q_id int64 0 1.27k | source_id stringlengths 36 36 | question stringlengths 220 3.66k | cot_ids listlengths 16 16 | cots listlengths 16 16 | parsed_answers listlengths 16 16 | answer stringclasses 4
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0 | 11798523-ae15-4a7d-8e75-5281282aeadf | Question: A junior orthopaedic surgery resident is completing a carpal tunnel repair with the department chairman as the attending physician. During the case, the resident inadvertently cuts a flexor tendon. The tendon is repaired without complication. The attending tells the resident that the patient will do fine, and... | [
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"The situation involves a medical error—cutting a flexor tendon during a carpal tunnel repair. While the attending physician claims the complication is minor and not harmful to the patient, he is advising the resident to omit the incident from the operative report to avoid patient worry. This raises ethical c... | [
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1 | 248ec4d4-f0a8-4dea-a192-044d7572c5ef | Question: A 67-year-old man with transitional cell carcinoma of the bladder comes to the physician because of a 2-day history of ringing sensation in his ear. He received this first course of neoadjuvant chemotherapy 1 week ago. Pure tone audiometry shows a sensorineural hearing loss of 45 dB. The expected beneficial e... | [
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"The patient is a 67-year-old man with transitional cell carcinoma of the bladder who is experiencing a ringing sensation in his ear (tinnitus) and sensorineural hearing loss following a first course of neoadjuvant chemotherapy. The question asks about the mechanism of action of the drug responsible for these... | [
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2 | 9cee7247-3969-4d30-87ca-a3a281b0c342 | Question: Two weeks after undergoing an emergency cardiac catherization with stenting for unstable angina pectoris, a 61-year-old man has decreased urinary output and malaise. He has type 2 diabetes mellitus and osteoarthritis of the hips. Prior to admission, his medications were insulin and naproxen. He was also start... | [
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"The patient is a 61-year-old man with a history of type 2 diabetes mellitus and osteoarthritis. He recently underwent emergency cardiac catheterization with stenting for unstable angina. His symptoms now include decreased urinary output, malaise, fever, and mottled, reticulated purplish discoloration of the ... | [
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3 | 31fa2f2b-ece6-4cb9-bae9-ce3b5674c3d7 | Question: A 39-year-old woman is brought to the emergency department because of fevers, chills, and left lower quadrant pain. Her temperature is 39.1°C (102.3°F), pulse is 126/min, respirations are 28/min, and blood pressure is 80/50 mm Hg. There is blood oozing around the site of a peripheral intravenous line. Pelvic ... | [
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"The patient is a 39-year-old woman presenting with symptoms and signs consistent with a severe systemic infection. Key findings include fever, hypotension, tachycardia, tachypnea, and evidence of disseminated intravascular coagulation (DIC), as shown by thrombocytopenia, low fibrinogen, and elevated D-dimer.... | [
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4 | 5e6ac665-df6c-4f18-a9da-a2da14c074e5 | Question: A 35-year-old man comes to the physician because of itchy, watery eyes for the past week. He has also been sneezing multiple times a day during this period. He had a similar episode 1 year ago around springtime. He has iron deficiency anemia and ankylosing spondylitis. Current medications include ferrous sulf... | [
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"The patient presents with itchy, watery eyes and frequent sneezing, which are classic symptoms of allergic conjunctivitis. The history of a similar episode around springtime suggests a seasonal allergic component. The physical examination findings (bilateral conjunctival injection with watery discharge) also... | [
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5 | 7c935763-6195-4d87-8f6e-901a2202f058 | Question: A 39-year-old man presents to the emergency department because of progressively worsening chest pain and nausea that started at a local bar 30 minutes prior. The pain radiates to the epigastric area. He has a 5-year history of untreated hypertension. He has smoked 1 pack of cigarettes daily for the past 5 yea... | [
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"The patient is presenting with chest pain that radiates to the epigastric area, is diaphoretic, and in marked distress. These are concerning signs that could indicate an acute cardiac event, such as a myocardial infarction or aortic dissection. Given his history of hypertension, cocaine abuse, and smoking, h... | [
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6 | 35364bfb-187e-4be0-b8d2-55003927dc4c | "Question: A 68-year-old male comes to the physician for evaluation of right flank pain. He has a hi(...TRUNCATED) | [
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7 | b6db6af8-0047-41c9-85ef-7250c8f49197 | "Question: A 65-year-old man is brought to the emergency department 30 minutes after the onset of ac(...TRUNCATED) | [
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8 | e18c905c-70f2-4a44-8517-a16063c55aaa | "Question: A 37-year-old-woman presents to her primary care physician requesting a new form of birth(...TRUNCATED) | [
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9 | d4290264-c2e9-4fe0-8366-0440fde274c5 | "Question: A 23-year-old woman comes to the physician because she is embarrassed about the appearanc(...TRUNCATED) | [
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