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pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nA 34-year-old woman is brought to the emergency department because of a 3-hour history of weakness, agitation, and slurred speech. She speaks slowly with frequent breaks and has difficulty keeping her eyes open. Over the past three days, she has had a sore throat, a runny nose, and a low-grade fever. She says her eyes and tongue have been “heavy” for the past year. She goes to bed early because she feels too tired to talk or watch TV after dinner. She appears pale and anxious. Her temperature is 38.0°C (100.4°F), pulse is 108/min, respirations are 26/min and shallow, and blood pressure is 118/65 mm Hg. On physical examination, there is bluish discoloration of her lips and around the mouth. Her nostrils dilate with every breath. The lungs are clear to auscultation. There is generalized weakness of the proximal muscles. Which of the following is the most appropriate next step in management?\nA. Intravenous immunoglobulin therapy\nB. Pyridostigmine therapy\nC. Plasmapheresis\nD. Endotracheal intubation\nE. Administration of edrophonium\n\"", "role": "user" } ]	medical	{ "ground_truth": "D. Endotracheal intubation", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Intravenous immunoglobulin therapy" }, { "key": "B", "value": "Pyridostigmine therapy" }, { "key": "C", "value": "Plasmapheresis" }, { "key": "D", "value": "Endotracheal intubation" }, { "key": "E", "value": "Administration of edrophonium\n\"" } ], "index": 6112, "question": "A 34-year-old woman is brought to the emergency department because of a 3-hour history of weakness, agitation, and slurred speech. She speaks slowly with frequent breaks and has difficulty keeping her eyes open. Over the past three days, she has had a sore throat, a runny nose, and a low-grade fever. She says her eyes and tongue have been “heavy” for the past year. She goes to bed early because she feels too tired to talk or watch TV after dinner. She appears pale and anxious. Her temperature is 38.0°C (100.4°F), pulse is 108/min, respirations are 26/min and shallow, and blood pressure is 118/65 mm Hg. On physical examination, there is bluish discoloration of her lips and around the mouth. Her nostrils dilate with every breath. The lungs are clear to auscultation. There is generalized weakness of the proximal muscles. Which of the following is the most appropriate next step in management?", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nA 65-year-old woman comes to the physician because of a 3-month history of intermittent palpitations and shortness of breath. Cardiopulmonary examination shows no other abnormalities. An ECG shows an absence of P waves, an oscillating baseline, and irregular RR intervals at a rate of approximately 95 beats per minute. The difference between atrial and ventricular rates in this patient is most likely due to which of the following?\nA. Temporary inactivation of Na+ channels in the AV node\nB. Inhibition of the Na+/K+-ATPase pump in ventricular cells\nC. Transient activation of K+ current in Purkinje fibers\nD. Limited speed of conduction through the left bundle branch\nE. Prolonged influx through voltage-gated Ca2+ channels in the bundle of His", "role": "user" } ]	medical	{ "ground_truth": "A. Temporary inactivation of Na+ channels in the AV node", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Temporary inactivation of Na+ channels in the AV node" }, { "key": "B", "value": "Inhibition of the Na+/K+-ATPase pump in ventricular cells" }, { "key": "C", "value": "Transient activation of K+ current in Purkinje fibers" }, { "key": "D", "value": "Limited speed of conduction through the left bundle branch" }, { "key": "E", "value": "Prolonged influx through voltage-gated Ca2+ channels in the bundle of His" } ], "index": 967, "question": "A 65-year-old woman comes to the physician because of a 3-month history of intermittent palpitations and shortness of breath. Cardiopulmonary examination shows no other abnormalities. An ECG shows an absence of P waves, an oscillating baseline, and irregular RR intervals at a rate of approximately 95 beats per minute. The difference between atrial and ventricular rates in this patient is most likely due to which of the following?", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nFrom which tendon is the graft typically taken for flexor tendon graft repair?", "role": "user" } ]	medical	{ "ground_truth": "Palmaris longus", "style": "rule" }	{ "choices": null, "index": 14749, "question": "From which tendon is the graft typically taken for flexor tendon graft repair?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nA 78-year-old left-handed woman with hypertension and hyperlipidemia is brought to the emergency room because of sudden-onset right leg weakness and urinary incontinence. Neurologic examination shows decreased sensation over the right thigh. Muscle strength is 2/5 in the right lower extremity and 4/5 in the right upper extremity. Strength and sensation in the face are normal but she has difficulty initiating sentences and she is unable to write her name. The most likely cause of this patient’s condition is an occlusion of which of the following vessels?