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Given the following medical question or situation, provide the most suitable reasoning or explanation.
A new antifungal medication is being tested in Phase I clinical trials. Examination of the pharmacokinetic propeies of the drug reveals that the half-life of the drug is 6 hours. If a continuous intravenous infusion of this drug were staed on a research subject, how long would it take to reach 75% of steady state?
A. 3
B. 6
C. 9
D. 12
|
#### D. 12
|
D. 12
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 28-week baby suffered from respiratory distress syndrome at bih. On day 14 of life, he developed sepsis. No other co-morbidity was seen. He should be evaluated for retinopathy of prematurity at what postnatal age?
A. 2 weeks
B. 4 weeks
C. 6 weeks
D. 8 weeks
|
#### B. 4 weeks
|
B. 4 weeks
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Hiatus hernia is treated by-a) Surgery when medical treatment has failedb) Nissens' fundoplicationc) Medical treatment onlyd) None of the above
A. ac
B. ab
C. ad
D. bc
|
#### B. ab
|
B. ab
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 51-year-old Caucasian female presents to her primary care provider complaining of intermittent chest pain. She reports that over the past 6 months, she has developed burning chest pain that occurs whenever she exerts herself. The pain decreases when she rests. Her past medical history is notable for type II diabetes mellitus. Her family history is notable for multiple myocardial infarctions in her father and paternal grandmother. She currently takes aspirin and metformin. Her primary care provider starts her on a medication which is indicated given her medical history and current symptoms. However, 10 days later, she presents to the emergency room complaining of weakness and muscle pain. Her plasma creatine kinase level is 250,000 IU/L. This patient was most likely started on a medication that inhibits an enzyme that produces which of the following?
A. Farnesyl pyrophosphate
B. HMG-CoA
C. Lanosterol
D. Mevalonic acid
E. Squalene
|
#### D. Mevalonic acid
|
D. Mevalonic acid
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 15-year-old boy with epilepsy on treatment with a combination of valproate and phenytoin has good control of seizures. Levels of both drugs are in the therapeutic range. All of the following adverse effects can be attributed to valproate except -
A. Weight gain of 5 kg
B. Serum alanine aminotransaminase 150 IU/L
C. Rise in serum ammonia level by 20 g/dl
D. Lymphadenopathy
|
#### D. Lymphadenopathy
|
D. Lymphadenopathy
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 4-year-old boy with a rash is brought in by his mother. The patient’s mother says that his symptoms started acutely a few hours ago after they had eaten shellfish at a restaurant which has progressively worsened. She says that the rash started with a few bumps on his neck and chest but quickly spread to involve his arms and upper torso. The patient says the rash makes him uncomfortable and itches badly. He denies any fever, chills, night sweats, dyspnea, or similar symptoms in the past. Past medical history is significant for a history of atopic dermatitis at the age of 9 months which was relieved with some topical medications. The patient is afebrile and his vital signs are within normal limits. On physical examination, the rash consists of multiple areas of erythematous, raised macules that blanch with pressure as shown in the exhibit (see image). There is no evidence of laryngeal swelling and his lungs are clear to auscultation. Which of the following is the best course of treatment for this patient’s most likely condition?
A. Topical corticosteroids
B. Cetirizine
C. Prednisone
D. IM epinephrine
|
#### B. Cetirizine
|
B. Cetirizine
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 9-year-old boy receives a deep laceration over his right eyebrow playing ice hockey. The wound is cleaned and sutured Which of the following collagens is deposited first during wound healing in the patient.
