correct_option int64 1 5 | explanations dict | full_answer stringlengths 26 2.98k | full_answer_no_ref stringlengths 26 2.89k | full_question stringlengths 123 1.09k | id int64 0 620 | lang stringclasses 1
value | options dict | question_id_specific int64 1 235 | type stringclasses 64
values | year int64 2.01k 2.02k | rag dict |
|---|---|---|---|---|---|---|---|---|---|---|---|
3 | {
"1": {
"exist": true,
"char_ranges": [
[
321,
542
]
],
"word_ranges": [
[
60,
96
]
],
"text": "The excessive secretion of androgens produced by an adrenal tumor would cause a greater amount of hair and an increase in penile size, which ... | In the male, the onset of puberty is considered normal from the age of 9 years, therefore in this case it is a premature puberty. The onset of puberty is defined as an increase in testicular volume (greater than or equal to 4cc); by specifying that the testicular size has not increased, we can rule out options 1 and 2.... | In the male, the onset of puberty is considered normal from the age of 9 years, therefore in this case it is a premature puberty. The onset of puberty is defined as an increase in testicular volume (greater than or equal to 4cc); by specifying that the testicular size has not increased, we can rule out options 1 and 2.... | An 8-year-old boy consults for the appearance of pubic hair at the base of the penis for the last 12 months. The testicle has not increased in volume and the penis has not increased in size. There is no increase in growth rate in the last year. The bone age is one year older than the chronological age. What is the most... | 503 | en | {
"1": "Central precocious puberty.",
"2": "Peripheral precocious puberty.",
"3": "Early adrenarche.",
"4": "Adrenal tumor.",
"5": null
} | 80 | PEDIATRICS | 2,020 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0870_2546",
"title": "Boy with central precocious puberty probably due to a peripheral cause.",
"score": 0.019246784491533265,
"content": "A 6½ years Indian boy was brought by his parents, ... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
0,
421
]
],
"word_ranges": [
[
... | The determination of ADA, in the presence of a pneumonia of long evolution that does not improve with antibiotic treatment, with an effusion with abundant leukocytes and lymphocytic predominance, in which the presence of neoplasia is ruled out, with values higher than 70 UI/L, should lead us to have a high degree of su... | The determination of ADA, in the presence of a pneumonia of long evolution that does not improve with antibiotic treatment, with an effusion with abundant leukocytes and lymphocytic predominance, in which the presence of neoplasia is ruled out, with values higher than 70 UI/L, should lead us to have a high degree of su... | A 32-year-old man from Cameroon consults for fever cough and left hemithorax pain of 1 month's evolution. He took amoxicillin-clavulanic acid for 1 week without improvement of symptoms. A blood test showed a white blood cell count of 8000/microL and a hemoglobin of 12.8 g/dL. Chest X-ray showed a loculated left pleural... | 300 | en | {
"1": "A thoracic computed tomography (CT) scan.",
"2": "Pleural fluid pH measurement.",
"3": "Measurement of adenosine deaminase in pleural fluid.",
"4": "Tuberculin test.",
"5": null
} | 106 | INFECTIOUS DISEASES | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0492_372",
"title": "[Cuttoff values of biochemical tests on pleural fluid: their usefulness in differential diagnosis of 1,040 patients with pleural effusion].",
"score": 0.0196078431372549,
... |
4 | {
"1": {
"exist": true,
"char_ranges": [
[
75,
122
]
],
"word_ranges": [
[
11,
18
]
],
"text": "Coxiella infection is not transmitted by ticks."
},
"2": {
"exist": true,
"char_ranges": [
[
431,
640
... | Acute infection by Coxiella burnetii manifested in this case by Pneumonia. Coxiella infection is not transmitted by ticks. The contact can be with high probability at the time of delivery of an infected farm animal, in which the bacterium is disseminated in aerosols. The treatment of choice is with doxycycline in the a... | Acute infection by Coxiella burnetii manifested in this case by Pneumonia. Coxiella infection is not transmitted by ticks. The contact [HIDDEN], in which the bacterium is disseminated in aerosols. The treatment of choice is with doxycycline [HIDDEN]. The combination of doxycycline plus hicroxychloroquine can be used, b... | A 38-year-old woman of veterinary profession, in charge of monitoring wild animals and assisting in the delivery of domestic livestock. She starts with a high fever with chills, headache, myalgia and non-productive cough that she interprets as a flu-like process. She presented with chest pain. Chest X-ray showed bilate... | 434 | en | {
"1": "The way of transmission of this entity is by ticks.",
"2": "Both doxycycline and hydroxychloroquine are effective in treating acute forms of this disease.",
"3": "In its acute form it also presents, generally, elevation of antibodies against phase I antigens.",