\nA. Right anterior cerebral artery\nB. Right vertebrobasilar artery\nC. Left posterior cerebral artery\nD. Right middle cerebral artery\nE. Left anterior cerebral artery", "role": "user" } ]	medical	{ "ground_truth": "E. Left anterior cerebral artery", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Right anterior cerebral artery" }, { "key": "B", "value": "Right vertebrobasilar artery" }, { "key": "C", "value": "Left posterior cerebral artery" }, { "key": "D", "value": "Right middle cerebral artery" }, { "key": "E", "value": "Left anterior cerebral artery" } ], "index": 3315, "question": "A 78-year-old left-handed woman with hypertension and hyperlipidemia is brought to the emergency room because of sudden-onset right leg weakness and urinary incontinence. Neurologic examination shows decreased sensation over the right thigh. Muscle strength is 2/5 in the right lower extremity and 4/5 in the right upper extremity. Strength and sensation in the face are normal but she has difficulty initiating sentences and she is unable to write her name. The most likely cause of this patient’s condition is an occlusion of which of the following vessels?", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nA 54-year-old man presents with 3 days of non-bloody and non-bilious emesis every time he eats or drinks. He has become progressively weaker and the emesis has not improved. He denies diarrhea, fever, or chills and thinks his symptoms may be related to a recent event that involved sampling many different foods. His temperature is 97.5°F (36.4°C), blood pressure is 133/82 mmHg, pulse is 105/min, respirations are 15/min, and oxygen saturation is 98% on room air. Physical exam is notable for a weak appearing man with dry mucous membranes. His abdomen is nontender. Which of the following laboratory changes would most likely be seen in this patient?\nA. Anion gap metabolic acidosis and hypokalemia\nB. Metabolic alkalosis and hyperkalemia\nC. Metabolic alkalosis and hypokalemia\nD. Non-anion gap metabolic acidosis and hypokalemia\nE. Respiratory acidosis and hyperkalemia", "role": "user" } ]	medical	{ "ground_truth": "C. Metabolic alkalosis and hypokalemia", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Anion gap metabolic acidosis and hypokalemia" }, { "key": "B", "value": "Metabolic alkalosis and hyperkalemia" }, { "key": "C", "value": "Metabolic alkalosis and hypokalemia" }, { "key": "D", "value": "Non-anion gap metabolic acidosis and hypokalemia" }, { "key": "E", "value": "Respiratory acidosis and hyperkalemia" } ], "index": 6416, "question": "A 54-year-old man presents with 3 days of non-bloody and non-bilious emesis every time he eats or drinks. He has become progressively weaker and the emesis has not improved. He denies diarrhea, fever, or chills and thinks his symptoms may be related to a recent event that involved sampling many different foods. His temperature is 97.5°F (36.4°C), blood pressure is 133/82 mmHg, pulse is 105/min, respirations are 15/min, and oxygen saturation is 98% on room air. Physical exam is notable for a weak appearing man with dry mucous membranes. His abdomen is nontender. Which of the following laboratory changes would most likely be seen in this patient?", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nWhich condition is characterized by advanced bone age?", "role": "user" } ]	medical	{ "ground_truth": "Congenital adrenal hyperplasia", "style": "rule" }	{ "choices": null, "index": 15388, "question": "Which condition is characterized by advanced bone age?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nWhat is the first-line pharmacologic treatment for a 59-year-old woman presenting with a progressively worsening postural hand tremor, a family history of tremor, and otherwise normal neurological examination and laboratory studies?", "role": "user" } ]	medical	{ "ground_truth": "Primidone", "style": "rule" }	{ "choices": null, "index": 8363, "question": "What is the first-line pharmacologic treatment for a 59-year-old woman presenting with a progressively worsening postural hand tremor, a family history of tremor, and otherwise normal neurological examination and laboratory studies?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nA 68-year-old man presents to the emergency department with palpitations. He also feels that his exercise tolerance has reduced over the previous week. His past history is positive for ischemic heart disease and he has been on multiple medications for a long time. On physical examination, his temperature is 36.9°C (98.4°F), pulse rate is 152/min and is regular, blood pressure is 114/80 mm Hg, and respiratory rate is 18/min. Auscultation of the precordial region confirms tachycardia, but there is no murmur or extra heart sounds. His ECG is obtained, which suggests a diagnosis of atrial flutter. Which of the following findings is most likely to be present on his electrocardiogram?\nA. Atrial rate above 400 beats per minute\nB. Slurred upstroke of R wave\nC. Atrioventricular block\nD. No discernible P waves\nE. Wenckebach phenomenon", "role": "user" } ]	medical	{ "ground_truth": "C. Atrioventricular block", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Atrial rate above 400 beats per minute" }, { "key": "B", "value": "Slurred upstroke of R wave" }, { "key": "C", "value": "Atrioventricular block" }, { "key": "D", "value": "No discernible P waves" }, { "key": "E", "value": "Wenckebach phenomenon" } ], "index": 4940, "question": "A 68-year-old man presents to the emergency department with palpitations. He also feels that his exercise tolerance has reduced over the previous week. His past history is positive for ischemic heart disease and he has been on multiple medications for a long time. On physical examination, his temperature is 36.9°C (98.4°F), pulse rate is 152/min and is regular, blood pressure is 114/80 mm Hg, and respiratory rate is 18/min. Auscultation of the precordial region confirms tachycardia, but there is no murmur or extra heart sounds. His ECG