A. Type I
B. Type II
C. Type III
D. Type IV
|
#### C. Type III
|
C. Type III
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 78-year-old man is brought to the physician by his daughter for a follow-up examination. The daughter noticed that he has gradually become more forgetful and withdrawn over the last year. He frequently misplaces his car keys and forgets the names of his neighbors, whom he has known for 30 years. He has difficulty recalling his address and telephone number. He recently had an episode of urinary and fecal incontinence. Last week, his neighbor found him wandering the parking lot of the grocery store. He has hypertension and hyperlipidemia. He had smoked one pack of cigarettes daily for 40 years but quit 18 years ago. His current medications include hydrochlorothiazide and atorvastatin. He appears healthy; BMI is 23 kg/m2. His temperature is 37.2°C (99.0°F), pulse is 86/min, respirations are 14/min, and blood pressure is 136/84 mm Hg. Mini-mental state examination score is 19/30. He is not bothered by his forgetfulness. Cranial nerves II–XII are intact. He has 5/5 strength and full sensation to light touch in all extremities. His patellar, Achilles, and biceps reflexes are 2+ bilaterally. His gait is steady. MRI scan of the brain shows ventriculomegaly and prominent cerebral sulci. Which of the following is the most appropriate pharmacotherapy?
A. Donepezil
B. Thiamine
C. Acetazolamide
D. Sertraline
E. Memantine
"
|
#### A. Donepezil
|
A. Donepezil
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Of the light produced by quartz — tungsten -halogen, only a small percentage is suitable for curing composite resin material and most is converted into heat. How much percentage of this light is useful for curing?
A. 0.50%
B. 5%
C. 10%
D. 50%
|
#### A. 0.50%
|
A. 0.50%
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Myospasm that is involuntary continuous contraction of a muscle due to overstretching which is already strained
because of sustained mouth opening during RCT is
A. Charley horse
B. Ercess expand
C. Muscle tear
D. Hardy stretch
|
#### A. Charley horse
|
A. Charley horse
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 35-year-old man comes to the physician because of dull abdominal pain on his right side for 4 months. He also reports episodic nausea and vomiting during this period. He does not have fever, altered bowel habits, or weight loss. He has had a pet dog for 8 years. He appears healthy. Vital signs are within normal limits. Abdominal examination shows a nontender mass 3 cm below the right costal margin that moves with respiration. Laboratory studies show:
Hemoglobin 14.6 g/dL
Leukocyte count 7200/mm3
Segmented neutrophils 58%
Eosinophils 8%
Lymphocytes 30%
Monocytes 4%
Ultrasound of the abdomen shows a focal hypoechoic cyst within the liver measuring 7 cm. An ELISA confirms the diagnosis. He is scheduled for CT-guided percutaneous drainage under general anesthesia with orotracheal intubation. Seven minutes into the procedure, the patient's oxygen saturation suddenly decreases from 95% to 64%. His heart rate is 136/min, and blood pressure is 86/58 mm Hg. Capnography cannot record an end tidal CO2 waveform. Breath sounds are absent bilaterally. Which of the following is most appropriate next step in management?"
A. Exploratory laparotomy
B. Epinephrine
C. Cricothyrotomy
D. Chest tube insertion
E. Norepinephrine
"
|
#### B. Epinephrine
|
B. Epinephrine
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Yesterday was 12/31/1929. Today could not be 12/32/1929 because December has only 31 days. What is the date 24 hours later in MM/DD/YYYY?
Options:
(A) 01/02/1930
(B) 08/02/1930
(C) 01/02/1884
(D) 11/06/1929
(E) 03/30/1930
(F) 01/02/1877
|
#### (A) 01/02/1930
|
(A) 01/02/1930
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 23 year old engineering student is brought by his family to he hospital with history of gradual onset of suspiciousness, muttering and smiling without clear reason, decreased socialization, violent outbursts, and lack of interest in studies for 8 months. Mental status examination revealed a blunt affect, thought broadcast, a relatively preserved cognition, impaired judgment and insight. He is most likely to be suffering from
A. Delusional disorder
B. Depression
C. Schizophrenia
D. Anxiety disorder
|
#### C. Schizophrenia
|
C. Schizophrenia
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 30-year-old male has had multiple episodes of sudden, severe pain, redness, and swelling of metatarsophalangeal joint of his great toes. These problems seem to occur after the man has had a night out on the town with his friends, when they go barhopping, and the night usually ends with a cab ride home for the group. This problem would also be exacerbated if the man eats which one of the following during his night out?
