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Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 55 year old comes to Victoria OPD with history of swelling of his hands, shoness of breath.O/E facial plethora, distened neck viens was noted. Which is the most probable structure involved to cause these symptoms?
A. 3
B. 4
C. 5
D. 6
|
#### A
|
A. 3
|
LLMcompe-Team-Watanabe/grpo4medical-1k
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Given the following medical question or situation, provide the most suitable reasoning or explanation.
Which of the following tumours have an increase delevation of placental alkaline phosphatase in the serum as well as a positive immunohistochemical staining for placental alkaline phosphatase?
A. Seminoma
B. Hepatoblastoma
C. Hepatocellular carcinoma
D. Peripheral neuroectodermal tumour
|
#### A
|
A. Seminoma
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
2 moles of an ideal gas are expanded reversibly and isothermally at 0°C from 1 atm. Calculate the final volume occupied by the gas if the heat absorbed during the pro-cess is 1 = 750 cal.
A. 84.4 liters
B. 44.8 liters
C. 60 liters
D. 50 liters
E. 110 liters
F. 100 liters
G. 75 liters
H. 120 liters
I. 92.1 liters
J. 70 liters
|
#### A
|
A. 84.4 liters
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Severe Laxity of joints - a) Marfan's syndrome b) Ehler Danlos c) RA d) Osteogenesis imperfecta e) OA
A. ab
B. abc
C. ade
D. ae
|
#### A
|
A. ab
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 57-year-old man presents to his physician with dyspnea on exertion and rapid heartbeat. He denies any pain during these episodes. He works as a machine operator at a solar panels manufacturer. He has a 21-pack-year history of smoking. The medical history is significant for a perforated ulcer, in which he had to undergo gastric resection and bypass. He also has a history of depression, and he is currently taking escitalopram. The family history is unremarkable. The patient weighs 69 kg (152 lb). His height is 169 cm (5 ft 7 in). The vital signs include: blood pressure 140/90 mm Hg, heart rate 95/min, respiratory rate 12/min, and temperature 36.6℃ (97.9℉). Lung auscultation reveals widespread wheezes. Cardiac auscultation shows decreased S1 and grade 1/6 midsystolic murmur best heard at the apex. Abdominal and neurological examinations show no abnormalities. A subsequent echocardiogram shows increased left ventricular mass and an ejection fraction of 50%. Which of the options is a risk factor for the condition detected in the patient?
A. The patient’s body mass
B. History of gastric bypass surgery
C. Exposure to heavy metals
D. Smoking
E. Escitalopram intake
|
#### D
|
D. Smoking
|
LLMcompe-Team-Watanabe/grpo4medical-1k
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Given the following medical question or situation, provide the most suitable reasoning or explanation.
A person involved in a murder is brought to you for determination of age since the defence attorney wants him to be treated as a minor. The results of Xrays are as given below:\r\n\r\n1) All the epiphyses of the elbow have fused\r\n2) All the epiphyses of the shoulder joint have fused\r\n3) The epiphyses of the inner end of the clavicles has fused\r\n4) The ramus of pubis and ischium has fused \r\n\r\n \r\nWhat is the approximate age of this person assuming that it is a male?
A. 15 - 17
B. 18 - 19
C. 20 years
D. 21 or more
|
#### D
|
D. 21 or more.
|
LLMcompe-Team-Watanabe/grpo4medical-1k
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Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 23-year-old woman presents with a 4-week menstrual delay. She also complains of irritability, increased somnolence, and occasional nausea. She had her first menarche at the age of 13, and her menstrual cycle became regular at the age of 15. She has been sexually active since the age of 20 but has had the same sexual partner since then. They stopped using birth control protection approximately 6 months ago. She does not smoke and consumes alcohol occasionally. Her blood pressure is 120/80 mm Hg, heart rate is 71/min, respiratory rate is 14/min, and temperature is 36.6℃ (98.2℉). Physical examination is significant only for slight breast engorgement and nipple pigmentation. Gynecologic examination reveals cervical softening and cyanosis. Which of the following drugs would be recommended for this patient?
A. Progesterone
B. Biphasic oral contraceptive
C. Folic acid
D. Vitamin A
E. Combination of natural estrogen and progestin
|
#### C
|
C. Folic acid
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
According to RNTCP, tubercular pericarditis should be treated with which category of anti-tubercular regimen?
A. Category III
B. Category I
C. Category II
D. Category IV
|
#### B
|
B. Category I
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
In population of 9000, 2100 were alcoholics out of which 70 alcoholics developed cirrhosis, 23 non-alcoholics developed cirrhosis. Calculate attribute risk
A. 90%
B. 70%
C. 60%
D. 40%
|
#### B
|
**B. 70%**.
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 50 year old woman presented with chief complaints of cough with bloody sputum, dyspnoea, chest pain, loss of appetite and unexplained weight loss. Chest X-Ray revealed a mass in the left lung with elevated left dome of the diaphragm. CT-scan revealed a tumor invading the lung surface anterior to the hilum. Which of the following nerves is most likely to be involved by the tumor?
A. Recurrent laryngeal nerve
B. Intercostal nerve
C. Vagus nerve
D. Phrenic nerve
|
#### D
|
D. Phrenic nerve
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 64-year-old woman presents to the hospital for chemotherapy. She has newly diagnosed acute myeloid leukemia. She is due to receive treatment with bendamustine for 2 days. On day 2 of her treatment, the patient complains of intense pain in her right great toe. On physical exam, the metatarsophalangeal joint of the 1st toe is warm, erythematous, swollen, and tender to both movement and palpation. An arthrocentesis is performed that reveals negatively birefringent needle-shaped crystals under polarized light. A Gram stain of the synovial fluid is negative. In addition to adequate intravenous hydration, which of the following if given would have most likely prevented the patient’s symptoms?