is obtained, which suggests a diagnosis of atrial flutter. Which of the following findings is most likely to be present on his electrocardiogram?", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nCone of light focuses on which quadrant of tympanic membrane\nA. Anteroinferior\nB. Posteroinferior\nC. Anterosuperior\nD. Posterosuperior", "role": "user" } ]	medical	{ "ground_truth": "A. Anteroinferior", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Anteroinferior" }, { "key": "B", "value": "Posteroinferior" }, { "key": "C", "value": "Anterosuperior" }, { "key": "D", "value": "Posterosuperior" } ], "index": 16371, "question": "Cone of light focuses on which quadrant of tympanic membrane", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nA 35-year-old woman presents with recurrent episodes of sudden intense fear accompanied by shortness of breath, sweating, and palpitations, during which she feels like she is \"going crazy.\" These episodes have been occurring for 7 months. She has identified specific places where these attacks occur, such as the subway, a crowded pharmacy, and a poorly lit elevator at work, and she now actively avoids these places out of fear of having another attack and being unable to escape or get help. Her physical examination and laboratory tests are normal. What is the most likely diagnosis for this patient?", "role": "user" } ]	medical	{ "ground_truth": "Panic disorder and agoraphobia", "style": "rule" }	{ "choices": null, "index": 9640, "question": "A 35-year-old woman presents with recurrent episodes of sudden intense fear accompanied by shortness of breath, sweating, and palpitations, during which she feels like she is \"going crazy.\" These episodes have been occurring for 7 months. She has identified specific places where these attacks occur, such as the subway, a crowded pharmacy, and a poorly lit elevator at work, and she now actively avoids these places out of fear of having another attack and being unable to escape or get help. Her physical examination and laboratory tests are normal. What is the most likely diagnosis for this patient?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nIndications for ECT are -a) Paranoid schizophreniab) Depression with suicidal tendencyc) Catatonic schizophreniad) Neurotic depressione) Depression in involutional stage\nA. bc\nB. c\nC. ac\nD. ad", "role": "user" } ]	medical	{ "ground_truth": "A. bc", "style": "rule" }	{ "choices": [ { "key": "A", "value": "bc" }, { "key": "B", "value": "c" }, { "key": "C", "value": "ac" }, { "key": "D", "value": "ad" } ], "index": 18254, "question": "Indications for ECT are -a) Paranoid schizophreniab) Depression with suicidal tendencyc) Catatonic schizophreniad) Neurotic depressione) Depression in involutional stage", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nNasopharyngeal tumor causes:\nA. Horner's syndrome.\nB. Trotter's syndrome.\nC. Eagles syndrome.\nD. Frey's syndrome.", "role": "user" } ]	medical	{ "ground_truth": "B. Trotter's syndrome.", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Horner's syndrome." }, { "key": "B", "value": "Trotter's syndrome." }, { "key": "C", "value": "Eagles syndrome." }, { "key": "D", "value": "Frey's syndrome." } ], "index": 12025, "question": "Nasopharyngeal tumor causes:", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nWhat is the most appropriate next step in management for a 73-year-old man who, five days after open colectomy and temporary colostomy, develops severe left calf pain and swelling, thrombocytopenia, and necrotic skin lesions while receiving unfractionated heparin?", "role": "user" } ]	medical	{ "ground_truth": "Switch from unfractionated heparin to argatroban therapy", "style": "rule" }	{ "choices": null, "index": 6970, "question": "What is the most appropriate next step in management for a 73-year-old man who, five days after open colectomy and temporary colostomy, develops severe left calf pain and swelling, thrombocytopenia, and necrotic skin lesions while receiving unfractionated heparin?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nA 25-year-old previously healthy woman is admitted to the hospital with progressively worsening shortness of breath. She reports a mild fever. Her vital signs at the admission are as follows: blood pressure 100/70 mm Hg, heart rate 111/min, respiratory rate 20/min, and temperature 38.1℃ (100.6℉); blood saturation on room air is 90%. Examination reveals a bilateral decrease of vesicular breath sounds and rales in the lower lobes. Plain chest radiograph demonstrates bilateral opacification of the lower lobes. Despite appropriate treatment, her respiratory status worsens. The patient is transferred to the intensive care unit and put on mechanical ventilation. Adjustment of which of the following ventilator settings will only affect the patient’s oxygenation?