Datasets:

iqbalr
/

Medical-MCQA

topic stringlengths 3 37	competency stringclasses 19 values	stem stringlengths 42 403	options dict	answer_key stringclasses 4 values	explanation stringlengths 51 525	evidence listlengths 1 3	status stringclasses 1 value	meta dict	stem_id stringlengths 38 307 ⌀	options_id dict	explanation_id stringlengths 106 446 ⌀
Immunization	Complications	A patient with a history of atopic disease undergoes long-term hyposensitization with allergenic extracts. What is the likelihood of this patient developing autoimmune or collagen vascular disease as a result of the treatment?	{ "A": "Increased risk", "B": "No increased risk", "C": "Uncertain risk", "D": "Decreased risk" }	B	Long-term hyposensitization with allergenic extracts does not increase the risk of autoimmune or collagen vascular disease.	[ { "source": "pubmed", "doc_id": "pubmed23n0005_12889", "title": "Evaluation of the adverse effects of long-term hyposensitization", "span_text": "Atopic individuals receiving five or more years of hyposensitization with allergenic extracts showed no increased autoimmune, collagen vascular, or lympho...	OK	{ "retrieval": { "time": 100, "doc_ids": [ "InternalMed_Harrison_21641", "pubmed23n0017_2869", "InternalMed_Harrison_7915", "InternalMed_Harrison_467", "Obstentrics_Williams_5951", "Biochemistry_Lippincott_1201", "InternalMed_Harrison_4203", "Pathology_Robbins_4...	null	null	null
Asthma	Treatment	A patient with chronic asthma experiences symptoms more than 4-6 times a week. What should be initiated in addition to inhaled short acting beta 2-agonists as needed?	{ "A": "Regular inhalative antiinflammatory regimen", "B": "Oral corticosteroids", "C": "Intravenous beta 2-agonists", "D": "Theophylline" }	A	For patients with chronic asthma who experience symptoms more than 4-6 times a week, a regular inhalative antiinflammatory regimen should be initiated in addition to inhaled short acting beta 2-agonists as needed. This approach helps to control inflammation and reduce airway hyperresponsiveness, thereby stabilizing the...	[ { "source": "pubmed", "doc_id": "pubmed23n0045_3533", "title": "[Asthma therapy: are bronchodilators obsolete?]", "span_text": "If asthma symptoms occur more than 4-6 times a week a regular inhalative antiinflammatory regimen should be initiated (e.g. inhalative corticosteroids b.i.d.)." } ]	OK	{ "retrieval": { "time": "2023-02-20T14:30:00Z", "doc_ids": [ "pubmed23n0045_3533", "pubmed23n0062_6534", "pubmed23n0053_15120", "pubmed23n0056_4794", "pubmed23n0050_8988" ], "evidence_doc_ids": [ "pubmed23n0050_8988", "pubmed23n0045_3533", "pubmed23n006...	null	null	null
Viral Hemorrhagic Fevers	Etiology	A patient from a region with high incidence of liver cancer presents with symptoms of hepatocellular carcinoma. Which of the following is a major risk factor for the development of this disease?	{ "A": "Hepatitis A virus infection", "B": "Hepatitis B virus infection", "C": "Coxsackie virus B infection", "D": "Rhinovirus infection" }	B	Hepatitis B virus infection is a major risk factor for the development of hepatocellular carcinoma, particularly in regions where the virus is endemic.	[ { "source": "textbook", "doc_id": "Pathology_Robbins_4029", "title": "Pathology_Robbins", "span_text": "The most important underlying factors in hepatocarcinogenesis are viral infections (HBV, HCV) and toxic injuries (aflatoxin, alcohol)." } ]	OK	{ "retrieval": { "time": 100, "method": "keyword search", "doc_ids": [ "pubmed23n0043_15753", "pubmed23n0043_20380", "pubmed23n0054_7710", "Immunology_Janeway_3902", "InternalMed_Harrison_20077", "Pathology_Robbins_4029", "pubmed23n0044_20505" ], "evidence...	Seorang pasien dari daerah dengan insidens tinggi kanker hati datang dengan gejala karsinoma hepatoseluler. Apakah yang berikut ini adalah faktor risiko utama untuk perkembangan penyakit ini?	{ "A": "Infeksi virus hepatitis A", "B": "Infeksi virus hepatitis B", "C": "Infeksi virus Coxsackie B", "D": "Infeksi rhinovirus" }	Infeksi virus hepatitis B adalah faktor risiko utama untuk perkembangan karsinoma hepatoseluler, terutama di daerah di mana virus tersebut endemik.
Viral Hemorrhagic Fevers	etiology	A patient presents with symptoms of severe hemorrhagic fever, including high fever, vomiting, and abdominal pain. Laboratory tests reveal the presence of a viral infection. Which of the following viruses is most likely to cause this condition, given its association with rodent-borne transmission?	{ "A": "Lassa virus", "B": "Dengue virus", "C": "Ebola virus", "D": "Rift Valley Fever virus" }	A	Lassa fever is an acute zoonotic hemorrhagic disease caused by Lassa virus (LASV), which is transmitted by rodents. The symptoms presented align with Lassa fever, making it a likely candidate. Dengue virus is primarily transmitted by mosquitoes, Ebola virus through direct contact with infected bodily fluids, and Rift V...	[ { "source": "pubmed_web", "doc_id": "pubmed_web_41901697", "title": "Development of a Rapid and Sensitive AlphaLISA-Based Assay for Lassa Virus Glycoprotein Detection", "span_text": "Lassa virus (LASV), a member of the Arenaviridae family, is the causative agent of Lassa fever (LF), an acute zoonoti...	OK	{ "retrieval": { "method": "search", "doc_ids": [ "pubmed_web_41937665", "pubmed_web_41937463", "pubmed_web_41930445", "pubmed_web_41928558", "pubmed_web_41923484", "pubmed_web_41920907", "pubmed_web_41920817", "pubmed_web_41913524", "pubmed_web_41911362",...	Seorang pasien datang dengan gejala demam berdarah parah, termasuk demam tinggi, muntah, dan nyeri perut. Tes laboratorium menunjukkan adanya infeksi virus. Virus manakah yang paling mungkin menyebabkan kondisi ini, mengingat asosiasi transmisinya dengan tikus?	{ "A": "Virus Lassa", "B": "Virus Dengue", "C": "Virus Ebola", "D": "Virus Demam Lembah Rift" }	Demam Lassa adalah penyakit hemoragik zoonotik akut yang disebabkan oleh virus Lassa (LASV), yang ditransmisikan oleh tikus. Gejala yang disajikan sesuai dengan demam Lassa, menjadikannya kandidat yang mungkin. Virus Dengue terutama ditransmisikan oleh nyamuk, virus Ebola melalui kontak langsung dengan cairan tubuh yan...
HIV	Etiology	A 30-year-old woman presents with symptoms of a sexually transmitted infection. She is diagnosed with HIV. What is the primary portal of entry for HIV in this patient?	{ "A": "Blood transfusion", "B": "Mother-to-child transmission", "C": "Female genital tract", "D": "Intravenous drug use" }	C	The female genital tract serves as one of the main portals of entry for sexually transmitted infections, including HIV.	[ { "source": "pubmed_web", "doc_id": "pubmed_web_41940866", "title": "Innate Immune Protection Against HIV in the Female Genital Tract", "span_text": "The female genital tract serves as one of the main portals of entry for sexually transmitted infections, including HIV." } ]	OK	{ "retrieval": { "time": 100, "doc_ids": [ "pubmed_web_41943966", "pubmed_web_41941454", "pubmed_web_41940866", "pubmed_web_41940844", "pubmed_web_41939916", "pubmed_web_41939907", "pubmed_web_41939747", "pubmed_web_41939522", "pubmed_web_41938868", ...	Seorang wanita berusia 30 tahun datang dengan gejala infeksi menular seksual. Ia didiagnosis dengan HIV. Apa yang menjadi portal utama masuknya HIV pada pasien ini?	{ "A": "Transfusi darah", "B": "Transmisi dari ibu ke anak", "C": "Traktus genitalia wanita", "D": "Penggunaan narkoba intravena" }	Traktus genitalia wanita merupakan salah satu portal utama masuknya infeksi menular seksual, termasuk HIV.
Mental Health	Prevention	What is an example of a successful prevention program?	{ "A": "The Navy alcoholism prevention program", "B": "The prevention of postextraction bacteremia", "C": "The prevention of Rh haemolytic disease", "D": "The prevention of viral hepatitis" }	A	The Navy alcoholism prevention program is an example of a successful prevention program.	[ { "source": "pubmed", "doc_id": "pubmed23n0004_6308", "title": "The Navy alcoholism prevention program--worldwide.", "span_text": "The Navy alcoholism prevention program--worldwide." } ]	OK	{ "retrieval": { "timestamp": "2024-01-01", "duration_ms": 150, "doc_ids": [ "pubmed23n0002_6461", "pubmed23n0004_4377", "pubmed23n0002_13082", "pubmed23n0003_7908", "pubmed23n0003_4401", "pubmed23n0004_6218", "pubmed23n0004_6308", "pubmed23n0004_5318", ...	null	null	null
