Datasets:

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lemon-mint

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GBaker-MedQA-USMLE-4-options-Korean

like 0

{ "A": "Ampicillin", "B": "Ceftriaxone", "C": "Doxycycline", "D": "Nitrofurantoin" }

[ "23 year old pregnant woman", "weeks presents", "burning", "urination", "states", "started 1 day", "worsening", "drinking", "water", "taking cranberry extract", "feels well", "followed by", "doctor", "pregnancy", "temperature", "97", "36", "blood pressure", "mmHg", "pulse", "80 min", "respirations", "min", "oxygen saturation", "98", "room air", "Physical exam", "notable", "absence", "costovertebral angle tenderness", "gravid uterus", "following", "best treatment", "patient" ]

{ "A": "영아를 잠자는 동안 단단한 매트리스 위에 반듯이 눕히는 것", "B": "영아를 덮어두고 높은 실내 온도를 유지하는 것", "C": "수면 자세를 유지하기 위한 장치 사용", "D": "수면 중 공갈 젖꼭지 사용 금지" }

[ "3 month old baby died", "night", "asleep", "mother", "died only", "awoke in", "morning", "cause of death", "based", "autopsy", "following precautions", "prevented", "death", "baby" ]

{ "A": "복측 췌장 싹의 비정상적인 이동", "B": "근위 십이지장의 완전한 재개통 실패", "C": "유문부의 비정상적인 비대", "D": "측면 체벽이 복측으로 이동하여 정중선에서 융합 실패" }

[ "mother", "week old infant", "pediatrician's office", "concerned", "feeding habits", "born", "complications", "not", "medical problems", "time", "past", "days", "fussy", "regurgitating", "feeds", "vomit", "yellow", "color", "physical exam", "child's abdomen", "distended", "abnormalities", "following embryologic errors", "account", "presentation" ]

{ "A": "Thromboembolism", "B": "Pulmonary ischemia", "C": "Pulmonary hypertension", "D": "Pulmonary passive congestion" }

[ "pulmonary autopsy specimen", "58 year old woman", "died", "acute hypoxic respiratory failure", "examined", "recently", "surgery", "fractured femur 3 months", "Initial hospital course", "uncomplicated", "discharged", "rehab facility", "good health", "discharge home", "rehab", "sudden shortness of breath", "cardiac", "Resuscitation", "unsuccessful", "histological examination", "lung tissue", "fibrous connective tissue", "lumen of", "pulmonary artery", "observed", "following", "most likely pathogenesis", "present findings" ]

{ "A": "혈우병 A", "B": "루푸스 항응고 인자", "C": "단백질 C 결핍", "D": "폰 빌레브란트병" }

[ "20 year old woman presents", "menorrhagia", "past", "years", "menses", "always", "heavy", "easy bruising", "long", "remember", "Family history", "significant", "mother", "similar problems", "bruising easily", "patient's vital signs include", "heart rate 98 min", "respiratory rate", "min", "temperature 36", "96 9F", "blood pressure", "87 mm Hg", "Physical examination", "unremarkable", "Laboratory tests show", "following", "platelet count 200", "mm3", "PT", "seconds", "PTT", "seconds", "following", "most likely cause", "patients symptoms" ]

{ "A": "Aspirin", "B": "Oral contraceptive pills", "C": "Scorpion sting", "D": "Hypothyroidism" }

[ "40 year old", "presents", "emergency department", "severe abdominal", "radiates", "back", "nausea", "pain started 2 days", "slowly increased", "not", "longer", "Past medical history", "significant", "hypertension", "hypothyroidism", "reports", "recently stung", "one", "smaller scorpions", "not", "medical treatment", "takes aspirin", "levothyroxine", "oral contraceptive pills", "multivitamin daily", "Family history", "Today", "blood pressure", "58 mm Hg", "heart rate", "99 min", "respiratory rate", "min", "temperature", "98", "physical exam", "well", "obese female", "looks unwell", "heart", "regular rate", "rhythm", "Radial pulses", "weak", "symmetric", "lungs", "clear", "auscultation", "lateral", "swollen", "erythematous", "painful to palpate", "abdominal CT", "consistent with acute pancreatitis", "following", "most likely etiology", "patients disease" ]

{ "A": "Bilirubin assessment", "B": "Coagulation studies", "C": "Leukocyte count with differential", "D": "24-hour urine protein" }

[ "year old primigravida presents", "physician", "routine prenatal visit", "weeks gestation", "confirmed by", "ultrasound examination", "complaints", "notes", "new shoes", "bought 2 weeks", "not fit", "course", "pregnancy", "compliant", "recommended prenatal care", "medical history", "unremarkable", "pound weight gain", "last visit", "weeks", "vital signs", "follows", "blood pressure", "90 mm Hg", "heart rate", "88 min", "respiratory rate", "min", "temperature", "36", "97", "blood", "repeat assessment", "hours later", "90 mm Hg", "fetal heart rate", "min", "physical examination", "significant", "pitting edema", "lower extremity", "following tests", "confirm", "probable condition", "patient" ]

{ "A": "Gastric fundus in the thorax", "B": "Pancreatic ring around the duodenum", "C": "Hypertrophy of the gastric pylorus", "D": "Large bowel in the inguinal canal" }

[ "male infant", "delivered", "weeks", "gestation", "spontaneous vaginal delivery", "Pregnancy", "delivery", "uncomplicated", "prenatal ultrasound", "20 weeks showed", "defect", "pleuroperitoneal membrane", "Further evaluation", "patient", "most likely to show", "following findings" ]

{ "A": "Atenolol", "B": "Diltiazem", "C": "Propafenone", "D": "Digoxin" }

[ "62 year old woman presents", "regular check-up", "lightheadedness", "palpitations", "occur", "Past medical history", "significant", "myocardial infarction", "months", "NYHA class II chronic heart failure", "diagnosed", "grade I arterial hypertension 4", "Current medications", "aspirin 81 mg", "atorvastatin 10 mg", "enalapril 10 mg", "metoprolol 200 mg daily", "vital signs", "blood pressure", "90 mm Hg", "heart rate", "min", "respiratory rate", "min", "temperature", "36", "97", "Cardiopulmonary examination", "significant", "irregular heart rhythm", "decreased S1 intensity", "ECG", "obtained", "shown", "picture", "see image", "Echocardiography shows", "left ventricular ejection fraction", "following drugs", "best choice", "rate control", "patient" ]

{ "A": "코피", "B": "영구적인 후각 상실", "C": "지속적인 비강 가피", "D": "지속적인 코막힘" }

[ "35 year old male presents", "primary care physician", "complaints", "seasonal allergies", "using intranasal vasoconstrictors", "times per day", "several weeks", "likely sequela of", "chronic use", "topical nasal decongestants" ]

{ "A": "Cavernous sinus의 육아종성 염증", "B": "Cavernous sinus와 internal carotid artery 사이의 비정상적인 소통", "C": "Orbit 내 Glycosaminoglycan 축적", "D": "Levator palpebrae superioris의 교감 신경 과잉 활동" }

[ "year old woman", "physician", "2-week history", "diplopia", "ocular pain", "reading", "newspaper", "3 month history of amenorrhea", "hot flashes", "increased sweating", "reports", "overweight", "adult life", "happy to", "lost", "kg", "weight", "past", "months", "pulse", "min", "blood pressure", "98 mm Hg", "Physical examination shows moist palms", "nontender thyroid gland", "enlarged", "two times", "normal size", "Ophthalmologic examination shows prominence", "globes", "eyes", "bilateral lid retraction", "conjunctival injection", "to converge", "eyes", "pain", "movement", "extraocular muscles", "Visual acuity", "20/20", "Neurologic examination shows", "fine resting tremor of", "hands", "Deep tendon reflexes", "3", "shortened relaxation phase", "following", "most likely cause", "patient's ocular complaints" ]

{ "A": "시냅스 전 전압 개폐 칼슘 채널에 대한 자가항체", "B": "말초 신경의 자가면역 탈수초화", "C": "신경근 접합부에서 시냅스 전 아세틸콜린 방출 차단", "D": "전각 내 하위 운동 신경 파괴" }

[ "year old boy presents", "emergency department", "weakness", "change in", "behavior", "parents state", "first", "change in", "behavior", "morning", "getting worse", "patient", "initially weak", "upper body", "arms", "now", "move", "legs", "strength", "vigor", "used to", "Physical exam", "notable", "bilateral ptosis", "sluggish pupillary response", "very weak sucking", "gag reflex", "shallow respirations", "patient", "currently drooling", "diaper", "dry", "parents state", "not", "bowel movement", "1 day", "following", "pathophysiology", "patients condition" ]

{ "A": "Neural tube", "B": "Surface ectoderm", "C": "Neural crest", "D": "Notochord" }

[ "23 year old man", "physician", "evaluation", "decreased hearing", "dizziness", "ringing in", "right ear", "past 6 months", "Physical examination shows multiple soft", "yellow plaques", "papules", "arms", "chest", "back", "sensorineural hearing loss", "weakness", "facial muscles", "gait", "unsteady", "MRI of", "brain shows", "3", "mass", "right internal auditory meatus", "2 cm mass", "left cerebellopontine angle", "abnormal cells", "masses", "most likely derived", "following embryological structures" ]