\nA. Tidal volume and respiratory rate\nB. Tidal volume and FiO2\nC. FiO2 and PEEP\nD. Respiratory rate and PEEP\nE. FiO2 and respiratory rate", "role": "user" } ]	medical	{ "ground_truth": "C. FiO2 and PEEP", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Tidal volume and respiratory rate" }, { "key": "B", "value": "Tidal volume and FiO2" }, { "key": "C", "value": "FiO2 and PEEP" }, { "key": "D", "value": "Respiratory rate and PEEP" }, { "key": "E", "value": "FiO2 and respiratory rate" } ], "index": 9186, "question": "A 25-year-old previously healthy woman is admitted to the hospital with progressively worsening shortness of breath. She reports a mild fever. Her vital signs at the admission are as follows: blood pressure 100/70 mm Hg, heart rate 111/min, respiratory rate 20/min, and temperature 38.1℃ (100.6℉); blood saturation on room air is 90%. Examination reveals a bilateral decrease of vesicular breath sounds and rales in the lower lobes. Plain chest radiograph demonstrates bilateral opacification of the lower lobes. Despite appropriate treatment, her respiratory status worsens. The patient is transferred to the intensive care unit and put on mechanical ventilation. Adjustment of which of the following ventilator settings will only affect the patient’s oxygenation?", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nIn patients who are intubated and mechanically ventilated, which medication should be given prophylactically to reduce the risk of ventilator-associated pneumonia?", "role": "user" } ]	medical	{ "ground_truth": "Sucralfate", "style": "rule" }	{ "choices": null, "index": 8722, "question": "In patients who are intubated and mechanically ventilated, which medication should be given prophylactically to reduce the risk of ventilator-associated pneumonia?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nWhat condition is associated with increased nuchal translucency at 14 weeks gestation?", "role": "user" } ]	medical	{ "ground_truth": "Down's syndrome", "style": "rule" }	{ "choices": null, "index": 14468, "question": "What condition is associated with increased nuchal translucency at 14 weeks gestation?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nDeep brain stimulation has been approved for treatment of\nA. Movement disorders like Parkinsonism\nB. Schizophrenia\nC. Depression\nD. Anxiety disorder", "role": "user" } ]	medical	{ "ground_truth": "A. Movement disorders like Parkinsonism", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Movement disorders like Parkinsonism" }, { "key": "B", "value": "Schizophrenia" }, { "key": "C", "value": "Depression" }, { "key": "D", "value": "Anxiety disorder" } ], "index": 12465, "question": "Deep brain stimulation has been approved for treatment of", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nMost common cause of gastric varices is\nA. Splenic vein thrombosis\nB. Splenectomy\nC. Cirrhosis\nD. Mesenteric thrombosis", "role": "user" } ]	medical	{ "ground_truth": "C. Cirrhosis", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Splenic vein thrombosis" }, { "key": "B", "value": "Splenectomy" }, { "key": "C", "value": "Cirrhosis" }, { "key": "D", "value": "Mesenteric thrombosis" } ], "index": 12556, "question": "Most common cause of gastric varices is", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nBing test is\nA. Audiometric test\nB. Air conduction test\nC. Bone conduction test\nD. Special test", "role": "user" } ]	medical	{ "ground_truth": "C. Bone conduction test", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Audiometric test" }, { "key": "B", "value": "Air conduction test" }, { "key": "C", "value": "Bone conduction test" }, { "key": "D", "value": "Special test" } ], "index": 16295, "question": "Bing test is", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nA 14-year-old boy is rushed to the emergency room after he became disoriented at home. His parents say that the boy was doing well until 2 days ago when he got sick and vomited several times. They thought he was recovering but today he appeared to be disoriented since the morning. His vitals are normal except shallow rapid breathing at a rate of 33/min. His blood sugar level is 654 mg/dL and urine is positive for ketone bodies. He is diagnosed with diabetic ketoacidosis and is managed with fluids and insulin. He responds well to the therapy. His parents are told that their son has type 1 diabetes and insulin therapy options are being discussed. Which of the following types of insulin can be used in this patient for the rapid action required during mealtimes?\nA. Insulin detemir\nB. NPH insulin\nC. Insulin lispro\nD. Insulin glargine\nE. NPH and regular insulin", "role": "user" } ]	medical	{ "ground_truth": "C. Insulin lispro", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Insulin detemir" }, { "key": "B", "value": "NPH insulin" }, { "key": "C", "value": "Insulin lispro" }, { "key": "D", "value": "Insulin glargine" }, { "key": "E", "value": "NPH and regular insulin" } ], "index": 7161, "question": "A 14-year-old boy is rushed to the emergency room after he became disoriented at home. His parents say that the boy was doing well until 2 days ago when he got sick and vomited several times. They thought he was recovering but today he appeared to be disoriented since the morning. His vitals are normal except shallow rapid breathing at a rate of 33/min. His blood sugar level is 654 mg/dL and urine is positive for ketone bodies. He is diagnosed with diabetic ketoacidosis and is managed with fluids and insulin. He responds well to the therapy. His parents are told that their son has type 1 diabetes and insulin therapy options are being discussed. Which of the following types of insulin can be used in this patient for the rapid action required during mealtimes?", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nWhat is the correct criterion regarding the positioning of the spinous process on a chest radiograph to ensure the image is acceptable and does not need to be repeated?", "role": "user" } ]	medical	{ "ground_truth": "If the spinous process is not in-between the two clavicular heads, the image is repeated.", "style": "rule" }	{ "choices": null, "index": 1558, "question": "What is the correct criterion regarding the positioning of the spinous process on a chest radiograph to ensure the image is acceptable and does not need to be repeated?