscle cells | Anterior horn of the spinal cord | 3 |
train-00038 | A investigator is studying the properties of an enzymes that adds inorganic phosphates groups to glucose monohydrate. She discovers that the enzymes is present in most body tissue and is located in the cytoplasms of the cell expressing the biocatalysts. She decides to mix this enzymes under subphysiologic conditions wi... | null | High X and high Y | High X and low Y | Low X and high Y | Low X and low Y | 3 |
train-00039 | A 31-year-old G2P2 females at 40 weeks pregnancy presents to the hospitals following a rush of hydrogen oxide that chlorin e6 triacetoxymethyl ester from her vaginas. She is 4 cm dilated and 80% effaced. Fetal hearts tracing shows a pulses of 155/min with variable deceleration. About 12 hours after presentation, she gi... | null | Spermatogonia | Allantois | Syncytiotrophoblast | Sertoli cells | 3 |
train-00040 | A 43-year-old girls presents to the emergencies department complaining of palpitations, dry cough, and shortness of breath for 1 week. She immigrated to the United States from republic of korea at the age of 20. She says that her hearts is racing and she has never felt these findings before. Her coughs is dry and is as... | null | A bacterium that induces partial lysis of red cells with hydrogen peroxide | A bacterium that induces complete lysis of the red cells of a blood agar plate with an oxygen-sensitive cytotoxin | A bacterium that induces heme degradation of the red cells of a blood agar plate | A bacterium that requires an anaerobic environment to grow properly | 1 |
train-00041 | A males infants, newborn is being examined by a pediatricians. His mothers informs the doctor that she had a mild pyrexia with rash, tissue, muscle pain, and swollen and tender lymphs nodes during the second month of pregnancy. The boy was born at 39 weeks pregnancy via spontaneous vaginal delivery with no prenatal car... | null | Atrial septal defect | Ventricular septal defect | Tetralogy of Fallot | Patent ductus arteriosus | 3 |
train-00042 | A 4-year-old boy is brought to the emergencies department by his ages, parental. He is lethargic and confused and has a severe headache, vomiting, and a high-grade pyrexias since earlier that day. His mothers investigative reports that the children was doing well until 2 days ago when he developed a pyrexia and green n... | null | Production of IL-2 by Th1 cells | Activation of TCRs by MHC-II | Formation of C5-9 complex | Cleavage of C2 component of complement into C2a and C2b | 2 |
train-00043 | A 66-year-old women with chronic obstructive pulmonary diseases is brought to the emergencies department because of fever, body aches, malaise, and a dry coughs. She has smoked one pack of cigar daily for 30 years but quit habit, smoking 1 year ago. She lives with her sons and her granddaughter, who attends daycare. He... | null | Inhibition of nucleoside reverse transcriptase | Inhibition of proton translocation | Inhibition of neuraminidase | Inhibition of protease | 2 |
train-00044 | A 38-year-old women undergoes hemithyroidectomy for therapy of localized, well-differentiated papillary glands, thyroid malignant epithelial tumors. The lesion is removed with clear margins. However, during the surgery, a structure hoax directly adjacent to the superior thyroid gland arteries at the upper pole of the t... | null | Voice pitch limitation | Ineffective cough | Weakness of shoulder shrug | Shortness of breath | 0 |
train-00045 | A 27-year-old man presents to the emergencies room with persistent fever, nausea, and emesis for the past 3 days. While waiting to be seen, he quickly becomes disoriented and agitated. Upon examination, he has visible diagnosis of difficulty respiration with copious oral bodily secretions and generalized muscle tissue ... | null | Contaminated beef | Epiglottic cyst | Mosquito bite | Spelunking | 3 |
train-00046 | A 21-year-old man presents to the emergencies department after sustaining a stab research-related injuries to the necks at a local farmer's market. The client is otherwise healthy and is complaining of suffering, physical. The clients is able to offer the history himself. His temperatures is 97.6°F (36.4°C), blood pres... | null | CT angiogram | Intubation | Observation and blood pressure monitoring | Surgical exploration | 0 |