A. Acetazolamide
B. Allopurinol
C. Colchicine
D. Corticosteroids
E. Probenecid
|
#### B
|
B. Allopurinol
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
In return for a 20% partnership interest, Skinner contributed 5,000 cash and land with a 12,000 basis and a 20,000 fair market value to the partnership. The land was subject to a 10,000 mortgage that the partnership assumed. In addition, the partnership had 20,000 in recourse liabilities that would be shared by partners according to their partnership interests. What amount represents Skinner’s basis in the partnership interest?
A. 17,000
B. 20,000
C. 25,000
D. 12,000
E. 15,000
F. 19,000
G. 13,000
H. 14,000
I. 27,000
J. 21,000
|
#### G
|
**G. 13,000**
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
You are examining a direct inguinal hernia in a 45 year old man. On examination the swelling is doughy in consistency and dull on percussion. The swelling is reducible but reduction is difficult towards the end. What is your diagnosis?
A. Cystocele
B. Enterocele
C. Epiplocele
D. Hydrocele
|
#### C
|
C. Epiplocele
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 31 year old female patient complains of bilateral impairment of hearing for the 5 year. On examination, tympanic membrane is normal and audiogram shows a bilateral conductive deafness. Impedance audiometry shows As type of curve and acoustic reflexes are absent. All constitute pa of treatment, except:
A. Hearing aid
B. Stapedectomy
C. Sodium fluoride
D. Gentamicin
|
#### D
|
D. Gentamicin
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Patient comes with crush injury to upper limb, doctor is concerned about gangrene and sepsis what can help decide between amputation and limb salvage?
A. MESS
B. GCS score
C. Gustilo-Anderson classification
D. ASIA guidelines
|
#### A
|
A. MESS
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 2-year-old boy is brought to a pediatrician for recurrent respiratory infections. The parents explain that their child has gotten sick every month since 2 months of age. The boy had multiple upper respiratory infections and has been treated for pneumonia twice. He coughs frequently, and a trial of salbutamol has not helped much. The parents also mention that the child has bulky, irregular stools. The boy was started late on his vaccinations as his parents were in Asia on missionary work when he was born, but his vaccinations are now up to date. The patient's brother and sister are both healthy and have no medical concerns. The boy's delivery was unremarkable. A sweat chloride test is positive. Genetic testing shows the absence of the typical deletion in the implicated gene, but the gene length appears to be shortened by one base pair. Which mutation could account for this finding?
A. Frameshift
B. Insertion
C. Missense
D. Nonsense
E. Silent
|
#### A
|
A. Frameshift
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A child presented with fever for 2 days, altered sensorium and purpuric rashes. His blood pressure is 90/60 mmHg. Treatment of choice is>
A. IV Quinine
B. IV Artesunate
C. IV Penicillin
D. Chloroquine
|
#### C
|
C. IV Penicillin
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 50-year-old female patient presented with swelling of the right jaw. The swelling was painless and covered with exudate. She also gave a history of trauma to the same area. The pus was sent for culture. On macroscopic examination, a Sulphur granule was found in the exudate. The gram stain of the exudate is given below. What is the drug of choice of the above condition: -
A. Penicillin
B. Azithromycin
C. Doxycycline
D. Streptomycin
|
#### A
|
A. Penicillin
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 57-year-old man presents the urgent care clinic with a one-week history of diffuse bone pain and generalized weakness. He was diagnosed with end-stage renal disease 6 months ago and is currently on dialysis. His wife, who is accompanying him today, adds that he is not compliant with his medicines. He has been diabetic for the last 10 years and hypertensive for the last 7 years. He has smoked 4–5 cigarettes per day for 30 years but does not drink alcohol. His family history is insignificant. On examination, the patient has a waddling gait. Hypotonia of all the limbs is evident on neurologic examination. Diffuse bone tenderness is remarkable. X-ray of his legs reveal osteopenia and osseous resorption. The final step of activation of the deficient vitamin in this patient occurs by which of the following enzymes?
A. 7-α-hydroxylase
B. 1-α-hydroxylase
C. α-Glucosidase
D. 24,25 hydroxylase
|
#### B
|
B. 1-α-hydroxylase
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
What does a kindergarten teacher do before nap time?
A. lower expectations
B. encourage
C. fear
D. time test
E. tell story
|
#### E
|
E. tell story
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 57-year-old man is brought to the emergency department by his wife 20 minutes after having had a seizure. He has had recurrent headaches and dizziness for the past 2 weeks. An MRI of the brain shows multiple, round, well-demarcated lesions in the brain parenchyma at the junction between gray and white matter. This patient's brain lesions are most likely comprised of cells that originate from which of the following organs?
A. Prostate
B. Kidney
C. Lung
D. Skin
|
#### C
|
C. Lung
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Here is a table where the first line is a header and each subsequent line is a penguin: name, age, height (cm), weight (kg) Louis, 7, 50, 11 Bernard, 5, 80, 13 Vincent, 9, 60, 11 Gwen, 8, 70, 15 For example: the age of Louis is 7, the weight of Gwen is 15 kg, the height of Bernard is 80 cm. What is the name of the 0.6 m tall penguin?
Options:
(A) Louis
(B) Bernard
(C) Vincent
(D) Gwen
(E) James
|
#### C
|
(C) Vincent
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 5-month old baby presents to emergency with history of vomiting, irritability & jaundice. The baby was previously healthy. History of introducing fruit juices into the diet one week back. USG revealed hepatomegaly and liver function test were abnormal. The infants most likely has deficiency of which of the following enzymes?