A. Hamburger
B. Chicago hot dog
C. Chopped liver
D. Nachos and salsa
|
#### C. Chopped liver
|
C. Chopped liver
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 52-year-old woman comes to the physician because of palpitations, sweating, and heat intolerance. Physical examination shows a palpable mass over the anterior aspect of the neck.
Which of the following features is most associated with this condition?
A. Constipation
B. Elevated thyroid stimulating (TSH)
C. Ophthalmoplegia
D. Slow relaxing reflexes
|
#### C. Ophthalmoplegia
|
C. Ophthalmoplegia
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A person knows the truth & wilfully concealed the truth &gives false evidence in the court of law. He will be punished under which I PC -
A. 190
B. 192
C. 191
D. 193
|
#### D. 193
|
D. 193
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 16-year-old boy lost his sight in one eye after a fight. Under which section of IPC is grievous injury included?
A. Section 319
B. Section 320
C. Section 324
D. Section 326
|
#### B. Section 320
|
B. Section 320
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
True about stomach carcinoma -a) Weightloss is commonest featureb) Secondaries are most commonly seen in peritoneum & omentumc) Lymphatic & hematogenous spread are rared) Barium meal is diagnostice) Radioresistant
A. a
B. ae
C. ab
D. ad
|
#### B. ae
|
B. ae
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
In an alaryngeal speech, with fistula based voice prosthesis, which of these prosthesis has the feature of "Loading tool with an instantaneous opening of the oesophagal flange
A. Blom-Singer Indwelling
B. Provox 2
C. Panje voice button
D. Blom Singer duckbill
|
#### **B. Provox 2**
|
**B. Provox 2**
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A male 45 years old wants his missing teeth to be replaced. Intraoral examination reveals Kennedy class 4 edentulous maxillary arch. Impression is made with fast setting alginate.
The setting time of the material is :
A. 1.5 to 3 min
B. 3 to 4.5 min
C. 3 to 4 min
D. 2 to 4 min
|
#### A. 1.5 to 3 min
|
A. 1.5 to 3 min
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 44-year-old farmer presented with high-grade fever for 4 days. On examination, an ulcer was found at the right-hand region along with painful cervical lymphadenopathy. History revealed a bite of an animal 4 days ago. A papule was formed which later progressed to form an ulcer. Erythematous, maculopapular rash all over the body along with erythema nodosum on lower limbs were present. Swabs from the ulcer and biopsy from the lymph nodes were taken and sent for examination. Gram staining was done. It showed growth on chocolate agar, BCYE agar and media supplemented with cysteine. What is the drug of choice of the above organism: -
A. Streptomycin
B. Doxycycline
C. Amikacin
D. Gentamycin
|
#### A. Streptomycin
|
A. Streptomycin
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Which of the following genetic disease results from a deficiency in the liver enzyme that converts phenylalanine to tyrosine?
A. Albinism
B. Homocystinuria
C. Porphyria
D. Phenylketonuria
|
#### D. Phenylketonuria
|
D. Phenylketonuria
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
How many hours after injury are activated fibroblasts, myofibroblasts, and capillary sprouts most abundant in the wound of a 29-year-old carpenter who receives a traumatic laceration?
A. 3 to 6 hours
B. 12 to 24 hours
C. 3 to 5 days
D. 8 to 10 days
|
#### C. 3 to 5 days
|
C. 3 to 5 days
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Which of the following organs is the most common site of origin of the tumour associated with the Zollinger-Ellison syndrome -
A. Duodenum
B. Lymph nodes
C. Spleen
D. Pancreas
|
#### A. Duodenum
|
A. Duodenum
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Stain is not taken by capsule in gram negative organisms because the capsule consist of -a) Polysaccharidesb) Lipopolysaccharidesc) Lipidsd) Protein
A. b
B. c
C. ac
D. ad
|
#### D. ad
|
D. ad
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 12-month-old boy is brought to the physician for a well-child examination. He was born at 38 weeks' gestation and was 48 cm (19 in) in length and weighed 3061 g (6 lb 12 oz); he is currently 60 cm (24 in) in length and weighs 7,910 g (17 lb 7 oz). He can walk with one hand held and can throw a small ball. He can pick up an object between his thumb and index finger. He can wave 'bye-bye'. He can say 'mama', 'dada' and 'uh-oh'. He cries if left to play with a stranger alone. Physical examination shows no abnormalities. Which of the following is most likely delayed in this child?