train-00047 | A 13-year-old woman presents to a medical office for the evaluation of a lump on the front of her necks. The client denies pain, but states that the mass bothers her because “it moves when I swallow”. The physical examination reveals a midline necks mass that is above the hyoid tissues, bone but below the level of the ... | null | Persistent thyroid tissue at the tongue base | Deletion of the 22q11 gene | Cyst formation in a persistent thyroglossal duct | Lymph node enlargement | 2 |
train-00048 | A 35-year-old women's group with a aspects, historical of Crohn diseases presents for a follow-up appointments and schedules. She says that lately, she has started to notice difficulty ambulation. She says that some of her friendships have joked that she appears to be ambulation as if she was drunk. Past medical histor... | null | Sporadic Creutzfeldt-Jakob disease (sCJD) | Variant Creutzfeldt-Jakob disease (vCJD) | Subacute sclerosing panencephalitis (SSPE) | Progressive multifocal encephalopathy (PML) | 3 |
train-00049 | A 23-year-old G1 at 10 weeks pregnancies based on her last menstrual period is brought to the emergencies department by her person, married due to sudden vaginal hemorrhages. She says that she has mild lower abdominal muscle cramps and is emotion dizzy and weak. Her blood pressures is 100/60 mm Hg, the pulses is 100/mi... | null | Rh immunization | Antiphospholipid syndrome | Chromosomal abnormalities | Trauma | 2 |
train-00050 | An 8-month-old boy is brought to a medical office by his mothers. The mothers states that the boy has been very fussy and has not been feeding recently. The mothers thinks the baby has been gaining weight despite not feeding well. The boy was delivered vaginally at 39 weeks pregnancy without associated disease. On phys... | null | Meckel diverticulum | DiGeorge syndrome | Duodenal atresia | Hirschsprung disease | 3 |
train-00051 | A 60-year-old man seeks evaluation at a medical office due to leg pains, splitting while ambulation. He says the crushing pains starts in his region, gluteal and extends to his thigh and down to his calves. Previously, the pain, radiating resolved with rest, but the physical suffering now persists in his feet, even dur... | null | Decreased permeability of endothelium | Narrowing and calcification of vessels | Peripheral emboli formation | Weakening of vessel wall | 1 |
train-00052 | A 52-year-old man presents to the emergencies department with thorax physical suffering radiating to his left jaw and arm. He states that he had experienced similar signs when playing netballs. The medical historical notes is significant for diabetes mellitus, hypertension, and GERD, for which he takes metformin, hydro... | null | Digoxin | Pantoprazole | Lisinopril | Nitroglycerin | 2 |
train-00053 | A 28-year-old women groups is brought to the hospitals by her boyfriend. She has had three days of pyrexia and headaches, vertex followed by one day of worsening bewilderment and hypnapompic hallucination. She also becomes agitated when offered hydrogen oxide. Her temperatures is 101°F (38.3°C). Two months prior to pre... | null | A killed vaccine within ten days of exposure | Oseltamivir within one week of exposure | Venom antiserum within hours of exposure | Doxycycline for one month after exposure | 0 |
train-00054 | A 60-year-old man comes to the physicians for an examination prior to a scheduled cholecystectomies. He has blood pressure, high treated with 2h-1,2,4-benzothiadiazine-7-sulfonamide, 6-chloro-3,4-dihydro-, 1,1-dioxide. His mothers had chronic granulomatous diseases of the lungs. He works in a glass manufacturing plants... | null | Perform arterial blood gas analysis | Perform CT-guided biopsy | Measure angiotensin-converting enzyme | Request previous chest x-ray | 3 |