{ "A": "Chronic decrease in pulmonary compliance", "B": "Local accumulation of kinins", "C": "Progressive obstruction of expiratory airflow", "D": "Incremental loss of functional residual capacity" }

[ "62 year old woman", "physician", "coughing", "fatigue", "past", "years", "morning", "cough", "productive", "white phlegm", "short of breath walking", "flight", "stairs", "hypertension", "hyperlipidemia", "recently retired", "working", "nurse", "homeless shelter", "smoked 1 pack", "cigarettes daily", "40 years", "Current medications include ramipril", "fenofibrate", "temperature", "36", "97", "respirations", "min", "pulse", "85 min", "blood pressure", "90 mm Hg", "Scattered wheezing", "rhonchi", "heard", "lung fields", "murmurs", "rubs", "heart sounds", "distant", "following", "most likely underlying cause", "patient's symptoms" ]

{ "A": "Graded exercise and aspirin", "B": "Heparin drip", "C": "Surgical thrombectomy", "D": "Tissue plasminogen activator" }

[ "68 year old man presents", "emergency department", "leg pain", "states", "pain started", "walking outside", "patient", "past medical diabetes", "hypertension", "obesity", "atrial fibrillation", "temperature", "99", "4C", "blood pressure", "98 mmHg", "pulse", "97 min", "respirations", "min", "oxygen saturation", "99", "room air", "Physical exam", "notable", "cold", "pale left leg", "patients sensation", "markedly diminished", "left leg", "compared", "right", "muscle strength", "1/5", "left leg", "following", "best next step", "management" ]

{ "A": "Hydrochlorothiazide", "B": "Midodrine", "C": "Oxybutynin", "D": "Tamsulosin" }

[ "76 year old African American man presents", "primary care provider", "urinary frequency", "wakes up", "times", "night to", "only", "to wake up", "night", "post-void dribbling", "difficulty initiating", "stream of urine", "denies", "difficulty maintaining", "erection", "past medical history", "notable", "non-alcoholic fatty liver disease", "hypertension", "hyperlipidemia", "gout", "takes aspirin", "atorvastatin", "enalapril", "allopurinol", "family history", "notable", "prostate cancer", "father", "lung cancer", "mother", "pack-year smoking history", "drinks alcohol", "digital rectal exam", "prostate", "enlarged", "smooth", "non-tender", "following medications", "indicated", "patient" ]

{ "A": "식도위십이지장 내시경 검사 (Esophagogastroduodenoscopy)", "B": "수소 호흡 검사 (Hydrogen breath test)", "C": "심장 부하 검사 (Cardiac stress test)", "D": "우상 복부 초음파 검사 (Abdominal ultrasonography of the right upper quadrant)" }

[ "68 year old man", "physician", "of recurrent episodes", "nausea", "abdominal discomfort", "past", "months", "discomfort", "upper abdomen", "sometimes occurs", "eating", "big meal", "to go", "walk", "dinner to help", "digestion", "complaints", "only increased", "past", "weeks", "symptoms", "climbing", "stairs", "apartment", "type 2 diabetes mellitus", "hypertension", "stage 2 peripheral arterial disease", "smoked one pack", "cigarettes daily", "past", "years", "drinks one", "two beers daily", "occasionally", "weekends", "current medications include metformin", "enalapril", "aspirin", "5 ft 6", "tall", "kg", "BMI", "kg/m2", "temperature", "36 4C", "97", "pulse", "min", "blood pressure", "mm Hg", "physical examination", "abdomen", "soft", "nontender", "organomegaly", "Foot pulses", "absent", "ECG shows", "abnormalities", "following", "most appropriate next step", "diagnosis" ]

{ "A": "It may result in corneal vascularization", "B": "It may result in the triad of confusion, ophthalmoplegia, and ataxia", "C": "It may be exacerbated by excessive ingestion of raw eggs", "D": "It may manifest itself as a prolonged PT" }

[ "27 year old female presents", "general medical clinic", "routine checkup", "genetic disease marked", "mutation", "chloride transporter", "history of chronic bronchitis", "brother", "similar history", "infections", "infertility", "following", "most likely true", "potential vitamin deficiency complication secondary to", "patient's chronic illness" ]

{ "A": "흉부 CT에서 폐 기저부의 Bullous changes", "B": "ERCP에서 간 내외 담관의 Beading", "C": "심혈관 MRI에서 심근 철분 침착", "D": "세극등 검사에서 각막의 짙은 고리" }

[ "healthy 36 year old man", "physician", "yellow discoloration", "skin", "dark-colored urine", "2 weeks", "not drink", "alcohol", "Physical examination shows jaundice", "Abdominal", "neurologic examinations show", "abnormalities", "Serum studies show increased levels", "alanine aminotransferase", "ALT", "aspartate aminotransferase", "AST", "liver biopsy", "performed", "photomicrograph", "periodic acid-Schiff-staining", "shown", "following", "most likely additional finding", "patient" ]

{ "A": "가장 가능성 있는 진단은 cauda equina syndrome이며 MRI 전에 스테로이드를 시작해야 합니다.", "B": "가장 가능성 있는 진단은 cauda equina syndrome이며 MRI 후에 스테로이드를 시작해야 합니다.", "C": "가장 가능성 있는 진단은 cauda equina syndrome이며 환자를 방사선 치료로 급히 옮겨야 합니다.", "D": "가장 가능성 있는 진단은 conus medullaris syndrome이며 MRI 전에 스테로이드를 시작해야 합니다." }

[ "69 year old male presents", "emergency room", "back pain", "history of personality disorder", "metastatic prostate cancer", "not", "candidate", "surgical resection", "began chemotherapy", "discontinued due to", "nausea", "denies", "bowel", "bladder incontinence", "never", "pain", "before", "demanding morphine", "nurse administers IV morphine", "feels more", "Vital signs", "stable", "physical examination", "note tenderness", "palpation", "lower spine", "weakness in", "bilateral lower extremities", "left greater than right", "Neurological examination", "notable", "hyporeflexia", "knee", "ankle jerks", "conduct", "rectal examination", "reveals saddle anesthesia", "patient", "most likely diagnosis", "appropriate next step", "management" ]

{ "A": "저체온증", "B": "고체온증", "C": "다음다증", "D": "식욕 부진" }

[ "investigator", "studying", "function", "lateral nucleus", "hypothalamus", "experimental animal", "Using", "viral vector", "genes encoding chloride conducting channelrhodopsins", "injected", "nucleus", "channels causes complete inhibition", "Persistent", "most likely to result", "following abnormalities", "animals" ]

{ "A": "Cytokine-independent activation of the JAK-STAT pathway", "B": "Loss of function of the APC gene", "C": "Altered expression of the retinoic acid receptor gene", "D": "Unregulated expression of the ABL1 gene" }

[ "year old woman", "physician", "month history", "generalized fatigue", "low-grade fever", "a 10 kg", "weight loss", "Physical examination shows generalized pallor", "splenomegaly", "hemoglobin concentration", "7.5 g/dL", "leukocyte count", "800 mm3", "Leukocyte alkaline phosphatase activity", "low", "Peripheral blood smear shows basophilia", "myelocytes", "metamyelocytes", "Bone marrow biopsy shows cellular hyperplasia", "proliferation", "immature granulocytic", "following mechanisms", "most likely responsible", "patient's condition" ]

{ "A": "Acute cholangitis", "B": "Alcoholic hallucinosis", "C": "Delirium tremens", "D": "Hepatic encephalopathy" }

[ "year old woman", "hospital recovering", "cholecystectomy performed 3 days", "complicated", "cholangitis", "treated with IV piperacillin-tazobactam", "calls", "nurse", "room", "heart", "racing", "demands", "clean", "pile", "garbage", "floor", "flies", "pulse", "min", "respiratory rate", "20 min", "temperature", "100 4F", "blood pressure", "90 mm Hg", "physical examination", "patient appears sweaty", "distressed", "unable to", "oriented to person", "not place", "time", "Palpation of", "abdomen shows", "tenderness", "guarding", "following", "most likely diagnosis", "patient" ]

{ "A": "간 이식 시도", "B": "경구 탈리도마이드 요법 시작", "C": "사혈 요법 시작", "D": "경구 하이드록시클로로퀸 요법 시작" }

[ "48 year old woman", "emergency department", "of", "photosensitive blistering", "hands", "forearms", "face", "weeks", "lesions", "not itchy", "urine", "dark brown", "color recently", "Twenty years", "treated", "Coats", "retina", "retinal sclerotherapy", "currently", "hormonal replacement", "perimenopausal symptoms", "aunt", "sister", "history of", "similar skin lesions", "Examination shows multiple fluid filled blisters", "erosions", "forearms", "dorsal side", "hands", "forehead", "hyperpigmented scarring", "patches", "bald skin", "sides", "blisters", "Laboratory studies show", "normal serum ferritin concentration", "following", "most appropriate next step", "management to induce remission in", "patient" ]