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nIn a 71-year-old man presenting with an acute left middle cerebral artery ischemic stroke, which aspect of his medical history or laboratory findings contraindicates the use of intravenous tissue plasminogen activator (tPA)?", "role": "user" } ]	medical	{ "ground_truth": "Platelet count 95,000/mm3", "style": "rule" }	{ "choices": null, "index": 5708, "question": "In a 71-year-old man presenting with an acute left middle cerebral artery ischemic stroke, which aspect of his medical history or laboratory findings contraindicates the use of intravenous tissue plasminogen activator (tPA)?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nA 12-year-old boy is brought to the physician because of difficulty in walking for 5 months. His mother reports that he has trouble keeping his balance and walking without support. Over the past year, he has started to have difficulty seeing in the dark and his hearing has been impaired. Examination shows marked scaling of the skin on the face and feet and a shortened 4th toe. Muscle strength is 3/5 in the lower extremities and 4/5 in the upper extremities. Sensation to pinprick is symmetrically decreased over the legs. Fundoscopy shows peripheral pigment deposits and retinal atrophy. His serum phytanic acid concentration is markedly elevated. The patient's condition is most likely caused by a defect in which of the following cellular structures?\nA. Peroxisomes\nB. Mitochondria\nC. Smooth endoplasmic reticulum\nD. Myofilaments\nE. Proteasomes", "role": "user" } ]	medical	{ "ground_truth": "A. Peroxisomes", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Peroxisomes" }, { "key": "B", "value": "Mitochondria" }, { "key": "C", "value": "Smooth endoplasmic reticulum" }, { "key": "D", "value": "Myofilaments" }, { "key": "E", "value": "Proteasomes" } ], "index": 3972, "question": "A 12-year-old boy is brought to the physician because of difficulty in walking for 5 months. His mother reports that he has trouble keeping his balance and walking without support. Over the past year, he has started to have difficulty seeing in the dark and his hearing has been impaired. Examination shows marked scaling of the skin on the face and feet and a shortened 4th toe. Muscle strength is 3/5 in the lower extremities and 4/5 in the upper extremities. Sensation to pinprick is symmetrically decreased over the legs. Fundoscopy shows peripheral pigment deposits and retinal atrophy. His serum phytanic acid concentration is markedly elevated. The patient's condition is most likely caused by a defect in which of the following cellular structures?", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nA 7-year-old girl is brought to the emergency department because she has had abdominal pain and vomiting for the past day. The pain is intermittent, diffuse in nature, and worse after meals. She does not have loose or bloody stools. She has had a nonpruritic rash on her legs and swelling of her ankles for 6 days. She was treated with oral amoxicillin for a sore throat 2 weeks ago. Her immunizations are up-to-date. Vital signs are within normal limits. Examination of the lower extremities shows non-blanching, raised erythematous papules. The left ankle joint is swollen and warm, and its range of motion is limited by pain. Abdominal examination shows tenderness to palpation in the left lower quadrant without guarding or rebound. Bowel sounds are normal. Test of the stool for occult blood is positive. Laboratory studies show:\nHemoglobin 10.1 g/dL\nLeukocyte count\n11,800/mm3\nPlatelet count 431,000/mm3\nErythrocyte sedimentation rate 45 mm/h\nSerum\nGlucose 72 mg/dL\nCreatinine 0.9 mg/dL\nWhich of the following is the most likely diagnosis?\"\nA. Familial mediterranean fever\nB. Drug-induced hypersensitivity syndrome\nC. Immune thrombocytopenic purpura\nD. Juvenile idiopathic arthritis\nE. Leukocytoclastic vasculitis", "role": "user" } ]	medical	{ "ground_truth": "E. Leukocytoclastic vasculitis", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Familial mediterranean fever" }, { "key": "B", "value": "Drug-induced hypersensitivity syndrome" }, { "key": "C", "value": "Immune thrombocytopenic purpura" }, { "key": "D", "value": "Juvenile idiopathic arthritis" }, { "key": "E", "value": "Leukocytoclastic vasculitis" } ], "index": 6449, "question": "A 7-year-old girl is brought to the emergency department because she has had abdominal pain and vomiting for the past day. The pain is intermittent, diffuse in nature, and worse after meals. She does not have loose or bloody stools. She has had a nonpruritic rash on her legs and swelling of her ankles for 6 days. She was treated with oral amoxicillin for a sore throat 2 weeks ago. Her immunizations are up-to-date. Vital signs are within normal limits. Examination of the lower extremities shows non-blanching, raised erythematous papules. The left ankle joint is swollen and warm, and its range of motion is limited by pain. Abdominal examination shows tenderness to palpation in the left lower quadrant without guarding or rebound. Bowel sounds are normal. Test of the stool for occult blood is positive. Laboratory studies show:\nHemoglobin 10.1 g/dL\nLeukocyte count\n11,800/mm3\nPlatelet count 431,000/mm3\nErythrocyte sedimentation rate 45 mm/h\nSerum\nGlucose 72 mg/dL\nCreatinine 0.9 mg/dL\nWhich of the following is the most likely diagnosis?\"", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nA 25-year-old man is brought to the emergency department 30 minutes after he was involved in a motorcycle collision. He was not wearing a helmet. Physical examination shows left periorbital ecchymosis. A CT scan of the head shows a fracture of the greater wing of the left sphenoid bone with compression of the left superior orbital fissure. Physical examination of this patient is most likely to show which of the following findings?