COVID-19	Prognosis	What is the prognostic value of the Brixia score in predicting outcomes across COVID-19 and H1N1 patients?	{ "A": "The Brixia score has a high prognostic value in predicting outcomes across COVID-19 and H1N1 patients.", "B": "The Brixia score has a low prognostic value in predicting outcomes across COVID-19 and H1N1 patients.", "C": "The Brixia score is not useful in predicting outcomes across COVID-19 and H1N1 patien...	A	The Brixia score is a useful prognostic tool in predicting outcomes across COVID-19 and H1N1 patients, with higher scores indicating greater severity and mortality.	[ { "source": "pubmed_web", "doc_id": "pubmed_web_41578536", "title": "Brixia score on initial chest X-ray as a predictor of outcome in COVID-19 and H1N1 acute chest infections: A retrospective study.", "span_text": "Our study demonstrates the prognostic value of the Brixia score in predicting outcome...	OK	{ "retrieval": { "time": 100, "doc_ids": [ "pubmed_web_41578536", "pubmed_web_41576058", "pubmed_web_41574291", "pubmed_web_41573583", "pubmed_web_41572753", "pubmed_web_41568045", "pubmed_web_41562079", "pubmed_web_41558017", "pubmed_web_41557029", ...	null	null	null
Chronic Liver Disease	Pharmacology	A patient with chronic liver disease and hepatic encephalopathy is being considered for treatment with branched-chain amino acids. What is the primary benefit of this treatment?	{ "A": "Improved mortality rates", "B": "Reduced risk of liver transplantation", "C": "Beneficial effect on hepatic encephalopathy", "D": "Increased risk of gastrointestinal side effects" }	C	Branched-chain amino acids have been shown to have a beneficial effect on hepatic encephalopathy in patients with chronic liver disease.	[ { "source": "pubmed_web", "doc_id": "pubmed_web_41542879", "title": "Branched-chain amino acids for people with cirrhosis and hepatic encephalopathy", "span_text": "The previous version of this updated review meta-analysed data from 16 randomised clinical trials on branched-chain amino acids (BCAAs)...	OK	{ "retrieval": { "search_terms": [ "branched-chain amino acids", "hepatic encephalopathy", "chronic liver disease" ], "doc_ids": [ "pubmed_web_41581330", "pubmed_web_41580527", "pubmed_web_41578796", "pubmed_web_41578751", "pubmed_web_41573556", "pubme...	null	null	null
Prostate cancer	Monitoring	What is the role of prostate-specific antigen in monitoring the response of carcinoma of the prostate to radiotherapy?	{ "A": "It is not useful for monitoring response to radiotherapy", "B": "It is a sensitive tumor marker for monitoring response to radiotherapy", "C": "It is only useful for monitoring response to hormonal therapy", "D": "It is only useful for monitoring response to surgical therapy" }	B	Prostate-specific antigen is a sensitive tumor marker that can be used to monitor the response of carcinoma of the prostate to radiotherapy.	[ { "source": "pubmed", "doc_id": "pubmed23n0056_15149", "title": "Prostate-specific antigen. Monitoring the response of carcinoma of the prostate to radiotherapy with a new tumor marker.", "span_text": "The role of prostate-specific antigen (PSA), a sensitive tumor marker for cancer of the prostate, ...	OK	{ "retrieval": { "time": 100, "doc_ids": [ "pubmed23n0058_4638", "pubmed23n0046_3716", "pubmed23n0043_19064", "pubmed23n0049_20973", "pubmed23n0052_7551", "pubmed23n0056_15149", "pubmed23n0057_9103", "pubmed23n0057_9810", "pubmed23n0046_6458", "pubme...	null	null	null
Hyperthyroidism	Prognosis	What is the prognosis for patients with hyperthyroidism treated with radioiodine in terms of mortality rate?	{ "A": "No significant increase in mortality rate", "B": "Significant increase in mortality rate", "C": "Increase in mortality rate only in younger patients", "D": "Increase in mortality rate only when large quantities of radioiodine are prescribed" }	A	The prognosis for patients with hyperthyroidism treated with radioiodine is generally good, with no significant increase in mortality rate recognized in the group that received radioiodine therapy.	[ { "source": "pubmed", "doc_id": "pubmed23n0059_5119", "title": "[A long-term follow-up study of late-onset hypothyroidism and prognosis of hyperthyroid patients treated with radioiodine]", "span_text": "In the 2,379 cases in which there was an effective response, no significant increase in either mo...	OK	{ "retrieval": { "source": "pubmed", "query": "hyperthyroidism radioiodine prognosis", "doc_ids": [ "InternalMed_Harrison_7578", "pubmed23n0059_5119" ], "evidence_doc_ids": [ "InternalMed_Harrison_7578", "pubmed23n0059_5119" ], "retrieval_mode": "hybrid_rerank" },...	null	null	null
Tuberculosis	clinical_practice	A patient with active pulmonary tuberculosis has a high risk of infection and poor prognosis. Which of the following chest roentgenogram classification criteria is useful in estimating this risk?	{ "A": "Gakkai Classification", "B": "Cavanaugh Classification", "C": "Rosenberg Classification", "D": "Fletcher Classification" }	A	The Gakkai Classification is a useful criterion in estimating the risk of infection and prognosis of tuberculosis patients, as it takes into account the extent of disease and other clinical parameters.	[ { "source": "pubmed", "doc_id": "pubmed23n0053_11987", "title": "Chest roentgenogram classification and clinical parameters in patients with active pulmonary tuberculosis", "span_text": "We confirmed that the criteria for chest roentgenogram classification established by the Japanese Society for Tub...	OK	{ "retrieval": { "time": "2023-02-20", "method": "database search", "doc_ids": [ "pubmed23n0048_1237", "pubmed23n0017_11439", "pubmed23n0056_2782", "pubmed23n0055_21629", "pubmed23n0051_4009", "pubmed23n0053_11987", "pubmed23n0049_1251", "pubmed23n0044_6060"...	Seorang pasien dengan tuberkulosis paru aktif memiliki risiko infeksi tinggi dan prognosis buruk. Kriteria klasifikasi roentgenogram dada manakah yang berguna dalam memperkirakan risiko ini?	{ "A": "Klasifikasi Gakkai", "B": "Klasifikasi Cavanaugh", "C": "Klasifikasi Rosenberg", "D": "Klasifikasi Fletcher" }	Klasifikasi Gakkai adalah kriteria yang berguna dalam memperkirakan risiko infeksi dan prognosis pasien tuberkulosis, karena mempertimbangkan luasnya penyakit dan parameter klinis lainnya.
Malaria	Diagnosis	A patient presents with symptoms of malaria and a rapid diagnostic test (RDT) is performed. Which of the following is a common antigen target for RDTs in malaria diagnosis?	{ "A": "Histidine-rich protein 2 (HRP2)", "B": "Lactate dehydrogenase (LDH)", "C": "Plasmodium falciparum antigen", "D": "Glucose-6-phosphate dehydrogenase (G6PD)" }	A	Histidine-rich protein 2 (HRP2) is a common antigen target for rapid diagnostic tests (RDTs) in malaria diagnosis, particularly for Plasmodium falciparum.	[ { "source": "pubmed_web", "doc_id": "pubmed_web_41913232", "title": "School-aged children as a silent reservoir of Plasmodium falciparum: findings from a cross-sectional survey conducted in Burkina Faso in 2022", "span_text": "Malaria diagnosis was performed using HRP2-based RDT, expert microscopy, ...	OK	{ "retrieval": { "query": "malaria rapid diagnostic test antigen target", "doc_ids": [ "pubmed_web_41947176", "pubmed_web_41946915", "pubmed_web_41938719", "pubmed_web_41938690", "pubmed_web_41935227", "pubmed_web_41931566", "pubmed_web_41929920", "pubmed_web_41...	Seorang pasien datang dengan gejala malaria dan tes diagnostik cepat (RDT) dilakukan. Manakah dari berikut ini yang merupakan target antigen umum untuk RDT dalam diagnosis malaria?	{ "A": "Protein kaya histidin 2 (HRP2)", "B": "Laktat dehidrogenase (LDH)", "C": "Antigen Plasmodium falciparum", "D": "Glukosa-6-fosfat dehidrogenase (G6PD)" }	Protein kaya histidin 2 (HRP2) merupakan target antigen umum untuk tes diagnostik cepat (RDT) dalam diagnosis malaria, terutama untuk Plasmodium falciparum.
Heart Failure	Pharmacology	A patient with heart failure is being treated with digoxin. What is the appropriate plasma digoxin level to aim for in this patient?	{ "A": "1 ng/mL or less", "B": "1.5 ng/mL or more", "C": "2 ng/mL or less", "D": "2.5 ng/mL or more" }	A	The appropriate plasma digoxin level to aim for in a patient with heart failure is 1 ng/mL or less, as levels higher than this may be associated with increased toxicity.	[ { "source": "textbook", "doc_id": "Pharmacology_Katzung_1314", "title": "Pharmacology_Katzung", "span_text": "Measurement of plasma digoxin levels is useful in patients who appear unusually resistant or sensitive; a level of 1 ng/mL or less is appropriate; higher levels may be required in patients w...	OK	{ "retrieval": { "time": 100, "doc_ids": [ "Pharmacology_Katzung_1555", "Pharmacology_Katzung_2783", "Pharmacology_Katzung_347", "Pharmacology_Katzung_1314", "Pharmacology_Katzung_1472", "Pharmacology_Katzung_1322", "Pharmacology_Katzung_4435", "Pharmacology_Kat...	null	null	null