{ "A": "요 pH: 7.3", "B": "요 pH: 4.7", "C": "양성 아질산염 검사", "D": "대량 양성 요 단백" }

[ "year old man", "emergency department", "of severe right-sided flank pain", "hours", "pain", "colicky", "radiates", "right groin", "8/10", "intensity", "vomited", "history of similar episodes", "past", "year", "treated with naproxen", "swelling", "pain", "right toe", "history of hypertension", "drinks one", "two beers", "weekends", "Current medications include amlodipine", "appears", "temperature", "99", "pulse", "min", "blood pressure", "90 mm Hg", "Examination shows", "soft", "nontender abdomen", "right costovertebral angle tenderness", "upright x-ray of", "abdomen shows", "abnormalities", "CT scan", "abdomen", "pelvis shows", "7-mm stone", "proximal ureter", "grade I hydronephrosis", "right", "following", "most likely to", "seen", "urinalysis" ]

{ "A": "Granulosa cell tumor", "B": "Idiopathic precocious puberty", "C": "McCune-Albright syndrome", "D": "Sertoli-Leydig tumor" }

[ "5 year old girl", "brought", "clinic", "mother", "excessive hair growth", "mother reports", "past", "months", "hair", "axillary", "pubic areas", "denies", "family history", "precocious puberty", "reports", "daughter", "relatively healthy", "uncomplicated birth history", "denies", "recent illnesses", "weight change", "fever", "vaginal bleeding", "pain", "medication use", "Physical examination demonstrates Tanner stage 4 development", "pelvic ultrasound shows", "ovarian mass", "Laboratory studies demonstrates", "elevated level", "estrogen", "most likely diagnosis" ]

{ "A": "Acting out (행동화)", "B": "Projection (투사)", "C": "Passive aggression (수동 공격성)", "D": "Regression (퇴행)" }

[ "year old boy", "brought", "physician", "mother", "worried", "behavior", "expelled from school", "repeatedly skipping classes", "past", "months", "suspended 3 times", "bullying", "aggressive behavior", "peers", "teachers", "neighbor found", "smoking cigarettes", "backyard", "past", "maintained", "grade average", "a regular", "youth group events", "local church", "mother first", "change in behavior", "months", "time", "father moved out", "discovering", "wife", "following defense mechanisms best", "change in", "patient's behavior" ]

{ "A": "직접 검안경 검사", "B": "안압", "C": "머리의 MR 혈관 조영술", "D": "측두 동맥 생검" }

[ "63 year old woman presents", "primary-care doctor", "2 month history", "vision changes", "gradual onset", "double vision", "double vision", "present", "time", "not", "better", "worse", "day", "hard time keeping", "right eye open", "right eyelid looks", "mirror", "Physical exam findings", "primary gaze", "shown", "right pupil", "6 mm", "poorly reactive to light", "rest", "neurologic exam", "unremarkable", "Laboratory studies show", "Hb A1c", "5.0", "following", "next best test", "patient" ]

{ "A": "Glycosylation", "B": "Phosphorylation", "C": "Carboxylation", "D": "Ubiquitination" }

[ "investigator", "studying", "modification", "newly formed polypeptides", "plated eukaryotic cells", "polypeptides", "released", "ribosome", "a chemically tagged protein", "lysine residues", "polypeptide chain", "forming", "modified polypeptide", "barrel-shaped complex", "added", "cytoplasm", "modified polypeptide lyses", "resulting in individual amino acids", "chemically tagged proteins", "following post-translational modifications", "most likely occurred" ]

{ "A": "Astrocytes에서 감소된 α-ketoglutarate dehydrogenase 활성", "B": "증가된 extracellular concentration of glutamate", "C": "증가된 astrocyte lactate", "D": "혈액-뇌 장벽의 붕괴" }

[ "year old man presents", "physician", "double vision", "week", "enters", "exam room", "physician notes", "patient", "broad-based gait", "mans wife informs", "doctor", "alcoholic", "years", "consumption", "alcohol", "increased", "past", "months", "reports", "indifferent", "family members", "time", "frequently agitated", "memory", "affected", "detail", "often recollects", "version", "true one", "physical examination", "vital signs", "stable", "doctor", "to", "confused", "neurological examination", "shows nystagmus", "following options", "earliest change", "pathophysiology", "central nervous system", "man" ]

{ "A": "Alteplase", "B": "Urokinase", "C": "Celecoxib", "D": "Clopidogrel" }

[ "69 year old man", "brought", "son", "emergency department", "weakness", "right arm", "leg", "man", "fine", "blames", "son", "creating panic", "Four hours", "patient", "tea", "wife", "dropped", "difficulty moving", "right arm", "then", "walk", "right leg feels", "history of hypertension", "dyslipidemia", "currently takes lisinopril", "atorvastatin", "allergic", "aspirin", "peanuts", "computerized tomography", "scan shows evidence", "ischemic stroke", "medication", "most likely prevent", "attacks", "patient", "future" ]

{ "A": "Methotrexate", "B": "Rituximab", "C": "Cyclophosphamide", "D": "Prednisone" }

[ "70 year old man presents", "medical clinic reporting blood", "urine", "lower abdominal pain", "past", "days", "concerned", "urinary frequency", "urgency", "states", "recently completed", "cycle", "chemotherapy", "non-Hodgkin lymphoma", "medication", "chemotherapy", "likely caused", "symptoms" ]

{ "A": "amoxicillin-clavulanic acid 투여", "B": "trimethoprim-sulfamethoxazole 투여", "C": "봉합으로 상처를 닫고 환자를 퇴원시킴", "D": "외래 진료를 예약하고 환자를 퇴원시킴" }

[ "27 year old man presents", "emergency department", "dog bite", "patient", "pulled", "dogs tail", "eating", "dog", "friend", "back", "friends house currently", "Physical exam", "notable", "dog bite", "patients right arm", "wound", "irrigated", "retained bodies found", "tetanus vaccination", "administered", "following", "appropriate management", "patient" ]

{ "A": "Intravenous hydration", "B": "Paracetamol", "C": "Stop risperidone", "D": "Switch risperidone to clozapine" }

[ "year old woman", "parents", "presents", "one-week history", "abnormal behavior", "delusions", "unusual aggression", "denies fever", "seizures", "illicit drug use", "Family history", "negative", "psychiatric illnesses", "started", "risperidone", "sent home", "parents", "Three days later", "brought", "emergency department", "fever", "confusion", "not", "responsive", "hospital", "temperature", "blood pressure", "100 60 mm Hg", "pulse rate", "min", "respiratory rate", "min", "extremely diaphoretic", "appears stiff", "spontaneous eye opening", "not", "responsive", "not following commands", "Laboratory studies show", "Sodium", "mmol", "0 mmol", "1 8 mg dl", "mg dl Creatine", "blood cells", "500", "Hemoglobin", "g", "Urinalysis shows protein 1", "hemoglobin", "occasional leukocytes", "red blood casts", "best first step", "management", "condition" ]

{ "A": "Myasthenia gravis", "B": "Polymyositis", "C": "Amyotrophic lateral sclerosis", "D": "Multiple sclerosis" }

[ "35 year old woman", "physician", "month history", "double vision", "difficulty climbing stairs", "weakness", "to brush", "hair", "reports", "symptoms", "worse", "exercises", "rests", "hours", "Physical examination shows drooping", "right upper eyelid", "worsens", "patient", "to gaze", "2 minutes", "diminished motor strength", "upper extremities", "examination shows", "abnormalities", "following", "most likely diagnosis" ]

{ "A": "CD4+ T 세포 수 증가", "B": "바이러스 단백질에 대한 분비형 IgA", "C": "세균 침입을 막는 IgM 증가", "D": "AB 외독소에 대한 순환 IgG" }

[ "year old male", "recently", "United States", "Asia", "admitted", "hospital", "dyspnea", "Physical exam reveals", "gray pseudomembrane", "patient's oropharynx", "lymphadenopathy", "patient", "myocarditis", "expires", "hospital day 5", "following", "prevented", "patient's presentation" ]

{ "A": "Posterior horn cells of the spinal cord", "B": "Myelin sheath of neurons", "C": "Muscle cells", "D": "Anterior horn of the spinal cord" }

[ "year old boy", "recently", "Pakistan presents", "fever", "muscle pain", "weakness", "trunk", "abdomen", "legs", "patients mother", "not", "vaccinated", "Physical examination reveals fasciculation", "flaccid paralysis of", "lower limbs", "CSF analysis reveals lymphocytosis", "normal glucose", "protein levels", "throat swab reveals", "RNA virus", "following", "most likely", "destroyed", "virus", "patient" ]

{ "A": "High X and high Y", "B": "High X and low Y", "C": "Low X and high Y", "D": "Low X and low Y" }

[ "researcher", "studying", "properties", "enzyme", "adds phosphate groups", "glucose", "discovers", "enzyme", "present", "body tissues", "cytoplasm", "cells", "enzyme", "to mix", "enzyme", "conditions", "levels", "glucose", "order to", "kinetic properties", "enzyme", "adds increasing levels", "glucose", "saturating concentration", "phosphate", "sees", "rate", "glucose", "gets faster", "higher levels", "glucose", "observes", "rate approaches", "maximum speed", "calls", "speed", "then", "concentration", "glucose", "needed to make", "enzyme function", "half", "speed", "calls", "concentration", "following", "most likely true", "properties", "enzyme" ]