A. Fructokinase
B. Aldolase B
C. Galactose-1-phosphate uridyl transferase
D. Alpha glucosidase
|
#### B
|
B. Aldolase B
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A middle aged man with chronuc renal failure is diagnostic to have sputum positive pulmonary tuberculosis. His creatinine clearance is 25ml /min. All of the following drugs need modification in doses except
A. Isoniazid
B. Streptomycin
C. Rifamipicin
D. Ethambutol
|
#### C
|
C. Rifampicin
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 5-year-old boy presents to his pediatrician along with his parents due to episodes of “staring into space.” This symptom occurs several times a day and lasts only a few seconds. During these episodes, the boy does not respond to verbal or physical stimulation, and his parents deny him falling down or shaking. After the episode, the boy returns to his normal activity and is not confused. The parents deny any history of head trauma, recent medication use, or infection. Neurological exam is unremarkable. His episode is precipitated as he blows at a pinwheel. An EEG is performed, which shows 3-Hz spike and waveform. Which of the following is the best treatment option for this patient?
A. Ethosuximide
B. Levetiracetam
C. Lamotrigine
D. Zonisamide
|
#### A
|
A. Ethosuximide
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 45-year-old man presents with exertional dyspnea and pitting pedal edema. His neck veins are dilated. A diagnosis of superior vena cava (SVC) syndrome is made. What will you do next?
A. Do total blood count and peripheral smear
B. Do a CT chest
C. Start cyclophosphamide
D. Start radiotherapy
|
#### B
|
B. Do a CT chest
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 35-year-old woman visits the office with complaints of yellowish vaginal discharge and increased urinary frequency for a week. She also complains of pain during urination. Past medical history is irrelevant. She admits to having multiple sexual partners in the past few months. Physical examination is within normal limits except for lower abdominal tenderness. Urine culture yields Chlamydiae trichomatis. What is the most appropriate next step in the management of this patient?
A. Acyclovir
B. Doxycycline
C. Boric acid
D. Metronidazole
|
#### B
|
B. Doxycycline
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
If z = arctan(e^{1 + (1 + x)^2}), what's the derivative of \frac{\partial z}{\partial x} at x = 0.
A. 0.4752
B. 0.6210
C. 0.4123
D. 0.5678
E. 0.5439
F. 0.2896
G. 0.3017
H. 0.1345
I. 0.6571
J. 0.2198
|
#### G
|
G. 0.3017
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Today, Nancy went to the beach. Between what times could they have gone?
We know that:
Nancy woke up at 6am.
John saw Nancy walking in the garden from 6am to 10am.
Tiffany saw Nancy working at the office from 10am to 11am.
Leslie saw Nancy buying clothes at the mall from 11am to 12pm.
Michael saw Nancy taking photos near the Leaning Tower of Pisa from 1pm to 6pm.
The beach was closed after 6pm.
Between what times could Nancy have gone to the beach?
Options:
(A) 12pm to 1pm
(B) 10am to 11am
(C) 6am to 10am
(D) 1pm to 6pm
|
#### A
|
(A) 12pm to 1pm.
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Treatment of solitary rectal ulcer are A/E:a) Laxativesb) Rectopexyc) Bandingd) Sclerosant injectione) Enema
A. cd
B. bc
C. bd
D. ac
|
#### A
|
A. cd
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Consider the following - 1. Kerosene poisoning 2. Organo-phosphorus poisoning 3. Corrosive poisoning 4. Iron poisoning In which of the above is gastric lavage contraindicated?
A. 1 only
B. 1 and 3 only
C. 2 and 4 only
D. l,2, 3and 4
|
#### B
|
B. 1 and 3 only
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 39-year-old woman presents to the emergency department with fever, cough, and shortness of breath. She reports developing flu-like symptoms 7 days ago but progressively worsened to the point where she experiences dyspnea on exertion. Her cough is accompanied by a mild amount of yellow sputum. Past medical history is notable for a previous admission to the hospital for pneumonia 4 months ago and an admission for bacteremia 6 weeks ago. She additionally has a history of IV heroin abuse, but her last use of heroin was 3 years ago. Temperature is 101.2°F (38.4°C), blood pressure is 104/70 mmHg, pulse is 102/min, and respirations are 20/min. Physical examination demonstrates coarse upper airway breath sounds over the right lower lung field. A faint 1/6 non-radiating systolic flow murmur is auscultated at the first right intercostal space. Abdominal examination is significant for moderate splenomegaly. Tenderness of the wrists and fingers is elicited on palpation, and range of motion is restricted. The patient comments that her range of motion and pain usually improve as the day goes on. Which of the following laboratory abnormalities is most likely to be found in this patient?
A. Decreased anion gap
B. Leukocytosis with left-shift
C. Neutropenia
D. Positive HIV serology
|
#### C
|
C. Neutropenia
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
An infant born at 35 weeks' gestation to a mother with no prenatal care is noted to be jittery and irritable, and is having difficulty feeding. You note coarse tremors on examination. The nurses repo a high-pitched cry and note several episodes of diarrhea and emesis. You suspect the infant is withdrawing from
A. Alcohol
B. Marijuana
C. Heroin
D. Cocaine
|
#### C
|
C. Heroin
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
This SVG path element <path d = "M 22.06,65.18 L 22.58,64.52 L 7.52,52.61 L 7.00,53.26 L 22.06,65.18"/> draws a
Options:
(A) circle
(B) heptagon
(C) hexagon
(D) kite
(E) line
(F) octagon
(G) pentagon
(H) rectangle
(I) sector
(J) triangle
(K) trapezoid
|
#### K
|
(K) trapezoid
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Congo red staining of abdominal fat has confirmed a diagnosis of Amyloidosis in a 28-year-old man. Which is the most common cause of death in primary AL Amylodosis?