Hepatitis B	clinical_practice	A hospital staff member is exposed to a patient's blood that is positive for hepatitis B surface antigen. What is the most appropriate prophylactic measure to prevent hepatitis B infection in the staff member?	{ "A": "Hepatitis B immune globulin", "B": "Standard gamma globulin", "C": "Hepatitis B vaccine", "D": "Antiviral medication" }	A	Hepatitis B immune globulin (HBIG) is the most appropriate prophylactic measure to prevent hepatitis B infection in individuals who have been exposed to the virus, such as hospital staff members. HBIG provides immediate, short-term protection against hepatitis B virus.	[ { "source": "pubmed", "doc_id": "pubmed23n0011_8022", "title": "Hepatitis B immune globulin in prevention of hepatitis B among hospital staff members", "span_text": "In a double-blind trial of hospital staff members at risk of contracting hepatitis B, 110 subjects received hepatitis B immune globuli...	OK	{ "retrieval": { "source": "pubmed", "query": "hepatitis B immune globulin", "doc_ids": [ "pubmed23n0028_3264", "pubmed23n0044_19424", "pubmed23n0028_5085", "pubmed23n0003_2264", "pubmed23n0060_6551", "pubmed23n0046_10013", "pubmed23n0015_4144", "Gynecology_...	Seorang staf rumah sakit terpapar darah pasien yang positif untuk antigen permukaan hepatitis B. Apa yang merupakan tindakan pencegahan paling tepat untuk mencegah infeksi hepatitis B pada staf?	{ "A": "Imun globulin hepatitis B", "B": "Globulin gamma standar", "C": "Vaksin hepatitis B", "D": "Obat antiviral" }	Imun globulin hepatitis B (HBIG) merupakan tindakan pencegahan paling tepat untuk mencegah infeksi hepatitis B pada individu yang telah terpapar virus, seperti staf rumah sakit. HBIG memberikan perlindungan langsung, jangka pendek terhadap virus hepatitis B.
Prostate cancer	Screening	What is the primary benefit of using serum prostate-specific antigen as a pre-screening test for prostate cancer?	{ "A": "It can detect prostate cancer at an early stage, reducing the risk of death from the disease.", "B": "It can distinguish between benign and malignant prostate tumors.", "C": "It can predict the aggressiveness of prostate cancer.", "D": "It can replace digital rectal examination and transrectal ultrasono...	A	The primary benefit of using serum prostate-specific antigen as a pre-screening test for prostate cancer is that it can detect the disease at an early stage, reducing the risk of death from prostate cancer.	[ { "source": "pubmed", "doc_id": "pubmed23n0045_19421", "title": "Serum prostate specific antigen as pre-screening test for prostate cancer.", "span_text": "Prostate cancer has become the most common cancer and the second cause of death due to cancer in men in North America. Since curative therapies ...	OK	{ "retrieval": { "time": 100, "doc_ids": [ "pubmed23n0045_19421", "pubmed23n0056_22895", "pubmed23n0052_12794", "pubmed23n0057_1843", "InternalMed_Harrison_7411", "InternalMed_Harrison_315", "pubmed23n0028_3223", "InternalMed_Harrison_6013", "InternalMed_H...	null	null	null
Malnutrition	Prevention	What is a key strategy for preventing malnutrition in infants?	{ "A": "Early assessment and prevention of sociocultural deprivation", "B": "Prevention of postextraction bacteremia", "C": "Prevention of iron loading in transfusion-dependent thalassaemia", "D": "Prevention of vitamin-D deficiency in Asians" }	A	Early assessment and prevention of sociocultural deprivation is a key strategy for preventing malnutrition in infants.	[ { "source": "pubmed", "doc_id": "pubmed23n0002_13082", "title": "Early assessment and prevention of sociocultural deprivation in infancy", "span_text": "Early assessment and prevention of sociocultural deprivation in infancy." } ]	OK	{ "retrieval": { "query": "malnutrition prevention in infants", "doc_ids": [ "pubmed23n0004_4377", "pubmed23n0002_13082", "pubmed23n0003_7908", "pubmed23n0002_6461", "pubmed23n0004_2412", "pubmed23n0004_5318", "pubmed23n0003_818", "pubmed23n0004_6218", "pu...	null	null	null
Hepatitis B	Pathophysiology	What is the relationship between the presence of HBsAb and liver dysfunction in carriers of HBsAg?	{ "A": "A close relationship was found between the presence of HBsAb and liver dysfunction in carriers of HBsAg.", "B": "No relationship was found between the presence of HBsAb and liver dysfunction in carriers of HBsAg.", "C": "The presence of HBsAb always prevents liver dysfunction in carriers of HBsAg.", "D"...	A	The correct answer is supported by the evidence, which states that a close relationship was found between the presence of HBsAb and liver dysfunction in carriers of HBsAg.	[ { "source": "pubmed", "doc_id": "pubmed23n0002_8762", "title": "Role of HBs Ab in development of hepatitis", "span_text": "A close relationship was found between the presence of HBsAb and liver dysfunction in carriers of HBsAg." } ]	OK	{ "retrieval": { "method": "keyword search", "doc_ids": [ "pubmed23n0002_8762", "pubmed23n0049_15263", "pubmed23n0003_9861", "pubmed23n0046_19718", "pubmed23n0055_20143", "pubmed23n0041_3305", "pubmed23n0008_9476", "pubmed23n0020_8865", "pubmed23n0026_1138...	null	null	null
Asthma	Investigation	What is the role of diagnostic imaging in the evaluation of allergic disease, specifically in the context of asthma?	{ "A": "Diagnostic imaging has a limited role in the evaluation of allergic disease, but chest radiography is helpful in the differential diagnosis of asthma.", "B": "Diagnostic imaging is essential in the evaluation of allergic disease and is used as a primary diagnostic tool for asthma.", "C": "Diagnostic imagi...	A	Diagnostic imaging has a limited role in the evaluation of allergic disease, but chest radiography can be helpful in the differential diagnosis of asthma. Sinus radiography and computed tomography may also be useful, but abnormal results do not distinguish between allergic and non-allergic disease.	[ { "source": "textbook", "doc_id": "Pediatrics_Nelson_1753", "title": "Pediatrics_Nelson", "span_text": "Diagnostic imaging has a limited role in the evaluation of allergic disease. Chest radiography is helpful with the differential diagnosis of asthma. Sinus radiography and computed tomography may b...	OK	{ "retrieval": { "time": 100, "doc_ids": [ "Pediatrics_Nelson_1753", "pubmed23n0043_5967", "pubmed23n0034_3594", "pubmed23n0051_20135", "pubmed23n0016_2380", "pubmed23n0038_3499" ], "evidence_doc_ids": [ "Pediatrics_Nelson_1753", "pubmed23n0043_5967", ...	null	null	null
Patient Safety & Quality Care	clinical_practice	A hospital is reviewing its transfusion practices to improve patient safety. Which of the following strategies is most effective in enhancing quality of care?	{ "A": "Implementing a Hospital Transfusion Committee to review transfusion practices", "B": "Increasing the use of fresh frozen plasma for coagulation disorders", "C": "Reducing the number of sonograms performed during obstetric ultrasounds", "D": "Decreasing physician-patient interaction to improve efficiency...	A	Peer review of transfusion practice in a hospital can be achieved by a Hospital Transfusion Committee. This committee can review and analyze statistical reports of the transfusion service, which helps in enhancing quality of patient care.	[ { "source": "pubmed", "doc_id": "pubmed23n0057_18694", "title": "Therapeutic use of fresh plasma and \"virus-safe\" plasma", "span_text": "Peer review of transfusion practice in a hospital can be achieved by a Hospital Transfusion Committee. The review and analysis of the statistical reports of the ...	OK	{ "retrieval": { "method": "database_query", "doc_ids": [ "pubmed23n0039_8048", "pubmed23n0057_18694", "pubmed23n0046_12821" ], "evidence_doc_ids": [ "pubmed23n0057_18694", "pubmed23n0046_12821", "pubmed23n0039_8048" ], "retrieval_mode": "hybrid_rerank" },...	Sebuah rumah sakit sedang memeriksa praktik transfusinya untuk meningkatkan keselamatan pasien. Strategi manakah yang paling efektif dalam meningkatkan kualitas perawatan?	{ "A": "Menerapkan Komite Transfusi Rumah Sakit untuk memeriksa praktik transfusi", "B": "Meningkatkan penggunaan plasma segar beku untuk gangguan koagulasi", "C": "Mengurangi jumlah sonogram yang dilakukan selama ultrasonografi obstetri", "D": "Mengurangi interaksi dokter-pasien untuk meningkatkan efisiensi" }	Revisi sejawat dari praktik transfusi di rumah sakit dapat dilakukan oleh Komite Transfusi Rumah Sakit. Komite ini dapat meninjau dan menganalisis laporan statistik layanan transfusi, yang membantu meningkatkan kualitas perawatan pasien.
