Dataset Viewer
Auto-converted to Parquet Duplicate
id
stringlengths
17
20
question
stringlengths
134
1.87k
answer_idx
stringclasses
4 values
options
listlengths
4
4
A
stringlengths
1
115
B
stringlengths
2
96
C
stringlengths
1
101
D
stringlengths
1
92
original_labelling_response
stringclasses
6 values
category
stringclasses
1 value
score
float64
0.7
1
medqa_4opt_test_2
Two weeks after undergoing an emergency cardiac catherization with stenting for unstable angina pectoris, a 61-year-old man has decreased urinary output and malaise. He has type 2 diabetes mellitus and osteoarthritis of the hips. Prior to admission, his medications were insulin and naproxen. He was also started on aspi...
B
[ { "key": "A", "value": "Renal papillary necrosis" }, { "key": "B", "value": "Cholesterol embolization" }, { "key": "C", "value": "Eosinophilic granulomatosis with polyangiitis" }, { "key": "D", "value": "Polyarteritis nodosa" } ]
Renal papillary necrosis
Cholesterol embolization
Eosinophilic granulomatosis with polyangiitis
Polyarteritis nodosa
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_5
A 39-year-old man presents to the emergency department because of progressively worsening chest pain and nausea that started at a local bar 30 minutes prior. The pain radiates to the epigastric area. He has a 5-year history of untreated hypertension. He has smoked 1 pack of cigarettes daily for the past 5 years and sta...
D
[ { "key": "A", "value": "Diltiazem" }, { "key": "B", "value": "Labetalol" }, { "key": "C", "value": "Propranolol" }, { "key": "D", "value": "Reassurance and continuous monitoring" } ]
Diltiazem
Labetalol
Propranolol
Reassurance and continuous monitoring
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_7
A 65-year-old man is brought to the emergency department 30 minutes after the onset of acute chest pain. He has hypertension and asthma. Current medications include atorvastatin, lisinopril, and an albuterol inhaler. He appears pale and diaphoretic. His pulse is 114/min and blood pressure is 130/88 mm Hg. An ECG shows ...
C
[ { "key": "A", "value": "Nifedipine" }, { "key": "B", "value": "Enoxaparin" }, { "key": "C", "value": "Clopidogrel" }, { "key": "D", "value": "Spironolactone" } ]
Nifedipine
Enoxaparin
Clopidogrel
Spironolactone
Cardiovascular = 0.95
Cardiovascular
0.95
medqa_4opt_test_13
A 47-year-old executive schedules an appointment his physician for a routine medical check-up. He currently has no complaints and claims to be “as fit as a fiddle.” The physical examination findings are unremarkable, except for a mid-systolic murmur heard in the 2nd left intercostal space that radiates to the carotids ...
D
[ { "key": "A", "value": "An increase in right atrial pressure" }, { "key": "B", "value": "An increase in pulmonary capillary wedge pressure" }, { "key": "C", "value": "A reduction in the slope of the pacemaker potential" }, { "key": "D", "value": "A reduction in diastolic ...
An increase in right atrial pressure
An increase in pulmonary capillary wedge pressure
A reduction in the slope of the pacemaker potential
A reduction in diastolic filling time
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_18
A 29-year-old man presents to the emergency department due to central chest pain over the past 3 days which is constant and unrelated to exertion. The pain is sharp, severe, increases when lying down, and improves with leaning forward. The pain also radiates to his shoulders and neck. The patient has no past medical hi...
B
[ { "key": "A", "value": "Indomethacin +/- omeprazole" }, { "key": "B", "value": "Ibuprofen + colchicine +/- omeprazole" }, { "key": "C", "value": "Pericardiocentesis" }, { "key": "D", "value": "Pericardiectomy" } ]
Indomethacin +/- omeprazole
Ibuprofen + colchicine +/- omeprazole
Pericardiocentesis
Pericardiectomy
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_21
A 3-month-old infant is brought to her pediatrician because she coughs and seems to have difficulty breathing while feeding. In addition, she seems to have less energy compared to other babies and appears listless throughout the day. She was born by cesarean section to a G1P1 woman with no prior medical history and had...
A
[ { "key": "A", "value": "22q11 deletion" }, { "key": "B", "value": "Deletion of genes on chromosome 7" }, { "key": "C", "value": "Lithium exposure in utero" }, { "key": "D", "value": "Maternal alcohol consumption" } ]
22q11 deletion
Deletion of genes on chromosome 7
Lithium exposure in utero
Maternal alcohol consumption
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_31
A 72-year-old woman is admitted to the intensive care unit for shortness of breath and palpitations. A cardiac catheterization is performed and measurements of the left ventricular volume and pressure at different points in the cardiac cycle are obtained. The patient's pressure-volume loop (gray) is shown with a normal...
C
[ { "key": "A", "value": "Mitral valve regurgitation" }, { "key": "B", "value": "Increased systemic vascular resistance" }, { "key": "C", "value": "Increased ventricular wall stiffness" }, { "key": "D", "value": "Impaired left ventricular contractility" } ]
Mitral valve regurgitation
Increased systemic vascular resistance
Increased ventricular wall stiffness
Impaired left ventricular contractility
Cardiovascular = 0.95
Cardiovascular
0.95
medqa_4opt_test_43
A healthy 23-year-old male is undergoing an exercise stress test as part of his physiology class. If blood were to be sampled at different locations before and after the stress test, which area of the body would contain the lowest oxygen content at both time points?
B
[ { "key": "A", "value": "Inferior vena cava" }, { "key": "B", "value": "Coronary sinus" }, { "key": "C", "value": "Pulmonary artery" }, { "key": "D", "value": "Pulmonary vein" } ]
Inferior vena cava
Coronary sinus
Pulmonary artery
Pulmonary vein
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_46
A medical research study is evaluating an investigational novel drug (medication 1) compared with standard therapy (medication 2) in patients presenting to the emergency department with myocardial infarction (MI). The study enrolled a total of 3,000 subjects, 1,500 in each study arm. Follow-up was conducted at 45 days ...
C
[ { "key": "A", "value": "5" }, { "key": "B", "value": "16" }, { "key": "C", "value": "20" }, { "key": "D", "value": "50" } ]
5
16
20
50
Cardiovascular = 1.0
Cardiovascular
1
medqa_4opt_test_47
A 55-year-old man comes to the physician because of a 6-week history of tingling pain in the sole of his right foot when he raises it above chest level during exercises. He reports that he started exercising regularly 2 months ago and that his right calf cramps when he uses the incline feature on the treadmill, forcing...
A
[ { "key": "A", "value": "Femoropopliteal artery stenosis" }, { "key": "B", "value": "Acute thrombosis of right popliteal vein" }, { "key": "C", "value": "Lumbar spinal stenosis" }, { "key": "D", "value": "Aortoiliac artery stenosis\n\"" } ]
Femoropopliteal artery stenosis
Acute thrombosis of right popliteal vein
Lumbar spinal stenosis
Aortoiliac artery stenosis "
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_71
A 27-year-old man presents to the emergency department after a motor vehicle collision. The patient was the front seat unrestrained driver in a head on collision. The patient’s echocardiogram (ECG) is notable only for sinus tachycardia. His temperature is 99.5°F (37.5°C), blood pressure is 107/58 mmHg, pulse is 120/min...
A
[ { "key": "A", "value": "Cardiac contusion" }, { "key": "B", "value": "Hemorrhage" }, { "key": "C", "value": "Pulmonary contusion" }, { "key": "D", "value": "Takotsubo cardiomyopathy" } ]
Cardiac contusion
Hemorrhage
Pulmonary contusion
Takotsubo cardiomyopathy
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_78
A newborn is found to be extremely cyanotic immediately after birth. He then develops progressive respiratory failure and is admitted to the neonatal ICU. A single loud S2 heart sound is appreciated as well as a machine-like murmur at the left upper sternal border. Radiography shows an enlarged "egg-shaped" heart. The ...
C
[ { "key": "A", "value": "Coarctation of the aorta" }, { "key": "B", "value": "Persistent truncus arteriosus" }, { "key": "C", "value": "Transposition of great vessels" }, { "key": "D", "value": "Tricuspid atresia" } ]
Coarctation of the aorta
Persistent truncus arteriosus
Transposition of great vessels
Tricuspid atresia
Cardiovascular = 0.95
Cardiovascular
0.95
medqa_4opt_test_79
A 25-year-old male involved in a knife fight presents with a penetrating wound to the chest. The patient is unconscious and cannot provide any further history. Vitals show a temperature of 37-0°C (98.6°F), blood pressure of 85/55 mm Hg, pulse of 115/min, respirations of 19/min, and oxygen saturation of 92% on room air....