{ "A": "Spermatogonia", "B": "Allantois", "C": "Syncytiotrophoblast", "D": "Sertoli cells" }

[ "31 year old", "female", "40 weeks presents", "hospital following", "rush", "water", "vagina", "4", "dilated", "80", "Fetal heart", "shows", "pulse", "min", "variable decelerations", "12 hours", "presentation", "gives birth", "oz baby boy", "APGAR scores", "8", "5 minutes", "following structures", "responsible", "inhibition", "female internal genitalia" ]

{ "A": "hydrogen peroxide로 적혈구의 부분 용해를 유도하는 박테리아", "B": "산소에 민감한 세포 독소로 혈액 한천 배지의 적혈구의 완전 용해를 유도하는 박테리아", "C": "혈액 한천 배지의 적혈구의 헴 분해를 유도하는 박테리아", "D": "제대로 성장하려면 혐기성 환경이 필요한 박테리아" }

[ "year old woman presents", "emergency department", "palpitations", "dry cough", "shortness of breath", "1 week", "United States", "Korea", "age", "20", "heart", "racing", "never felt", "symptoms", "cough", "dry", "associated with shortness of breath", "occurs", "minimal exertion", "past medical history", "unremarkable", "allergies", "not currently taking", "medications", "nonsmoker", "occasional drinker", "denies illicit drug use", "blood pressure", "100 65 mm Hg", "pulse", "76 min", "respiratory rate", "23 min", "temperature", "36", "98", "physical examination", "significant", "lung crackles", "non radiating", "low-pitched", "mid-diastolic rumbling murmur best heard", "apical region", "addition", "jugular vein distention", "bilateral pitting edema", "lower extremities", "following best", "infectious agent", "led", "patients condition" ]

{ "A": "Atrial septal defect", "B": "Ventricular septal defect", "C": "Tetralogy of Fallot", "D": "Patent ductus arteriosus" }

[ "male neonate", "examined", "pediatrician", "mother informs", "doctor", "mild fever with rash", "muscle pain", "swollen", "tender lymph nodes", "second month", "gestation", "boy", "born", "weeks gestation", "spontaneous vaginal delivery", "prenatal care", "physical examination", "neonate", "normal vital signs", "Retinal examination reveals", "findings shown", "image", "following congenital heart defects", "most likely to", "present", "neonate" ]

{ "A": "Th1 세포에 의한 IL-2 생성", "B": "MHC-II에 의한 TCR 활성화", "C": "C5-9 복합체 형성", "D": "보체의 C2 성분 분해로 C2a 및 C2b 생성" }

[ "4 year old boy", "brought", "emergency department", "parents", "lethargic", "confused", "severe headache", "vomiting", "high-grade fever since earlier", "day", "mother reports", "child", "well", "2 days", "fever", "green nasal discharge", "patient", "history of neonatal sepsis", "meningococcemia", "months", "age", "pneumococcal pneumonia", "3 years", "age", "scheduled vaccinations", "date", "blood pressure", "70 50 mm Hg", "heart rate", "min", "respiratory rate", "min", "temperature", "3C", "4F", "examination", "child", "lethargic", "skin", "pale", "several petechiae", "buttocks", "purulent nasal discharge", "nostrils", "lungs", "clear", "auscultation", "Heart sounds", "normal", "marked neck rigidity", "Cerebrospinal fluid analysis shows", "following results", "Opening pressure 100 mm H2O Appearance cloudy Protein 500 mg/dL", "5 g/L", "White blood cells 2500 L", "predominance", "Protein 450 mg/dL", "4.5 g/L", "Glucose 31 mg/dL", "1.7 mmol/L", "Culture positive", "N", "meningitidis", "following immunological processes", "most likely to", "impaired", "child" ]

{ "A": "Inhibition of nucleoside reverse transcriptase", "B": "Inhibition of proton translocation", "C": "Inhibition of neuraminidase", "D": "Inhibition of protease" }

[ "66 year old woman", "chronic obstructive pulmonary disease", "brought", "emergency department", "fever", "body aches", "malaise", "dry cough", "smoked one pack", "cigarettes daily", "30 years", "quit smoking 1 year", "lives with", "daughter", "granddaughter", "attends daycare", "temperature", "Physical examination shows bilateral conjunctivitis", "rhinorrhea", "erythematous tonsils", "exudates", "Further testing confirms infection", "orthomyxovirus", "Administration", "drug", "of", "following mechanisms", "action", "most appropriate" ]

{ "A": "음성 고음 제한", "B": "기침 무력", "C": "어깨 으쓱거림 약화", "D": "호흡 곤란" }

[ "year old woman", "hemithyroidectomy", "treatment of localized", "well-differentiated papillary thyroid carcinoma", "lesion", "removed", "clear margins", "surgery", "structure lying directly adjacent to", "superior thyroid artery", "upper", "thyroid lobe", "damaged", "patient", "most likely to experience", "following symptoms" ]

{ "A": "Contaminated beef", "B": "Epiglottic cyst", "C": "Mosquito bite", "D": "Spelunking" }

[ "27 year old man presents", "emergency room", "persistent fever", "nausea", "vomiting", "past 3 days", "waiting to", "seen", "disoriented", "agitated", "examination", "visible signs", "difficulty breathing", "copious oral secretions", "generalized muscle twitching", "patients temperature", "blood pressure", "90 64 mmHg", "pulse", "88 min", "respirations", "18 min", "oxygen saturation", "90", "room air", "nurse", "to place", "nasal cannula", "patient", "fearful", "combative", "patient", "sedated", "placed", "mechanical ventilation", "following", "a risk factor", "patients", "likely diagnosis" ]

{ "A": "CT angiogram", "B": "Intubation", "C": "Observation and blood pressure monitoring", "D": "Surgical exploration" }

[ "21-year-old man presents", "emergency department", "sustaining", "stab", "neck", "local farmer's market", "patient", "healthy", "pain", "patient", "able to", "history", "temperature", "97", "36 4C", "blood pressure", "84 mmHg", "pulse", "90 min", "respirations", "min", "oxygen saturation", "98", "room air", "Physical exam demonstrates", "3", "laceration 1", "inferior", "mastoid process", "right side", "patient's breath sounds", "clear", "airway", "stridor", "difficulty breathing", "noted", "following", "most appropriate next step", "management", "patient" ]

{ "A": "혀 기저부의 지속적인 갑상선 조직", "B": "22q11 유전자 결실", "C": "지속적인 갑상설관 내 낭포 형성", "D": "림프절 비대" }

[ "year old girl presents", "medical office", "evaluation", "lump", "front of", "neck", "patient denies pain", "states", "mass", "moves", "I swallow", "physical examination reveals", "midline neck mass", "hyoid bone", "level", "mandible", "mass", "mobile", "feels fluctuant", "erythema", "patient", "afebrile", "vital signs", "stable", "complete blood count", "thyroid function tests", "performed", "normal limits", "most likely cause", "patients presentation" ]

{ "A": "Sporadic Creutzfeldt-Jakob disease (sCJD)", "B": "Variant Creutzfeldt-Jakob disease (vCJD)", "C": "Subacute sclerosing panencephalitis (SSPE)", "D": "Progressive multifocal encephalopathy (PML)" }

[ "35 year old woman", "history of Crohn disease presents", "follow-up appointment", "started", "difficulty walking", "friends", "joked", "appears to", "walking", "drunk", "Past medical history", "significant", "Crohn disease diagnosed 2 years", "managed", "natalizumab", "past year", "intestinal symptoms", "severe", "unresponsive", "therapies", "physical examination", "gait", "limb ataxia present", "Strength", "4/5", "right upper limb", "T1 T2 MRI of", "brain", "ordered", "shown", "following", "most likely diagnosis" ]

{ "A": "Rh 면역", "B": "항인지질 증후군", "C": "염색체 이상", "D": "외상" }

[ "23 year old G1", "10 weeks based", "last menstrual period", "brought", "emergency department", "husband due to sudden vaginal bleeding", "mild lower abdominal cramps", "feeling dizzy", "weak", "blood pressure", "100 60 mm Hg", "pulse", "100 min", "respiration rate", "min", "light spotting", "3 days", "today", "bleeding increased markedly", "passage", "clots", "changed three pads", "morning", "nausea", "experiencing", "past", "days", "physician", "notes", "cervical os", "open", "blood", "pooling", "vagina", "Products of conception", "visualized", "os", "patient", "prepared", "suction curettage", "following", "most likely cause", "pregnancy loss" ]

{ "A": "메켈 게실", "B": "디조지 증후군", "C": "십이지장 폐쇄", "D": "히르쉬스프룽병" }

[ "month old boy", "brought", "medical office", "mother", "mother states", "boy", "very fussy", "not", "feeding recently", "mother thinks", "baby", "gaining weight", "not feeding well", "boy", "delivered", "weeks gestation", "complications", "physical examination", "boy", "noted to", "crying", "mothers arms", "evidence", "cyanosis", "cardiac examination", "normal limits", "crying", "abdomen", "palpated", "abdomen", "distended", "tympany", "left lower quadrant", "suspect", "condition caused", "failure", "specialized cells to migrate", "most likely diagnosis" ]