A. Respiratory failure
B. Cardiac failure
C. Renal failure
D. Septicemia
|
#### B
|
B. Cardiac failure
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 56-year-old man presents to his family physician for issues with his back that have persisted since he was in his 20’s. For the last 6 months, his neck has been very stiff and he has been unable to tilt his head backwards. He also has severe kyphosis and feels limited in his range of motion. He tries to get at least 8 hours of sleep each night, but he says he rarely feels rested. On examination, the patient has no pain on active and passive movements. His cervical spine is moderately stiff; limitations are in extension, flexion, and rotation. There is also evidence of mild swelling of his wrist joints. The patient is sent for an X-ray of his lumbar spine. Unfortunately, he did not seek medical care for years due to financial hardships. Which of the following therapies would have been first line for improving this patient’s symptoms early in the course of this disease?
A. Infliximab
B. Indomethacin
C. Ceftriaxone
D. Methotrexate
E. Sulfasalazine
|
#### B
|
B. Indomethacin
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A lung biopsy of a HIV patient showed intra nuclear basophilic inclusion bodies with perinuclearhalo.The patient's CD4 was les then 100 at the time of diagnosis. What is the probable cause?
A. CMV
B. MAC
C. Pneumocystis
D. TB
|
#### A
|
A. CMV
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Ultrasound examination of a developing fetus demonstrates a fluid-filled sac at the base of the fetus' spine that connects to the spinal canal and apparently contains pa of the spinal cord. A dietary deficiency of which of the following is most strongly associated with this type of lesion?
A. Calcium
B. Folate
C. Iron
D. Vitamin C
|
#### B
|
B. Folate
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 30 year old farmer presents with the features of high fever painful inguinal lymphadenopathy, vomiting and diarrhoea with hypotension. Which stain will help in the diagnosis?
A. Wayson's stain
B. Neisser stain
C. Albes stain
D. McFadyean's stain
|
#### A
|
A. Wayson's stain
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 42-year-old man comes to the physician for the evaluation of episodic headaches involving both temples for 5 months. The patient has been taking acetaminophen, but it has not provided relief. He has also had double vision. Ophthalmic examination shows impaired peripheral vision bilaterally. Contrast MRI of the head shows a 14 x 10 x 8-mm intrasellar mass. Further evaluation is most likely to show which of the following findings?
A. Macroglossia
B. Impotence
C. Galactorrhea
D. Polyuria
|
#### B
|
B. Impotence
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
An 8-year-old boy is brought to the pediatrician because his mother is concerned about recent behavioral changes. His mother states that she has started to notice that he is slurring his speech and seems to be falling more than normal. On exam, the pediatrician observes the boy has pes cavus, hammer toes, and kyposcoliosis. Based on these findings, the pediatrician is concerned the child has a trinucleotide repeat disease. Which of the following trinucleotide repeats is this child most likely to possess?
A. CGG
B. GAA
C. CAG
D. GCC
|
#### B
|
B. GAA
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 77-year-old woman with congestive heart failure is admitted to the hospital for evaluation prior to cardiac transplantation. During her stay at the hospital, the physician prescribes a drug to improve cardiac contractility. The drug works by selectively inhibiting an isoenzyme that is responsible for the degradation of cyclic adenosine monophosphate. Which of the following is the most likely adverse effect of this drug?
A. Hyperkalemia
B. Hypotension
C. Hyperglycemia
D. Bronchospasm
|
#### B
|
B. Hypotension
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Say the incidence of a disease D is about 5 cases per 100 people (i.e., P(D) = 0.05). Let Boolean random variable D mean a patient “has disease D” and let Boolean random variable TP stand for "tests positive." Tests for disease D are known to be very accurate in the sense that the probability of testing positive when you have the disease is 0.99, and the probability of testing negative when you do not have the disease is 0.97. What is P(TP), the prior probability of testing positive.
A. 0.051
B. 0.091
C. 0.0368
D. 0.025
E. None of the above
F. 0.473
G. All of the above
H. 0.099
I. 0.078
J. 0.065
|
#### I
|
I. 0.078
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 58-year-old woman with refractory gastrointestinal complaints undergoes a bowel biopsy. On histology, the pathologist observes that submucosal glands of Brunner are present in the specimen. Which portion of the bowel was most likely biopsied?
A. Duodenum
B. Jejunum
C. Ileum
D. Descending colon
|
#### A
|
A. Duodenum
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 19-year-old college student develops a rash. She works part-time in a pediatric AIDS clinic. Her blood is drawn and tested for specific antibody to the chicken pox virus (varicella-zoster). Which of the following antibody classes would you expect to find if she is immune to chicken pox?
A. IgG
B. IgA
C. IgM
D. IgD
|
#### A
|
A. IgG
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Baby 20 year old female complains of sudden onset palpitation and apprehension. She is sweating for last 10 minutes and fears of impending death. Diagnosis is -
A. Hysteria
B. Generalized anxiety disorder
C. Cystic fibrosis
D. Panic attack
|
#### D
|
D. Panic attack
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 10-year old child is undergoing squint surgery. He suddenly developed increased hea rate, arrhythmia, high fever, metabolic and respiratory acidosis on aerial blood gases and elevation of end tidal CO2. Which of the following would be the first agent of choice in the management of this condition?
A. Dantrolene
B. Paracetamol
C. Procainamide
D. Sodium bicarbonate
|
#### A
|
A. Dantrolene
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 50-year-old HIV-positive male comes to OPD wit complaints of fever and breathlessness . He is diagnosed as a case of Pneumocystis jiroveci pneumonia (PCP). At what CD4 T cell % ,primary prophylaxis for this condition is recommended to be staed?
A. < 20%
B. < 5%
C. <15%
D. <10%
|
#### A
|
A. < 20%
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A Woman, 29 yrs, married for 3 years, unable to conceive, has regular menstrual cycles, mild dysmenorrhea, Her pelvic scan shows an intramural fibroid of 3 cms and a follicular ovarian cyst A tubal assessment by HSG is normal as well. Husbands semen analysis is normal and so is his hormonal profile. Which of these is the most likely cause for infeility?