Stroke	Therapy	A patient presents with symptoms of an ischemic stroke and is not eligible for tPA or mechanical thrombectomy. What is the primary focus of their management?	{ "A": "Hemodynamic optimization and neurologic monitoring", "B": "Pharmacotherapy with anticoagulants", "C": "Surgical intervention to restore blood flow", "D": "Physical therapy and rehabilitation" }	A	The primary focus of management for a patient with ischemic stroke who is not eligible for tPA or mechanical thrombectomy is hemodynamic optimization and neurologic monitoring. This involves admitting the patient to the ICU stroke service for blood pressure management and frequent neurologic checks, with the goal of ma...	[ { "source": "textbook", "doc_id": "Surgery_Schwartz_12249", "title": "Surgery_Schwartz", "span_text": "Patients not eligible for tPA or mechanical thrombectomy require hemodynamic optimization and neurologic monitoring. Admit such patients to the ICU stroke service for blood pres-sure management and...	OK	{ "retrieval": { "time": 100, "doc_ids": [ "InternalMed_Harrison_22127", "InternalMed_Harrison_19619", "Neurology_Adams_12314", "First_Aid_Step2_1046", "pubmed23n0014_10562", "pubmed23n0026_6003", "pubmed23n0022_2751", "Gynecology_Novak_7505", "Surgery_Sch...	null	null	null
Therapeutic Communication	Clinical Practice	A patient with limited English proficiency is admitted to the hospital. Which approach is most effective for ensuring accurate communication?	{ "A": "Using a family member as an interpreter", "B": "Relying on a hospital volunteer to translate", "C": "Utilizing a professional interpreter or bilingual staff", "D": "Assuming the patient understands English" }	C	Using a professional interpreter or bilingual staff is the most effective approach to ensure accurate communication with patients who have limited English proficiency. This approach helps to overcome language barriers and ensures that patients receive clear and accurate information about their care.	[ { "source": "textbook", "doc_id": "Gynecology_Novak_11", "title": "Gynecology_Novak", "span_text": "barriers exist between patients and the staff of any general acute care hospital, arrangements shall be made for interpreters or bilingual professional staff to ensure adequate and speedy communicatio...	OK	{ "retrieval": { "method": "semantic_search", "doc_ids": [ "pubmed23n0004_6095", "pubmed23n0025_11438", "pubmed23n0021_6018", "pubmed23n0062_8122", "pubmed23n0059_779", "pubmed23n0059_2362", "pubmed23n0057_23677", "pubmed23n0054_8933", "Gynecology_Novak_11...	Seorang pasien dengan kemampuan bahasa Inggris yang terbatas dirawat di rumah sakit. Pendekatan manakah yang paling efektif untuk memastikan komunikasi yang akurat?	{ "A": "Menggunakan anggota keluarga sebagai interpreter", "B": "Mengandalkan sukarelawan rumah sakit untuk menerjemahkan", "C": "Menggunakan interpreter profesional atau staf bilingual", "D": "Menganggap pasien mengerti bahasa Inggris" }	Menggunakan interpreter profesional atau staf bilingual adalah pendekatan yang paling efektif untuk memastikan komunikasi yang akurat dengan pasien yang memiliki kemampuan bahasa Inggris yang terbatas. Pendekatan ini membantu mengatasi hambatan bahasa dan memastikan bahwa pasien menerima informasi yang jelas dan akurat...
overthinking	Prevention	How can nurse practitioners contribute to the prevention of health issues in their communities?	{ "A": "By providing health education and preventive care services", "B": "By only treating existing health conditions", "C": "By ignoring the role of prevention in healthcare", "D": "By focusing solely on mental health issues" }	A	Nurse practitioners play a crucial role in prevention and health education, and their contributions can have a significant impact on the health of their communities.	[ { "source": "pubmed", "doc_id": "pubmed23n0021_3813", "title": "Nurse practitioners in prevention and health education", "span_text": "Nurse practitioners in prevention and health education" } ]	OK	{ "retrieval": { "time": "2022-01-01", "method": "database search", "doc_ids": [ "pubmed23n0037_2915", "pubmed23n0025_2082", "pubmed23n0039_319", "pubmed23n0015_4344", "pubmed23n0004_4377", "pubmed23n0021_3813", "pubmed23n0034_5587", "pubmed23n0023_1066", ...	null	null	null
Osteosarcoma	Diagnosis	A patient with a history of radiotherapy presents with a new malignant tumor within the irradiated area. What type of sarcoma is this patient at risk for developing, which can mimic osteosarcoma in its clinical and radiologic features?	{ "A": "Post-radiation sarcoma", "B": "Ewing sarcoma", "C": "Chondrosarcoma", "D": "Clear cell myoepithelial carcinoma" }	A	Post-radiation sarcoma is a rare but severe complication following radiotherapy, and it can mimic osteosarcoma in its clinical and radiologic features.	[ { "source": "pubmed_web", "doc_id": "pubmed_web_41550183", "title": "A retrospective study of post-radiation sarcoma from three institutions in Japan with a review of the literature", "span_text": "Post-radiation sarcoma is a malignant tumor arising within irradiated areas after a latency period, hi...	OK	{ "retrieval": { "time": 100, "doc_ids": [ "pubmed_web_41582380", "pubmed_web_41562936", "pubmed_web_41562935", "pubmed_web_41558915", "pubmed_web_41552210", "pubmed_web_41550183", "pubmed_web_41547692", "pubmed_web_41539257", "pubmed_web_41534128", ...	null	null	null
Hypertension	Basic Sciences	What is the potential role of glucagon-like peptide-1 receptor agonists in relation to hypertension?	{ "A": "They have no effect on blood pressure", "B": "They increase the risk of arrhythmias", "C": "They offer protective effects against hypertension", "D": "They are only used to treat type 2 diabetes mellitus" }	C	Glucagon-like peptide-1 receptor agonists have demonstrated cardioprotective benefits, including protective effects against hypertension, heart failure, myocardial infarction, and arrhythmias.	[ { "source": "pubmed_web", "doc_id": "pubmed_web_41908941", "title": "Potential Antiarrhythmic Mechanisms of Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RAs)", "span_text": "Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a novel class of glucose-lowering agents that offer benefits beyon...	OK	{ "retrieval": { "time": "2023-12-01", "method": "pubmed_web", "doc_ids": [ "pubmed_web_41948013", "pubmed_web_41939243", "pubmed_web_41930768", "pubmed_web_41929468", "pubmed_web_41927564", "pubmed_web_41922812", "pubmed_web_41921306", "pubmed_web_41916234"...	Apa peran potensial agonis reseptor peptida-1 glukagon dalam kaitannya dengan hipertensi?	{ "A": "Mereka tidak memiliki efek pada tekanan darah", "B": "Mereka meningkatkan risiko aritmia", "C": "Mereka menawarkan efek pelindung terhadap hipertensi", "D": "Mereka hanya digunakan untuk mengobati diabetes melitus tipe 2" }	Agonis reseptor peptida-1 glukagon telah menunjukkan manfaat kardioprotektif, termasuk efek pelindung terhadap hipertensi, gagal jantung, infark miokard, dan aritmia.
Chronic kidney disease	Monitoring	What is the significance of monitoring kidney graft function at 1 day, 1 week, or 1 month after transplantation in predicting long-term graft survival?	{ "A": "It has no correlation with long-term graft survival", "B": "It is significantly correlated with long-term graft survival", "C": "It is only correlated with short-term graft survival", "D": "It is not a reliable indicator of graft survival" }	B	Monitoring kidney graft function at 1 day, 1 week, or 1 month after transplantation is significantly correlated with long-term graft survival, as it can help identify potential issues early on and allow for timely interventions.	[ { "source": "pubmed", "doc_id": "pubmed23n0012_3584", "title": "Prediction of long-term kidney transplant survival rates by monitoring early graft function and clinical grades", "span_text": "Statistically significant correlations were found between kidney graft function at 1 day, 1 week, or 1 month...	OK	{ "retrieval": { "time": 100, "doc_ids": [ "pubmed23n0012_3584", "Obstentrics_Williams_6959", "pubmed23n0049_5754", "pubmed23n0044_6373", "pubmed23n0052_4583", "pubmed23n0047_7602", "pubmed23n0058_4011", "pubmed23n0052_7551", "pubmed23n0050_6798", "p...	null	null	null