C
[ { "key": "A", "value": "Immediate cardiac transplant" }, { "key": "B", "value": "Watchful waiting while resuscitative fluids are initiated" }, { "key": "C", "value": "Interrupted 2-0 polypropylene suture with supporting pledgets" }, { "key": "D", "value": "Needle thoracos...
Immediate cardiac transplant
Watchful waiting while resuscitative fluids are initiated
Interrupted 2-0 polypropylene suture with supporting pledgets
Needle thoracostomy over the 2nd intercostal space
Cardiovascular = 0.95
Cardiovascular
0.95
medqa_4opt_test_87
A 50-year-old man visits his physician after 20 years of not seeking any medical care. He is concerned about his health after a colleague recently had a heart attack. The patient has no active complaints and says he feels healthy; however, he does not exercise regularly and lives a sedentary lifestyle. He is employed a...
C
[ { "key": "A", "value": "Blood pressure reading" }, { "key": "B", "value": "Patient’s weight" }, { "key": "C", "value": "High LDL-cholesterol" }, { "key": "D", "value": "Serum glucose level" } ]
Blood pressure reading
Patient’s weight
High LDL-cholesterol
Serum glucose level
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_88
A 26-year-old woman is brought to the emergency department 20 minutes after being involved in a high-speed motor vehicle collision in which she was a restrained passenger. On arrival, she is lethargic and incoherent. She has severe facial lacerations and is in respiratory distress. Her pulse is 130/min, respirations ar...
C
[ { "key": "A", "value": "Diaphragmatic rupture" }, { "key": "B", "value": "Traumatic bronchial rupture" }, { "key": "C", "value": "Thoracic aortic rupture" }, { "key": "D", "value": "Tension pneumothorax" } ]
Diaphragmatic rupture
Traumatic bronchial rupture
Thoracic aortic rupture
Tension pneumothorax
Cardiovascular = 0.95
Cardiovascular
0.95
medqa_4opt_test_91
A 3-month-old girl is brought to a pediatrician by her parents. She has central cyanosis without signs of respiratory distress or signs of heart failure. An echocardiogram reveals severe pulmonary outflow obstruction, right ventricular hypertrophy, a ventricular septal defect, and an overriding of the aorta. An electiv...
B
[ { "key": "A", "value": "The tricuspid valve is the most common valve affected by bacterial endocarditis in uncorrected tetralogy of Fallot." }, { "key": "B", "value": "Normal hemoglobin in patients with tetralogy of Fallot does not rule out iron deficiency anemia." }, { "key": "C", "...
The tricuspid valve is the most common valve affected by bacterial endocarditis in uncorrected tetralogy of Fallot.
Normal hemoglobin in patients with tetralogy of Fallot does not rule out iron deficiency anemia.
Cerebral arterial thrombosis is more common than cerebral venous thrombosis.
Refractory heart failure is a common complication of tetralogy of Fallot.
Cardiovascular = 1.0
Cardiovascular
1
medqa_4opt_test_94
A 24-year-old man is brought to the emergency department 15 minutes after he sustained a stab wound to the left chest just below the clavicle. On arrival, he has rapid, shallow breathing and appears anxious. His pulse is 135/min, respirations are 30/min and shallow, and palpable systolic blood pressure is 80 mm Hg. He ...
C
[ { "key": "A", "value": "Tracheal deviation toward the right side" }, { "key": "B", "value": "Hemoptysis" }, { "key": "C", "value": "A drop in systolic blood pressure of 14 mmHg during inspiration" }, { "key": "D", "value": "Paradoxical motion of part of the chest with bre...
Tracheal deviation toward the right side
Hemoptysis
A drop in systolic blood pressure of 14 mmHg during inspiration
Paradoxical motion of part of the chest with breathing "
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_104
A 66-year-old male presents to his primary care physician to discuss his increasing shortness of breathover the last 3 months. He notes that this is particularly obvious when he is mowing his lawn or climbing the stairs in his home. His past medical history is significant for hypertension that is well-controlled with l...
B
[ { "key": "A", "value": "Mitral regurgitation" }, { "key": "B", "value": "Aortic regurgitation" }, { "key": "C", "value": "Aortic stenosis" }, { "key": "D", "value": "Mitral prolapse" } ]
Mitral regurgitation
Aortic regurgitation
Aortic stenosis
Mitral prolapse
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_133
A 67-year-old man presents to his primary care physician for erectile dysfunction. He states that for the past month he has been unable to engage in sexual intercourse with his wife despite having appropriate sexual desire. He also endorses deep and burning buttock and hip pain when walking, which is relieved by rest. ...
B
[ { "key": "A", "value": "Anxiety" }, { "key": "B", "value": "Aortoiliac atherosclerosis" }, { "key": "C", "value": "Spinal stenosis" }, { "key": "D", "value": "Vascular claudication" } ]
Anxiety
Aortoiliac atherosclerosis
Spinal stenosis
Vascular claudication
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_167
A 43-year-old woman is brought to the emergency department by her brother for severe chest pain. The patient recently lost her husband in a car accident and is still extremely shocked by the event. On physical examination, her blood pressure is 105/67 mm Hg, the heart rate is 96/min and regular, breathing rate is 23/mi...
C
[ { "key": "A", "value": "Atrial fibrillation" }, { "key": "B", "value": "Constrictive pericarditis" }, { "key": "C", "value": "Takotsubo cardiomyopathy" }, { "key": "D", "value": "Restrictive cardiomyopathy" } ]
Atrial fibrillation
Constrictive pericarditis
Takotsubo cardiomyopathy
Restrictive cardiomyopathy
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_230
An 11-year-old child complains of pain in the leg while playing. Blood pressure in the upper limb is 140/90 mm Hg and lower limbs are 110/70 mm Hg. There is a brachiofemoral delay in the pulse. Auscultation shows a loud S1, loud S2, and S4. There is a presence of an ejection systolic murmur in the interscapular area. C...
B
[ { "key": "A", "value": "Pulmonic stenosis" }, { "key": "B", "value": "Coarctation of the aorta" }, { "key": "C", "value": "Aortic stenosis" }, { "key": "D", "value": "Transposition of great vessels" } ]
Pulmonic stenosis
Coarctation of the aorta
Aortic stenosis
Transposition of great vessels
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_242
A 5-year-old female presents to the pediatrician for a routine office visit. The patient is in kindergarten and doing well in school. She is learning to read and is able to write her first name. Her teacher has no concerns. The patient’s mother is concerned that the patient is a picky eater and often returns home from ...
A
[ { "key": "A", "value": "Absent Barr bodies on buccal smear" }, { "key": "B", "value": "Elevated serum alkaline phosphatase level" }, { "key": "C", "value": "Elevated serum TSH level" }, { "key": "D", "value": "Mass in the sella turcica" } ]
Absent Barr bodies on buccal smear
Elevated serum alkaline phosphatase level
Elevated serum TSH level
Mass in the sella turcica
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_246
A 43-year-old man with a history of hepatitis C and current intravenous drug use presents with 5 days of fever, chills, headache, and severe back pain. On physical exam, temperature is 100.6 deg F (38.1 deg C), blood pressure is 109/56 mmHg, pulse is 94/min, and respirations are 18/min. He is thin and diaphoretic with ...
A
[ { "key": "A", "value": "Repeat blood cultures now" }, { "key": "B", "value": "Repeat blood cultures 24 hours after initial cultures were drawn" }, { "key": "C", "value": "Repeat blood cultures 48 hours after initial cultures were drawn" }, { "key": "D", "value": "Do not r...
Repeat blood cultures now
Repeat blood cultures 24 hours after initial cultures were drawn
Repeat blood cultures 48 hours after initial cultures were drawn
Do not repeat blood cultures
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_275
A 56-year-old man presents to his primary care doctor with intermittent chest pain. He reports a 2-month history of exertional chest pain that commonly arises after walking 5 or more blocks. He describes the pain as dull, burning, non-radiating substernal pain. His past medical history is notable for hypercholesterolem...
A
[ { "key": "A", "value": "Adenosine" }, { "key": "B", "value": "Inorganic phosphate" }, { "key": "C", "value": "Prostaglandin E2" }, { "key": "D", "value": "Transforming growth factor beta" } ]
Adenosine
Inorganic phosphate
Prostaglandin E2
Transforming growth factor beta
Cardiovascular = 1.0
Cardiovascular
1
medqa_4opt_test_284
An elderly man presents to his physician with complaints of difficulty breathing, easy fatigability, and bilateral leg swelling which began 2 months ago. His breathlessness worsens while walking, climbing the stairs, and lying flat on his back. He also finds it difficult to sleep well at night, as he often wakes up to ...