A. Polycystic ovarian disease
B. Fibroid uterus
C. Endometriosis
D. Tubal factor
|
#### C
|
C. Endometriosis.
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 6-year-old boy is brought to the physician because of increasing swelling around his eyes for the past 3 days. During this period, he has had frothy light yellow urine. He had a sore throat 12 days ago. He appears tired. His temperature is 37°C (98.6°F), pulse is 90/min, and blood pressure is 105/65 mm Hg. Examination shows periorbital edema and pitting edema of the lower extremities. Cardiopulmonary examination shows no abnormalities. Which of the following findings on urinalysis is most likely associated with this patient's condition?
A. WBC casts
B. Hyaline casts
C. RBC casts
D. Fatty casts
|
#### D
|
D. Fatty casts
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
During growth factor-induced cellular regeneration, which transition during cell cycle is controlled by the phosphorylation of the retinoblastoma protein:
A. G0 to Gl
B. Gl to S
C. S to G2
D. G2 to M
|
#### B
|
B. G1 to S
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 6-year-old Hispanic male was admitted to the hospital for pain in his left thigh that has increased in severity over the past several months to the point that he can no longer walk. His mother explained that he had the pain about a year ago that resolved spontaneously. She also explained that he has had nose bleeds frequently for the past 6 months. On physical exam, hepatosplenomegaly was observed and he was noted to have a low-grade fever. A CT with intravenous contrast demonstrated aseptic necrosis of the left femoral head. Based on the clinical presentation, the attending physician ordered an assay showing significantly low levels of beta-glucocerebrosidase in peripheral blood leukocytes. Which of the following diseases shares a similar mode of inheritance as the disease experienced by this patient?
A. Phenylketonuria
B. Menke's disease
C. Alport's syndrome
D. Hemophilia A
|
#### A
|
A. Phenylketonuria
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 39-year-old woman complains of developing painful pale fingers on cold exposure for the past 5 years. Recently, she has noticed swollen fingers and tight skin, which limit flexion and extension. She also has new abdominal symptoms that are bothersome. On examination, the skin on the fingers is smooth and shiny with associated edema. The rest of the examination is normal. Which part of the gastrointestinal (GI) tract is most frequently involved in this condition?
A. esophagus
B. stomach
C. duodenum
D. ileum
|
#### A
|
A. esophagus
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Here is a table where the first line is a header and each subsequent line is a penguin: name, age, height (cm), weight (kg) Louis, 7, 50, 11 Bernard, 5, 80, 13 Vincent, 9, 60, 11 Gwen, 8, 70, 15 For example: the age of Louis is 7, the weight of Gwen is 15 kg, the height of Bernard is 80 cm. We now add a penguin to the table:
James, 12, 90, 12
How many penguins are more than 8 years old?
Options:
(A) 1
(B) 2
(C) 3
(D) 4
(E) 5
|
#### B
|
(B) 2
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Suppose a monopoly market has a demand function in which quantity demanded depends not only on market price (P) but also on the amount of advertising the firm does (A, measured in dollars). The specific form of this function is Q = (20 - P)(1 + 0.1A - 0.01A^2). The monopolistic firm's cost function is given by C = 10Q + 15 + A. Suppose there is no advertising (A = 0). What output will the profit-maximizing firm choose?
A. 20
B. 0
C. 12
D. 5
E. 8
F. 30
G. 15
H. 10
I. 18
J. 25
|
#### D
|
D. 5
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 52-year-old man presents to the out-patient clinic complaining of episodes of severe unilateral, stabbing facial pain that is intermittent for several hours, and then disappears for several days. The pain is described as "electric shock-like" and only lasts a few seconds. Physical examination of the face and mouth is entirely normal. Which of the following treatments is most effective for this condition?
A. morphine
B. indomethacin
C. cimetidine
D. carbamazepine
|
#### D
|
D. carbamazepine
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A patient married for 3 years, unable to conceive, has regular menstrual cyclesHusbands semen analysis is normal and so is his hormonal profile What is the right time in menstrual cycle to do endometrial biopsy for infeility:-
A. 12-14 days
B. 17-19 days
C. 20-22 days
D. 3-5 days
|
#### C
|
C. 20-22 days
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A patient has carcinoma of right tongue on its lateral border of anterior 2/3rd, with lymph node of size 4 cm in level 3 on left side of the neck, stage of disease is:
A. NO
B. N1
C. N2
D. N3
|
#### C
|
C. N2
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 35 year old male presented with nasal discharge, facial pain and fever which subsided with a course of antibiotics and antihistaminics, which recurred again after 2 months. O/E mucopurulent discharge from middle meatus, and inflammed sinus openings, investigation of choice -
A. X-ray PNS
B. NCCT PNS
C. MRI of the face
D. Inferior meatal puncture
|
#### B
|
B. NCCT PNS
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A child with unilateral white reflex and raised intraocular pressure. the required investigation are all except
A. Usg
B. Tonometer
C. Observation under anaesthesia
D. CT scan
|
#### D
|
**D. CT scan**
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
An old man's autopsy shows brown atrophy of the liver. Microscopic morphology shows finely granular, yellow-brown pigment which often surrounded the nucleus. Brown atrophy is due to accumulation of:
A. Melanin
B. Hemosiderin
C. Hematin
D. Lipofuscin
|
#### D
|
D. Lipofuscin
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A ten year old child with aggressive behavior and poor concentration is brought with presenting complaints of joint pain and reduced urinary output. Mother gives history of self mutilitative behavior stating that he tends to mutilate his fingers. Which of the following enzymes is likely to be deficient in this child
A. HGP
B. Adenosine Deaminase
C. Galactokinase
D. Acid Maltase
|
#### A
|
A. HGP
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Downbeat nystagmus is characteristic of -a) Posterior fossa lesionb) Vestibular lesionc) Labyrinthine lesiond) Cerebellar lesion
A. b
B. ad
C. ac
D. ab
|
#### B
|
B. ad
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 9 year old girl presents with menarche. History reveals thelarche at the age of 7 years and adrenarche at the age of 8 years- the M/C cause of this condition in girls is:
A. Idiopathic
B. Gonadal tumor
C. Mc cure albright syndrome
D. Hypothyroidism
|
#### A
|
A. Idiopathic
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 55-year-old woman who is an established patient presents to your office. She is complaining of increased urination and increased thirst. She has recently began taking several over-the-counter vitamins and supplements. On further review, she reports she has also been having abdominal pain and constipation. She denies significant weight changes. Her fingerstick blood glucose in your office is 96 mg/dL.