train-00055 | You are examining a 3-day-old infant, newborn who was delivered vaginally without any sequels. The neonate presents with vomiting, hyperventilation, lethargy, and generalized tonic clonic seizures. blood work demonstrates hyperammonemia, elevated l glutamine levels, and decreased blood basodexan nitrogen. A CT scan dem... | null | Phenylalanine hydroxylase | Branched-chain ketoacid dehydrogenase | Cystathionine synthase | Carbamoyl phosphate synthetase I | 3 |
train-00056 | A 48-year-old man with HIV comes to the physicians because of skin lesions over his faces and necks for 2 weeks. They are not itchy or painful. He does not have fevers or a sore pharynxs. He was treated for candidal esophagitides 3 months ago. He is sexually active with his wife, who knows of his condition, and uses co... | null | Bartonella | Papillomavirus | Poxvirus | Coccidioides
" | 2 |
train-00057 | A 55-year-old man comes to the physicians because of lassitude and worsening abdominal migratory pains for 4 weeks. He also investigative reports excessive night sweat and a 5.4-kg (12-lb) weight loss during this effects, long term. He has a necks swelling for 4 days. Physical examination shows a nontender, enlarged, a... | null | Adult T-cell lymphoma | Burkitt lymphoma | Diffuse large B-cell lymphoma | Hodgkin lymphoma | 2 |
train-00058 | A 26-year-old G1P0 girl at 32-weeks pregnancies presents for follow-up x-ray diagnosis. She was diagnosed with gestational diabetes during her second trimester, but admits to poor glucose, (beta-d)-isomer prevention & control and non-adherence to regular insulin treatment. Fetal diagnostic imaging reveals an asymmetric... | null | Emergent open fetal surgery | Cardiac magnetic resonance imaging | Cardiac catheterization | Medical management | 3 |
train-00059 | A recent study attempted to analyze whether increased "patient satisfaction" driven healthcare deliveries resulted in increased hospitalizations. In this hospital, several of the wards adopted new aspects of "patient satisfaction" driven healthcare, whereas the remainder of the hospitals continued to use existing proto... | null | Prospective cohort | Retrospective case-control | Prospective case-control | Cross-sectional study | 0 |
train-00060 | A new screening, mass test utilizing a tele-icu approach to diagnosing diabetic retinopathy has been implemented in a diabetes clinic. An ophthalmologist’s exam was also performed on all patient as the gold standard for diagnosis, antemortem. In a aviator study of 500 patients, the signs test detected the presence of d... | null | Sensitivity = 83%, Specificity = 95%, PPV = 80%, NPV = 96% | Sensitivity = 83%, Specificity = 95%, PPV = 96%, NPV = 80% | Sensitivity = 80%, Specificity = 95%, PPV = 96%, NPV = 83% | Sensitivity = 95%, Specificity = 83%, PPV = 80%, NPV = 96% | 3 |
train-00061 | A healthy 22-year-old males participates in a development and research study you are leading to compare the properties of skeletal and cardiac tissues, muscle. You conduct a 3-phased experiment with the participant. In the first phase, you get him to lift up a 2.3 kg (5 lb) weight off a tables with his left hands. In t... | null | Recruitment of small motor units at the start of experiments 1 and 2 | Recruitment of large motor units followed by small motor units in experiment 1 | Fused tetanic contraction at the end of all three experiments | Increase of tension in all phases | 3 |
train-00062 | A 20-year-old males comes into your office two days after slip and fall during a pick up netballs game. The clients states that the lateral aspect of his knee collided with another player's knee. On exam, the patient's right knee appears the same size as his left knee without any swelling or effusion. The patients has ... | null | Posterior cruciate ligament | Anterior cruciate ligament | Medial collateral ligament | Lateral collateral ligament | 2 |
train-00063 | A 4-year-old boy is brought to the physicians because of swelling around his eye for 4 days. The swelling is most severe in the morning and milder by bedtime. Ten days ago, he had a sore pharynx that resolved spontaneously. His temperatures is 37°C (98.6°F), pulses is 103/min, and blood pressures is 88/52 mm Hg. Examin... | null | Enalapril therapy | Furosemide therapy | Anti-streptolysin O levels | Prednisone therapy | 3 |