\nA. Decreased sense of smell\nB. Numbness of the left cheek\nC. Preserved left lateral gaze\nD. Absent left corneal reflex\nE. Complete loss of vision of the left eye", "role": "user" } ]	medical	{ "ground_truth": "D. Absent left corneal reflex", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Decreased sense of smell" }, { "key": "B", "value": "Numbness of the left cheek" }, { "key": "C", "value": "Preserved left lateral gaze" }, { "key": "D", "value": "Absent left corneal reflex" }, { "key": "E", "value": "Complete loss of vision of the left eye" } ], "index": 3550, "question": "A 25-year-old man is brought to the emergency department 30 minutes after he was involved in a motorcycle collision. He was not wearing a helmet. Physical examination shows left periorbital ecchymosis. A CT scan of the head shows a fracture of the greater wing of the left sphenoid bone with compression of the left superior orbital fissure. Physical examination of this patient is most likely to show which of the following findings?", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nWhat is the most likely underlying pathological cause of dementia with visual hallucinations and fluctuating cognition in a patient with Parkinson disease?", "role": "user" } ]	medical	{ "ground_truth": "Lewy body deposition", "style": "rule" }	{ "choices": null, "index": 9928, "question": "What is the most likely underlying pathological cause of dementia with visual hallucinations and fluctuating cognition in a patient with Parkinson disease?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nWhat is the most appropriate treatment for a 68-year-old man presenting with intermittent dysuria, pain with ejaculation, mild lower abdominal pain, difficulty voiding, a mildly tender but normal-sized prostate on exam, and urinalysis showing trace leukocyte esterase but no bacteria?", "role": "user" } ]	medical	{ "ground_truth": "Tamsulosin and ciprofloxacin", "style": "rule" }	{ "choices": null, "index": 6263, "question": "What is the most appropriate treatment for a 68-year-old man presenting with intermittent dysuria, pain with ejaculation, mild lower abdominal pain, difficulty voiding, a mildly tender but normal-sized prostate on exam, and urinalysis showing trace leukocyte esterase but no bacteria?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nA 24-year-old woman presents with painful menstrual cramps, abdominal pressure, and bloating during her cycles. She has not menstruated since undergoing a dilatation and curettage (D&C) for a missed abortion seven months ago. She is sexually active without contraception, has normal vital signs, and an unremarkable physical exam. Laboratory tests show normal thyroid-stimulating hormone, follicle-stimulating hormone, and prolactin levels. A qualitative serum beta-hCG test is negative, and a progestin challenge test does not induce withdrawal bleeding. What is the most likely diagnosis?", "role": "user" } ]	medical	{ "ground_truth": "Asherman syndrome", "style": "rule" }	{ "choices": null, "index": 7081, "question": "A 24-year-old woman presents with painful menstrual cramps, abdominal pressure, and bloating during her cycles. She has not menstruated since undergoing a dilatation and curettage (D&C) for a missed abortion seven months ago. She is sexually active without contraception, has normal vital signs, and an unremarkable physical exam. Laboratory tests show normal thyroid-stimulating hormone, follicle-stimulating hormone, and prolactin levels. A qualitative serum beta-hCG test is negative, and a progestin challenge test does not induce withdrawal bleeding. What is the most likely diagnosis?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nWhich blood types of packed red blood cells are safe to transfuse into a patient with blood type AB+?", "role": "user" } ]	medical	{ "ground_truth": "A+, A-, B+, B-, AB+, AB-, O+, O-", "style": "rule" }	{ "choices": null, "index": 2541, "question": "Which blood types of packed red blood cells are safe to transfuse into a patient with blood type AB+?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nA 38-year-old woman with multiple sclerosis who has had multiple recent exacerbations is starting treatment with natalizumab. What serious complication is she at increased risk for with this medication?", "role": "user" } ]	medical	{ "ground_truth": "Progressive multifocal leukoencephalopathy", "style": "rule" }	{ "choices": null, "index": 7571, "question": "A 38-year-old woman with multiple sclerosis who has had multiple recent exacerbations is starting treatment with natalizumab. What serious complication is she at increased risk for with this medication?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nA 1-year-old boy presents to the physician with a fever and a persistent cough for the past 5 days. His parents noted that since birth, he has had a history of recurrent skin infections, ear infections, and episodes of pneumonia with organisms including Staphylococcus aureus, Pseudomonas, and Candida. Physical exam is notable for prominent facial scars in the periorbital and nasal regions, which his parents explain are a result of healed abscesses from previous skin infections. A sputum sample is obtained from the patient and the culture grows Aspergillus. Which of the following diagnostic test findings would confirm the patient’s underlying genetic disease?