Which of the following test is most likely to provide the diagnosis?
A. Pyridoxine levels
B. Niacin levels
C. Calcium level
D. Free T4 levels
|
#### C
|
C. Calcium level
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 26-year-old man comes to the physician because of a 1-week history of left-sided chest pain. The pain is worse when he takes deep breaths. Over the past 6 weeks, he had been training daily for an upcoming hockey tournament. He does not smoke cigarettes or drink alcohol but has used cocaine once. His temperature is 37.1°C (98.7°F), pulse is 75/min, and blood pressure is 128/85 mm Hg. Physical examination shows tenderness to palpation of the left chest. An x-ray of the chest is shown. Which of the following is the most appropriate initial pharmacotherapy?
A. Nitroglycerin
B. Alprazolam
C. Alteplase
D. Heparin
E. Naproxen
|
#### E
|
E. Naproxen
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 10-year-old girl is brought to the emergency department by her mother 30 minutes after having had a seizure. When her mother woke her up that morning, the girl's entire body stiffened and she started shaking vigorously for several minutes. Her mother also reports that over the past few months, her daughter has had multiple episodes of being unresponsive for less than a minute, during which her eyelids were fluttering. The girl did not recall these episodes afterwards. Upon arrival, she appears drowsy. Neurologic examination shows no abnormalities. Which of the following is the most appropriate pharmacotherapy to prevent recurrence of this patient's symptoms?
A. Phenytoin
B. Lorazepam
C. Ethosuximide
D. Valproate
|
#### D
|
D. Valproate
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Within 5 minutes after a bee sting, a 15-year-old girl suddenly has difficulty breathing, with marked inspiratory stridor from laryngeal edema. She experiences marked urticaria and notes swelling of the hand that was stung. Which of the following is the best pharmacologic agent to treat her signs and symptoms?
A. Cyclosporine
B. Epinephrine
C. Glucocorticoids
D. Methotrexate
|
#### B
|
B. Epinephrine
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A ruby laser is aimed in free space at a target 10,000 Km away. If the laser beam initially is 14 mm in diameter, how large in diameter will the beam be when it hits the target? (\lambda = 694.3 nm)
A. 1600 m
B. 1210 m
C. 1500 m
D. 1700 m
E. 1410 m
F. 2000 m
G. 1800 m
H. 1000 m
I. 1310 m
J. 1900 m
|
#### B
|
**B. 1210 m**.
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 32-year-old woman makes an appointment with her family physician for a new-employment physical examination. She has no complaints and the physical examination is unremarkable. The family history is negative for malignancies and inherited disorders. During the visit, she provides the results of a Pap smear taken last week, which reports the presence of atypical squamous cells of undetermined significance (ASC-US), along with a test for HPV, which was negative. The previous Pap smear was normal (negative for intraepithelial lesions or malignancy). When would you recommend that she have another Pap smear?
A. Immediately
B. 6 months
C. 3 years
D. 5 years
E. 1 year
|
#### C
|
C. 3 years
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 29-year-old patient presents to her primary care physician with persistent amenorrhea and inability to breastfeed over the last 5 months. She says that she has also been very tired since her baby was born and this fatigue was accompanied by an inability to deal with cold weather despite having no problem with cold prior to becoming pregnant. She has gained an additional 5 pounds since delivery. Review of her hospital records reveals that she had a vaginal delivery that was complicated by severe hemorrhage and episodes of hypotension. Which of the following hormone levels is most likely to be normal in this patient?
A. Follicle-stimulating hormone (FSH)
B. Prolactin
C. Thyroid hormone
D. Aldosterone
|
#### D
|
**D. Aldosterone**
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 25-year-old female presented in the month of December with chronic fatigue, cyanosis with bluish lips and ahralgia. Peripheral blood film is shown below. What is the likely cause?
A. Cold AIHA
B. Warm AIHA
C. Hemoglobinopathy
D. G6PD Deficiency
|
#### A
|
A. Cold AIHA
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 14-year-old girl is brought to the physician because she frequently experiences cramping and pain in her legs during school sports. She is at the 10th percentile for height. Her blood pressure is 155/90 mm Hg. Examination shows a high-arched palate with maloccluded teeth and a low posterior hairline. The patient has a broad chest with widely spaced nipples. Pelvic examination shows normal external female genitalia with scant pubic hair. Without appropriate treatment, this patient is at the greatest risk of developing which of the following complications?