Asthma	Screening	A community health program aims to identify individuals with asthma through a screening process. What is the primary goal of estimating prevalence from the results of this screening test?	{ "A": "To determine the effectiveness of the screening test", "B": "To identify individuals who require immediate medical attention", "C": "To estimate the number of individuals with asthma in the population", "D": "To evaluate the cost-effectiveness of the screening program" }	C	Estimating prevalence from the results of a screening test is crucial in understanding the scope of the disease in the population, which can inform public health decisions and resource allocation.	[ { "source": "pubmed", "doc_id": "pubmed23n0021_4713", "title": "Estimating prevalence from the results of a screening test", "span_text": "Estimating prevalence from the results of a screening test." } ]	OK	{ "retrieval": { "time": "2023-02-20T14:30:00.000Z", "doc_ids": [ "pubmed23n0040_1068", "pubmed23n0010_169", "pubmed23n0003_6904", "pubmed23n0029_6126", "pubmed23n0039_6903", "pubmed23n0021_4713", "pubmed23n0031_5089", "pubmed23n0040_7515", "pubmed23n0024_...	null	null	null
Malnutrition	Pathophysiology	A patient with malnutrition has an impaired immune response. What is a possible indicator of this condition?	{ "A": "Elevated serum alpha-fetoprotein", "B": "Decreased serum albumin", "C": "Increased white blood cell count", "D": "Normal serum electrolyte levels" }	A	Elevated serum alpha-fetoprotein is a possible indicator of impaired immune response in malnutrition.	[ { "source": "pubmed", "doc_id": "pubmed23n0003_2026", "title": "Elevated serum alpha-fetoprotein and impaired immune response in malnutrition.", "span_text": "Elevated serum alpha-fetoprotein and impaired immune response in malnutrition." } ]	OK	{ "retrieval": { "timestamp": "2023-12-01T12:00:00", "duration_ms": 100, "doc_ids": [ "pubmed23n0001_4131", "pubmed23n0003_2353", "pubmed23n0002_1879", "pubmed23n0004_6265", "pubmed23n0002_13187", "pubmed23n0002_6279", "pubmed23n0003_5182", "pubmed23n0003_11...	null	null	null
Acne	Etiology	What is the pathogenesis of acne vulgaris?	{ "A": "A chronic inflammatory disorder with multifactorial causes", "B": "A bacterial infection caused by Propionibacterium acnes", "C": "A viral infection caused by a skin virus", "D": "A fungal infection caused by a skin fungus" }	A	Acne vulgaris is a chronic inflammatory disorder that affects areas with the greatest concentration of sebaceous glands, such as the face, chest, and back. The pathogenesis of acne is multifactorial.	[ { "source": "textbook", "doc_id": "Pediatrics_Nelson_4021", "title": "Pediatrics_Nelson", "span_text": "Pediatrics_Nelson Acne vulgaris (or acne) is a chronic inflammatory disorderthat affects areas with the greatest concentration of sebaceous glands, such as the face, chest, and back. The pathogene...	OK	{ "retrieval": { "time": 10, "doc_ids": [ "Pediatrics_Nelson_4021", "pubmed23n0061_5616" ], "evidence_doc_ids": [ "Pediatrics_Nelson_4021", "pubmed23n0061_5616" ], "retrieval_mode": "hybrid_rerank" }, "verification": { "time": 5, "gate": { "pass": true...	null	null	null
Nephrology	Pathology	A patient presents with symptoms of kidney disease. Which of the following fields of study, alongside others, is relevant to understanding the pathological aspects of this condition?	{ "A": "Gastroenterology", "B": "Nephrology", "C": "Immunopathology", "D": "Perinatal pathology" }	B	Nephrology is the field of study that deals with the diagnosis, treatment, and management of kidney diseases and disorders. It is directly relevant to understanding the pathological aspects of kidney disease.	[ { "source": "pubmed", "doc_id": "pubmed23n0034_3013", "title": "Basic trends and perspectives of development of Soviet pathological anatomy of childhood diseases", "span_text": "New data are presented on respiratory infectious diseases in children, pneumonias, serum hepatitis, meningococcal infectio...	OK	{ "retrieval": { "time": "2023-02-20 14:30:00", "doc_ids": [ "pubmed23n0034_3013" ], "evidence_doc_ids": [ "pubmed23n0034_3013" ], "retrieval_mode": "hybrid_rerank" }, "verification": { "time": "2023-02-20 14:35:00", "gate": { "pass": true, "failed_checks": ...	Seorang pasien datang dengan gejala penyakit ginjal. Bidang studi manakah, bersama dengan yang lain, relevan untuk memahami aspek patologis dari kondisi ini?	{ "A": "Gastroenterologi", "B": "Nefrologi", "C": "Imunopatologi", "D": "Patologi perinatal" }	Nefrologi adalah bidang studi yang berkaitan dengan diagnosis, pengobatan, dan manajemen penyakit dan gangguan ginjal. Ini secara langsung relevan untuk memahami aspek patologis dari penyakit ginjal.
Viral Hemorrhagic Fevers	etiology	Which of the following viruses is primarily transmitted to humans through contact with infected rodents?	{ "A": "Rift Valley Fever Virus", "B": "Lassa Virus", "C": "Dengue Virus", "D": "Ebola Virus" }	B	Lassa virus is primarily transmitted to humans through contact with infected rodents, which are its natural reservoir. This typically occurs through handling food or household items contaminated with rodent urine or feces.	[ { "source": "pubmed_web", "doc_id": "pubmed_web_41901697", "title": "Development of a Rapid and Sensitive AlphaLISA-Based Assay for Lassa Virus Glycoprotein Detection", "span_text": "Lassa virus (LASV), a member of the Arenaviridae family, is the causative agent of Lassa fever (LF), an acute zoonoti...	OK	{ "retrieval": { "query": "Lassa virus transmission", "doc_ids": [ "pubmed_web_41937665", "pubmed_web_41937463", "pubmed_web_41930445", "pubmed_web_41928558", "pubmed_web_41923484", "pubmed_web_41920907", "pubmed_web_41920817", "pubmed_web_41913524", "pubm...	Virus manakah berikut yang terutama ditularkan ke manusia melalui kontak dengan tikus yang terinfeksi?	{ "A": "Virus Rift Valley Fever", "B": "Virus Lassa", "C": "Virus Dengue", "D": "Virus Ebola" }	Virus Lassa terutama ditularkan ke manusia melalui kontak dengan tikus yang terinfeksi, yang merupakan reservoir alaminya. Hal ini biasanya terjadi melalui penanganan makanan atau barang-barang rumah tangga yang terkontaminasi urine atau feses tikus.
Stroke	Pathophysiology	Which of the following best describes a mechanism by which bacterial infections may increase the risk of stroke?	{ "A": "Bacterial components directly activate platelets via toll-like receptors, promoting thrombosis.", "B": "Bacterial infections reduce blood viscosity, increasing shear stress on cerebral vessels.", "C": "Infections lead to chronic elevation of stroke volume, causing cerebral hyperperfusion.", "D": "Bacter...	A	Bacterial and viral infections are associated with a transient increase in the risk of acute thrombotic events, including stroke. Platelets express toll-like receptors (TLRs), and stimulation of TLR2, TLR3, and TLR4 can directly activate platelet thrombotic and inflammatory responses. Live bacteria induce a proinflamma...	[ { "source": "textbook", "doc_id": "InternalMed_Harrison_9290", "title": "InternalMed_Harrison", "span_text": "Bacterial and viral infections are associated with a transient increase in the risk of acute thrombotic events, such as acute myocardial infarction and stroke. In addition, platelets contrib...	OK	{ "retrieval": { "query": "mechanism bacterial infection increase stroke risk", "doc_ids": [ "InternalMed_Harrison_9290", "Neurology_Adams_6867", "Neurology_Adams_6131", "pubmed23n0052_2663", "InternalMed_Harrison_20981", "pubmed23n0052_16924", "pubmed23n0051_7826", ...	null	null	null
Pulmonary Tuberculosis	Diagnosis	A patient with suspected pulmonary tuberculosis has a positive ELISA test for IgG antibodies against antigen 60. Which of the following is a limitation of this test?	{ "A": "Low sensitivity in primary pulmonary tuberculosis cases", "B": "High false positive rate in healthy individuals", "C": "Inability to distinguish between active and inactive tuberculosis", "D": "Requirement for multiple blood draws" }	A	The ELISA test for IgG antibodies against antigen 60 has a low sensitivity in primary pulmonary tuberculosis cases, making it less useful for diagnosing this condition.	[ { "source": "pubmed", "doc_id": "pubmed23n0048_1233", "title": "Diagnostic value of ELISA for determining the occurrence of antibodies to antigen A60 in active pulmonary tuberculosis", "span_text": "It has been decided that these values have no superiority compared to the sputum examination. It was ...	OK	{ "retrieval": { "doc_ids": [ "pubmed23n0061_22424", "pubmed23n0035_217", "pubmed23n0053_7777", "pubmed23n0043_7799", "pubmed23n0048_1233", "pubmed23n0055_22109", "pubmed23n0048_20836", "pubmed23n0029_360", "pubmed23n0044_23767" ], "evidence_doc_ids": ...	Seorang pasien yang diduga menderita tuberkulosis paru memiliki hasil tes ELISA positif untuk antibodi IgG terhadap antigen 60. Apa yang merupakan keterbatasan dari tes ini?	{ "A": "Sensitivitas rendah pada kasus tuberkulosis paru primer", "B": "Tingkat palsu positif tinggi pada individu sehat", "C": "Keterbatasan untuk membedakan antara tuberkulosis aktif dan tidak aktif", "D": "Penggunaan darah yang berulang" }	Tes ELISA untuk antibodi IgG terhadap antigen 60 memiliki sensitivitas rendah pada kasus tuberkulosis paru primer, membuatnya kurang berguna untuk mendiagnosis kondisi ini.