train-00064 | An 18-year-old man comes to the clinic with his mom for “pins and needles” of both of his arm, upper. He denies any past medical historical notes besides a recent anterior cruciate interosseous ligament (ACL) meibomian lipid that was repaired 1 week ago. The patients research reports that the paresthesias, painful are ... | null | Loss of arm abduction | Loss of finger abducton | Loss of forearm flexion and supination | Loss of wrist extension | 3 |
train-00065 | A 9-year-old women groups is resuscitated after the administrative technics of an erroneous dose of intravenous hydantol for recurrent generalized tonic-clonic seizures. This incident is reported to the authorities. A thorough investigation reveals various causative factors leading to the event. One important finding i... | null | Closed-loop communication | Near miss | Root cause analysis | Sentinel event | 0 |
train-00066 | You are the team physicians for an NBA netballs team. On the morning of an important playoff game, an EKG of a star player, Mr. P, shows signs suspicious for hypertrophic myocardial disease (HCM). Mr. P is an otherwise healthy, fit, professional athlete.. . The playoff game that night is the most important of Mr. P... | null | Consult with a psychiatrist to have Mr. P committed | Call the police and have Mr. P arrested | Allow Mr. P to play against medical advice | Educate Mr. P about the risks of HCM | 3 |
train-00067 | A 37-year-old girl presents to the emergencies department complaining of generalized malaise, weakness, headache, nausea, vomiting, and diarrhea; she last felt well roughly two days ago. She is otherwise healthy, and takes no medications. Her vital diagnosis are: T 38.0, HR 96 beats per minute, BP 110/73, and O2 sat 96... | null | High-dose glucocorticoids | Cyclophosphamide and rituximab | Vancomycin and cefepime | Plasma exchange therapy | 3 |
train-00068 | A 5-week-old infants born at 36 weeks' pregnancies is brought to the physicians for a well-child examination. Her mothers report, investigative that she previously breast fed her for 15 minutes every 2 hours but now feeds her for 40 minutes every 4 hours. The infants has six wet diapers and two stools daily. She curren... | null | Prostaglandin E1 infusion | Indomethacin infusion | Surgical ligation | Percutaneous surgery | 1 |
train-00069 | A 51-year-old women's group comes to the physicians because of a 1-day historical aspects of right flank pain, crushing and bloody urine. Over the past 2 weeks, she has also developed progressive lower limb swelling and a 3-kg (7-lb) weight gain. She has a historical aspects of chronic hepatitides B infection, which wa... | null | Acquired factor VIII deficiency | Loss of antithrombin III | Impaired estrogen degradation | Antiphospholipid antibodies | 1 |
train-00070 | A 57-year-old man comes to the physicians for a follow-up evaluation of chronic, retrosternal thorax crushing pain. The aches is worse at night and after heavy supper. He has taken oral sk&f96022 for several months without any relief of his findings. procedure, endoscopic, digestive system, surgical shows ulcerations i... | null | Squamous epithelium in the bladder | Paneth cells in the duodenum | Branching muscularis mucosa in the jejunum | Disorganized squamous epithelium in the endocervix | 0 |
train-00071 | A 37-year-old women's group comes to the physicians because of a 6-month histories of weight loss, bloating, and diarrheas. She does not smoke or drink alcohol. Her vital symptoms are within normal limits. She is 173 cm (5 ft 8 in) tall and weighs 54 kg (120 lb); BMI is 18 kg/m2. Physical examination shows bilateral wh... | null | Gluten-free diet | Pancreatic enzyme replacement | Tetracycline therapy | Lactose-free diet | 1 |
train-00072 | A 52-year-old man presents for a routine checkup. Past medical historical aspects is remarkable for stage 1 systemic blood pressure, high and hepatitides A infection and infestation diagnosed 10 years ago. He takes aspirin, rosuvastatin, mk-421 daily, and a magnesium supplement every once in a while. He is planning to ... | null | The patient’s condition is due to consumption of water polluted with nitrates. | This condition resulted from primaquine overdose. | The condition developed because of his concomitant use of primaquine and magnesium supplement. | It is a type B adverse drug reaction. | 3 |