{ "A": "Decreased permeability of endothelium", "B": "Narrowing and calcification of vessels", "C": "Peripheral emboli formation", "D": "Weakening of vessel wall" }

[ "60 year old man", "evaluation", "medical office", "leg pain", "walking", "pain starts", "buttocks", "extends", "thighs", "calves", "pain resolved", "rest", "pain now", "feet", "rest", "past medical history", "significant", "diabetes mellitus", "hypertension", "cigarette smoking", "vital signs", "normal limits", "physical examination shows", "atrophied leg", "bilateral loss", "following", "most likely cause", "patients condition" ]

{ "A": "디곡신", "B": "판토프라졸", "C": "리시노프릴", "D": "니트로글리세린" }

[ "year old man presents", "emergency department", "chest pain radiating to", "left jaw", "arm", "states", "similar symptoms", "playing basketball", "medical history", "significant", "diabetes mellitus", "hypertension", "GERD", "takes metformin", "hydrochlorothiazide", "pantoprazole", "blood pressure", "90 mm Hg", "pulse", "100 min", "respirations", "min", "ECG reveals ST elevation", "leads V3 V6", "hospitalized", "acute MI", "started on treatment", "next day", "dizziness", "blurred vision", "Repeat vital signs", "follows", "blood pressure 90 60 mm Hg", "pulse 72 min", "respirations", "min", "laboratory results", "follows", "Serum", "mEq/L Potassium", "98", "Creatinine", "Glucose", "following drugs", "responsible", "patients lab abnormalities" ]

{ "A": "노출 후 10일 이내의 사백신 (A killed vaccine within ten days of exposure)", "B": "노출 후 1주일 이내의 Oseltamivir (Oseltamivir within one week of exposure)", "C": "노출 후 수 시간 이내의 독액 항혈청 (Venom antiserum within hours of exposure)", "D": "노출 후 한 달 동안의 Doxycycline (Doxycycline for one month after exposure)" }

[ "year old woman", "brought", "hospital", "boyfriend", "three days", "fever", "headache followed by one day", "worsening confusion", "hallucinations", "agitated", "offered water", "temperature", "3C", "Two months prior to presentation", "couple", "camping", "encountered bats", "injection", "exposure", "most effective", "patient" ]

{ "A": "Perform arterial blood gas analysis", "B": "Perform CT-guided biopsy", "C": "Measure angiotensin-converting enzyme", "D": "Request previous chest x-ray" }

[ "60 year old man", "physician", "examination prior to", "scheduled cholecystectomy", "hypertension treated with hydrochlorothiazide", "mother", "chronic granulomatous disease of the lung", "works", "glass manufacturing plant", "smoked two packs", "cigarettes daily", "years", "vital signs", "normal limits", "Examination shows", "abnormalities", "Laboratory studies", "reference range", "x-ray of", "chest", "shown", "following", "most appropriate next step", "management" ]

{ "A": "Phenylalanine hydroxylase", "B": "Branched-chain ketoacid dehydrogenase", "C": "Cystathionine synthase", "D": "Carbamoyl phosphate synthetase I" }

[ "examining", "3 day old newborn", "delivered", "complications", "newborn presents", "vomiting", "hyperventilation", "lethargy", "seizures", "Blood work demonstrates hyperammonemia", "elevated glutamine levels", "decreased blood urea nitrogen", "CT scan demonstrates cerebral edema", "Defects", "following enzymes", "result", "clinical presentation similar", "infant" ]

{ "A": "Bartonella", "B": "Papillomavirus", "C": "Poxvirus", "D": "Coccidioides" }

[ "48 year old man", "HIV", "physician", "of skin lesions", "face", "neck", "2 weeks", "not itchy", "painful", "not", "fever", "sore throat", "treated", "candidal esophagitis", "months", "sexually active", "wife", "condition", "uses condoms", "currently receiving triple antiretroviral therapy", "lamivudine", "abacavir", "efavirenz", "5 ft 9", "tall", "58 kg", "BMI", "kg/m2", "Examination shows multiple skin colored papules", "face", "neck", "dimpled center", "lymphadenopathy", "present", "examination", "unremarkable", "hemoglobin concentration", "g/dL", "leukocyte count", "4 900 mm3", "platelet count", "mm3", "serum studies", "urinalysis show", "abnormalities", "CD4", "T-lymphocyte", "312 mm3", "normal", "500", "following", "most likely cause", "patient's findings" ]

{ "A": "Adult T-cell lymphoma", "B": "Burkitt lymphoma", "C": "Diffuse large B-cell lymphoma", "D": "Hodgkin lymphoma" }

[ "55 year old man", "physician", "fatigue", "worsening abdominal", "weeks", "reports excessive night sweats", "5.4 kg", "weight loss", "time", "neck swelling", "4 days", "Physical examination shows", "nontender", "enlarged", "fixed supraclavicular", "splenomegaly", "CT scan", "thorax", "abdomen shows massively enlarged axillary", "mediastinal", "cervical lymph nodes", "Analysis", "shows lymphocytes", "high proliferative index", "stain positive", "CD20", "following", "most likely diagnosis" ]

{ "A": "Emergent open fetal surgery", "B": "Cardiac magnetic resonance imaging", "C": "Cardiac catheterization", "D": "Medical management" }

[ "year old", "woman", "weeks presents", "follow-up ultrasound", "diagnosed", "gestational diabetes", "second trimester", "admits", "poor glucose control", "non", "insulin therapy", "Fetal reveals", "asymmetric", "enlarged interventricular septum", "left ventricular outflow tract obstruction", "reduced ejection fraction", "following", "most appropriate step", "management", "delivery" ]

{ "A": "Prospective cohort", "B": "Retrospective case-control", "C": "Prospective case-control", "D": "Cross-sectional study" }

[ "recent study attempted to", "increased", "patient satisfaction", "driven healthcare resulted", "increased hospitalization", "hospital", "several", "wards adopted new aspects", "patient satisfaction", "driven healthcare", "hospital continued to use", "protocols", "Baseline population", "demographics", "collected", "start", "study", "end", "following year", "hospital use", "assessed", "compared", "two groups", "following best", "type", "study" ]

{ "A": "Sensitivity = 83%, Specificity = 95%, PPV = 80%, NPV = 96%", "B": "Sensitivity = 83%, Specificity = 95%, PPV = 96%, NPV = 80%", "C": "Sensitivity = 80%, Specificity = 95%, PPV = 96%, NPV = 83%", "D": "Sensitivity = 95%, Specificity = 83%, PPV = 80%, NPV = 96%" }

[ "new screening test", "telemedicine approach", "diagnosing diabetic retinopathy", "implemented", "diabetes clinic", "ophthalmologists exam", "performed", "patients", "gold", "diagnosis", "pilot study", "500 patients", "screening test detected", "presence", "diabetic retinopathy", "patients", "Ophthalmologist exam confirmed", "diagnosis", "diabetic retinopathy", "200 patients", "tested positive", "screening test", "10 patients", "tested negative", "screening test", "sensitivity", "specificity", "positive predictive value", "negative predictive value of", "screening test" ]

{ "A": "실험 1과 2 시작 시 소운동 단위 동원", "B": "실험 1에서 대운동 단위 동원 후 소운동 단위 동원", "C": "세 실험 모두 종료 시 융합된 강축 수축", "D": "모든 단계에서 장력 증가" }

[ "healthy", "year old male", "research study", "leading to compare", "properties", "skeletal", "cardiac muscle", "conduct", "3-phased experiment", "participant", "first phase", "to lift", "kg", "5", "weight", "table", "left hand", "second phase", "to", "20", "taking", "heart rate", "min", "third phase", "electrically", "gastrocnemius", "frequency", "50 Hz", "interested", "tension", "electrical", "specific muscles", "follows", "Biceps", "phase 1", "cardiac muscle", "phase 2", "gastrocnemius", "phase 3", "to", "phases", "muscles", "interest" ]

{ "A": "Posterior cruciate ligament", "B": "Anterior cruciate ligament", "C": "Medial collateral ligament", "D": "Lateral collateral ligament" }

[ "20 year old male", "office two days", "falling", "pick", "basketball game", "patient states", "lateral aspect of", "knee", "knee", "exam", "patient's appears", "same size", "left knee", "swelling", "effusion", "patient", "intact sensation", "strength", "lower extremities", "patient's", "laxity", "varus stress test", "more lax", "valgus stress test", "compared", "left knee", "Lachman's test", "posterior drawer test", "firm endpoints", "laxity", "following structures", "patient injured" ]

{ "A": "Enalapril therapy", "B": "Furosemide therapy", "C": "Anti-streptolysin O levels", "D": "Prednisone therapy" }

[ "4 year old boy", "brought", "physician", "of swelling", "eyes", "4 days", "swelling", "most severe", "morning", "milder", "bedtime", "Ten days", "sore throat", "resolved", "temperature", "98", "pulse", "min", "blood pressure", "88", "mm Hg", "Examination shows 3", "pitting edema of", "lower extremities", "periorbital edema", "examination shows", "abnormalities", "Laboratory studies show", "g", "mm3 Platelet count", "mg", "mg", "Creatinine", "8", "Urine", "negative", "RBC", "WBC", "hpf", "casts numerous Protein/creatinine ratio", "N 0.2", "Serum complement concentrations", "reference ranges", "following", "most appropriate next step", "management" ]