A. Gross motor skills
B. Growth
C. Fine motor skills
D. Social skills
|
#### B. Growth
|
B. Growth
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 73-year-old man has angina pectoris on exertion, but an angiogram reveals noncritical stenosis of the coronary arteries. This occurs most frequently with which of the following valvular heart diseases?
A. mitral stenosis
B. mitral insufficiency
C. pulmonary stenosis
D. aortic stenosis
|
#### D. aortic stenosis
|
D. aortic stenosis
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 3-year-old girl is brought to her pediatrician with 2 days of fever and abdominal pain. She has also been crying and complaining of pain while urinating. She was born at term without incident and was previously healthy at regular checkups. On presentation, her temperature is 102.2°F (39°C), blood pressure is 137/85 mmHg, pulse is 122/min, and respirations are 24/min. Physical exam reveals a palpable, painless, abdominal mass that does not cross the midline. Which of the following additional findings would be associated with this patient's disorder?
A. 11;22 chromosome translocation
B. Aniridia
C. Ash leaf spots
D. Epstein-Barr virus
E. Opsoclonus myoclonus
|
#### B. Aniridia
|
B. Aniridia
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A middle-aged man presents with a lower jaw swelling. Clinically, there is expansion of the left ramus and the X-ray mandible shows soap bubble appearance. What is the clinical - diagnosis?
A. Keratocyst
B. Adamantinoma
C. Aneurysmal bone cyst
D. Odontogenic myxoma
|
#### B. Adamantinoma
|
B. Adamantinoma
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 36-year-old man presents with the complaint of loose and watery stools for the past 3 days. He is now having bowel movements four to five times a day. He denies any blood or mucus in the stool. He also complains of abdominal pain and fatigue. Furthermore, he feels nauseous and does not feel like drinking anything. His urine is visibly yellow and low in volume. He recently returned from a trip to South America where he enjoyed all the local delicacies. He is most concerned about his urine color and volume. Which segment of the nephron is primarily responsible for these changes?
A. Glomerulus
B. Proximal convoluted tubule
C. Proximal straight tubule
D. Loop of Henle
E. Distal tubule
|
#### D. Loop of Henle
|
D. Loop of Henle
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
In the following sentences, explain the antecedent of the pronoun (which thing the pronoun refers to), or state that it is ambiguous.
Sentence: The librarian helped the CEO to find the book because they asked.
Options:
(A) The librarian asked
(B) The CEO asked
(C) Ambiguous
|
#### (B) The CEO asked.
|
(B) The CEO asked.
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 20 year old lady, Maya, frequently experiences palpitations, breathlessness, sweating and a fear of impending death. She has one episode of such attacks every week. There are no identifiable triggers for the episodes Which among the following is the best drug options for her long term treatment?
A. Fluoxetine
B. Diazepam
C. Olanzapine
D. Beta Blockers
|
#### A. Fluoxetine
|
A. Fluoxetine
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Alice, Bob, and Claire are friends and avid readers who occasionally trade books. At the start of the semester, they each buy one new book: Alice gets Lolita, Bob gets The Great Gatsby, and Claire gets The Odyssey.
As the semester proceeds, they start trading around the new books. First, Claire and Alice swap books. Then, Bob and Alice swap books. Finally, Claire and Alice swap books. At the end of the semester, Alice has
Options:
(A) Lolita
(B) The Great Gatsby
(C) The Odyssey
|
#### (A) Lolita
|
(A) Lolita
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A patient with blunt trauma of abdomen at 48 hours, USG shows normal, but patient had tenderness in left lumbar region. Best appropriate diagnosis is by:
A. MCU
B. IVP
C. CECT abdomen
D. Repeat USG
|
#### C. CECT abdomen
|
C. CECT abdomen
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 11 year old male patient complains of swollen and painful gums. He gives a history of Ventricular septal defect and delayed eruption of teeth. Extra-oral examination reveals an underdeveloped midface, brachycephalic skull, flat nasal bridge and oblique palpebral fissures. Which of the following condition will not be seen in this child?