train-00073 | A 31-year-old woman, gravida 2, para 1, at 32 weeks' pregnancies comes to the emergencies department for sudden leakage of clear vaginal fluid. Her pregnancies has been uncomplicated. Her first children was born at term by vaginal delivery. She has no historical aspects of serious illness. She does not drink alcohol or... | null | Administer betamethasone, ampicillin, and proceed with cesarean section | Administer ampicillin and perform amnioinfusion | Administer betamethasone and ampicillin | Administer betamethasone, ampicillin, and proceed with induction of labor | 2 |
train-00074 | A 16-year-old girls is brought to the emergencies department by her friendships who say that she took a whole bottle of her mom’s medication. They do not know which medication it was she ingested. The clients is slipping in and out of consciousnesses and is unable to offer any history. Her temperatures is 39.6°C (103.2... | null | Naloxone | Dantrolene | Fenoldopam | Cyproheptadine | 1 |
train-00075 | A 68-year-old women is brought to the emergencies department because of fever, productive cough, and recumbent dyspnea for 3 days. She has had upper back splitting pain for 3 months, which is worse after activity. She takes ibuprofen, sodium salt for crushing pains relief. She has no histories of smoking behavior. The ... | null | Metastatic breast cancer | Multiple myeloma | Paget’s disease | Primary hyperparathyroidism | 1 |
train-00076 | A 22-year-old women's group presents to the emergencies department with a 2-day aspects, historical of severe blistering. She says that she woke up 2 days ago with a number of painful bullous lesion in her oral cavity and has since been continuing to develop bleb of her cutaneous skin all over her body and the membrane... | null | Cadherin | Collagen | Integrin | Keratin | 0 |
train-00077 | A 3-week-old boy is brought to the emergencies department by his parental age because of a 3-day aspects, historical of progressive lethargy and difficulty feeding. He was born at term and did not have difficulty feeding previously. His temperatures is 39.4°C (103°F), pulses is 220/min, respirations are 45/min, and blo... | null | Intramuscular epinephrine | Internal jugular vein cannulation | Intraosseous cannulation | Ultrasound-guided antecubital vein cannulation | 2 |
train-00078 | A previously healthy 10-year-old boy is brought to the emergencies room by his mothers 5 hours after the onset of abdominal suffering, physical and nausea. Over the past 2 weeks, he has also had progressive abdominal migratory pains and a 4-kg (8.8-lb) weight loss. The mothers summary reports that her son has been wate... | null | Decreased total body potassium | Increased total body sodium | Increased arterial pCO2 | Hypervolemia | 0 |
train-00079 | A 70-year-old Caucasian males visits your office regularly for disease management of New York hearts associations class IV congestive hearts failure. Which of the following medications would you add to this man's pharmaceutical preparations regimen in order to improve his overall survival?. | null | Spironolactone | Amiloride | Hydrochlorothiazide | Acetazolamide | 0 |
train-00080 | Several hours after vaginal delivery, a males newborn infant delivered at full-term develops tachycardias and tachypneas. His blood pressures is within normal limits. pulses pulse oximetries on room air shows an oxygen 16 saturation of 79% in the right hands and 61% in the left feet. Physical examination shows bluish d... | null | Sildenafil | Alprostadil | Metoprolol | Indomethacin | 1 |
train-00081 | A 5-year-old males visits his pediatricians for a check-up. His height corresponds to the 99th percentile for his age, and pubic hair, fetal is present upon physical examination. serums cryorenin and potassium levels are high, as is 17-hydroxyprogesterone. Which of the following is likely deficient in this patient?. | null | 17a-hydroxylase | 21-hydroxylase | Aromatase | 5a-reductase | 1 |