Deep vein thrombosis	Pathophysiology	Which of the following best describes a key mechanism by which platelets contribute to the development of deep vein thrombosis?	{ "A": "Platelets release microparticles that bind neutrophils and promote the formation of neutrophil extracellular traps, which are prothrombotic.", "B": "Platelets primarily cause venous thrombosis through mechanical obstruction of venous valves.", "C": "Platelets inhibit fibrin formation by suppressing factor...	A	Activated platelets release microparticles containing proinflammatory mediators that bind neutrophils, stimulating them to form neutrophil extracellular traps (NETs). These NETs contain histones that promote platelet aggregation and thrombin generation, contributing to venous thrombosis. This process is part of the inf...	[ { "source": "textbook", "doc_id": "InternalMed_Harrison_19653", "title": "InternalMed_Harrison Text", "span_text": "Virchow’s triad of inflammation, hypercoagulability, and endothelial injury leads to recruitment of activated platelets, which release microparticles. These microparticles contain proi...	OK	{ "retrieval": { "query": "platelets pathophysiology deep vein thrombosis", "doc_ids": [ "pubmed23n0061_13507", "InternalMed_Harrison_19653", "pubmed23n0026_7298", "pubmed23n0063_1900", "InternalMed_Harrison_9290", "InternalMed_Harrison_19849", "pubmed23n0048_6008", ...	null	null	null
Routine Laboratory Results	Diagnosis	A patient with chronic widespread pain and normal laboratory results presents for further evaluation. Which of the following tests is most appropriate to exclude a common condition in the differential diagnosis?	{ "A": "Rheumatoid factor", "B": "Serum ferritin", "C": "Thyroid-stimulating hormone (TSH)", "D": "Erythrocyte sedimentation rate (ESR)" }	C	In patients with chronic widespread pain and normal laboratory results, it is essential to consider and exclude common conditions in the differential diagnosis. Hypothyroidism can present with similar symptoms, and thyroid dysfunction is a common condition that can be easily tested. Therefore, measuring TSH levels is a...	[ { "source": "textbook", "doc_id": "InternalMed_Harrison_26171", "title": "InternalMed_Harrison", "span_text": "Routine laboratory and radiographic tests yield normal results in FM. Thus diagnostic testing is focused on exclusion of other diagnoses and evaluation for pain generators or comorbid condi...	OK	{ "retrieval": { "method": "knowledge_graph", "doc_ids": [ "InternalMed_Harrison_32560", "InternalMed_Harrison_26171", "pubmed23n0020_1117", "pubmed23n0060_19660", "pubmed23n0012_40", "pubmed23n0061_8494", "pubmed23n0007_4725", "pubmed23n0051_13043", "pubm...	Seorang pasien dengan nyeri luas kronis dan hasil laboratorium normal datang untuk evaluasi lanjutan. Tes manakah yang paling tepat untuk menyingkirkan kondisi umum dalam diagnosis banding?	{ "A": "Faktor rheumatoid", "B": "Serum feritin", "C": "Hormon perangsang tiroid (TSH)", "D": "Laju endapan eritrosit (ESR)" }	Pada pasien dengan nyeri luas kronis dan hasil laboratorium normal, penting untuk mempertimbangkan dan menyingkirkan kondisi umum dalam diagnosis banding. Hipotiroidisme dapat menimbulkan gejala serupa, dan disfungsi tiroid adalah kondisi umum yang dapat diuji dengan mudah. Oleh karena itu, mengukur kadar TSH adalah la...
Sepsis	Diagnosis	A newborn is suspected of having sepsis. Which of the following statements about the diagnosis of neonatal sepsis is accurate?	{ "A": "Blood culture is a definitive diagnostic test for neonatal sepsis.", "B": "A combination of historical, clinical, and laboratory data is used to diagnose neonatal sepsis.", "C": "Neonatal sepsis can be ruled out with a single negative blood culture.", "D": "The incidence of neonatal sepsis is high, but ...	B	The diagnosis of neonatal sepsis is challenging due to the lack of a definitive diagnostic test. Blood cultures, which are often used, have a relatively low sensitivity. Therefore, a comprehensive approach that includes historical, clinical, and laboratory data is necessary for optimal diagnosis and treatment.	[ { "source": "pubmed", "doc_id": "pubmed23n0062_17702", "title": "Clinicopathologic approach to the diagnosis of neonatal sepsis", "span_text": "Accurate diagnosis is difficult because there is no definitive diagnostic test; even blood cultures have an unacceptably low sensitivity. Therefore, the cli...	OK	{ "retrieval": { "doc_ids": [ "pubmed23n0062_17702" ], "evidence_doc_ids": [ "pubmed23n0062_17702" ], "retrieval_mode": "hybrid_rerank" }, "verification": { "gate": { "pass": true, "failed_checks": [], "notes": [ "topic_coverage_error: topic_coverage_e...	Seorang bayi baru lahir dicurigai menderita sepsis. Pernyataan manakah yang akurat mengenai diagnosis sepsis neonatal?	{ "A": "Kultur darah adalah tes diagnostik definitif untuk sepsis neonatal.", "B": "Kombinasi data historis, klinis, dan laboratorium digunakan untuk mendiagnosis sepsis neonatal.", "C": "Sepsis neonatal dapat disingkirkan dengan satu kultur darah negatif.", "D": "Insidensi sepsis neonatal tinggi, namun risikon...	Diagnosis sepsis neonatal sulit karena tidak ada tes diagnostik definitif. Kultur darah yang sering digunakan memiliki sensitivitas yang relatif rendah. Oleh karena itu, pendekatan komprehensif yang meliputi data historis, klinis, dan laboratorium diperlukan untuk diagnosis dan pengobatan yang optimal.
Clinical Toxicology (Poisoning)	Etiology	Inflammatory bowel disease (IBD) is characterized by which of the following features?	{ "A": "Acute onset and resolution", "B": "Chronic persistence, recurrent exacerbation and remission", "C": "Production of alloantibodies", "D": "Expression of normal HLA-class II molecules on the surface of epithelial cells" }	B	Inflammatory bowel disease (IBD) is characterized by chronic persistence, recurrent exacerbation and remission, which are common features of the disease.	[ { "source": "pubmed", "doc_id": "pubmed23n0054_9240", "title": "Current insights on the pathogenesis of chronic inflammatory bowel diseases", "span_text": "Common features of both diseases are chronic persistence, recurrent exacerbation and remission, the production of autoantibodies, as well as the...	OK	{ "retrieval": { "time": "2023-02-20 14:30:00", "method": "keyword search", "doc_ids": [ "pubmed23n0054_9240" ], "evidence_doc_ids": [ "pubmed23n0054_9240" ], "retrieval_mode": "hybrid_rerank" }, "verification": { "time": "2023-02-20 14:35:00", "method": "expert rev...	Penyakit inflamasi usus (IBD) ditandai dengan salah satu fitur berikut?	{ "A": "Onset akut dan resolusi", "B": "Kronis persisten, eksaserbasi berulang dan remisi", "C": "Produksi alloantibodi", "D": "Ekspresi molekul HLA-kelas II normal pada permukaan sel epitel" }	Penyakit inflamasi usus (IBD) ditandai dengan kronis persisten, eksaserbasi berulang dan remisi, yang merupakan fitur umum dari penyakit ini.
Myocardial infarction	Investigation	What is the role of technetium-99m pyrophosphate scintigraphy in the detection of acute myocardial infarction?	{ "A": "It is a highly specific method for detecting acute myocardial infarction", "B": "It is a highly sensitive method for detecting acute myocardial infarction but not specific", "C": "It is not useful in the detection of acute myocardial infarction", "D": "It is only used for detecting transmural infarction...	A	Technetium-99m pyrophosphate scintigraphy is a highly sensitive and specific method for detecting acute myocardial infarction, especially when using a modified classification that defines the 2+ diffuse pattern of tracer uptake as equivocal rather than positive.	[ { "source": "pubmed", "doc_id": "pubmed23n0011_7609", "title": "New approach to interpretation of technetium-99m pyrophosphate scintigraphy in detection of acute myocardial infarction: clinical assessment of diagnostic accuracy", "span_text": "Thus the definitely positive scintigraphic pattern was r...	OK	{ "retrieval": { "time": 100, "doc_ids": [ "pubmed23n0011_7609", "pubmed23n0013_4500", "pubmed23n0051_6443", "pubmed23n0018_7002", "pubmed23n0027_15051", "InternalMed_Harrison_19227", "pubmed23n0010_8536", "InternalMed_Harrison_19243", "pubmed23n0007_1075"...	null	null	null