"4": "Mortality in acute forms is almost n... | 119 | INFECTIOUS DISEASES AND MICROBIOLOGY | 2,018 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n1159_13154",
"title": "Importance of clinical history in the diagnosis of psittacosis: A case report.",
"score": 0.018521679754182313,
"content": "Psittacosis, caused by the bacteria Chlamy... |
4 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"4": {
"exist": false,
... | As of 2018, there are four dosing schedules for treatment of latent TB infection recommended by the CDC using isoniazid (INH), rifapentine (RPT) or rifampin (RIF). All treatments are effective. Health care providers should prescribe the shorter treatments, which are more convenient, whenever possible. The shortest comb... | As of 2018, there are four dosing schedules for treatment of latent TB infection recommended by the CDC using isoniazid (INH), rifapentine (RPT) or rifampin (RIF). All treatments are effective. Health care providers should prescribe the shorter treatments, which are more convenient, whenever possible. The shortest comb... | A 62-year-old patient who consults because of close contact in recent weeks with a person with active tuberculosis. Mantoux test is positive (12 mm). His history includes treatment with oral anticoagulants (acenocoumarol) for a deep vein thrombosis a few months ago. He does not report fever or cough and is asymptomatic... | 563 | en | {
"1": "Isoniazid, for nine months.",
"2": "Rifampicin, for four months.",
"3": "Isoniazid and rifampicin, for three months.",
"4": "Isoniazid and rifapentine, for three months.",
"5": null
} | 175 | PREVENTIVE MEDICINE | 2,022 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0972_25773",
"title": "Pulmonary vein thrombosis secondary to tuberculosis in a non-HIV infected patient.",
"score": 0.01816545290892726,
"content": "Our patient is a 67-year-old male with ... |
2 | {
"1": {
"exist": true,
"char_ranges": [
[
295,
417
]
],
"word_ranges": [
[
44,
60
]
],
"text": "Imaging techniques (arteriography, angioCT or angioMRI) are used when surgical repair of arterial occlusion is considered."
},
"2": {
... | Although the diagnosis of peripheral arteriopathy is fundamentally clinical (in this patient the picture is very typical), we can objectively assess the severity of the disease with the use of bloodless techniques. The most important is the ankle-brachial index. Therefore, answer 2 is correct. Imaging techniques (arter... | Although the diagnosis of peripheral arteriopathy is fundamentally clinical (in this patient the picture is very typical), we can objectively assess the severity of the disease with the use of bloodless techniques. The most important is the ankle-brachial index. Therefore, [HIDDEN]. Imaging techniques (arteriography, a... | A 64-year-old man consults for right calf pain when climbing hills and stairs and when walking on level ground for a prolonged period of time. He reports that the pain becomes so intense with exertion that he is forced to stand up, which causes the pain to improve in a matter of minutes. As personal history, the patien... | 89 | en | {
"1": "Arteriography of lower extremities.",
"2": "Ankle-brachial index.",
"3": "Computerized axial tomography with vascular reconstruction of lower extremities.",
"4": "Tape stress test.",
"5": "Magnetic resonance imaging."
} | 57 | CARDIOLOGY AND VASCULAR SURGERY | 2,012 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en071_59106",
"title": "Peripheral vascular examination",
"score": 0.014681970349115257,
"content": "Special maneuvers Ankle-brachial pressure index (ABPI) assesses peripheral vascular d... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
0,
145
]
],
"word_ranges": [
[
... | Given her circumstances and taking into account that she is exclusively breastfeeding, the best thing to do would be to prescribe only gestagens. | Given her circumstances and taking into account that she is exclusively breastfeeding, the best thing to do would be to prescribe only gestagens. | A 30-year-old woman requesting a contraceptive method. She has a history of an emergency cesarean section 7 months ago, giving birth to a 3,550 g baby girl. She is exclusively breastfeeding. Point out the correct statement: | 586 | en | {
"1": "Explain to her that, if she is amenorrheic, she does not require another contraceptive method since breastfeeding is sufficient as a contraceptive method.",
"2": "He informed her that the levonogestrel IUD is contraindicated because she had a cesarean section less than a year ago.",
"3": "He explains that... | 75 | OBSTETRICS AND GYNECOLOGY | 2,022 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0404_6537",
"title": "Norplant contraceptive maker accused of profiteering on drug.",
"score": 0.011752946853243261,
"content": "Family planning groups and a lawmaker accused a US drug comp... |
1 | {
"1": {
"exist": true,
"char_ranges": [
[
299,
423
]
],
"word_ranges": [
[
50,
68
]
],
"text": "In addition, it is predominantly morning (option 1 is correct) because in the morning intracranial pressure naturally rises."