{ "A": "팔 벌림 상실", "B": "손가락 벌림 상실", "C": "전완 굴곡 및 회외 상실", "D": "손목 신전 상실" }

[ "year old man", "clinic", "mom", "pins", "needles", "arms", "denies", "past medical history", "recent anterior cruciate ligament", "tear", "repaired 1 week", "patient reports", "paresthesias", "mostly", "posterior forearms", "left more", "right", "physical examination finding", "patient" ]

{ "A": "폐쇄 루프 의사소통", "B": "아차 사고", "C": "근본 원인 분석", "D": "중대한 사건" }

[ "year old girl", "resuscitated", "administration", "erroneous dose", "intravenous phenytoin", "recurrent seizures", "incident", "reported", "authorities", "investigation reveals various", "factors leading", "event", "One important finding", "verbal", "dose", "phenytoin", "ordering senior resident", "receiving first year resident", "handover", "patient", "To", "risk", "error", "future", "most appropriate management", "to", "following" ]

{ "A": "정신과 의사와 상담하여 P 씨를 입원시킨다", "B": "경찰에 신고하여 P 씨를 체포한다", "C": "의학적 권고에 반하여 P 씨가 경기에 출전하도록 허락한다", "D": "P 씨에게 HCM의 위험성에 대해 교육한다" }

[ "team physician", "NBA basketball", "morning", "important", "game", "EKG", "star", "Mr", "shows findings suspicious", "hypertrophic cardiomyopathy", "Mr", "healthy", "fit", "professional athlete", "game", "night", "the most important", "Mr", "P", "areer.", "nform ", "oach ", "hinking ", "estricting r.", "'", "rticipation, ", " f re y", "ter t", "y y", "ceive a", "one call f", "ner o", "am t", "strict M . ", "s", "lity to pl y. M", " P", "t tes th", "ying in", "e \"i", " thi g I d .", "owing is ", " app opriate nex ste ?" ]

{ "A": "고용량 글루코코르티코이드", "B": "사이클로포스파미드 및 리툭시맙", "C": "반코마이신 및 세페핌", "D": "혈장 교환 요법" }

[ "year old woman presents", "emergency department", "generalized malaise", "weakness", "headache", "nausea", "vomiting", "diarrhea", "last felt well", "two days", "healthy", "takes", "medications", "vital signs", "T", "0", "96 beats per minute", "BP", "O2 sat 96", "room air", "Examination reveals", "somewhat ill appearing woman", "drowsy", "focal neurological deficits", "Initial laboratory studies", "notable", "hematocrit", "platelets", "80", "mL", "serum creatinine", "mg dL", "following", "most appropriate treatment", "time" ]

{ "A": "Prostaglandin E1 주입", "B": "Indomethacin 주입", "C": "수술적 결찰", "D": "경피적 수술" }

[ "5 week old infant born", "36 weeks", "gestation", "brought", "physician", "well", "mother reports", "breastfed", "15 minutes", "2 hours", "now feeds", "40 minutes", "4 hours", "infant", "six wet diapers", "two stools daily", "currently", "3500 g", "20", "length", "Vital signs", "normal limits", "Cardiopulmonary examination shows", "grade", "6 continuous murmur heard best", "left infraclavicular area", "confirming", "diagnosis", "echocardiography", "following", "most appropriate next step", "management", "patient" ]

{ "A": "획득된 제VIII 인자 결핍", "B": "안티트롬빈 III 손실", "C": "에스트로겐 분해 장애", "D": "항인지질 항체" }

[ "year old woman", "physician", "1-day history", "right flank pain", "bloody urine", "past 2 weeks", "progressive lower extremity swelling", "3 kg", "weight gain", "history of chronic hepatitis B infection", "diagnosed 10 years", "frequently flies", "California", "New York", "business", "appears fatigued", "pulse", "98 min", "respirations", "min", "blood pressure", "75 mm Hg", "Examination shows periorbital edema", "distended abdomen", "2", "edema of", "lower extremities", "lungs", "clear", "auscultation", "CT scan", "abdomen shows", "nodular liver", "ascites", "large right", "abundant collateral", "filling defect in", "right renal vein", "Urinalysis shows 4", "protein", "positive glucose", "casts", "following", "most likely underlying cause", "patient's renal findings" ]

{ "A": "방광의 편평 상피", "B": "십이지장의 Paneth cells", "C": "공장의 분지된 muscularis mucosa", "D": "자궁경부 내막의 무질서한 편평 상피" }

[ "57 year old man", "physician", "follow-up evaluation of chronic", "retrosternal chest pain", "pain", "worse", "night", "heavy meals", "taken oral pantoprazole", "months", "relief", "symptoms", "Esophagogastroduodenoscopy shows ulcerations", "distal esophagus", "dislocated Z-line", "biopsy of", "distal esophagus shows columnar epithelium", "cells", "following microscopic findings", "same", "cellular changes seen", "patient" ]

{ "A": "글루텐 프리 다이어트", "B": "췌장 효소 대체", "C": "테트라사이클린 요법", "D": "유당 프리 다이어트" }

[ "year old woman", "physician", "of", "month history", "weight loss", "bloating", "diarrhea", "not smoke", "drink alcohol", "vital signs", "normal limits", "5 ft 8", "tall", "54 kg", "BMI", "kg/m2", "Physical examination shows bilateral white spots", "temporal half", "conjunctiva", "dry skin", "hard neck mass", "anterior midline", "not move", "swallowing", "Urinalysis", "a D xylose meal shows", "increase", "renal", "xylose excretion", "following", "most likely to", "prevented", "patient's weight loss" ]

{ "A": "환자의 상태는 질산염으로 오염된 물을 섭취했기 때문입니다.", "B": "이 상태는 primaquine 과다 복용으로 인해 발생했습니다.", "C": "이 상태는 primaquine과 마그네슘 보충제를 병용했기 때문에 발생했습니다.", "D": "이는 B형 약물 부작용입니다." }

[ "year old man presents", "routine checkup", "Past medical history", "stage 1 systemic hypertension", "hepatitis A infection diagnosed 10 years", "takes aspirin", "rosuvastatin", "enalapril daily", "magnesium supplement", "planning to visit Ecuador", "week long vacation", "concerned", "malaria prophylaxis", "travel", "physician", "taking 1 primaquine pill", "day", "7 consecutive days", "leaving Ecuador", "third day", "trip", "patient", "acute headache", "dizziness", "shortness of breath", "fingertips", "toes turning blue", "blood pressure", "80 mm Hg", "heart rate", "min", "respiratory rate", "min", "temperature", "36", "98", "blood oxygen saturation", "97", "room air", "drawing blood", "laboratory workup", "nurse notes", "blood", "chocolate brown color", "following statements best", "etiology", "patients", "likely condition" ]

{ "A": "Betamethasone과 ampicillin을 투여하고 제왕절개를 진행합니다.", "B": "Ampicillin을 투여하고 양수 주입을 시행합니다.", "C": "Betamethasone과 ampicillin을 투여합니다.", "D": "Betamethasone, ampicillin을 투여하고 분만 유도를 진행합니다." }

[ "31 year old woman", "gravida 2", "para 1", "weeks", "gestation", "emergency department", "sudden leakage", "clear vaginal", "pregnancy", "uncomplicated", "first child", "born", "term", "vaginal delivery", "history", "serious illness", "not drink alcohol", "smoke cigarettes", "Current medications include vitamin supplements", "temperature", "98 9F", "pulse", "70 min", "respirations", "min", "blood pressure", "mm Hg", "Speculum examination demonstrates clear fluid", "cervical canal", "fetal heart rate", "reactive", "min", "decelerations", "shows uterine contractions", "testing", "positive", "started", "indomethacin", "following", "most appropriate next step", "management" ]

{ "A": "날록손", "B": "단트롤렌", "C": "페놀도팜", "D": "시프로헵타딘" }

[ "year old girl", "brought", "emergency department", "friends", "took", "whole bottle", "moms medication", "not", "medication", "ingested", "patient", "slipping", "out", "consciousness", "unable to", "history", "temperature", "heart rate", "min", "blood pressure", "98 mm Hg", "respiratory rate", "min", "physical examination", "significant muscle", "tremor", "clonus", "following", "best course", "treatment", "patient" ]

{ "A": "Metastatic breast cancer", "B": "Multiple myeloma", "C": "Paget's disease", "D": "Primary hyperparathyroidism" }

[ "68 year old woman", "brought", "emergency department", "fever", "productive cough", "dyspnea", "3 days", "upper back pain", "months", "worse", "activity", "takes ibuprofen", "pain relief", "history of smoking", "temperature", "blood pressure", "100 70 mm Hg", "pulse", "95 min", "respirations", "min", "Lung auscultation shows rales", "left lower lobe area", "Painful lymph nodes", "1", "1", "palpated", "left axillary", "cervical regions", "point tenderness", "thoracic vertebrae", "Laboratory studies", "skull X-ray", "lung window", "computed tomography scan", "shown", "following disorders", "likely played", "role", "patients acute condition" ]