Chronic Liver Disease	Pharmacology	What is the effect of impaired drug metabolism in chronic liver disease on the extrapyramidal effects of phenothiazines and related compounds?	{ "A": "It decreases the risk of extrapyramidal effects", "B": "It increases the risk of extrapyramidal effects", "C": "It has no effect on the risk of extrapyramidal effects", "D": "It is unrelated to the extrapyramidal effects" }	B	Impaired drug metabolism in chronic liver disease can increase the risk of extrapyramidal effects of phenothiazines and related compounds.	[ { "source": "pubmed", "doc_id": "pubmed23n0029_4831", "title": "Drug-induced extrapyramidal signs in chronic liver disease--a case report", "span_text": "Impaired drug metabolism can occur in chronic liver disease. A case is reported of extra pyramidal signs occurring in a patient with alcoholic liv...	OK	{ "retrieval": { "time": 100, "doc_ids": [ "Pharmacology_Katzung_5740", "pubmed23n0040_6690", "Pharmacology_Katzung_4057", "Pharmacology_Katzung_1289", "pubmed23n0013_3263", "Pharmacology_Katzung_295", "Pharmacology_Katzung_5758", "Pharmacology_Katzung_5511", ...	null	null	null
Diabetes Mellitus	Treatment	What is the potential benefit of using glycated albumin as an alternative to detect and monitor glycaemic status in patients with diabetes mellitus?	{ "A": "It is less accurate than HbA1c", "B": "It is affected by conditions that distort HbA1c", "C": "It can be used to detect dysglycaemia and diabetes", "D": "It is only used for screening" }	C	Glycated albumin can be used as an alternative to detect and monitor glycaemic status in patients with diabetes mellitus because it is not affected by conditions that distort HbA1c, and it has been shown to correlate significantly with other markers of glycaemic control.	[ { "source": "pubmed_web", "doc_id": "pubmed_web_41635539", "title": "Associations between glycated albumin and current measures of glycaemic control in Saudi adults", "span_text": "GA correlated significantly with other markers and can be suggested as an alternative to detect and monitor glycaemic s...	OK	{ "retrieval": { "time": "2023-02-20T14:30:00Z", "doc_ids": [ "pubmed_web_41636892", "pubmed_web_41636679", "pubmed_web_41636656", "pubmed_web_41636295", "pubmed_web_41636014", "pubmed_web_41635853", "pubmed_web_41635837", "pubmed_web_41635832", "pubmed_we...	null	null	null
Urinary tract infection	Investigation	What is the significance of antibody-coated bacteria test in the diagnosis of urinary tract infections in children?	{ "A": "It can differentiate between upper and lower urinary tract infections", "B": "It is used to diagnose asymptomatic bacteriuria", "C": "It is a screening test for urinary tract infections in adults", "D": "It is used to diagnose kidney infections" }	A	The antibody-coated bacteria test can help differentiate between upper and lower urinary tract infections in children.	[ { "source": "pubmed", "doc_id": "pubmed23n0026_7093", "title": "Antibody-coated bacteria in the urine of children with urinary tract infections", "span_text": "The test for antibody-coated bacteria in urine for the diagnosis of the anatomical level of urinary tract infections was evaluated in childr...	OK	{ "retrieval": { "method": "exact_match", "doc_ids": [ "pubmed23n0003_4246", "pubmed23n0059_19723", "pubmed23n0024_5555", "pubmed23n0053_15759", "pubmed23n0058_9997", "Pediatrics_Nelson_2204", "pubmed23n0055_8652", "pubmed23n0026_7093", "pubmed23n0058_4750...	null	null	null
Appendicitis	Prognosis	What is the relationship between the normal appendectomy rate and the perforated appendicitis rate in patients suspected of having acute appendicitis?	{ "A": "There is a direct relationship between the two rates", "B": "There is an inverse relationship between the two rates", "C": "The rates are unrelated", "D": "The normal appendectomy rate always exceeds the perforated appendicitis rate" }	B	The inverse relationship between the normal appendectomy rate and the perforated appendicitis rate suggests that as one rate increases, the other decreases. This is because a lower perforated appendicitis rate is often achieved by performing more appendectomies, which can result in a higher normal appendectomy rate.	[ { "source": "pubmed", "doc_id": "pubmed23n0053_1832", "title": "Balancing the normal appendectomy rate with the perforated appendicitis rate: implications for quality assurance", "span_text": "There is an inverse relationship between the normal appendectomy rate and perforated appendicitis rate." ...	OK	{ "retrieval": { "source": "pubmed", "query": "appendicitis prognosis", "doc_ids": [ "pubmed23n0053_1832", "Surgery_Schwartz_8806", "pubmed23n0034_664" ], "evidence_doc_ids": [ "pubmed23n0053_1832", "Surgery_Schwartz_8806", "pubmed23n0034_664" ], "retrie...	null	null	null
Pancreatitis	Diagnosis	A 5½‑year‑old boy is admitted with acute pancreatitis. Which of the following conditions should be included in the differential diagnosis?	{ "A": "Kawasaki disease", "B": "Celiac disease", "C": "Crohn disease", "D": "Ulcerative colitis" }	A	Kawasaki disease can present shortly after an episode of pancreatitis in children, and case reports have highlighted the need to consider it when evaluating pediatric acute pancreatitis.	[ { "source": "pubmed", "doc_id": "pubmed23n0047_21213", "title": "Pancreatitis heralding Kawasaki disease", "span_text": "A 5 1/2 year-old boy was hospitalized with clinical and laboratory evidence of pancreatitis. Four days later the classic signs and symptoms of Kawasaki disease developed. This cas...	OK	{ "retrieval": { "doc_ids": [ "pubmed23n0023_5526", "pubmed23n0047_21213", "pubmed23n0013_3149", "InternalMed_Harrison_24368", "pubmed23n0062_1500", "pubmed23n0004_1792", "pubmed23n0062_5886", "InternalMed_Harrison_24307", "pubmed23n0056_18914", "Interna...	null	null	null
Hyperthyroidism	Screening	A 46-year-old male is incidentally diagnosed with hyperthyroidism during an annual physical examination. What is the most likely cause of his condition, given that he has elevated TSH and free T4 consistent with central hyperthyroidism?	{ "A": "Graves' disease", "B": "TSH-secreting pituitary adenoma", "C": "Toxic multinodular goiter", "D": "Thyroiditis" }	B	The patient's elevated TSH and free T4 levels are consistent with central hyperthyroidism, which is often caused by a TSH-secreting pituitary adenoma. This condition is characterized by the excessive production of TSH, leading to hyperthyroidism.	[ { "source": "pubmed_web", "doc_id": "pubmed_web_41573500", "title": "Thyroid-Stimulating Hormone (TSH)-Secreting Pituitary Macroadenoma Presenting as Biochemical Hyperthyroidism Without Clinical Symptoms: A Case Report", "span_text": "Thyroid-stimulating hormone (TSH)-secreting pituitary adenomas (T...	OK	{ "retrieval": { "time": 100, "doc_ids": [ "pubmed_web_41573500", "pubmed_web_41571841", "pubmed_web_41557149", "pubmed_web_41551367", "pubmed_web_41549983", "pubmed_web_41536459", "pubmed_web_41531741", "pubmed_web_41522638", "pubmed_web_41520457", ...	null	null	null
Sepsis	Etiology	A patient with sepsis is found to have a significant decrease in intestinal epithelial barrier function. Which of the following molecular pathways is most likely involved in this process?	{ "A": "TNF-alpha signaling pathway", "B": "Gzma/GEF-H1/RhoA signaling axis", "C": "IL-10 signaling pathway", "D": "IFN-gamma signaling pathway" }	B	The Gzma/GEF-H1/RhoA signaling axis has been shown to contribute to the disruption of the intestinal epithelial barrier in sepsis, leading to intestinal barrier dysfunction.	[ { "source": "pubmed_web", "doc_id": "pubmed_web_41943423", "title": "Mechanism of Gzma-mediated GEF-H1 activation in intestinal epithelial cells leading to intestinal barrier dysfunction in sepsis", "span_text": "The present study sought to explore how the Gzma/GEF-H1/RhoA signalling axis contribute...	OK	{ "retrieval": { "query": "sepsis intestinal epithelial barrier function molecular pathways", "doc_ids": [ "pubmed_web_41950070", "pubmed_web_41949810", "pubmed_web_41949250", "pubmed_web_41948606", "pubmed_web_41948377", "pubmed_web_41948323", "pubmed_web_41947789", ...	Seorang pasien dengan sepsis ditemukan memiliki penurunan signifikan pada fungsi penghalang epitel usus. Jalur molekuler manakah yang paling mungkin terlibat dalam proses ini?	{ "A": "Jalur sinyal TNF-alpha", "B": "Sumbu sinyal Gzma/GEF-H1/RhoA", "C": "Jalur sinyal IL-10", "D": "Jalur sinyal IFN-gamma" }	Sumbu sinyal Gzma/GEF-H1/RhoA telah terbukti berkontribusi pada gangguan penghalang epitel usus pada sepsis, yang menyebabkan disfungsi penghalang usus.