},
"2": {
... | It is a headache in the context of papilledema. In this case the papilledema is due to increased intracranial pressure due to a tumor. The headache due to increased intracranial pressure is of positional type (it increases with Valsalva maneuvers and when bending down), so option 2 is not correct. In addition, it is pr... | It is a headache in the context of papilledema. In this case the papilledema is due to increased intracranial pressure due to a tumor. The headache due to increased intracranial pressure is of positional type (it increases with Valsalva maneuvers and when bending down), so option 2 is [HIDDEN]. In addition, it is predo... | A 59-year-old woman with recent onset of epileptic seizures comes to the emergency department. On examination she presents left pyramidal signs and papillary edema. A brain MRI shows a right hemispheric mass with edema, midline deviation and signs of tentorial herniation. She reports that for the past week she has been... | 461 | en | {
"1": "Morning predominance.",
"2": "It does not change with effort.",
"3": "Photophobia.",
"4": "Sonophobia.",
"5": null
} | 148 | OPHTHALMOLOGY (ECTOPIC) | 2,018 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0882_3374",
"title": "Chronic Headaches After a Concussion in an Obese 16-Year-Old Girl.",
"score": 0.015826564739608216,
"content": "Jennifer is a 16-year-old Latina girl who is new to you... |
4 | {
"1": {
"exist": true,
"char_ranges": [
[
196,
384
]
],
"word_ranges": [
[
25,
47
]
],
"text": "digoxin and non-dihydropyridine calcium channel blockers (e.g., verapamil, diltiazem) are contraindicated because they may increase the ventr... | Procainamide. The treatment of choice for Wolff-Parkinson-White syndrome is cardioversion with direct current. Heart rate slowing drugs, commonly used in atrial fibrillation, are ineffective, and digoxin and non-dihydropyridine calcium channel blockers (e.g., verapamil, diltiazem) are contraindicated because they may i... | Procainamide. The treatment of choice for Wolff-Parkinson-White syndrome is cardioversion with direct current. Heart rate slowing drugs, commonly used in atrial fibrillation, are ineffective, and digoxin and non-dihydropyridine calcium channel blockers (e.g., verapamil, diltiazem) are contraindicated because they may i... | A 23-year-old male diagnosed with Wolff-Parkinson-White syndrome who comes to the emergency department for palpitations. The ECG shows an irregular wide QRS tachycardia, with a heart rate of 205 bpm, compatible with pre-excited atrial fibrillation. Which of the following drugs do you consider appropriate to stop the ta... | 547 | en | {
"1": "Verapamil.",
"2": "Digoxin.",
"3": "Adenosine.",
"4": "Procainamide.",
"5": null
} | 125 | CARDIOLOGY | 2,022 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0090_6111",
"title": "Wolff-Parkinson-White syndrome: illustrative case and brief review.",
"score": 0.01951265943270512,
"content": "The Wolff-Parkinson-White syndrome (WPWS) is a pre-exci... |
5 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"4": {
"exist": false,
... | Dehydration may be due to diarrhea of other etiologies. I have doubts about answer 3 since it does not specify which secretions are involved. We have to understand that the growth of Pseudomona aeruginosa is in the culture of bronchial secretions. Because clearly the indication to perform a sweat chlorine (to rule out ... | Dehydration may be due to diarrhea of other etiologies. I have doubts about answer 3 since it does not specify which secretions are involved. We have to understand that the growth of Pseudomona aeruginosa is in the culture of bronchial secretions. Because clearly the indication to perform a sweat chlorine (to rule out ... | In a 3-month-old infant all the clinical manifestations outlined below would make it necessary to rule out cystic fibrosis, EXCEPT: | 193 | en | {
"1": "Delayed meconium evacuation.",
"2": "Salty taste of the skin.",
"3": "Isolation of secretions of Pseudomonas aeruginosa.",
"4": "Deterioration/detention of the weight curve.",
"5": "Hypernatremic dehydration."
} | 161 | PEDIATRICS | 2,013 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0269_12339",
"title": "[Cystic fibrosis revealed by dehydration with hypochloronatremic alkalosis in 3 infants and a neonate].",
"score": 0.019704911667637354,
"content": "BACKGROUND--Acute... |
2 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
0,
325
]
],
"word_ranges": [
[
0,
48
]
],
"text": "In severe cases of Plasmodium infection, the grea... | In severe cases of Plasmodium infection, the greatest risk of mortality occurs in the first 24 hours of clinical presentation, so treatment should be started immediately. Treatment with parenteral or intramuscular artesunate is more indicated in severe Plasmodium infection, both in adults and children and in pregnant w... | In severe cases of Plasmodium infection, the greatest risk of mortality occurs in the first 24 hours of clinical presentation, so treatment should be started immediately. Treatment with parenteral or intramuscular artesunate is [HIDDEN] in severe Plasmodium infection, both in adults and children and in pregnant women. | A 38-year-old man comes to the emergency department with fever above 39ºC and deterioration of consciousness after a trip to Equatorial Guinea without antimalarial prophylaxis. Laboratory tests showed creatinine 3.4 mg/dL, AST 764 UlL, ALT 678 UlL. The laboratory reports the visualization of Plasmodium falciparum in th... | 431 | en | {
"1": "Mefloquine orally.",
"2": "Intravenous artesunate.",
"3": "Doxycycline orally.",
"4": "Oral quinine sulfate.",
"5": null
} | 116 | INFECTIOUS DISEASES AND MICROBIOLOGY | 2,018 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0559_8892",
"title": "UK malaria treatment guidelines.",
"score": 0.01818331413526411,
"content": "Malaria is the tropical disease most commonly imported into the UK, with 1500-2000 cases r... |
1 | {
"1": {
"exist": true,
"char_ranges": [
[
30,
169
]
],
"word_ranges": [
[
5,
26
]
],
"text": "Microhematuria, proteinuria and sensorineural hearing loss in a young male with a family history of women with hematuria = Alport syndrome."