{ "A": "Cadherin", "B": "Collagen", "C": "Integrin", "D": "Keratin" }

[ "year old woman presents", "emergency department", "2-day history", "severe blistering", "woke up 2 days", "number", "painful blisters", "mouth", "since", "continuing to", "blisters of", "cutaneous", "body", "the mucosa of", "mouth", "past medical history", "never experienced", "symptoms", "Physical exam reveals", "diffuse vesicular", "painful", "flaccid blisters", "separate easily", "gentle", "function", "following proteins", "most likely disrupted", "patient" ]

{ "A": "근육 내 에피네프린", "B": "내경정맥 삽관술", "C": "골내 삽관술", "D": "초음파 유도 전완 정맥 삽관술" }

[ "3 week old boy", "brought", "emergency department", "parents", "3-day history", "progressive lethargy", "difficulty feeding", "born", "term", "not", "difficulty feeding", "temperature", "4C", "pulse", "min", "respirations", "min", "blood pressure", "50 30 mm Hg", "Pulse oximetry", "100", "oxygen shows", "oxygen saturation", "97", "Examination shows dry mucous membranes", "delayed capillary refill time", "cool skin", "poor turgor", "multiple attempts", "nursing staff", "unable to establish peripheral intravenous access", "following", "most appropriate next step", "management" ]

{ "A": "Decreased total body potassium", "B": "Increased total body sodium", "C": "Increased arterial pCO2", "D": "Hypervolemia" }

[ "healthy 10 year old boy", "brought", "emergency room", "mother", "hours", "onset", "abdominal", "nausea", "past 2 weeks", "progressive abdominal pain", "4 kg", "8.8", "weight loss", "mother reports", "son", "drinking more water", "usual", "period", "Last week", "wet", "bed three times", "completely toilet trained since", "years", "age", "temperature", "pulse", "min", "respirations", "35 min", "blood pressure", "95 55 mm Hg", "appears lethargic", "Physical examination shows deep", "labored breathing", "dry mucous membranes", "abdomen", "soft", "diffuse tenderness", "palpation", "guarding", "Serum laboratory studies show", "Na", "mEq/L K", "5", "Cl", "HCO3", "Urea mg Creatinine 1 0 mg dL Urine dipstick", "positive", "ketones", "glucose", "Further evaluation", "most likely to reveal", "following" ]

{ "A": "Spironolactone", "B": "Amiloride", "C": "Hydrochlorothiazide", "D": "Acetazolamide" }

[ "70 year old Caucasian male visits", "office", "treatment", "New York Heart association class IV", "congestive", "failure", "following medications", "add", "man's drug regimen", "order to", "overall survival" ]

{ "A": "실데나필", "B": "알프로스타딜", "C": "메토프롤롤", "D": "인도메타신" }

[ "Several hours", "vaginal delivery", "male newborn delivered", "full-term", "tachycardia", "tachypnea", "blood pressure", "normal limits", "Pulse oximetry", "room air shows", "oxygen saturation", "right hand", "61", "left foot", "Physical examination shows", "discoloration", "face", "trunk", "supraclavicular", "intercostal retractions", "machine", "murmur", "precordium", "echocardiography shows pulmonary", "systemic circulation", "in parallel", "in series", "most appropriate pharmacotherapy", "patient" ]

{ "A": "17a-hydroxylase", "B": "21-hydroxylase", "C": "Aromatase", "D": "5a-reductase" }

[ "5 year old male visits", "pediatrician", "check-up", "height", "99th percentile", "age", "pubic hair", "present", "physical examination", "Serum renin", "potassium levels", "high", "17-hydroxyprogesterone", "following", "likely deficient", "patient" ]

{ "A": "Coproporphyrinogen III", "B": "Hydroxymethylbilane", "C": "Porphobilinogen", "D": "Protoporphyrin IX" }

[ "year old African American woman presents", "husband", "primary care doctor", "evaluation", "depression", "anxiety", "reports", "2-week history", "rapid onset sadness", "clear", "factor", "husband", "notes", "three similar episodes", "occurred", "past two years", "notes", "more emotional", "confused", "day", "to leave", "job", "librarian", "childs elementary school", "past medical history", "notable", "two diagnostic laparoscopies", "recurrent episodes of abdominal pain", "unknown etiology", "family history", "notable", "psychosis", "mother", "maternal grandfather", "temperature", "blood pressure", "75 mmHg", "pulse", "75 min", "respirations", "min", "exam", "appears confused", "disoriented", "attention span", "limited", "exhibits emotional lability", "patients condition", "most likely due to", "defect", "enzyme", "following compounds" ]

{ "A": "lisinopril 용량 증가", "B": "furosemide 추가", "C": "도플러 초음파", "D": "추가적인 관리 불필요" }

[ "year old woman presents", "primary care physician", "general wellness appointment", "patient", "complaints currently", "to", "sure", "good health", "patient", "past medical", "hypertension", "anxiety", "current medications include albuterol", "fluticasone", "hydrochlorothiazide", "lisinopril", "fexofenadine", "temperature", "99", "blood pressure", "95 mmHg", "pulse", "70 min", "respirations", "min", "oxygen saturation", "98", "room air", "exam", "note", "healthy young woman", "Cardiac exam reveals", "S1", "S2 heart", "normal", "Pulmonary exam", "clear", "auscultation", "good air movement", "Abdominal exam reveals", "bruit", "bowel sounds", "borborygmus", "Neurological exam reveals cranial nerves II XII", "intact", "normal strength", "reflexes", "upper", "lower extremities", "following", "best next step", "management" ]

{ "A": "Ribavirin and interferon", "B": "Supportive therapy", "C": "Emergency liver transplantation", "D": "Pegylated interferon-alpha" }

[ "year old man", "emergency department", "a 10 day history", "right upper quadrant abdominal pain", "feeling tired", "nauseous", "past", "weeks", "examination", "scleral icterus", "present", "Abdominal examination shows tenderness", "palpation", "right upper quadrant", "liver edge", "palpated 2 cm", "right costal margin", "Laboratory studies show", "U", "2520", "Hepatitis A", "antibody", "Positive", "RNA", "following", "best course", "action", "patient" ]

{ "A": "바빈스키 징후 양성", "B": "저반사", "C": "근간대성 경련", "D": "회내 변위" }

[ "5 year old boy", "recently", "Nigeria", "brought", "emergency department", "of", "2-day history", "lower leg weakness", "swallowing difficulty", "drooling", "saliva", "not", "received", "childhood vaccinations", "Two days", "admission", "patient", "shortness of breath", "Pulse oximetry shows", "oxygen saturation", "64", "resuscitative efforts", "patient dies", "respiratory failure", "autopsy", "examination", "spinal cord shows destruction of", "anterior horn cells", "Neurological examination", "patient", "most likely shown", "following findings" ]

{ "A": "CT scan abdomen with pancreatic protocol", "B": "Serum vitamin D level", "C": "24-hour urinary calcium", "D": "Serum parathyroid hormone (PTH) level" }

[ "30 year old woman", "brought", "urgent care clinic", "husband", "numbness", "lips", "tingling", "hands", "feet", "total thyroidectomy", "enlarged thyroid gland", "month", "Vital signs include", "blood pressure", "70 mm Hg", "pulse", "72 min", "respiratory rate", "min", "temperature", "98", "surgical scar", "present", "anterior aspect", "neck", "attending physician", "blood pressure cuff", "mm Hg", "observes", "patient", "couple", "minutes", "measuring", "blood pressure", "patient", "sudden stiffness", "tingling", "hand", "Blood test results", "follows", "Hemoglobin", "Hb", "g", "White blood cell count", "Platelet", "Calcium", "serum", "Ca2", "6 0 mg/dL Albumin 4 g", "Alanine aminotransferase", "ALT", "serum", "U/L Aspartate aminotransferase", "AST", "serum", "U", "creatinine 0.5", "dL", "Sodium", "Potassium", "Magnesium 2", "Urinalysis shows", "white", "red blood cells", "leukocyte esterase", "negative", "following", "next best step", "management", "patient" ]

{ "A": "심박수 증가가 각 심장 주기 동안 소요되는 시간을 증가시킨다", "B": "심박수 증가가 이완기 동안 소요되는 상대적 시간을 감소시킨다", "C": "심근 관류는 주로 수축기 동안 발생한다", "D": "심근 관류는 심장 주기 전체에 걸쳐 동일하게 발생한다" }

[ "woman", "coronary artery disease", "starting to go", "walk", "begins", "heart rate accelerates", "resting pulse", "60", "reaches", "rate", "point", "begins to feel", "chest", "stops walking to rest", "resolves", "last", "months", "following", "true statement" ]

{ "A": "싹트는 효모 세포 및/또는 가사상균", "B": "다수의 세균 세포로 덮인 상피 세포", "C": "운동성이 있는 둥글거나 타원형 모양의 미생물", "D": "연쇄상 구균" }