A. Open bite
B. Periodontal disease
C. Rampant caries
D. Bruxism
|
#### C. Rampant caries
|
C. Rampant caries
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A train pulls out of the station at constant velocity. The received signal energy thus falls off with time as $1/i^2$. The total received signal at time $i$ is $Y_i = \frac{1}{i}X_i + Z_i$ where $Z_1, Z_2, \ldots$ are i.i.d. drawn from $N(0,1)$. The transmitter constraint for block length $n$ is $\frac{1}{n}\sum_{i=1}^n x_i^2(w) \leq 2 $ for $w \in \{1,2,\ldots, 2^{nR}\}$. Use Fano's inequality to find the capacity for this channel.
A. 1.5
B. 2.5
C. 1.0
D. 0.0
E. 0.5
F. 0.75
G. 3.0
H. 1.25
I. 0.25
J. 2.0
|
#### D. 0.0
|
D. 0.0
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Today, Lisa went to the art show. Between what times could they have gone?
We know that:
Lisa woke up at 10am.
Lisa saw Lisa driving to the water park from 12pm to 2pm.
Hannah saw Lisa waiting at the airport from 2pm to 3pm.
Thomas saw Lisa buying a phone at the electronics store from 3pm to 4pm.
The art show was closed after 4pm.
Between what times could Lisa have gone to the art show?
Options:
(A) 3pm to 4pm
(B) 12pm to 2pm
(C) 10am to 12pm
(D) 2pm to 3pm
|
#### (C) 10am to 12pm.
|
(C) 10am to 12pm.
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A patient with severe atherosclerosis of the external iliac aery and adjacent femoral aery is scheduled for coronary aery bypass surgery. The surgeon decides to use a long, mostly unbranched muscular vein found on the medial aspect of the leg both above and below the knee. Through which of the following structures does this vein pass to eventually join the femoral vein?
A. Anatomic snuff box
B. Antecubital fossa
C. Fossa ovalis
D. Inguinal canal
|
#### C. Fossa ovalis
|
C. Fossa ovalis
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Arrange the following nerves according to incidence of their involvement in Supra-condylar fracture of humerus a. Median nerve b. Radial nerve c. Anterior interosseous nerve d. Ulnar nerve
A. c,a,d,b
B. c,a,b,d
C. a,c,b,d
D. d,a,b,c
|
#### B. c, a, b, d
|
B. c, a, b, d
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 30-year-old G3P2 woman delivered a term baby and staed bleeding after delivery. She was given in fluids but bleeding did not stop. The EMO advised blood transfusion. After how many blood trans! fusions should be given FFP:
A. 1
B. 2
C. 3
D. 4
|
#### D. 4
|
D. 4
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A man with diabetes insipidus has a glomerular filtration of 155 L/day. Which range most likely represents the upper limit for urine flow rate in this individual if he were not receiving treatment but had free access to water?
A. 1 to 3 L/day
B. 5 to 10 L/day
C. 15 to 20 L/day
D. 30 to 35 L/day
|
#### C. 15 to 20 L/day
|
C. 15 to 20 L/day
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A case of gestational trophoblastic neoplasia is detected to have lung metastasis. She should be staged as:
A. Stage-I
B. Stage-II
C. Stage-III
D. Stage - IV
|
#### C. Stage-III
|
C. Stage-III
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 33-year-old woman comes to the physician 1 week after noticing a lump in her right breast. Fifteen years ago, she was diagnosed with osteosarcoma of her left distal femur. Her father died of an adrenocortical carcinoma at the age of 41 years. Examination shows a 2-cm, firm, immobile mass in the lower outer quadrant of the right breast. A core needle biopsy of the mass shows adenocarcinoma. Genetic analysis in this patient is most likely to show a defect in which of the following genes?