A
[ { "key": "A", "value": "Decrease in transmembrane sodium gradient" }, { "key": "B", "value": "Preferential dilatation of capacitance vessels" }, { "key": "C", "value": "Inhibition of aldosterone-mediated sodium reabsorption" }, { "key": "D", "value": "Reduction in myocard...
Decrease in transmembrane sodium gradient
Preferential dilatation of capacitance vessels
Inhibition of aldosterone-mediated sodium reabsorption
Reduction in myocardial contractility
Cardiovascular = 0.95
Cardiovascular
0.95
medqa_4opt_test_292
A 28-year-old female visits her physician for workup of a new onset diastolic murmur found on physical examination. Past medical history is insignificant. Her temperature is 37.0 degrees C, blood pressure is 115/75 mm Hg, pulse is 76/min, and respiratory rate is 16/min. The patient denies dyspnea, fatigue, and syncope....
C
[ { "key": "A", "value": "Abrupt hypotension" }, { "key": "B", "value": "Sudden cardiac death" }, { "key": "C", "value": "Acute arterial occlusion" }, { "key": "D", "value": "Septic embolism" } ]
Abrupt hypotension
Sudden cardiac death
Acute arterial occlusion
Septic embolism
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_299
A 72-year-old woman is admitted to the hospital for treatment of unstable angina. Cardiac catheterization shows occlusion that has caused a 50% reduction in the diameter of the left circumflex artery. Resistance to blood flow in this vessel has increased by what factor relative to a vessel with no occlusion?
B
[ { "key": "A", "value": "64" }, { "key": "B", "value": "16" }, { "key": "C", "value": "8" }, { "key": "D", "value": "4" } ]
64
16
8
4
Cardiovascular = 1.0
Cardiovascular
1
medqa_4opt_test_308
A 50-year-old man with congestive heart failure (CHF) was started on an experimental analog of atrial natriuretic peptide. Which of the following would he expect to experience?
C
[ { "key": "A", "value": "Increased water reabsorption by the renal collecting ducts" }, { "key": "B", "value": "Vasoconstriction, increased blood pressure, aldosterone release" }, { "key": "C", "value": "Increased glomerular filtration rate, restricted aldosterone release, vascular sm...
Increased water reabsorption by the renal collecting ducts
Vasoconstriction, increased blood pressure, aldosterone release
Increased glomerular filtration rate, restricted aldosterone release, vascular smooth muscle dilation
Increased plasma calcium and decreased renal reabsorption of phosphate
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_321
A 55-year-old man recovering from knee replacement surgery complains of breathlessness in the postoperative ward. He has been confined to bed for the past 5 days and is under observation. He felt a sudden difficulty in breathing and called for the ward nurse. He says that he is unable to take deep breaths and has a sha...
A
[ { "key": "A", "value": "Subcutaneous fondaparinux" }, { "key": "B", "value": "Inferior vena cava filter" }, { "key": "C", "value": "Ventilation-perfusion scan" }, { "key": "D", "value": "Lower extremity doppler" } ]
Subcutaneous fondaparinux
Inferior vena cava filter
Ventilation-perfusion scan
Lower extremity doppler
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_328
A 27-year-old woman, gravida 2, para 1, at 40 weeks' gestation is admitted to the hospital in active labor. The patient reports severe pelvic pain. Pregnancy has been complicated by gestational diabetes. Pregnancy and delivery of her first child were uncomplicated. Current medications include insulin, folic acid, and a...
A
[ { "key": "A", "value": "Sympathetic block" }, { "key": "B", "value": "Hypovolemia" }, { "key": "C", "value": "Acute pulmonary hypertension" }, { "key": "D", "value": "Aortocaval compression" } ]
Sympathetic block
Hypovolemia
Acute pulmonary hypertension
Aortocaval compression
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_335
A 23-year-old man presents with sudden loss of consciousness while pitching in a baseball game. There is no history of injury. Consciousness is regained after cardiopulmonary resuscitation. Past medical history is negative for any neurological and cardiovascular problems. Physical examination reveals a prominent A wave...
A
[ { "key": "A", "value": "Hypertrophic cardiomyopathy" }, { "key": "B", "value": "Aortic stenosis" }, { "key": "C", "value": "Takotsubo cardiomyopathy" }, { "key": "D", "value": "Restrictive cardiomyopathy" } ]
Hypertrophic cardiomyopathy
Aortic stenosis
Takotsubo cardiomyopathy
Restrictive cardiomyopathy
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_337
A 22-year-old woman from a rural area who recently discovered she was pregnant is referred for a cardiology consultation due to cyanosis, dyspnea, and a cardiac murmur revealed at the initial prenatal visit. She is gravida 1, para 0 with an estimated gestational age of 19 weeks. She says that the murmur was found in he...
B
[ { "key": "A", "value": "Increase in heart rate" }, { "key": "B", "value": "Decrease in systemic vascular resistance" }, { "key": "C", "value": "Increase in cardiac output" }, { "key": "D", "value": "Increase in blood volume" } ]
Increase in heart rate
Decrease in systemic vascular resistance
Increase in cardiac output
Increase in blood volume
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_366
A 28-year-old female comes to the physician’s office with a complaint of episodic chest pain. She describes the pain as squeezing and tightness in her chest. This pain has been happening every few days for 3 months. She says there is no association of the pain with food or exercise. She is able to climb up to her fourt...
A
[ { "key": "A", "value": "Raynaud's phenomenon" }, { "key": "B", "value": "Myocardial infarction" }, { "key": "C", "value": "Aortic dissection" }, { "key": "D", "value": "Costochondritis" } ]
Raynaud's phenomenon
Myocardial infarction
Aortic dissection
Costochondritis
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_379
A 52-year-old man is brought to the emergency department because of worsening shortness of breath for 6 hours. For the past 5 days, he has had intermittent stabbing pain in the middle of his chest that worsens with lying down or taking deep breaths. He has also had a runny nose and a dry cough for the past 2 weeks. He ...
C
[ { "key": "A", "value": "Dilation of the atria and ventricles" }, { "key": "B", "value": "Occlusion of a coronary artery" }, { "key": "C", "value": "Accumulation of fluid in the pericardial space" }, { "key": "D", "value": "Fibrous thickening of the pericardium" } ]
Dilation of the atria and ventricles
Occlusion of a coronary artery
Accumulation of fluid in the pericardial space
Fibrous thickening of the pericardium
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_380
A 70-year-old obese male presents to the emergency department with shortness of breath and cough of sudden onset. The patient states that his symptoms came on while he was sleeping. The patient has a past medical history of type II diabetes and is currently taking lisinopril, metformin, insulin, and fish oil. On physic...
B
[ { "key": "A", "value": "Furosemide" }, { "key": "B", "value": "Hydrochlorothiazide" }, { "key": "C", "value": "Renal tubular acidosis type II" }, { "key": "D", "value": "Renal tubular acidosis type IV" } ]
Furosemide
Hydrochlorothiazide
Renal tubular acidosis type II
Renal tubular acidosis type IV
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_391
A 34-year-old patient is brought to the emergency room after a motor vehicle accident. An EKG shows sinus tachycardia and chest radiograph reveals an enlarged cardiac silhouette. While observing sinus tachycardia on the patient's telemetry, you note that the radial pulse cannot be palpated during inspiration. What shou...
A
[ { "key": "A", "value": "Pericardiocentesis" }, { "key": "B", "value": "Chest CT scan" }, { "key": "C", "value": "Pericardial window" }, { "key": "D", "value": "Insert chest tube" } ]
Pericardiocentesis
Chest CT scan
Pericardial window
Insert chest tube
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_421
A 65-year-old woman presented to the emergency room due to progressive dyspnea. She is a known hypertensive but is poorly compliant with medications. The patient claims to have orthopnea, paroxysmal nocturnal dyspnea, and easy fatigability. On physical examination, the blood pressure is 80/50 mm Hg. There is prominent ...
C
[ { "key": "A", "value": "Furosemide" }, { "key": "B", "value": "Nesiritide" }, { "key": "C", "value": "Metoprolol" }, { "key": "D", "value": "Digoxin" } ]
Furosemide
Nesiritide
Metoprolol
Digoxin
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_422
A 49-year-old woman is brought to the emergency department with progressive dyspnea and cough which she developed approx. 8 hours ago. 2 weeks ago she had a prophylactic ovariectomy because of a family history of ovarian cancer. She is known to have type 2 diabetes mellitus and stage 1 hypertension, but she does not ta...