[ "year old female presents", "physician", "evaluation", "vaginal discharge", "itching", "irritation", "recently started", "new relationship", "boyfriend", "only sexual partner", "not report", "genitourinary symptoms", "takes oral contraceptives", "not use", "barrier contraception", "medical history", "unremarkable", "vital signs", "normal limits", "gynecologic examination reveals", "thin", "yellow", "frothy vaginal discharge", "musty", "odor", "numerous punctate red maculae", "ectocervix", "exam", "normal", "following organisms", "most likely", "revealed", "wet mount microscopy" ]

{ "A": "ibuprofen 투여", "B": "소변 hydroxyindoleacetic acid 수치 측정", "C": "소변 metanephrine 수치 측정", "D": "niacin을 fenofibrate로 전환" }

[ "year old woman", "hypertension", "hyperlipidemia", "physician", "generalized reddening", "skin", "itching", "past 2 weeks", "symptoms occur", "evening", "bedtime", "last", "30 minutes", "Three months", "atorvastatin", "stopped", "experienced", "worsening neck", "back pain", "Statin therapy", "lower doses", "weeks", "to", "stopped", "musculoskeletal symptoms recurred", "menses occur", "23 month intervals", "last", "days", "smoked one pack", "cigarettes daily", "past 30 years", "current medications include lisinopril", "niacin", "brother died", "colonic adenocarcinoma", "father died of small cell lung cancer", "5 ft 6", "tall", "83 kg", "BMI", "29 kg/m2", "vital signs", "normal limits", "Physical examination shows", "abnormalities", "Serum lipid studies show", "Total cholesterol", "mg/dL HDL", "Triglycerides", "following", "most appropriate next step", "management" ]

{ "A": "외과적 변연 절제술", "B": "나파실린 치료", "C": "보철물 제거", "D": "방부 드레싱" }

[ "Five days", "right knee arthroplasty", "osteoarthritis", "68 year old man", "severe pain in", "right knee preventing", "participating", "physical therapy", "third postoperative day", "dressing", "changed", "surgical wound appeared to", "intact", "slightly swollen", "clear secretion", "history", "diabetes", "hyperlipidemia", "hypertension", "Current medications include metformin", "enalapril", "simvastatin", "temperature", "3C", "99", "pulse", "min", "blood pressure", "88 mm Hg", "right knee", "swollen", "erythematous", "tender", "palpation", "pain on movement", "joint", "medial parapatellar skin incision appears", "opened", "proximal", "distal part", "yellow-green discharge", "skin", "sides", "incision", "following", "next best step", "management", "patient" ]

{ "A": "Supportive therapy only", "B": "Amantadine", "C": "Inactivated influenza vaccine", "D": "Oseltamivir" }

[ "year old woman", "physician", "February", "1-day history", "fever", "chills", "headache", "dry cough", "reports malaise", "generalized muscle aches", "works", "teacher", "local high school", "recently", "outbreak", "influenza", "history of intermittent asthma", "takes albuterol as needed", "influenza vaccine offered", "fall", "sister", "friend", "flulike illness", "receiving", "vaccine", "worried", "possibly", "ill", "to miss work", "temperature", "100", "heart rate", "58 min", "respirations", "min", "Physical examination", "unremarkable", "hemoglobin concentration", "g/dL", "leukocyte count", "400 mm3", "platelet count", "mm3", "analgesia", "following", "most appropriate next step", "management" ]

{ "A": "1/200", "B": "199/200", "C": "1/100", "D": "1/400" }

[ "Red-green color blindness", "X-linked recessive disorder", "incidence", "200", "males", "certain population", "probability", "normal male", "female", "child", "red-green color blindness" ]

{ "A": "Defects in the immune response", "B": "Aspergillus fumigatus suppresses the production of IgA", "C": "Aspergillus fumigatus suppresses the production of IgM", "D": "Suppression of the innate immune system by Aspergillus fumigatus" }

[ "year old man", "transferred", "intensive care unit", "emergency department", "acute respiratory failure", "rushed", "hospital", "progressive respiratory distress", "24 hours", "medical history", "significant", "long standing severe persistent asthma", "hypertension", "several bouts", "community", "hospital-acquired pneumonia", "medications include amlodipine", "lisinopril", "inhaled fluticasone", "salmeterol", "oral prednisone", "lifelong non-smoker", "drinks alcohol occasionally", "weekends", "works", "sales executive", "to Hawaii", "month", "emergency department", "started", "broad spectrum antibiotics", "bronchodilators", "respiratory failure", "worsens", "day 2", "admission", "mechanical ventilator support", "Chest X-ray shows multiple nodules", "lower lobes", "Flexible bronchoscopy", "performed", "bronchoalveolar lavage sample", "medial segment", "right lower lobe shows neutrophils", "fungal preparation shows Aspergillus fumigatus", "video-assisted thoracoscopy", "performed", "biopsy", "right lower lobe", "taken", "shows plugging", "terminal bronchioles", "mucus", "inflammatory cells", "fungal vascular invasion", "following", "most likely mechanism responsible", "biopsy findings" ]

{ "A": "TGF-β", "B": "IL-6", "C": "IL-2", "D": "TNF-β" }

[ "70 year old man", "physician", "4 month history", "epigastric pain", "nausea", "weakness", "smoked one pack", "cigarettes daily", "50 years", "drinks one alcoholic beverage daily", "appears emaciated", "5 ft 9", "tall", "kg", "BMI", "kg/m2", "diagnosed", "gastric cancer", "following cytokines", "most likely direct cause of", "patients examination findings" ]

{ "A": "정맥 부전", "B": "림프관 폐쇄", "C": "신성 단백질 손실", "D": "염분 정체" }

[ "40 year old woman", "physician", "1-week history", "fatigue", "dark urine", "feeling of heaviness", "legs", "Two weeks", "returned", "vacation", "Brazil", "spent most", "days", "city", "Rio de", "foot", "gained 3 kg", "vacation", "systemic lupus erythematosus", "only medication", "hydroxychloroquine", "temperature", "99", "pulse", "min", "blood pressure", "98 mm Hg", "Physical examination shows 2", "edema", "Urinalysis shows", "Blood", "Protein 1", "RBC 68 hpf", "dysmorphic features", "casts numerous WBC", "hpf", "casts rare Bacteria negative", "following", "most likely cause", "patient", "eg indings?" ]

{ "A": "Mesna", "B": "Amifostine", "C": "Rasburicase", "D": "Leucovorin" }

[ "67 year old woman", "advanced bladder", "physician", "follow-up examination", "currently", "chemotherapy", "agent", "forms cross-links", "DNA strands", "Serum studies show", "creatinine concentration", "2", "mg dL", "blood urea nitrogen concentration", "mg/dL", "Urine", "clean-catch", "specimen shows 2", "protein", "1", "glucose", "Prior to initiation", "chemotherapy", "laboratory values", "reference range", "hydration", "administration", "following", "most likely", "prevented", "patient's current condition" ]

{ "A": "Squamous cell carcinoma", "B": "Basal cell carcinoma", "C": "Melanoma", "D": "Sarcoma botryoides" }

[ "57 year old post-menopausal woman", "physician", "of intermittent", "bloody post-coital vaginal discharge", "past month", "not", "pain with intercourse", "Eleven years", "LSIL", "routine Pap smear", "testing", "high-risk HPV strains", "positive", "Colposcopy showed CIN 1", "not returned", "follow-up Pap smears", "then", "sexually active", "husband only", "not use condoms", "smoked half", "pack", "cigarettes", "day", "past", "years", "not drink alcohol", "speculum exam", "erythematous exophytic mass", "ulceration", "noted", "posterior wall of", "upper third of", "vagina", "following", "most probable histopathology", "mass" ]

{ "A": "Primaquine", "B": "Dapsone", "C": "Ivermectin", "D": "Doxycycline" }

[ "Three days", "starting", "new", "malaria", "year old college student", "physician", "dark-colored urine", "fatigue", "not", "fever", "dysuria", "abdominal pain", "history", "serious illness", "Physical examination shows scleral icterus", "Laboratory studies show a hemoglobin", "g/dL", "serum lactate dehydrogenase", "234 U L", "Peripheral blood smear shows poikilocytes", "bite shaped irregularities", "following drugs", "patient", "likely", "taking" ]

{ "A": "245 / (245 + 10)", "B": "245 / (245 + 5)", "C": "240 / (240 + 5)", "D": "240 / (240 + 15)" }

[ "reviewing raw data", "research study performed", "medical center examining", "effectiveness", "novel AIDS screening examination", "study enrolled", "patients", "confirmed AIDS", "patients", "positive screening examination", "control arm", "study enrolled", "patients", "not", "AIDS", "only", "patients tested positive", "novel screening examination", "NPV", "novel test" ]

{ "A": "신생아 면역 체계 억제", "B": "제II형 폐포 세포의 분비물 증가", "C": "미성숙한 폐의 감염 예방", "D": "제II형 폐포 세포의 분비물 감소" }

[ "diabetic woman", "at risk", "delivering", "30 weeks gestation", "obstetrician counsels", "risk", "baby", "significant pulmonary distress", "born", "states", "administer", "drug", "mother to help prevent", "occurring", "action", "drug prevent respiratory distress", "premature infant" ]