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 |
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