... | Textbook case, little to add. Microhematuria, proteinuria and sensorineural hearing loss in a young male with a family history of women with hematuria = Alport syndrome. | Textbook case, little to add. Microhematuria, proteinuria and sensorineural hearing loss in a young male with a family history of women with hematuria = [HIDDEN]. | 24-year-old male presenting with dysmorphic microhematuria, proteinuria of 3 g/24 h, eGFR (CKD-EPI) 85 ml/min and sensorineural hearing loss. He reports that his maternal grandmother required dialysis at 70 years of age and both his mother and younger sister have isolated microhematuria. Which of the following diseases... | 569 | en | {
"1": "Alport syndrome.",
"2": "IgA nephropathy.",
"3": "Fabry disease.",
"4": "Autosomal dominant polycystic kidney disease.",
"5": null
} | 152 | NEPHROLOGY | 2,022 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n1164_2297",
"title": "Polycystic kidney disease complicates renal pathology in a family with Fabry disease.",
"score": 0.01763791763791764,
"content": "Fabry disease is a rare lysosomal sto... |
4 | {
"1": {
"exist": true,
"char_ranges": [
[
0,
103
]
],
"word_ranges": [
[
0,
18
]
],
"text": "Calcium gluconate has no effect on blood potassium levels (therefore options 1, 2 and 3 are ruled out)."
},
"2": {
"exist": true,
"c... | Calcium gluconate has no effect on blood potassium levels (therefore options 1, 2 and 3 are ruled out). Its function is to decrease the excitability of cardiac myocytes to decrease the likelihood of developing heart rhythm disorders. | Calcium gluconate has no effect on blood potassium levels (therefore [HIDDEN]). Its function is to decrease the excitability of cardiac myocytes to decrease the likelihood of developing heart rhythm disorders. | A 5-year-old boy diagnosed with chronic renal failure. He comes to the emergency department with vomiting, malaise, and palpitations. An electrocardiogram was performed with T-wave elevation and blood tests showed potassium levels of 5.9 mEq/L. Immediate administration of calcium gluconate is decided. What is the purpo... | 501 | en | {
"1": "Encourage the displacement of potassium from the plasma space to the intracellular space.",
"2": "Chelate circulating potassium to favor its hepatic elimination.",
"3": "Chelate circulating potassium to favor its renal elimination.",
"4": "Antagonize the action of potassium on the myocardial cell membra... | 76 | PEDIATRICS | 2,020 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0496_7258",
"title": "[Life threatening hyperkalemia: the value of the electrocardiogram].",
"score": 0.018304351443547716,
"content": "In two men, aged 19 and 64, with chronic renal insuff... |
4 | {
"1": {
"exist": true,
"char_ranges": [
[
999,
1228
]
],
"word_ranges": [
[
162,
199
]
],
"text": "If the dosage had not been adequate and the presence of drug resistance was possible, one option could have been to treat with ceftriaxone... | The patient is a man with pneumonia with isolated germ in blood culture and antibiogram. According to the data provided, it is a pneumococcus sensitive to penicillin (MIC < 0.125), so treatment is started with penicillin at high doses every 4 h, despite which the fever persists. If we analyze the case carefully, the tr... | The patient is a man with pneumonia with isolated germ in blood culture and antibiogram. According to the data provided, it is a pneumococcus sensitive to penicillin (MIC < 0.125), so treatment is started with penicillin at high doses every 4 h, despite which the fever persists. If we analyze the case carefully, the tr... | A 50-year-old man with chronic bronchitis is admitted for pneumonia with positive blood culture for Streptococcus pneumoniae, with an MIC to penicillin of 0.0125 mg/l. Treatment was started with penicillin 2 million every 4h. On the fifth day, she still has a fever of 38ºC. Which of the following decisions do you think... | 242 | en | {
"1": "I would change the treatment to ceftriaxone because of its greater efficacy.",
"2": "I would add a quinolone to the treatment.",
"3": "I would switch to amoxicillin/clavulanic acid.",
"4": "It would rule out the presence of pleural empyema.",
"5": "I would continue with the same treatment, assuming it... | 111 | INFECTIOUS DISEASES | 2,014 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0325_5708",
"title": "[Would ampicillin alone again be enough for treating community-acquired pneumonias?].",
"score": 0.018779756656674307,
"content": "MORE THAN SEMANTICS: The complexity ... |
2 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
150,
535
]
],
"word_ranges": [
[
25,
81
]
],