A
[ { "key": "A", "value": "Increased alveolar dead space due to absent perfusion of certain alveoli" }, { "key": "B", "value": "Alveolar fibrosis" }, { "key": "C", "value": "Depression of the respiratory center via opioid receptors activation" }, { "key": "D", "value": "Decr...
Increased alveolar dead space due to absent perfusion of certain alveoli
Alveolar fibrosis
Depression of the respiratory center via opioid receptors activation
Decreased V/Q due to bronchial obstruction
Cardiovascular = 0.8
Cardiovascular
0.8
medqa_4opt_test_438
A 45-year-old man comes to his primary-care doctor with his wife for a 4-week history of constipation. The patient reports that his bowel habits have changed from every day to every 3 or 4 days. He also now has to strain to pass stool. On further questioning, his wife has also noticed that he has seemed fatigued, with ...
C
[ { "key": "A", "value": "Angiotensin-II receptors in the membranes of vascular smooth muscle cells" }, { "key": "B", "value": "Angiotensin-converting enzyme" }, { "key": "C", "value": "Na+/Cl- cotransporter in the membranes of epithelial cells in the distal convoluted tubule" }, {...
Angiotensin-II receptors in the membranes of vascular smooth muscle cells
Angiotensin-converting enzyme
Na+/Cl- cotransporter in the membranes of epithelial cells in the distal convoluted tubule
Na+/K+/2Cl- transporters in the membranes of epithelial cells in the ascending loop of Henle
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_445
Three days after undergoing a laparoscopic Whipple's procedure, a 43-year-old woman has swelling of her right leg. She does not have pain. She has nausea but has not vomited. She was diagnosed with pancreatic cancer 1 month ago. She has been using an incentive spirometer every 6 hours since recovering from her surgery....
B
[ { "key": "A", "value": "CT pulmonary angiography" }, { "key": "B", "value": "Compression ultrasonography" }, { "key": "C", "value": "D-dimer level" }, { "key": "D", "value": "2 sets of blood cultures\n\"" } ]
CT pulmonary angiography
Compression ultrasonography
D-dimer level
2 sets of blood cultures "
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_446
A 36-year-old man presents to a physician after having a transient loss of consciousness while resting after dinner the previous night. His symptoms only lasted for a few seconds and resolved spontaneously. This is the third time he experienced such an episode. He says that he recently started having nightmares. His fa...
A
[ { "key": "A", "value": "Headache and tinnitus" }, { "key": "B", "value": "Pulmonary fibrosis and corneal deposits" }, { "key": "C", "value": "Pedal edema and flushing" }, { "key": "D", "value": "Hypothyroidism and phototoxicity" } ]
Headache and tinnitus
Pulmonary fibrosis and corneal deposits
Pedal edema and flushing
Hypothyroidism and phototoxicity
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_447
A 52-year-old man is brought to the emergency department for recurrent vomiting that began 5 hours ago. He describes the vomitus as bloody and containing black specks. He drinks 10–12 beers daily and has not seen a physician in 15 years. He appears pale. His temperature is 36.7°C (98.1°F), pulse is 122/min, and blood p...
C
[ { "key": "A", "value": "Systemic vascular resistance" }, { "key": "B", "value": "Fractional tissue oxygen extraction" }, { "key": "C", "value": "Carotid baroreceptor firing activity" }, { "key": "D", "value": "Cardiac inotropy" } ]
Systemic vascular resistance
Fractional tissue oxygen extraction
Carotid baroreceptor firing activity
Cardiac inotropy
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_448
A 69-year-old male with a longstanding history of hypertension and high cholesterol presents with abdominal pain and ‘bruising on his feet’. The patient states that his symptoms started about a week ago and have steadily worsened. He describes the abdominal pain as mild to moderate, dull, and deeply localized to the um...
D
[ { "key": "A", "value": "Discharge with clinical surveillance and ultrasound every 6 months" }, { "key": "B", "value": "Elective endovascular repair" }, { "key": "C", "value": "Elective open surgical repair" }, { "key": "D", "value": "Emergency open surgical repair" } ]
Discharge with clinical surveillance and ultrasound every 6 months
Elective endovascular repair
Elective open surgical repair
Emergency open surgical repair
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_451
A 63-year-old man is aiming to improve his health by eating a well balanced diet, walking daily, and quitting smoking following a 45-year smoking history. While on his daily walks he notices a strong cramping pain in his calves that consistently appears after a mile of walking. He sees his physician and a diagnosis of ...
D
[ { "key": "A", "value": "Irreversible cyclooxygenase inhibitor" }, { "key": "B", "value": "Thromboxane synthase inhibitor" }, { "key": "C", "value": "Adenosine diphosphate receptor inhibitor" }, { "key": "D", "value": "Phosphodiesterase inhibitor" } ]
Irreversible cyclooxygenase inhibitor
Thromboxane synthase inhibitor
Adenosine diphosphate receptor inhibitor
Phosphodiesterase inhibitor
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_455
A 62-year-old woman presents to the emergency department for vision changes. About 90 minutes ago she was on the couch watching television with her husband when she suddenly noticed that she couldn't see the screen normally. She also felt a little dizzy. She has never had anything like this happen before. Her general p...
C
[ { "key": "A", "value": "Internal carotid artery" }, { "key": "B", "value": "Anterior cerebral artery" }, { "key": "C", "value": "Posterior cerebral artery" }, { "key": "D", "value": "Basilar artery" } ]
Internal carotid artery
Anterior cerebral artery
Posterior cerebral artery
Basilar artery
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_458
A 20-year-old healthy man is running on a treadmill for the last 30 minutes. He is in good shape and exercises 3 times per week. He takes no medications and denies smoking cigarettes, drinking alcohol, and illicit drug use. Prior to starting his run, his heart rate was 70/min, and the blood pressure was 114/74 mm Hg. I...
C
[ { "key": "A", "value": "Baroreceptor reflex" }, { "key": "B", "value": "Increased activation of the vagal nuclei" }, { "key": "C", "value": "Sympathetic nervous system activation" }, { "key": "D", "value": "Vasopressin release from the pituitary" } ]
Baroreceptor reflex
Increased activation of the vagal nuclei
Sympathetic nervous system activation
Vasopressin release from the pituitary
Cardiovascular = 1.0
Cardiovascular
1
medqa_4opt_test_461
A 58-year-old man comes to the physician because he is unable to achieve erections during sexual intercourse. He first noticed the problem 8 months ago, when he became sexually active with a new girlfriend. He states that his relationship with his girlfriend is good, but his inability to engage in sexual intercourse ha...
C
[ { "key": "A", "value": "Psychotherapy" }, { "key": "B", "value": "Penile prosthesis insertion" }, { "key": "C", "value": "Nocturnal penile tumescence testing" }, { "key": "D", "value": "Switch citalopram to bupropion" } ]
Psychotherapy
Penile prosthesis insertion
Nocturnal penile tumescence testing
Switch citalopram to bupropion
Cardiovascular = 0.7
Cardiovascular
0.7
medqa_4opt_test_475
A 63-year-old man comes to the emergency department because of retrosternal chest pain. He describes it as 7 out of 10 in intensity. He has coronary artery disease, hypertension, and type 2 diabetes mellitus. His current medications are aspirin, simvastatin, metformin, and enalapril. He has smoked one pack of cigarette...
D
[ { "key": "A", "value": "Coronary angiogram" }, { "key": "B", "value": "Intravenous esmolol" }, { "key": "C", "value": "Intravenous amiodarone" }, { "key": "D", "value": "Synchronized cardioversion" } ]
Coronary angiogram
Intravenous esmolol
Intravenous amiodarone
Synchronized cardioversion
Cardiovascular = 0.95
Cardiovascular
0.95
medqa_4opt_test_479
A 63-year-old patient presents to the emergency department because of severe left leg pain and tingling. His condition started suddenly 30 minutes ago. He has had hypertension for the past 10 years for which he takes bisoprolol. He does not smoke or drink alcohol. His temperature is 37.1°C (98.7°F), the blood pressure ...
C
[ { "key": "A", "value": "Vasculitis" }, { "key": "B", "value": "Hyperhomocysteinemia" }, { "key": "C", "value": "Arterial emboli" }, { "key": "D", "value": "Arterial trauma" } ]
Vasculitis
Hyperhomocysteinemia
Arterial emboli
Arterial trauma
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_503
While in the ICU, a 62-year-old male undergoes placement of a Swan-Ganz catheter to evaluate his right heart pressures. All pressures are found to be within normal limits, and the cardiology fellow records a pulmonary wedge pressure of 10 mmHg. Which of the following are normal values for the pressures that will be obt...