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NLI-Filtered Medical MCQs

This repository contains 650 evidence-grounded medical multiple-choice questions in JSONL format. The dataset was prepared from a larger question bank generated with a retrieval-augmented generation pipeline that retrieves supporting evidence from PubMed and textbook-style medical sources, then verifies each item before logging it.

Dataset Summary

Total rows: 650
File format: JSON Lines (dataset.jsonl)
Primary language: English
Optional Indonesian translations: 131 rows include stem_id, options_id, and explanation_id
Topics: 135
Competencies: 19
Status distribution: all released rows have status = "OK"

Data Fields

Each line in dataset.jsonl is a single JSON object with the following core fields:

topic: medical topic label
competency: competency/category label
stem: question stem
options: answer options with keys A, B, C, D
answer_key: correct option key
explanation: explanation for the correct answer
evidence: supporting evidence spans, each with source, doc_id, title, and span_text
status: release status of the item
meta: retrieval, verification, and timing metadata

Optional bilingual fields:

stem_id: Indonesian translation of the stem
options_id: Indonesian translation of answer options
explanation_id: Indonesian translation of the explanation

Note: meta is provenance-oriented logging data and may vary slightly across rows because it reflects the generation and verification process over time.

Evidence Sources

The released file includes supporting evidence from multiple sources. Across all evidence entries in the dataset:

pubmed: 365
textbook: 179
pubmed_web: 113

These counts describe evidence entries, not unique questions.

Example

{
  "topic": "Asthma",
  "competency": "Treatment",
  "stem": "A patient with chronic asthma experiences symptoms more than 4-6 times a week. What should be initiated in addition to inhaled short acting beta 2-agonists as needed?",
  "options": {
    "A": "Regular inhalative antiinflammatory regimen",
    "B": "Oral corticosteroids",
    "C": "Intravenous beta 2-agonists",
    "D": "Theophylline"
  },
  "answer_key": "A",
  "explanation": "For patients with chronic asthma who experience symptoms more than 4-6 times a week, a regular inhalative antiinflammatory regimen should be initiated in addition to inhaled short acting beta 2-agonists as needed.",
  "evidence": [
    {
      "source": "pubmed",
      "doc_id": "pubmed23n0045_3533",
      "title": "[Asthma therapy: are bronchodilators obsolete?]",
      "span_text": "If asthma symptoms occur more than 4-6 times a week a regular inhalative antiinflammatory regimen should be initiated."
    }
  ],
  "status": "OK"
}

Usage

Load directly from the Hugging Face Hub:

from datasets import load_dataset

dataset = load_dataset("YOUR_USERNAME/YOUR_DATASET_REPO", split="train")
print(dataset[0]["stem"])

Load from the local JSONL file:

from datasets import load_dataset

dataset = load_dataset("json", data_files="dataset.jsonl", split="train")
print(dataset[0]["answer_key"])

Intended Use

This dataset is intended for:

research on medical multiple-choice question generation
evidence-grounded QA and MCQ benchmarking
filtering or ranking experiments using retrieval and NLI signals
bilingual medical education experiments where partial Indonesian translations are useful

Limitations

The dataset is machine-generated and machine-filtered.
It is designed for research and benchmarking, not direct clinical decision-making.
Medical facts can become outdated and should be independently reviewed before downstream use.
Metadata in meta is operational provenance, not a fully normalized benchmark schema.
Indonesian translations are only available for a subset of the examples.

License

No explicit license file is included in the current project snapshot. Add the intended license before making the dataset public on Hugging Face.

Citation

If you use this dataset, please cite the Hugging Face repository and mention that it is an NLI-filtered subset of an evidence-grounded medical MCQ question bank.

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