"text": "Triplet expansion diseases, such as this one, ... | Another classic MIR, asked in 2019 and in 2017, fragile X syndrome. Also, on the same concept as question 44, the phenomenon of genetic anticipation. Triplet expansion diseases, such as this one, can have the anticipation phenomenon whereby females with premutations (between 55-200 repeats) can have children with full ... | Another classic MIR, asked in 2019 and in 2017, fragile X syndrome. Also, on the same concept as question 44, the phenomenon of genetic anticipation. Triplet expansion diseases, such as this one, can have the anticipation phenomenon whereby females with premutations (between 55-200 repeats) can have children with full ... | What genetic and reproductive counseling would you indicate to a 30-year-old woman who consults because she is a carrier of a premutation in the FMR1 gene, responsible for Fragile X syndrome, and who wishes to have offspring. Point out the correct answer: | 487 | en | {
"1": "All her male children will be carriers and, therefore, will manifest the disease.",
"2": "There is a phenomenon of genetic anticipation, so their offspring will present more severe and earlier symptoms.",
"3": "Preimplantation genetic diagnosis for sex selection of embryos by fluorescence in situ hybridiz... | 68 | GENETICS | 2,020 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en021_104757",
"title": "Preimplantation genetic diagnosis",
"score": 0.015489084684886918,
"content": "In the case of families at risk for X-linked diseases, patients are provided with ... |
3 | {
"1": {
"exist": true,
"char_ranges": [
[
0,
225
]
],
"word_ranges": [
[
0,
35
]
],
"text": "There may be debate about whether to start Rituximab with another cytostatic drug or in monotherapy, but given the lack of survival benefit with... | There may be debate about whether to start Rituximab with another cytostatic drug or in monotherapy, but given the lack of survival benefit with early initiation of treatment, the NCCN guidelines recommend waiting and seeing, unless GELF criteria are met to initiate treatment: GELF criteria (Follicular Lymphoma Study G... | There may be debate about whether to start Rituximab with another cytostatic drug or in monotherapy, but given the [HIDDEN], the NCCN guidelines recommend waiting and seeing, unless GELF criteria are met to initiate treatment: GELF criteria (Follicular Lymphoma Study Group): - Involvement of ≥3 nodal areas, each with a... | A 78-year-old woman with a history of type 2 diabetes treated with oral antidiabetics, hypertension treated with beta-blockers and ACE inhibitors, and NYHA grade 1 congestive heart failure with LVEF of 48%, and currently asymptomatic. Functional status: ECOG 0. History of 2 years of evolution of small lumps in the neck... | 364 | en | {
"1": "Rituximab-CHOP (Cyclophosphamide, Adriamycin, Vincristine, Prednisone).",
"2": "Rituximab-CVP (Cyclophosphamide, Vincristine, Prednisone).",
"3": "Do not treat and monitor (wait and see).",
"4": "Rituxirnab-Bendamustine.",
"5": null
} | 176 | HEMATOLOGY | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0771_21251",
"title": "[Chronic lymphocytic leukemia].",
"score": 0.012909921129099212,
"content": "Chronic lymphocytic leukemia (CLL) is a lymphoproliferative disorder that accounts for ap... |
4 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"4": {
"exist": true,
"... | The statement with the family history indicates that this is a case of hereditary nonpolyposis colorectal cancer (Lynch syndrome). The age and right location data lead us to answer 4: total colectomy with ileorectal anastomosis. If a conventional right hemicolectomy type surgery is performed, the chances of recurrence ... | The statement with the family history indicates that [HIDDEN]. The age and right location data lead us to [HIDDEN]. If a conventional right hemicolectomy type surgery is performed, the chances of recurrence are higher than 30%. Excision of the rectum is not necessary prophylactically. | A 35-year-old woman is diagnosed with colon cancer located in the hepatic angle. She has a family history of colon cancer in her mother, an aunt at the age of 45 and a grandfather. The most accepted surgical intervention is: | 90 | en | {
"1": "Right hemicolectomy.",
"2": "Extended right hemicolectomy.",
"3": "Subtotal colectomy.",
"4": "Total colectomy with ileorectal anatomosis.",
"5": "Total colectomy with ileoanal anatomy."
} | 32 | GENERAL SURGERY | 2,012 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en051_6125",
"title": "Colectomy",
"score": 0.017009009009009007,
"content": "Laparoscopic surgery As of 2012, more than 40% of colon resections in United States are performed via laparo... |
2 | {
"1": {
"exist": true,
"char_ranges": [
[
134,
223
]
],
"word_ranges": [
[
22,
39
]
],
"text": "It is not secondary HT because no study has been done to confirm it (option 1 incorrect)."