B
[ { "key": "A", "value": "25/10 mmHg" }, { "key": "B", "value": "25/5 mmHg" }, { "key": "C", "value": "10/0 mmHg" }, { "key": "D", "value": "100/70 mmHg" } ]
25/10 mmHg
25/5 mmHg
10/0 mmHg
100/70 mmHg
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_511
A 67-year-old man comes to the physician for a routine medical check-up prior to a scheduled elective femoropopliteal bypass surgery of his left leg. He feels well but reports occasional episodes of weakness and numbness in his left hand. He has a history of peripheral arterial disease, type 2 diabetes mellitus, hypert...
A
[ { "key": "A", "value": "Ultrasonography of the neck" }, { "key": "B", "value": "Echocardiography" }, { "key": "C", "value": "Warfarin therapy" }, { "key": "D", "value": "CT angiography of the head" } ]
Ultrasonography of the neck
Echocardiography
Warfarin therapy
CT angiography of the head
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_515
An 8-year-old boy who recently immigrated to the United States presents with a rash. Past medical history is significant for a recent sore throat which caused him to miss several days at school. The patient’s vaccination status is unknown. On physical examination, the patient is pale and ill-looking. There are pink rin...
D
[ { "key": "A", "value": "Atypical lymphocytes on peripheral blood smear" }, { "key": "B", "value": "Starry sky appearance" }, { "key": "C", "value": "Needle-shaped, negatively birefringent crystal deposits" }, { "key": "D", "value": "Granulomas with giant cells" } ]
Atypical lymphocytes on peripheral blood smear
Starry sky appearance
Needle-shaped, negatively birefringent crystal deposits
Granulomas with giant cells
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_516
A 59-year-old man presents to general medical clinic for his yearly checkup. He has no complaints except for a dry cough. He has a past medical history of type II diabetes, hypertension, hyperlipidemia, asthma, and depression. His home medications are sitagliptin/metformin, lisinopril, atorvastatin, albuterol inhaler, ...
D
[ { "key": "A", "value": "Change lisinopril to propanolol" }, { "key": "B", "value": "Change lisinopril to amlodipine" }, { "key": "C", "value": "Change atorvastatin to to lovastatin" }, { "key": "D", "value": "Change lisinopril to losartan" } ]
Change lisinopril to propanolol
Change lisinopril to amlodipine
Change atorvastatin to to lovastatin
Change lisinopril to losartan
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_519
A 36-year-old man is brought to the emergency department 40 minutes after being involved in a shooting. He sustained a gunshot wound in an altercation outside of a bar. On arrival, he is oriented to person but not to place or time. His temperature is 37.3°C (99.1°F), pulse is 116/min, respirations are 18/min, and blood...
C
[ { "key": "A", "value": "CT scan of the chest, abdomen, and pelvis" }, { "key": "B", "value": "Local wound exploration" }, { "key": "C", "value": "Exploratory laparotomy" }, { "key": "D", "value": "Video-assisted thoracoscopic surgery" } ]
CT scan of the chest, abdomen, and pelvis
Local wound exploration
Exploratory laparotomy
Video-assisted thoracoscopic surgery
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_521
A 62-year-old man presents to the emergency department with crushing chest pain (10/10 in severity), radiating to the left side of the neck and the left arm. His symptoms started 20 minutes ago while shaving. He also feels nauseated, lightheaded and short of breath. He has had type 2 diabetes for 27 years and essential...
A
[ { "key": "A", "value": "Percutaneous coronary intervention" }, { "key": "B", "value": "Intravenous alteplase" }, { "key": "C", "value": "Coronary artery bypass graft" }, { "key": "D", "value": "Oral ramipril" } ]
Percutaneous coronary intervention
Intravenous alteplase
Coronary artery bypass graft
Oral ramipril
Cardiovascular = 0.95
Cardiovascular
0.95
medqa_4opt_test_529
A 60-year-old woman is brought to the emergency department because of sudden, painless loss of vision in her right eye that occurred 30 minutes ago while watching TV. She has coronary artery disease, hypertension, and type 2 diabetes mellitus; she has had trouble adhering to her medication regimen. Her blood pressure i...
B
[ { "key": "A", "value": "Retinal detachment" }, { "key": "B", "value": "Central retinal artery occlusion" }, { "key": "C", "value": "Acute angle-closure glaucoma" }, { "key": "D", "value": "Anterior ischemic optic neuropathy" } ]
Retinal detachment
Central retinal artery occlusion
Acute angle-closure glaucoma
Anterior ischemic optic neuropathy
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_530
A previously healthy 35-year-old woman comes to the emergency department because of sudden weakness of her right arm and leg that started 3 hours ago. She returned from a business trip from Europe 3 days ago. She has smoked a pack of cigarettes daily for 10 years. Her only medication is an oral contraceptive. Her tempe...
A
[ { "key": "A", "value": "Patent foramen ovale" }, { "key": "B", "value": "Mitral valve vegetation" }, { "key": "C", "value": "Atrial fibrillation" }, { "key": "D", "value": "Carotid artery dissection" } ]
Patent foramen ovale
Mitral valve vegetation
Atrial fibrillation
Carotid artery dissection
Cardiovascular = 0.8
Cardiovascular
0.8
medqa_4opt_test_534
A 48-year-old man is brought to the emergency department for sudden onset of difficulty breathing 6 hours ago. For the past several months, he has had shortness of breath on exertion and while lying down on the bed, frequent headaches, and swelling of his feet. He does not take any medications despite being diagnosed w...
B
[ { "key": "A", "value": "Loud P2" }, { "key": "B", "value": "S3 gallop" }, { "key": "C", "value": "Absent S4" }, { "key": "D", "value": "A loud S1" } ]
Loud P2
S3 gallop
Absent S4
A loud S1
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_541
In a study to determine the risk factors for myocardial infarction (MI) at a young age (age < 30 years), 30 young patients with the condition are recruited into the study group. Sixty similar but healthy individuals are recruited into the control group. Educational status is considered to be an important variable, as i...
A
[ { "key": "A", "value": "The association is not statistically significant, and low education is not a risk factor." }, { "key": "B", "value": "The association is statistically significant, but low education is not a risk factor." }, { "key": "C", "value": "The association is not stati...
The association is not statistically significant, and low education is not a risk factor.
The association is statistically significant, but low education is not a risk factor.
The association is not statistically significant, but low education is a risk factor.
One can not comment, as the p-value is not given.
Cardiovascular = 0.8
Cardiovascular
0.8
medqa_4opt_test_543
A 39-year-old man presents to the emergency department complaining of a sharp pain that radiates along his right hemithorax, which worsens with deep inspiration. He says this started abruptly about 6 hours ago. He says that he has not noticed that anything that makes his pain better or worse. He also denies any other s...
C
[ { "key": "A", "value": "ECG" }, { "key": "B", "value": "V/Q scan" }, { "key": "C", "value": "D-dimer" }, { "key": "D", "value": "CT pulmonary angiogram with IV contrast" } ]
ECG
V/Q scan
D-dimer
CT pulmonary angiogram with IV contrast
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_566
A 61-year-old man is brought to the emergency room with chest pain. He developed severe, crushing, substernal chest pain 10 hours ago while he was hiking in the Adirondack mountains. He was with 2 friends at the time who gave him aspirin before carrying him 5 miles to a town to get phone service, where they then called...
B
[ { "key": "A", "value": "Left anterior descending artery" }, { "key": "B", "value": "Left circumflex artery" }, { "key": "C", "value": "Left coronary artery" }, { "key": "D", "value": "Right marginal artery" } ]
Left anterior descending artery
Left circumflex artery
Left coronary artery
Right marginal artery
Cardiovascular = 0.95
Cardiovascular
0.95
medqa_4opt_test_573
A previously healthy 46-year-old woman comes to the physician because of progressive shortness of breath, fatigue, and chest pain during exercise for the last 6 months. She does not smoke. Her maternal uncle had similar symptoms. Cardiac examination shows wide splitting of S2. The second component of S2 is loud and bes...