train-00082 | A 41-year-old African American girl presents with her married persons to her primary care doctor for evaluation of depressive symptom and anxieties, social. She report, field a 2-week history of rapid onset unhappiness with no clear inciting factor. She is accompanied by her spousal notification who notes that she has ... | null | Coproporphyrinogen III | Hydroxymethylbilane | Porphobilinogen | Protoporphyrin IX | 2 |
train-00083 | A 32-year-old girl presents to her primary care physicians for a general wellness appointments. The clients has no complaints currently and just wants to be sure that she is in good health, individual. The patients has a past medical aspects, historical of asthma, hypertension, and social anxiety. Her current medicatio... | null | Raise lisinopril dose | Add furosemide | Ultrasound with doppler | No additional management needed | 2 |
train-00084 | A 46-year-old man comes to the emergencies department because of a 10-day aspect, historical of right upper quadrant abdominal pain, burning. He has also been emotion tired and nauseous for the past 6 weeks. On examination, scleral jaundice is present. Abdominal examination shows tenderness to palpations in the right u... | null | Ribavirin and interferon | Supportive therapy | Emergency liver transplantation | Pegylated interferon-alpha | 1 |
train-00085 | A 5-year-old boy who recently emigrated from federal republic of nigeria is brought to the emergencies department because of a 2-day historical aspects of lower leg weakness, deglutition difficulty, and hypersalivation of salivas. He has not yet received any childhood immunizations, active. Two days after admission, th... | null | Positive Babinski sign | Hyporeflexia | Myoclonus | Pronator drift | 1 |
train-00086 | A 30-year-old women's groups is brought to the urgent care clinic by her wives. She complains of sensation, impaired around her philtrums and a tingling function, sensory in her hand and foot. She underwent near-total thyroidectomies for an enlarged glands, thyroid gland a month ago. Vital screening include: blood pres... | null | CT scan abdomen with pancreatic protocol | Serum vitamin D level | 24-hour urinary calcium | Serum parathyroid hormone (PTH) level | 3 |
train-00087 | A women groups with coronary arteries diseases is starting to go for a walk. As she begins, her hearts rate accelerates from a resting pulses of 60 bpm until it reaches a rate of 120 bpm, at which point she begins to feel a tightening in her thorax. She stops ambulation to rests and the tightening resolves. This has be... | null | Increasing the heart rate increases the amount of time spent during each cardiac cycle | Increasing the heart rate decreases the relative amount of time spent during diastole | Perfusion of the myocardium takes place primarily during systole | Perfusion of the myocardium takes place equally throughout the cardiac cycle | 1 |
train-00088 | A 22-year-old females presents to her physicians for evaluation of a vaginal discharge, itching, and irritation. She recently started a new relationship with her boyfriend, who is her only sexual partner. He does not field report any genitourinary signs. She takes oral effect, contraceptive and does not use barrier con... | null | Budding yeasts cells and/or pseudohyphae | Epithelial cells covered by numerous bacterial cells | Motile round or oval-shaped microorganisms | Chains of cocci | 2 |
train-00089 | A 53-year-old women's group with high blood pressures and hyperlipemias comes to the physicians because of generalized reddening of her skin and pruritis for the past 2 weeks. Her signs occur every evening before bedtime and last for about 30 minutes. Three months ago, (3r,5r)-7-(2-(4-fluorophenyl)-5-isopropyl-3-phenyl... | null | Administer ibuprofen | Measure urine hydroxyindoleacetic acid levels | Measure urine metanephrine levels | Switch niacin to fenofibrate | 0 |
train-00090 | Five days after undergoing right knee bone tunnel widening for osteoarthritis, a 68-year-old man has severe radiating pain in this right knee preventing him from participating in physical therapeutics. On the third postoperative day when the bandage was changed, the surgical trauma, physical appeared to be intact, slig... | null | Surgical debridement | Nafcillin therapy | Removal of prostheses | Antiseptic dressing