},
"2": {
"exist": true,
"char_ranges"... | The patient described is the definition of masked HT, normal figures in consultation and elevated on AMPA or ABPM (option 2 correct). It is not secondary HT because no study has been done to confirm it (option 1 incorrect). It is not isolated HT because the elevated figures are maintained for several weeks (option 3 in... | The patient described is the definition of masked HT, normal figures in consultation and elevated on AMPA or ABPM ([HIDDEN]). It is not secondary HT because no study has been done to confirm it ([HIDDEN]). It is not isolated HT because the elevated figures are maintained for several weeks ([HIDDEN]). It is not refracto... | 53-year-old woman with a personal history of obesity and migraine. Her blood pressure has been taken repeatedly at the doctor's and nurse's office, presenting figures below 140/90 mmHg. However, an approved blood pressure measuring device has been purchased and she has been taught how to use it correctly. He comes in s... | 528 | en | {
"1": "She has secondary hypertension.",
"2": "Presents masked arterial hypertension.",
"3": "Presents isolated clinical hypertension.",
"4": "Presents refractory arterial hypertension.",
"5": null
} | 134 | NEPHROLOGY | 2,021 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0728_7280",
"title": "[Influence of blood pressure variability during office visit on the estimation of blood pressure control in treated hypertensive patients].",
"score": 0.014926168772322619,
... |
4 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"4": {
"exist": true,
"... | The hormonal profile we are told is in menopausal range (FSH >20; estradiol <5) and the patient has systemic vasomotor symptoms. Therefore, it would be more appropriate to administer systemic estrogens. To compensate, she already has a local uterine progestin (levonorgestrel IUD). | The hormonal profile we are told is in menopausal range (FSH >20; estradiol <5) and the patient has systemic vasomotor symptoms. Therefore, it would be more appropriate to administer systemic estrogens. To compensate, she already has a local uterine progestin (levonorgestrel IUD). | A 43-year-old woman with a levonorgestrel intrauterine device who consults for lack of rest at night with the appearance of heat and palpitations. In the analytical analysis highlights free T4 10.5 pmol/L (9-19), thyrotropin 2.1 mIU/L (0.30-5.00), FSH 95.6 IU/L (1.38-16.7), LH 21 IU/L (2.4-9.3), estradiol < 0.07 nmol/L... | 583 | en | {
"1": "Benzodiazepines.",
"2": "Vaginal estrogens.",
"3": "Oral estrogens and progestogens in continuous regimen.",
"4": "Transdermal estrogens in a continuous regimen.",
"5": null
} | 70 | OBSTETRICS AND GYNECOLOGY | 2,022 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0673_22461",
"title": "A 60-month non-comparative study on bleeding profiles with the levonorgestrel intrauterine system from the late transition period to estrogen supplemented menopause.",
"score":... |
5 | {
"1": {
"exist": true,
"char_ranges": [
[
167,
288
]
],
"word_ranges": [
[
23,
39
]
],
"text": "The first thing is INTRAMUSCULAR adrenaline NOW! The venous route, corticosteroids, antihistamines, etc. will come later."
},
"2": {
... | She is describing egg anaphylaxis, a potentially fatal condition. The treatment of choice is intramuscular adrenaline, and effectively, without wasting too much time. The first thing is INTRAMUSCULAR adrenaline NOW! The venous route, corticosteroids, antihistamines, etc. will come later. | She is describing egg anaphylaxis, a potentially fatal condition. The treatment of choice is intramuscular adrenaline, and effectively, without wasting too much time. The first thing is INTRAMUSCULAR adrenaline NOW! The venous route, corticosteroids, antihistamines, etc. will come later. | A 15-month-old boy, who during dinner, after eating a bite of tortilla, suddenly presented with facial reddening predominantly perioral, habonous lesions on the trunk and extremities and cough. On arrival at the center, the patient was conscious and, in addition to what was described above, the following were observed:... | 195 | en | {
"1": "The priority is to cannulate a venous line.",
"2": "Intramuscular methylprednisolone is the treatment of choice.",
"3": "It is a picture of urticaria associated with asthma, and should be treated with antihistamines and inhaled bronchodilators.",
"4": "Parents should be advised to transfer to a hospital... | 163 | PEDIATRICS | 2,013 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0521_21402",
"title": "[Emergency due to allergy: the therapy--adrenaline for physicians and patients].",
"score": 0.014523909395973155,
"content": "Emergency due to allergy may proceed wit... |
4 | {
"1": {
"exist": true,
"char_ranges": [
[
0,
353
]
],
"word_ranges": [
[
0,
46
]
],
"text": "In a patient with multiple CVRF with concomitant heart and renal failure (presumably of multiple etiology: renal hypoperfusion, arteriosclerosis... | In a patient with multiple CVRF with concomitant heart and renal failure (presumably of multiple etiology: renal hypoperfusion, arteriosclerosis...), we must be very careful when using diuretics and ACEI/ARA-II, since we can worsen renal function and/or increase potassium levels (among diuretics, spironolactone and epl... | In a patient with multiple CVRF with concomitant heart and renal failure (presumably of multiple etiology: renal hypoperfusion, arteriosclerosis...), we must be very careful when using diuretics and ACEI/ARA-II, since we can worsen renal function and/or increase potassium levels (among diuretics, spironolactone and epl... | A 75-year-old man, hypertensive and dyslipidemic with a history of heart failure due to left ventricular systolic dysfunction (EF < 30%). He comes to our office for worsening of his usual dyspnea in recent weeks. His systolic blood pressure is 160/95 mmHg with a heart rate of 65 bpm. In the physical examination no crac... | 84 | en | {
"1": "Enalapril.",
"2": "Losartan.",
"3": "Spironolactone.",
"4": "Bisoprolol.",
"5": "Eplerenone."