C
[ { "key": "A", "value": "Increased right ventricular preload" }, { "key": "B", "value": "Increased left ventricular preload" }, { "key": "C", "value": "Increased right ventricular afterload" }, { "key": "D", "value": "Increased left-to-right shunting" } ]
Increased right ventricular preload
Increased left ventricular preload
Increased right ventricular afterload
Increased left-to-right shunting
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_577
A 63-year-old man from the countryside presents with leg swelling and right upper abdominal tenderness. He reports a history of myocardial infarction 4 years ago, but he has no supporting documentation. At the moment, his only medication is aspirin. He also stated that he used to have ‘high blood sugars’ when checked i...
B
[ { "key": "A", "value": "Left ventricular ejection fraction of 41%" }, { "key": "B", "value": "Increased peak tricuspid regurgitation" }, { "key": "C", "value": "Hypokinetic wall of the left ventricle" }, { "key": "D", "value": "Abnormal left ventricular relaxation" } ]
Left ventricular ejection fraction of 41%
Increased peak tricuspid regurgitation
Hypokinetic wall of the left ventricle
Abnormal left ventricular relaxation
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_585
A 55-year-old man is brought to the emergency department 12 hours after the sudden onset of shortness of breath and substernal chest pain at rest; the pain is increased by inspiration. He has also had a nonproductive cough, fever, and malaise for the past 5 days. He does not smoke or use illicit drugs. His temperature ...
D
[ { "key": "A", "value": "Kawasaki disease" }, { "key": "B", "value": "Rheumatic fever" }, { "key": "C", "value": "Infective endocarditis" }, { "key": "D", "value": "Cardiac tamponade" } ]
Kawasaki disease
Rheumatic fever
Infective endocarditis
Cardiac tamponade
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_587
A 33-year-old G2P1 woman presents to the office because of poor diabetic control. She is currently at 18 weeks gestation and admits to having poor control of her type 1 diabetes before becoming pregnant. Her family history is non-contributory. The physical examination shows a pregnant woman with a fundal height of 20 c...
D
[ { "key": "A", "value": "Amelia" }, { "key": "B", "value": "Sacral agenesis" }, { "key": "C", "value": "Spina bifida" }, { "key": "D", "value": "Ventricular septal defect" } ]
Amelia
Sacral agenesis
Spina bifida
Ventricular septal defect
Cardiovascular = 0.8
Cardiovascular
0.8
medqa_4opt_test_604
A previously healthy 3-year-old boy is brought to the physician by his parents because of fever and a rash for 6 days. His temperature is 38.9°C (102°F). Examination shows right-sided anterior cervical lymphadenopathy, bilateral conjunctival injection, erythema of the tongue and lips, and a maculopapular rash involving...
A
[ { "key": "A", "value": "Coronary artery aneurysm" }, { "key": "B", "value": "Rapidly progressive glomerulonephritis" }, { "key": "C", "value": "Hearing loss" }, { "key": "D", "value": "Retinopathy" } ]
Coronary artery aneurysm
Rapidly progressive glomerulonephritis
Hearing loss
Retinopathy
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_611
A 52-year-old man presents to the physician because of ongoing shortness of breath, which is more prominent when he lies down. Occasionally, he experiences palpitations, especially during strenuous activities. In addition to this, he has been experiencing difficulty in digestion and often experiences regurgitation and ...
C
[ { "key": "A", "value": "Alcohol abuse" }, { "key": "B", "value": "Hypertensive changes" }, { "key": "C", "value": "Parasitic infection" }, { "key": "D", "value": "Bacterial infection" } ]
Alcohol abuse
Hypertensive changes
Parasitic infection
Bacterial infection
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_630
A 64-year-old male with a past medical history of two myocardial infarctions presents to the emergency room with shortness of breath. He notes that he stopped taking his furosemide two weeks prior, because he ran out of pills. On exam, his oxygen saturation is 78%, his lungs have crackles throughout, and jugular venous...
D
[ { "key": "A", "value": "Decreased Aa gradient, decreased surface area for diffusion, normal diffusion distance" }, { "key": "B", "value": "Decreased Aa gradient, increased surface area for diffusion, decreased diffusion distance" }, { "key": "C", "value": "Increased Aa gradient, norm...
Decreased Aa gradient, decreased surface area for diffusion, normal diffusion distance
Decreased Aa gradient, increased surface area for diffusion, decreased diffusion distance
Increased Aa gradient, normal surface area for diffusion, increased diffusion distance
Increased Aa gradient, decreased surface area for diffusion, increased diffusion distance
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_632
A 41-year-old woman presents with shortness of breath that is worse when she lies on her left side. About 10 days ago, she had an episode of unexplained loss of consciousness. Past medical history is negative and family history is irrelevant. Clinical examination shows a diastolic murmur, which is prominent when she li...
D
[ { "key": "A", "value": "Rheumatic fever" }, { "key": "B", "value": "Innocent murmur" }, { "key": "C", "value": "Non-bacterial thrombotic endocarditis" }, { "key": "D", "value": "Atrial myxoma" } ]
Rheumatic fever
Innocent murmur
Non-bacterial thrombotic endocarditis
Atrial myxoma
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_635
A 55-year-old man presents into the emergency department with a severe cough and difficulty breathing. He says that he finds himself out of breath after taking a few steps, and has to sit down and rest, in order to continue. He also says that, at night, he has the greatest difficulty in breathing and usually uses at le...
B
[ { "key": "A", "value": "Computed Tomography (CT)" }, { "key": "B", "value": "Echocardiogram" }, { "key": "C", "value": "Stress test" }, { "key": "D", "value": "Cardiac biopsy" } ]
Computed Tomography (CT)
Echocardiogram
Stress test
Cardiac biopsy
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_636
A 2-day-old boy delivered at 34 weeks gestation is found to have a murmur on routine exam. He is lying supine and is not cyanotic. He has a pulse of 195/min, and respirations of 59/min. He is found to have a nonradiating continuous machine-like murmur at the left upper sternal border. S1 and S2 are normal. The peripher...
A
[ { "key": "A", "value": "Indomethacin" }, { "key": "B", "value": "Thiazide diuretic" }, { "key": "C", "value": "Aspirin" }, { "key": "D", "value": "Penicillin" } ]
Indomethacin
Thiazide diuretic
Aspirin
Penicillin
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_657
A 62-year-old man presents with episodes of palpitations for the past 3 weeks. He says that he has episodes where he feels his heart is ‘racing and pounding’, lasting 1–2 hours on average. Initially, he says the episodes would happen 1–2 times per week but now happen almost every day. This last episode has been constan...
D
[ { "key": "A", "value": "Begin aspirin therapy" }, { "key": "B", "value": "Begin clopidogrel" }, { "key": "C", "value": "Carotid endarterectomy" }, { "key": "D", "value": "Begin warfarin and heparin" } ]
Begin aspirin therapy
Begin clopidogrel
Carotid endarterectomy
Begin warfarin and heparin
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_661
A 3-year-old girl is brought to the cardiologist because of sweating and respiratory distress while eating. She is at the 30th percentile for height and 15th percentile for weight. Echocardiography shows a defect in the membranous portion of the interventricular septum and a moderately decreased left ventricular ejecti...
A
[ { "key": "A", "value": "Systolic murmur that increases with hand clenching" }, { "key": "B", "value": "Systolic murmur that increases with forced exhalation against a closed glottis" }, { "key": "C", "value": "Diastolic murmur preceded by opening snap" }, { "key": "D", "v...
Systolic murmur that increases with hand clenching
Systolic murmur that increases with forced exhalation against a closed glottis
Diastolic murmur preceded by opening snap
Continuous murmur that is loudest at the second heart sound
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_693
A 38-year-old woman presents to her physician’s clinic for recurrent episodes of chest pain that wakes her from her sleep. While usually occurring late at night, she has also had similar pains during the day at random times, most recently while sitting at her desk in her office and at other times while doing the dishes...
B
[ { "key": "A", "value": "Aspirin" }, { "key": "B", "value": "Isosorbide dinitrate" }, { "key": "C", "value": "Heparin" }, { "key": "D", "value": "Propranolol" } ]
Aspirin
Isosorbide dinitrate
Heparin
Propranolol
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_714
A 28-year-old male presents to the emergency department with chest pain. He reports that one hour ago he was climbing the stairs in his home when he suddenly developed excruciating chest pain. He describes the pain as ripping and radiating to the back. The patient’s past medical history is significant for a heart murmu...
B
[ { "key": "A", "value": "Holosystolic, high-pitched blowing murmur at the lower left sternal border" }, { "key": "B", "value": "Late systolic crescendo murmur at the apex with mid-systolic click" }, { "key": "C", "value": "Mid-diastolic murmur at the left lower sternal border" }, ...