A. KRAS
B. TP53
C. PTEN
D. Rb
|
#### B. TP53
|
B. TP53
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Single massive does of vitamin A for preventing the deficiency in preschool children between the age of 1-6 years for every 6 months is
A. 2,000 IU
B. 20,000 IU
C. 2,00,000 IU
D. 20,00,000 IU
|
#### C. 200,000 IU
|
C. 200,000 IU
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 26-year-old G6P1050 presents for evaluation of infertility. She and her husband have been trying to have a child for the past three years. Over that time period, the patient suffered five miscarriages. Her past medical history is significant for anemia, bipolar disorder, and a blood clot in her right lower extremity that occurred during her first pregnancy. The patient reports she has been feeling fatigued and has gained at least 10 pounds within the last two months. She often cries when she thinks about the miscarriages and has trouble falling asleep at night. She admits that while she had quit smoking during the pregnancy of her first child, and one month after the birth she started smoking again. She currently smokes about a half a pack of cigarettes a day. A review of systems is also positive for diffuse joint discomfort. The patient's current medications include minocycline for acne, and prenatal vitamins. A physical exam is unremarkable. Her temperature is 99°F (37.2°C), pulse is 72/minute, blood pressure is 118/78 mmHg, and oxygen saturation is 98% O2 on room air. Routine labs are drawn, as shown below:
Leukocyte count: 6,500/mm^3
Platelet count: 210,000/mm^3
Hemoglobin: 11.0 g/dL
Prothrombin time: 12 seconds
Activated partial thromboplastin time: 43 seconds
International normalized ratio: 1.1
Which of the following is associated with this patient’s infertility?
A. Elevated TSH levels
B. Autosomal dominant mutation in factor V
C. Positive VDRL
D. Positive antihistone antibodies
E. Vasoconstriction with reduced placental blood flow
|
#### C. Positive VDRL
|
C. Positive VDRL
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 67-year-old woman is brought to the clinic by her husband for changes in personality. He reports that 3 years ago she began to forget day-to-day things (e.g., where her keys are and the directions home). She would intermittently forget who her friends are and put the remote in the refrigerator. Recently, the husband noticed stark changes in her personality as she is more impatient, aggressive, and sometimes violent. She denies any fever, trauma, focal neurologic deficits, or sensory changes. Her past medical history is significant for diabetes and hypertension for which she takes metformin and lisinopril, respectively. A physical examination is unremarkable. Which of the following Figures is characteristic of her disease?
A. A
B. B
C. C
D. D
|
#### B. B
|
B. B
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
An HIV-positive 48-year-old man comes to the emergency department because of a 3-month history of recurrent, painful mouth ulcers. This time, the pain is so severe that the patient cannot eat. He has a history of a seizure disorder but currently does not take any medications. He appears very ill. His temperature is 39.0°C (102.2°F). Physical examination shows numerous vesicular ulcerations on the lips and sloughing of the gums, buccal mucosa, and hard palate. Genetic analysis of the pathogen isolated from the lesions shows a mutation in a gene encoding viral phosphotransferases. Which of the following drugs is the most appropriate treatment?
A. Acyclovir
B. Cidofovir
C. Ganciclovir
D. Famciclovir
|
#### B. Cidofovir
|
B. Cidofovir
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 7-year-old boy presents to the ER with progressive dysphagia over the course of 3 months and a new onset fever for the past 24 hours. The temperature in the ER was 39.5°C (103.1°F). There are white exudates present on enlarged tonsils (Grade 2). Routine blood work reveals a WBC count of 89,000/mm3, with the automatic differential yielding a high (> 90%) percentage of lymphocytes. A peripheral blood smear is ordered, demonstrating the findings in the accompanying image. The peripheral smear is submitted to pathology for review. After initial assessment, the following results are found on cytologic assessment of the cells:
TdT: positive
CALLA (CD 10): positive
Which of the following cell markers are most likely to be positive as well?