A. Osteoporosis
B. Severe acne
C. Hyperphagia
D. Alzheimer disease
|
#### A
|
A. Osteoporosis
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Ocular examination of a man with a systemic disease shows 'sunflower cataract'. It has developed due to:
A. Diabetes mellitus
B. SLE
C. Chalcosis
D. Sarcoidosis
|
#### C
|
C. Chalcosis
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
True about laryngitis sicca -a) Caused by Klebsiella ozaenab) Caused by Klebsiella rhinoscleromatosisc) Hemorrhagic crust formation seend) Antifungal are effectivee) Microlaryngoscopic surgery is a modality of treatment
A. acd
B. ace
C. cde
D. ade
|
#### B
|
B. ace
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
This SVG path element <path d = "M 12.98,31.92 L 92.45,24.58 M 92.45,24.58 L 59.03,76.23 L 12.98,31.92"/> draws a
Options:
(A) circle
(B) heptagon
(C) hexagon
(D) kite
(E) line
(F) octagon
(G) pentagon
(H) rectangle
(I) sector
(J) triangle
|
#### J
|
(J) triangle
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 55 year old male patient with gastritis symptoms diagnosed to have gastric ulcer for which he had undergone partial gastrectomy three years back is on high dose omeprazole. Follow-up endoscopy reveals two ulcerative lesions in gastric mucosa. What is the next step in management?
A. H pylori serology
B. Insulin tolerance
C. Gastrin level
D. CT Scan
|
#### C
|
C. Gastrin level
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 32-year-old male presents to his primary care provider for headache. He reports that he has headaches at night several times a week. He first developed these headaches over a year ago, but he had not had any for several months before they started up again three weeks ago. The episodes start suddenly and feel like a stabbing, electrical pain over his left eye. He also reports tearing of the left eye during these episodes. The headaches self-resolve over the course of 2-3 hours, but the patient complains that he is avoiding going to sleep for fear of waking up in pain. His past medical history includes type I diabetes mellitus and an episode of herpes zoster on his right flank one year ago. His only home medication is insulin. On physical exam, his extraocular muscles are intact and his eyes are not injected and without lacrimation. A CT of the head and sinuses shows no acute abnormalities. Which of the following is most likely to prevent future episodes of headache in this patient?
A. Carbamazepine
B. Sumatriptan
C. Topiramate
D. Verapamil
|
#### D
|
D. Verapamil
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
All are true regarding agammaglobulinemia except -a) Loss of germinal centre in lymph nodeb) Normal cortical lymphocytesc) Normal cortical lymphocytes in paracortex and medullad) Decreased red pulp in spleene) Immunodeficiency (cell mediated)
A. abc
B. acd
C. ac
D. bcd
|
#### D
|
D. bcd
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 40 year old male, chronic smoker comes with acute epigastric discomfo, for past one hour. ECG showing ST segment elevation in inferior leads. What is the immediate intervention ?
A. Aspirin
B. Thrombolytic therapy
C. IV pantoprazole
D. Beta blockers
|
#### A
|
A. Aspirin
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 4-day-old male newborn delivered at 39 weeks' gestation is evaluated because of poor feeding, recurrent vomiting, and lethargy. Physical examination shows tachypnea with subcostal retractions. An enzyme assay performed on a liver biopsy specimen shows decreased activity of carbamoyl phosphate synthetase I. This enzyme plays an important role in the breakdown and excretion of amino groups that result from protein digestion. Which of the following is an immediate substrate for the synthesis of the molecule needed for the excretion of amino groups?
A. N-acetylglutamate
B. Homocysteine
C. Phenylalanine
D. Aspartate
"
|
#### D
|
D. Aspartate
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Intermittent dysphagia is caused by -a) Strictureb) Reflux esophagitisc) Achalasia cardiad) Pharyngeal diverticulme) Diffuse esophageal spasm
A. ab
B. bc
C. cd
D. de
|
#### D
|
D. de
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 59-year-old man presents to the emergency department with diffuse abdominal pain that radiates to his back, nausea, and vomiting. The vital signs include: temperature 36.7°C (98.0°F), blood pressure 126/74 mm Hg, heart rate 74/min, and respiratory rate 14/min. The laboratory evaluation on admission is significant for a serum glucose 241 mg/dL, aspartate aminotransferase (AST) 321 IU/dL, and leukocyte count 21,200/mL. Within 3 days of admission with supportive care in the intensive care unit, the patient’s clinical condition begins to improve. Based on Ranson’s Criteria, what is this patient’s overall risk of mortality, assuming all other relevant factors are negative?
A. < 10%
B. 20%
C. 40%
D. 80%
E. 100%
|
#### B
|
B. 20%
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
PCOD which of the following is seen:a) Hirsutismb) Secondary amenorrhoeac) Streak ovariesd) ↑ FSH / LHe) Oestrogen (E2)
A. abc
B. bcd
C. abe
D. acd
|
#### C
|
C. abe
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A patient presented with weakness of the right side of the face with loss of pain and temperature , Pain and temperature sensation of the left leg is lost The lesion is most likely located
A. lateral poms
B. medial pons
C. lateral medulla
D. Medial medulla
|
#### A
|
A. lateral pons
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A village has a total of 100 under-five children. The coverage with measles vaccine in this age group is 60%. Following the occurrence of a measles case in a child after a visit outside, twenty six children developed measles. The secondary attack rate ofmeasles is -
A. 25%
B. 40%
C. 50%
D. 65%
|
#### D
|
D. 65%
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Young child weighing 20 kg was given a drug in the dose 100mg/kg body weight. The plasma concentration of the drug is 2mg/ dl and the clearance is 200 ml/hr. What is the time required to reach steady state plasma concentration -
A. 10 hrs
B. 20hrs
C. 30hrs
D. 40hrs
|
#### B
|
**B. 20 hours**
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
50 year old, Rishi has a diagnosis of pulmonary tuberculosis. How many infectious nuclei per cough are likely to be seen in sputum examination?