Holosystolic, high-pitched blowing murmur at the lower left sternal border
Late systolic crescendo murmur at the apex with mid-systolic click
Mid-diastolic murmur at the left lower sternal border
Systolic ejection murmur at the right second intercostal space
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_718
A 50-year-old man comes to the physician because of swelling of his legs for 2 months. Three months ago, he was diagnosed with hypertension and started on a new medication. His blood pressure is 145/95 mm Hg. Physical examination shows 2+ edema in both lower extremities. Laboratory studies are within the reference rang...
D
[ { "key": "A", "value": "Losartan" }, { "key": "B", "value": "Spironolactone" }, { "key": "C", "value": "Hydrochlorothiazide" }, { "key": "D", "value": "Amlodipine" } ]
Losartan
Spironolactone
Hydrochlorothiazide
Amlodipine
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_723
A 10-year-old boy is brought to the physician because of a generalized, non-itchy rash for 2 days. He has also had a fever and sore throat for 4 days. He has not received any routine childhood vaccinations. Examination shows a flushed face except around his mouth. A diffuse, papular, erythematous rash that blanches wit...
C
[ { "key": "A", "value": "Coronary artery aneurysms" }, { "key": "B", "value": "Encephalitis" }, { "key": "C", "value": "Mitral valve regurgitation" }, { "key": "D", "value": "Minimal change disease" } ]
Coronary artery aneurysms
Encephalitis
Mitral valve regurgitation
Minimal change disease
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_737
A 55-year-old male presents to the emergency department with dyspnea and palpitations. He does not smoke cigarettes or consume alcohol, and past medical history is insignificant. Blood pressure is 115/75 mmHG and heart rate is 125/min. Heart rhythm is irregularly irregular. After initial treatment with IV digoxin the p...
C
[ { "key": "A", "value": "Blockade of beta-adrenergic receptors" }, { "key": "B", "value": "Calcium channel blockade" }, { "key": "C", "value": "Vagal stimulation" }, { "key": "D", "value": "Increased ventricular contractility" } ]
Blockade of beta-adrenergic receptors
Calcium channel blockade
Vagal stimulation
Increased ventricular contractility
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_742
A 23-year-old woman visits her obstetrician for an antenatal appointment. She is at the 24th week of gestation. She has had type 1 diabetes mellitus for 5 years and is on insulin. She also has mitral stenosis, for which she has been advised to undergo a balloon valvotomy. Her temperature is 37.1°C (98.7°F), blood press...
B
[ { "key": "A", "value": "Hypertrophic obstructive cardiomyopathy" }, { "key": "B", "value": "Transient hypertrophic cardiomyopathy" }, { "key": "C", "value": "Tetralogy of Fallot" }, { "key": "D", "value": "Mitral valve prolapse" } ]
Hypertrophic obstructive cardiomyopathy
Transient hypertrophic cardiomyopathy
Tetralogy of Fallot
Mitral valve prolapse
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_745
A 63-year-old woman with end-stage renal disease complains of feeling lightheaded after her hemodialysis sessions for the past month. She worries she might eventually lose her balance and fall. She has had diabetes mellitus for 22 years. Her medications include folic acid, vitamin B12, amlodipine, and erythropoietin. A...
A
[ { "key": "A", "value": "Cooling the dialysate" }, { "key": "B", "value": "Eating heavier meals during dialysis" }, { "key": "C", "value": "Increasing ultrafiltration" }, { "key": "D", "value": "Steroid administration" } ]
Cooling the dialysate
Eating heavier meals during dialysis
Increasing ultrafiltration
Steroid administration
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_755
A 31-year-old G1-P0 woman at 28-weeks gestation presents with shortness of breath and nonspecific right-sided chest pain that is worse with inspiration. She works as a graduate student at the local university, and she informs you that she recently returned to the west coast from a trip to New York for an Economics conf...
C
[ { "key": "A", "value": "ECG" }, { "key": "B", "value": "Chest radiography" }, { "key": "C", "value": "V/Q scan" }, { "key": "D", "value": "CT pulmonary angiogram" } ]
ECG
Chest radiography
V/Q scan
CT pulmonary angiogram
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_773
A 21-year-old female presents to the office after a health screening in which she was found to have high blood pressure. At the office, the blood pressure is 168/114 mm Hg. You have seen the patient in the past for amenorrhea and infertility issues, but she denies taking any medication at this time. On examination, the...
A
[ { "key": "A", "value": "Central fusion of the inferior poles of the kidneys" }, { "key": "B", "value": "Genetic predisposition to essential hypertension" }, { "key": "C", "value": "Neuroendocrine tumor of the adrenal gland" }, { "key": "D", "value": "Oral contraceptive us...
Central fusion of the inferior poles of the kidneys
Genetic predisposition to essential hypertension
Neuroendocrine tumor of the adrenal gland
Oral contraceptive use
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_775
A gunshot victim is brought to the Emergency Department and appears to be in shock. You note a penetrating wound at the level of L3. Assuming the bullet remained at this level, which vascular structure might have been injured?
A
[ { "key": "A", "value": "Inferior vena cava" }, { "key": "B", "value": "Internal iliac vein" }, { "key": "C", "value": "Renal artery" }, { "key": "D", "value": "Portal vein" } ]
Inferior vena cava
Internal iliac vein
Renal artery
Portal vein
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_794
A 75-year-old man comes to the physician for the evaluation of progressive shortness of breath and fatigue over the past month. He reports that he cannot climb more than one flight of stairs without experiencing shortness of breath and dizziness. He has hypertension and hyperlipidemia. He has smoked one pack of cigaret...
D
[ { "key": "A", "value": "Tricuspid valve stenosis" }, { "key": "B", "value": "Mitral valve prolapse" }, { "key": "C", "value": "Mitral valve stenosis" }, { "key": "D", "value": "Aortic valve stenosis" } ]
Tricuspid valve stenosis
Mitral valve prolapse
Mitral valve stenosis
Aortic valve stenosis
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_799
A 68-year-old woman presents to the emergency room with chest pain. She reports sudden severe and crushing substernal chest pain that started 1 hour ago. Her past medical history is notable for hypertension, hyperlipidemia, diabetes mellitus, obesity, and a prior myocardial infarction requiring a coronary artery bypass...
B
[ { "key": "A", "value": "Alpha-2 adrenergic receptor" }, { "key": "B", "value": "Beta-1 adrenergic receptor" }, { "key": "C", "value": "Beta-2 adrenergic receptor" }, { "key": "D", "value": "D2 receptor" } ]
Alpha-2 adrenergic receptor
Beta-1 adrenergic receptor
Beta-2 adrenergic receptor
D2 receptor
Cardiovascular = 1.0
Cardiovascular
1
medqa_4opt_test_803
A 75-year-old woman presents to the emergency department with 30 minutes of slurred speech and arm weakness. On the drive over to the hospital, her symptoms have resolved completely. The patient has a past medical history of hypertension, atrial fibrillation, diabetes, morbid obesity, gout, and vascular claudication. H...
A
[ { "key": "A", "value": "CT angiogram" }, { "key": "B", "value": "Echocardiogram" }, { "key": "C", "value": "Heparin" }, { "key": "D", "value": "MRI" } ]
CT angiogram
Echocardiogram
Heparin
MRI
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_807
A 45-year-old man presents to the emergency department after being stabbed 12 times in various parts of his body. Paramedics report extensive blood loss at the scene where he was found. Due to his Glasgow Coma Scale score of 3, an endotracheal airway and large-bore access are secured prior to arrival. He is aggressivel...
A
[ { "key": "A", "value": "Cardiac tamponade" }, { "key": "B", "value": "Cervical spinal cord transection" }, { "key": "C", "value": "Pulmonary embolism" }, { "key": "D", "value": "Undiagnosed pneumonia" } ]
Cardiac tamponade
Cervical spinal cord transection
Pulmonary embolism
Undiagnosed pneumonia
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_813
A 70-year-old man with hyperlipidemia and hypertension returns to his cardiologist for ongoing blood pressure management. He reports feeling fine with no trouble with his medications. He exercises regularly and sleeps well without snoring or daytime somnolence. His blood pressure measurements in the past have ranged fr...
C
[ { "key": "A", "value": "Primary hyperaldosteronism" }, { "key": "B", "value": "Hypothyroidism" }, { "key": "C", "value": "Stiffening of the aorta" }, { "key": "D", "value": "Aortic stenosis" } ]
Primary hyperaldosteronism
Hypothyroidism
Stiffening of the aorta
Aortic stenosis
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_851
A 69-year-old male presents to the emergency department with shortness of breath. The patient has presented three times this past month with similar complaints. The patient sees no primary care physician and is currently not taking any medications. The patient states his shortness of breath started when he was walking ...