\nA. Complete blood count\nB. Dihydrorhodamine test\nC. Flow cytometry for CD18 protein\nD. Fluorescent in situ hybridization\nE. Quantitative serum immunoglobulin test", "role": "user" } ]	medical	{ "ground_truth": "B. Dihydrorhodamine test", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Complete blood count" }, { "key": "B", "value": "Dihydrorhodamine test" }, { "key": "C", "value": "Flow cytometry for CD18 protein" }, { "key": "D", "value": "Fluorescent in situ hybridization" }, { "key": "E", "value": "Quantitative serum immunoglobulin test" } ], "index": 6352, "question": "A 1-year-old boy presents to the physician with a fever and a persistent cough for the past 5 days. His parents noted that since birth, he has had a history of recurrent skin infections, ear infections, and episodes of pneumonia with organisms including Staphylococcus aureus, Pseudomonas, and Candida. Physical exam is notable for prominent facial scars in the periorbital and nasal regions, which his parents explain are a result of healed abscesses from previous skin infections. A sputum sample is obtained from the patient and the culture grows Aspergillus. Which of the following diagnostic test findings would confirm the patient’s underlying genetic disease?", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nA 67-year-old man with a history of diabetes mellitus, COPD, and a ST-elevation myocardial infarction currently on dialysis presents with shortness of breath for the past 2 hours. The patient missed his recent dialysis appointment and has been noncompliant with his other medications. The patient found out his best friend died this morning and has felt worse since this event. His temperature is 98.7°F (37.1°C), blood pressure is 87/48 mmHg, pulse is 130/min, respirations are 27/min, and oxygen saturation is 92% on room air. A bedside ultrasound demonstrates an anechoic rim surrounding the heart with poor cardiac squeeze, global hypokinesis, and right ventricular collapse with pleural sliding. Laboratory values are notable for 2 cardiac troponins that measure 0.72 ng/mL and 0.71 ng/mL. Which of the following is the most likely diagnosis?\nA. Cardiac tamponade\nB. Hyperkalemia\nC. Myocardial infarction\nD. Takotsubo cardiomyopathy\nE. Tension pneumothorax", "role": "user" } ]	medical	{ "ground_truth": "A. Cardiac tamponade", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Cardiac tamponade" }, { "key": "B", "value": "Hyperkalemia" }, { "key": "C", "value": "Myocardial infarction" }, { "key": "D", "value": "Takotsubo cardiomyopathy" }, { "key": "E", "value": "Tension pneumothorax" } ], "index": 6181, "question": "A 67-year-old man with a history of diabetes mellitus, COPD, and a ST-elevation myocardial infarction currently on dialysis presents with shortness of breath for the past 2 hours. The patient missed his recent dialysis appointment and has been noncompliant with his other medications. The patient found out his best friend died this morning and has felt worse since this event. His temperature is 98.7°F (37.1°C), blood pressure is 87/48 mmHg, pulse is 130/min, respirations are 27/min, and oxygen saturation is 92% on room air. A bedside ultrasound demonstrates an anechoic rim surrounding the heart with poor cardiac squeeze, global hypokinesis, and right ventricular collapse with pleural sliding. Laboratory values are notable for 2 cardiac troponins that measure 0.72 ng/mL and 0.71 ng/mL. Which of the following is the most likely diagnosis?", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nA 41-year-old woman is brought to the emergency depament by her family because of acute onset of right upper quadrant pain, nausea, and vomiting. For this case, it is impoant to remember that the bile duct:\nA. Drains bile into the second pa of the duodenum\nB. Can be blocked by cancer in the body of the pancreas\nC. Joins the main pancreatic duct, which carries hormones\nD. Is formed by union of the right and left hepatic duct", "role": "user" } ]	medical	{ "ground_truth": "A. Drains bile into the second pa of the duodenum", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Drains bile into the second pa of the duodenum" }, { "key": "B", "value": "Can be blocked by cancer in the body of the pancreas" }, { "key": "C", "value": "Joins the main pancreatic duct, which carries hormones" }, { "key": "D", "value": "Is formed by union of the right and left hepatic duct" } ], "index": 12478, "question": "A 41-year-old woman is brought to the emergency depament by her family because of acute onset of right upper quadrant pain, nausea, and vomiting. For this case, it is impoant to remember that the bile duct:", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nA 32-year-old pregnant woman at 32 weeks' gestation presents with new-onset severe hypertension (blood pressure 170/100 mm Hg), headaches, dizziness, and lower extremity edema. Laboratory studies reveal thrombocytopenia with a platelet count of 60,000/mm³, while other labs including liver enzymes and creatinine are normal. What is the most appropriate next step in management for this patient?", "role": "user" } ]	medical	{ "ground_truth": "Magnesium sulfate and labetalol therapy", "style": "rule" }	{ "choices": null, "index": 5999, "question": "A 32-year-old pregnant woman at 32 weeks' gestation presents with new-onset severe hypertension (blood pressure 170/100 mm Hg), headaches, dizziness, and lower extremity edema. Laboratory studies reveal thrombocytopenia with a platelet count of 60,000/mm³, while other labs including liver enzymes and creatinine are normal. What is the most appropriate next step in management for this patient?