" | 0 |
train-00091 | A 53-year-old women's groups comes to the physicians in February because of a 1-day history of fever, chills, headache, and dry coughs. She also report, progress malaise and generalized muscle tissues burning pain. She works as a teacher at a local high school, where there was recently an outbreak of human influenzas. ... | null | Supportive therapy only | Amantadine | Inactivated influenza vaccine | Oseltamivir | 3 |
train-00092 | Red-green colors blindness, an X-linked recessive disorder, has an incidence, cumulative of 1/200 in male in a certain population, school age. What is the probabilities of a phenotypically normal males and females having a children with red-green colors blindness?. | null | 1/200 | 199/200 | 1/100 | 1/400 | 3 |
train-00093 | A 45-year-old man is transferred to the intensive care unit from the emergencies department for acute respiratory failure. He was rushed to the hospitals after developing progressive respiratory distress over the last 24 hours. His medical historical notes is significant for long-standing severe persistent asthma, hype... | null | Defects in the immune response | Aspergillus fumigatus suppresses the production of IgA | Aspergillus fumigatus suppresses the production of IgM | Suppression of the innate immune system by Aspergillus fumigatus | 0 |
train-00094 | A 70-year-old man comes to the physicians because of a 4-month historical aspects of epigastric pain, nausea, and weakness. He has smoked one pack of products, tobacco daily for 50 years and drinks one skid row alcoholics herbal tea daily. He appears emaciated. He is 175 cm (5 ft 9 in) tall and weighs 47 kg (103 lb); B... | null | TGF-β | IL-6 | IL-2 | TNF-β | 1 |
train-00095 | A 40-year-old women comes to the physicians because of a 1-week historical aspects of fatigue, dark urine, and a emotion of heaviness in her leg. Two weeks ago, she returned from a vacation to Brazil, where she spent most of her days exploring the city of Rio de Janeiro on feet. She also gained 3 kg (7 lb) during her v... | null | Venous insufficiency | Lymphatic obstruction | Renal protein loss | Salt retention | 3 |
train-00096 | A 67-year-old women with advanced bladder, urinary neoplasias comes to the physicians for a follow-up examination. She is currently undergoing drug therapy with an agent that form cross-links between DNA strands. serum, blood studies show a creatinine sulfate salt concentration of 2.1 mg/dL and a blood carbamide nitrog... | null | Mesna | Amifostine | Rasburicase | Leucovorin | 1 |
train-00097 | A 57-year-old post-menopausal girls comes to the physicians because of intermittent, bloody post-coital vaginal discharge for the past month. She does not have pain, splitting with intercourse. Eleven years ago, she had LSIL on a routine Pap smear and testing for high-risk HPV strain was positive. procedures, colposcop... | null | Squamous cell carcinoma | Basal cell carcinoma | Melanoma | Sarcoma botryoides | 0 |
train-00098 | Three days after starting a new drugs for plasmodium infection prophylaxis, a 19-year-old college enrollments, school comes to the physicians because of dark-colored urine and lassitude. He has not had any fever, dysuria, or abdominal radiating pains. He has no histories of serious illness. Physical examination shows s... | null | Primaquine | Dapsone | Ivermectin | Doxycycline | 0 |
train-00099 | You are reviewing raw data from a research priority study performed at your medical center examining the effectiveness of a novel acquired immuno deficiency syndrome signs examination. The study enrolled 250 clients with confirmed AIDS, and 240 of these patient demonstrated a positive screening, mass examination. The p... | null | 245 / (245 + 10) | 245 / (245 + 5) | 240 / (240 + 5) | 240 / (240 + 15) | 0 |
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MedQA dataset perturbed using knowledge-based synonym replacement technique with BAT
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