} | 49 | CARDIOLOGY AND VASCULAR SURGERY | 2,012 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0878_11977",
"title": "A Case of Refractory Heart Failure in Becker Muscular Dystrophy Improved With Corticosteroid Therapy.",
"score": 0.014958824142603981,
"content": "The patient was a 2... |
1 | {
"1": {
"exist": true,
"char_ranges": [
[
315,
489
]
],
"word_ranges": [
[
47,
73
]
],
"text": "The presence of a calcemia higher than 13mgr/dl, together with dysphonia, indicates a malignant tumor (higher calcemia level and infiltration... | Palpable mass in the neck: suspect thyroid/parathyroid pathology. It is associated with hypercalcemia, therefore, the option of medullary thyroid cancer is ruled out (it does not affect the level of calcemia). To think of MEN type I we should associate other pathologies (pituitary, pancreatic or duodenal tumors). The p... | Palpable mass in the neck: suspect thyroid/parathyroid pathology. It is associated with hypercalcemia, therefore, the option of medullary thyroid cancer is ruled out (it does not affect the level of calcemia). To think of MEN type I we should associate other pathologies (pituitary, pancreatic or duodenal tumors). The p... | A 45-year-old woman comes to the emergency department with confusional symptoms accompanied by dysphonia. On examination she has a palpable neck mass and a blood test shows plasma calcium levels of 15 mg/dL (normal up to 10.2 mg/dL). Given these findings, which of the following diagnoses should be suspected? | 427 | en | {
"1": "Parathyroid carcinoma.",
"2": "Medullary thyroid carcinoma.",
"3": "MEN type I.",
"4": "Parathyroid adenoma.",
"5": null
} | 95 | ENDOCRINOLOGY | 2,018 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n1053_19333",
"title": "A rare coexistence of parathyroid adenoma and medullary and papillary thyroid carcinoma.",
"score": 0.018375566370196342,
"content": "The combination of parathyroid a... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
110,
267
]
],
"word_ranges": [
[
... | Diplopia is usually caused by acute or secondary strabismus. Vertical gaze palsy is due to a midbrain lesion. In this case the MRI already places the origin of the symptoms in the pineal gland. The most frequent tumor in this region is the germ cell tumor (answer 3). | Diplopia is usually caused by acute or secondary strabismus. Vertical gaze palsy is due to a midbrain lesion. In this case the MRI already places the origin of the symptoms in the pineal gland. The most frequent tumor in this region is the germ cell tumor ([HIDDEN]). | A 13-year-old boy presents with subacute headache and diplopia. Neurologic examination shows vertical gaze palsy and MRI shows a contrast-enhancing lesion in the pineal region obstructing the aqueduct of Sylvian. The most likely diagnosis is: | 462 | en | {
"1": "Glioblastoma.",
"2": "Medulloblastoma.",
"3": "Germ cell tumor.",
"4": "Meningioma.",
"5": null
} | 151 | OPHTHALMOLOGY (ECTOPIC) | 2,018 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en303_24570",
"title": "Neuro-oncology",
"score": 0.017908538535337384,
"content": "5. Pituitary Region Tumors A wide variety of tumors can occur in and around the sella turcica. The mos... |
2 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
0,
240
]
],
"word_ranges": [
[
0,
43
]
],
"text": "Diagnostic Criteria for DM according to ISPAD 201... | Diagnostic Criteria for DM according to ISPAD 2018 *Classic symptoms of diabetes with blood glucose > 200mgr/dl or: * Fasting glycemia ≥ 126mgr/dl (fasting at least 8h) or * Glycemia at 2h SOG ≥ 200mgr/dl (on 2 occasions) or * HbA1C ≥ 6.5%. | Diagnostic Criteria for DM according to ISPAD 2018 *Classic symptoms of diabetes with blood glucose > 200mgr/dl or: * Fasting glycemia ≥ 126mgr/dl (fasting at least 8h) or * Glycemia at 2h SOG ≥ 200mgr/dl (on 2 occasions) or * HbA1C ≥ 6.5%. | 58-year-old male, obese, asymptomatic, moderate drinker, who presents a first baseline blood glucose of 153 mg/d with negative glycosuria. In the following weeks he has had two other baseline blood glucose readings of 118 and 136 mg/dl. Which of the following is the most appropriate approach to confirm the diagnosis of... | 557 | en | {
"1": "Practice a blood glucose curve with 75 g of glucose.",
"2": "Already meets diagnostic criteria for diabetes mellitus.",
"3": "Request a determination of basal insulinemia or C-peptide.",
"4": "Request a determination of glycosylated hemoglobin.",
"5": null
} | 168 | ENDOCRINOLOGY | 2,022 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en159_37769",
"title": "Random glucose test",
"score": 0.01695402298850575,
"content": "Reference values The reference values for a \"normal\" random glucose test in an average adult are... |
2 | {
"1": {
"exist": true,
"char_ranges": [
[
20,
53
]
],
"word_ranges": [
[
3,
8
]
],
"text": "It does not explain pyramidalism."