C
[ { "key": "A", "value": "High BNP, high ADH, high sodium, high potassium" }, { "key": "B", "value": "High BNP, low ADH, normal sodium, low potassium" }, { "key": "C", "value": "High BNP, high ADH, low sodium, low potassium" }, { "key": "D", "value": "Low BNP, low ADH, norm...
High BNP, high ADH, high sodium, high potassium
High BNP, low ADH, normal sodium, low potassium
High BNP, high ADH, low sodium, low potassium
Low BNP, low ADH, normal sodium, normal potassium
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_859
A 58-year-old male presents with an acutely elevated blood pressure of 220/140 mmHg. The patient complains of a headache and chest pain, and he has been vomiting for the last several hours. Physical exam demonstrates papilledema and a depressed level of consciousness. To treat this patient's hypertensive emergency, he ...
D
[ { "key": "A", "value": "Decreased cardiac contractility" }, { "key": "B", "value": "Increased left ventricular end-diastolic pressure" }, { "key": "C", "value": "Decreased stroke volume" }, { "key": "D", "value": "Decreased pulmonary capillary wedge pressure" } ]
Decreased cardiac contractility
Increased left ventricular end-diastolic pressure
Decreased stroke volume
Decreased pulmonary capillary wedge pressure
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_862
A 27-year-old woman presents to her primary care physician for a general checkup. She has been doing well in school and has no complaints. The patient has a past medical history of asthma which is controlled with albuterol. She is currently sexually active but states that she uses birth control. She has many friends an...
B
[ { "key": "A", "value": "Colonoscopy" }, { "key": "B", "value": "Discontinue birth control and place an intrauterine device" }, { "key": "C", "value": "Pap smear" }, { "key": "D", "value": "Recommend weight loss" } ]
Colonoscopy
Discontinue birth control and place an intrauterine device
Pap smear
Recommend weight loss
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_868
An 80-year-old man is brought to the emergency department because of fatigue and lightheadedness. He does not have chest pain, palpitations, or difficulty breathing. He has a history of hyperlipidemia, type 2 diabetes mellitus, hypertension, osteoarthritis, and asthma. Current medications include simvastatin, metformin...
C
[ { "key": "A", "value": "Dobutamine" }, { "key": "B", "value": "Norepinephrine" }, { "key": "C", "value": "Cardiac pacing" }, { "key": "D", "value": "Epinephrine" } ]
Dobutamine
Norepinephrine
Cardiac pacing
Epinephrine
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_892
A 55-year-old man presents with complaints of exertional dyspnea and dry cough. He reports using extra pillows at night to sleep and two nighttime awakenings to catch his breath in the last month. The patient lives in a homeless shelter and has not seen a doctor in the last 20 years. He has been drinking 5-8 drinks of ...
D
[ { "key": "A", "value": "Decreased glomerular filtration rate (GFR)" }, { "key": "B", "value": "Decreased extracellular fluid (ECF) volume" }, { "key": "C", "value": "Increased renal blood flow" }, { "key": "D", "value": "Increased renal tubular sodium reabsorption" } ]
Decreased glomerular filtration rate (GFR)
Decreased extracellular fluid (ECF) volume
Increased renal blood flow
Increased renal tubular sodium reabsorption
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_906
A 45-year-old woman comes to the emergency department because of intermittent chest pain and palpitations. She also complains of dyspnea on exertion and has had a 4.5-kg (10-lb) weight loss in the past 2 months despite normal appetite. She has no history of serious medical illness. Cardiac examination shows an irregula...
D
[ { "key": "A", "value": "Nonencapsulated groups of well-differentiated skeletal muscle cells" }, { "key": "B", "value": "Mixture of cells from different germinal layers" }, { "key": "C", "value": "Encapsulated cluster of mature fat cells" }, { "key": "D", "value": "Nests o...
Nonencapsulated groups of well-differentiated skeletal muscle cells
Mixture of cells from different germinal layers
Encapsulated cluster of mature fat cells
Nests of atypical melanocytes
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_907
A 58-year-old woman comes to the physician because of intermittent painful retrosternal dullness for 4 weeks. The pain is recurrent and occurs when she exerts herself or when she is outside during cold weather. She also experiences shortness of breath and palpitations during these episodes. The symptoms resolve spontan...
A
[ { "key": "A", "value": "Myocardial perfusion scan under pharmacological stress" }, { "key": "B", "value": "Upper endoscopy" }, { "key": "C", "value": "Coronary angiography" }, { "key": "D", "value": "Echocardiography at rest" } ]
Myocardial perfusion scan under pharmacological stress
Upper endoscopy
Coronary angiography
Echocardiography at rest
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_909
A 36-year-old G3P2 woman with no significant past medical history delivers a 3.7 kg (8 lb, 3 oz) baby boy following an uncomplicated pregnancy. On physical examination in the delivery room, the pediatrician notes that the baby has upslanting palpebral fissures, epicanthal folds, a flat facial profile, small ears, a sin...
B
[ { "key": "A", "value": "Tetralogy of Fallot" }, { "key": "B", "value": "Omphalocele" }, { "key": "C", "value": "Congenital cataracts" }, { "key": "D", "value": "Cleft lip" } ]
Tetralogy of Fallot
Omphalocele
Congenital cataracts
Cleft lip
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_916
A 52-year-old man with hypertension and hyperlipidemia comes to the emergency department 30 minutes after the sudden onset of substernal chest pain while sitting in a chair at home. He reports drinking 2 glasses of whiskey earlier that day, after a stressful day at work. Current medications include hydrochlorothiazide ...
A
[ { "key": "A", "value": "Coronary artery vasospasm" }, { "key": "B", "value": "Coronary artery vasodilation" }, { "key": "C", "value": "Atherosclerotic plaque rupture" }, { "key": "D", "value": "Pericardial inflammation" } ]
Coronary artery vasospasm
Coronary artery vasodilation
Atherosclerotic plaque rupture
Pericardial inflammation
Cardiovascular = 0.95
Cardiovascular
0.95
medqa_4opt_test_926
A 48-year-old man with type II diabetes mellitus complicated by peripheral neuropathy presents to the emergency department for a foot wound that he noticed. He denies any pain, fevers, or chills. His temperature is 101°F (38.3°C), blood pressure is 150/80 mmHg, pulse is 80/min, and respirations are 22/min. An ulcer wit...
B
[ { "key": "A", "value": "Complete blood count, type and screen, and order 1 unit of blood" }, { "key": "B", "value": "CT angiography of the chest and give oxygen" }, { "key": "C", "value": "Deep wound culture and start piperacillin-tazobactam" }, { "key": "D", "value": "Er...
Complete blood count, type and screen, and order 1 unit of blood
CT angiography of the chest and give oxygen
Deep wound culture and start piperacillin-tazobactam
Erythrocyte sedimentation rate and give oxycodone
Cardiovascular = 0.85
Cardiovascular
0.85
medqa_4opt_test_940
A 66-year-old male with a history of myocardial infarction presents to your primary care office with complaints of dyspnea on exertion and swollen feet and ankles. On exam, you note an elevated JVP and 2+ pitting edema of bilateral lower extremities. What is the most likely explanation for this patient's lower extremit...
A
[ { "key": "A", "value": "Increase in capillary pressure" }, { "key": "B", "value": "Decrease in plasma proteins" }, { "key": "C", "value": "Increase in capillary permeability" }, { "key": "D", "value": "Increase in interstitial fluid pressure" } ]
Increase in capillary pressure
Decrease in plasma proteins
Increase in capillary permeability
Increase in interstitial fluid pressure
Cardiovascular = 0.9
Cardiovascular
0.9
medqa_4opt_test_943
A scientist observes a myocyte beating in cell culture. Which step is the most direct necessary component of relaxation for this cell?
D
[ { "key": "A", "value": "Influx of sodium ions" }, { "key": "B", "value": "Influx of calcium ions from the sacroplasmic reticulum" }, { "key": "C", "value": "Influx of calcium ions from outside the myocyte" }, { "key": "D", "value": "Efflux of calcium ions" } ]
Influx of sodium ions
Influx of calcium ions from the sacroplasmic reticulum
Influx of calcium ions from outside the myocyte
Efflux of calcium ions
Cardiovascular = 0.9
Cardiovascular
0.9
End of preview. Expand in Data Studio
README.md exists but content is empty.
Downloads last month
6