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nA 32-year-old otherwise healthy woman presents with severe headaches, visual disturbances, and papilledema on physical examination. Which medication is most likely responsible for the development of her condition?", "role": "user" } ]	medical	{ "ground_truth": "Oral contraceptive pill", "style": "rule" }	{ "choices": null, "index": 10318, "question": "A 32-year-old otherwise healthy woman presents with severe headaches, visual disturbances, and papilledema on physical examination. Which medication is most likely responsible for the development of her condition?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nSmack otherwise known as\nA. Heroin\nB. Cocaine\nC. Cannabis\nD. LSD", "role": "user" } ]	medical	{ "ground_truth": "A. Heroin", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Heroin" }, { "key": "B", "value": "Cocaine" }, { "key": "C", "value": "Cannabis" }, { "key": "D", "value": "LSD" } ], "index": 15925, "question": "Smack otherwise known as", "split": "train", "type": "mcq" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nWhat is a common complication associated with transfusing blood that has been stored for a prolonged period?", "role": "user" } ]	medical	{ "ground_truth": "Potassium toxicity", "style": "rule" }	{ "choices": null, "index": 10298, "question": "What is a common complication associated with transfusing blood that has been stored for a prolonged period?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nFor a premature infant born at 27 weeks gestation weighing 1500 grams, at what gestational age should the first fundus examination by an ophthalmologist be performed?", "role": "user" } ]	medical	{ "ground_truth": "At 34 weeks gestational age", "style": "rule" }	{ "choices": null, "index": 17084, "question": "For a premature infant born at 27 weeks gestation weighing 1500 grams, at what gestational age should the first fundus examination by an ophthalmologist be performed?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-rank	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process and then provides the user with an accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think>reasoning process here</think> answer here. After thinking, when you finally reach a conclusion, clearly list all possible answers in order from most likely to least likely. Start with \"# Final Answer\" followed by numbered lines using the format `n. answer` for each answer. Each item MUST contain only the answer without any explanation or reasoning.\n\nExample:\n<think>...</think>\n\n# Final Answer\n1. xxx\n2. xxx\n\nNow the user asks you to solve a problem.\n\nWhat is the first sign observed in sympathetic ophthalmia?", "role": "user" } ]	medical	{ "ground_truth": "Retrolental flare", "style": "rule" }	{ "choices": null, "index": 16745, "question": "What is the first sign observed in sympathetic ophthalmia?", "split": "train", "type": "rank" }
pittawat/medqa-medmcqa-mcq	[ { "content": "You are a helpful and harmless expert clinical assistant. The assistant first thinks about the reasoning process in the mind and then provides the user with the accurate answer. The reasoning process is enclosed within <think></think> tags followed by an answer, i.e., <think> reasoning process here </think> answer here. Now the user asks you to solve a problem. After thinking, when you finally reach a conclusion, clearly state the final answer in \\boxed{}. You always begins your answer with the choice, e.g., A., B., C., D., E. in the \\boxed{}.\n\nA 1-week-old baby is brought to the pediatrician’s office for a routine checkup. On examination, she is observed to have microcephaly with a prominent occiput. She also has clenched fists and rocker-bottom feet with prominent calcanei. A cardiac murmur is evident on auscultation. Based on the clinical findings, a diagnosis of nondisjunction of chromosome 18 is suspected. The pediatrician orders a karyotype for confirmation. He goes on to explain to the mother that her child will face severe growth difficulties. Even if her daughter progresses beyond a few months, she will not be able to reach developmental milestones at the appropriate age. In addition to the above, which of the following is most likely a consequence of this genetic disturbance?\nA. Alzheimer’s disease\nB. Supravalvular aortic stenosis\nC. Death within the first year life\nD. Cutis aplasia\nE. Macroglossia", "role": "user" } ]	medical	{ "ground_truth": "C. Death within the first year life", "style": "rule" }	{ "choices": [ { "key": "A", "value": "Alzheimer’s disease" }, { "key": "B", "value": "Supravalvular aortic stenosis" }, { "key": "C", "value": "Death within the first year life" }, { "key": "D", "value": "Cutis aplasia" }, { "key": "E", "value": "Macroglossia" } ], "index": 8671, "question": "A 1-week-old baby is brought to the pediatrician’s office for a routine checkup. On examination, she is observed to have microcephaly with a prominent occiput. She also has clenched fists and rocker-bottom feet with prominent calcanei. A cardiac murmur is evident on auscultation. Based on the clinical findings, a diagnosis of nondisjunction of chromosome 18 is suspected. The pediatrician orders a karyotype for confirmation. He goes on to explain to the mother that her child will face severe growth difficulties. Even if her daughter progresses beyond a few months, she will not be able to reach developmental milestones at the appropriate age. In addition to the above, which of the following is most likely a consequence of this genetic disturbance?", "split": "train", "type": "mcq" }