A. 1000
B. 2000
C. 3000
D. 4000
|
#### C
|
C. 3000
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
An obese lady aged 45 years, was brought to emergency in a semi comatose condition. The laboratory investigations showed K+ (5.8 mmol/L); Na+ (136 mmol/L); blood pH (7.1), HCO3 (12 mmol/L),' ketone bodies (350 mg/dI). The expected level of blood glucose for this lady is -
A. < 45 mg/dl.
B. < 120 mg/dl.
C. >180 mg/dl.
D. < 75 mg/dl.
|
#### C
|
C. >180 mg/dl.
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 16-year-old male was brought with removal of clothes while watching movies complaints of seeing wave like forms and sudden monocular blindness. The diagnosis is
A. Migraine
B. Exhibitionism
C. Temporal lobe epilepsy
D. Grandmal epilepsy
|
#### A
|
A. Migraine
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
Solve for the sum of all possible values of x when 3^{x^2+4x+4} = 9^{x+2}.
A. 3
B. -5
C. -2
D. -4
E. 2
F. 1
G. -3
H. 0
I. 4
J. 5
|
#### C
|
C. -2
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 5-year-old male visits his pediatrician for a check-up. His height corresponds to the 99th percentile for his age, and pubic hair is present upon physical examination. Serum renin and potassium levels are high, as is 17-hydroxyprogesterone. Which of the following is likely deficient in this patient?
A. 17a-hydroxylase
B. 11ß-hydroxylase
C. 21-hydroxylase
D. Aromatase
E. 5a-reductase
|
#### C
|
C. 21-hydroxylase
|
LLMcompe-Team-Watanabe/grpo4medical-1k
|
Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 25-year-old medical student returns from a volunteer mission trip in Nicaragua with persistent cough and occasional hemoptysis for 3 weeks. A purified protein derivative test revealing a 20 mm wheal and a chest radiograph with hilar lymphadenopathy support a diagnosis of active tuberculosis. The patient is started on appropriate therapy. Among the prescribed medications, one drug inhibits carbohydrate polymerization of the pathogen's cell wall. What is the most likely complaint that the patient may present with because of this drug?
A. Joint pain
B. Leg numbness
C. Nausea and vomiting
D. Orange colored urine
E. Vision changes
|
#### E
|
E. Vision changes
|
LLMcompe-Team-Watanabe/grpo4medical-1k
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Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 60 year old male suffering from auditory hallucination says that people staying upwards are talking about him and conspiring against him. He dropped a police compliant against them but the allegations were proved to be wrong. The diagnosis is:
A. Depression
B. Dementia
C. Delusional disorder
D. Schizophrenia
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#### D
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D. Schizophrenia
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LLMcompe-Team-Watanabe/grpo4medical-1k
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Given the following medical question or situation, provide the most suitable reasoning or explanation.
An investigator is comparing the risk of adverse effects among various antiarrhythmic medications. One of the drugs being studied primarily acts by blocking the outward flow of K+ during myocyte repolarization. Further investigation shows that the use of this drug is associated with a lower rate of ventricular tachycardia, ventricular fibrillation, and torsade de points when compared to similar drugs. Which of the following drugs is most likely being studied?
A. Esmolol
B. Sotalol
C. Procainamide
D. Verapamil
E. Amiodarone
|
#### E
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E. Amiodarone
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LLMcompe-Team-Watanabe/grpo4medical-1k
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Given the following medical question or situation, provide the most suitable reasoning or explanation.
Superficial perineal muscles include -a) Superficial transverse perineib) Bulbospongiosusc) Ischiocavernosusd) Iliococcygeuse) Pubococcygeus
A. ab
B. bc
C. acd
D. abc
|
#### D
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D. abc
|
LLMcompe-Team-Watanabe/grpo4medical-1k
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Given the following medical question or situation, provide the most suitable reasoning or explanation.
a female have pain and insect crawling like feeling on legs at night which is relieved by shaking her legs .whats the doc ?
A. pramiprexole
B. vit b12
C. fe tablets
D. gabapentin
|
#### A
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A. pramiprexole
|
LLMcompe-Team-Watanabe/grpo4medical-1k
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Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 25 year old male patient complains of pain in the lower back tooth region. History of similar complaint 6 months ago.
Intra-oral examination reveals pericoronitis with 36. An IOPA is taken with the same tooth. During film processing, the thermometer in the manual processing tank reads 68◦F. The approximate time to keep the x-ray film in the developer solution is?
A. 2 minutes
B. 3 minutes
C. 4 minutes
D. 5 minutes
|
#### D
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D. 5 minutes
|
LLMcompe-Team-Watanabe/grpo4medical-1k
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Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 36 years old woman recently treated for leukemia is admitted to the hospital with malaise, chills and high fever. Gram stain of blood reveals the presence of gram-negative bacilli. The initial diagnosis is bacteremia and parenteral antibiotics are indicated. The record of the patient reveals that she had a severe urticarial rash, hypotension and respiratory difficulty after oral penicillin V about 6 months ago. The most appropriate drug should be :
A. Ampicillin plus Sulbactam
B. Aztreonam
C. Cefazolin
D. Imipenem plus cilastatin
|
#### B
|
B. Aztreonam
|
LLMcompe-Team-Watanabe/grpo4medical-1k
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Given the following medical question or situation, provide the most suitable reasoning or explanation.
A 57-year-old man with a history of coronary artery disease has been brought to the emergency department due to the sudden onset of chest pain. He was diagnosed with hypertension 12 years ago and takes enalapril regularly. The patient is hypotensive to 70/42 mm Hg, and on further examination his skin is cold and clammy. He is diagnosed with a life-threatening condition that resulted from inadequate circulation of blood, with decreased cardiac output and high pulmonary capillary wedge pressure. Which of the conditions below can cause the same disorder?
I. Acute myocardial infarction
II. Atrial fibrillation
III. Hemorrhage
IV. Valvular stenosis
V. Pulmonary embolism
VI. Sepsis
A. I, II, III
B. I, IV, VI
C. I, IV, V
D. I, II, IV, V
E. I, II, IV
|
#### E
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E. I, II, IV
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LLMcompe-Team-Watanabe/grpo4medical-1k
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