A. CD 8
B. CD 7
C. CD 19
D. CD 5
|
#### C. CD 19
|
C. CD 19
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Sort the following words alphabetically: List: thirteenth tinfoil thimble snuff ernie pow celebrity abuilding indiscoverable chigger burgher synchronous yap medlar exorcism newsboy
|
#### 16. yap
|
16. yap
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A doctor conducts criminal aboion for a women with consent. He will be prosecuted under which of the following IPC section?
A. 312 IPC
B. 313 IPC
C. 316 IPC
D. 317 IPC
|
#### Answer: A. 312 IPC
|
Answer: A. 312 IPC
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 48-yrs-old male alcoholic with bilateral gynecomastia. Which physical findings has cirrhosis has the same pathogenesis as gynecomastia?
A. Caput medusa
B. Asterixis
C. Ascites
D. Spider angioma
|
#### D. Spider angioma
|
D. Spider angioma
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 32-year-old patient has decreased pain and temperature sensation in the upper extremities, atrophy of the intrinsic muscles of his hand, and brisk deep tendon reflexes in the upper extremity. Your diagnosis?
A. Amyotrophic lateral sclerosis
B. Multiple sclerosis
C. Syringomyelia
D. Subacute combined degeneration
|
#### C. Syringomyelia
|
C. Syringomyelia
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Predominantly, for management of which one of the following resources is the critical path method (CPM) used as one of the health administration techniques-
A. Money
B. Manpower
C. Time
D. Material
|
#### C. Time
|
C. Time
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 50-year-old man develops a mass on the back of his hand. The lesion somewhat resembles a "volcano" and consists of a round, firm, flesh colored, 1-cm nodule with sharply rising edges and a central crater. Keratotic debris can be expressed from the central crater. The lesion has developed very rapidly over about a three-month period. Most likely diagnosis?
A. Keratoacanthoma
B. Lipoma
C. Malignant melanoma
D. Pyogenic granuloma
|
#### A. Keratoacanthoma
|
A. Keratoacanthoma
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
An 11-year-old boy is brought to the physician for a follow-up examination. He has been having difficulties with his schoolwork over the past 4 years. He has a seizure disorder treated with valproic acid. He was able to walk independently at the age of 3 years and was able to use a fork and spoon at the age of 4 years. He is at the 40th percentile for height and 60th percentile for weight. Vitals signs are within normal limits. Examination shows multiple freckles in the axillary and groin skin folds as well as scoliosis. There are 14 hyperpigmented macules over the back and chest. There are multiple soft, painless nodules over the extremities and the trunk. Ophthalmic examination shows hyperpigmented iris nodules bilaterally. This patient is at increased risk for which of the following conditions?
A. Optic glioma
B. Glaucoma
C. Renal cell carcinoma
D. Giant cell astrocytoma
"
|
#### A. Optic glioma
|
A. Optic glioma
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 70 year old male presented with excessive fatigue, fever & bleeding from gums while brushing. O/E- he has splenomegaly. CBC shows marked pancytopenia with presence of blasts. t(15;17)(q22;q12) cytogenetic rearrangement is found in this patient. Which of the following agents will you use in management of this patient?
A. Acyclovir
B. Daunorubicin
C. Rituximab
D. Tretinoin
|
#### D. Tretinoin
|
D. Tretinoin
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 64-year-old man presents to the outpatient clinic because of abdominal pain. He reports that for the last few months, he has had postprandial pain that is worsened by spicy foods. He states that the pain is often located in the right upper portion of his abdomen and feels like it's traveling to his shoulder blade. These episodes are sporadic and unpredictable. He denies any fevers. Physical examination shows no abnormalities. Abdominal ultrasound is shown. Which of the following is the best treatment for this condition?
A. Cholecystectomy
B. Endoscopic retrograde cholangiopancreatography (ERCP)
C. Ketorolac
D. Ursodeoxycholic acid
|
#### A. Cholecystectomy
|
A. Cholecystectomy
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
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