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
... | Answer 1 incorrect: It does not explain pyramidalism. Answer 2 correct: A nonspecific answer, but probably the correct answer. Answer 3 incorrect: We would lack data to think of a Brown Sequard hemimedullary syndrome. It would explain the pyramidalism, but we would be missing data suggestive of this picture such as a c... | Answer 1 [HIDDEN]: It does not explain pyramidalism. Answer 2 [HIDDEN]: A nonspecific answer, but probably [HIDDEN]. Answer 3 [HIDDEN]: We would lack data to think of a Brown Sequard hemimedullary syndrome. It would explain the pyramidalism, but we would be missing data suggestive of this picture such as a contralatera... | A 56-year-old patient with no personal or family history of interest is studied because he has been having difficulty walking with his right leg for six months. He reports no other symptoms. The examination shows a 4/5 weakness for dorsal flexion and eversion of the foot and 4/5 for flexion and inversion of the foot, w... | 35 | en | {
"1": "Mononeuropathy of the right common peroneal nerve.",
"2": "Focal involvement of the first motor neuron and probably of the second.",
"3": "Right hemimedullary involvement (Brown-Sequard).",
"4": "Multiple mononeuropathy with involvement of the common peroneal and right posterior tibial nerve.",
"5": "... | 68 | NEUROLOGY AND NEUROSURGERY | 2,011 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0605_2048",
"title": "Clinical neurophysiology in the diagnosis of peroneal nerve palsy.",
"score": 0.01801874595992243,
"content": "Peroneal neuropathy is one of the common focal mononeuro... |
4 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"4": {
"exist": true,
"... | This is a completely gratuitous question, from a healthier gentleman than me who is going to undergo low-risk surgery on a scheduled basis. The answer is obviously 4. Had there been a fifth option it would have been that nothing needs to be done, which might have generated some doubt in the student, but since the quest... | This is a completely gratuitous question, from a healthier gentleman than me who is going to undergo low-risk surgery on a scheduled basis. The answer is [HIDDEN]. Had there been a fifth option it would have been that nothing needs to be done, which might have generated some doubt in the student, but since the question... | An 80-year-old man comes to your office for evaluation of a scheduled cholecystectomy by laparoscopy. He has a history of arterial hypertension under treatment for 10 years. He denies heart or pulmonary disease. She has no chest pain. She has an active life and goes daily to the gym where she alternates swimming and wa... | 271 | en | {
"1": "Perform a stress test.",
"2": "Perform echocardiography",
"3": "Perform a thallium and dipyridamole scan.",
"4": "Perform electrocardiogram.",
"5": null
} | 170 | ANESTHESIOLOGY AND CRITICAL CARE | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "Pharmacology_Katzung_1130",
"title": "Pharmacology_Katzung",
"score": 0.016733232337143644,
"content": "Irbesartan Generic,Avapro Treatment of Angina Pectoris Bertram G. Katzung, MD, PhD* A 56-year-... |
1 | {
"1": {
"exist": true,
"char_ranges": [
[
96,
387
]
],
"word_ranges": [
[
13,
57
]
],
"text": "As the mechanical function of the left inferior rectus is compromised, it would not allow to complete the supraduccion movement generating ver... | The statement describes diplopia to superior vision with limitation of upper eyeball extension. As the mechanical function of the left inferior rectus is compromised, it would not allow to complete the supraduccion movement generating vertical diplopia, this plus the traumatic antecedent allows to suspect a fracture of... | The statement describes diplopia to superior vision with limitation of upper eyeball extension. As the mechanical function of the left inferior rectus is compromised, it would not allow to complete the supraduccion movement generating vertical diplopia, this plus the traumatic antecedent allows to suspect a fracture of... | A 34-year-old patient playing tennis is hit by a tennis ball in the left orbit. On examination he presents significant palpebral hematoma, hyposphagmia, diplopia to the upper vision with limitation of the upper version of the eyeball. What would you suspect? | 306 | en | {
"1": "Fracture of the inferior wall of the floor of the orbit with entrapment of the inferior rectus muscle.",
"2": "Zygomatic arch fracture.",
"3": "Fracture of the superior wall of the orbit with entrapment of the superior rectus muscle.",
"4": "Dentoalveolar fracture.",
"5": null
} | 207 | OPHTHALMOLOGY | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en128_11452",
"title": "Orbital blowout fracture",
"score": 0.01960972796308757,
"content": "Signs & Symptoms Some clinically observed signs and symptoms include: Orbital pain Eyes displ... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
0,
57
]
],
"word_ranges": [
[
... | Discontinue sulfonylurea because of Risk of hypoglycemia. | Discontinue sulfonylurea because of Risk of hypoglycemia. | A 49-year-old man who consults for severe polyuria and polydipsia and unintentional weight loss of 10 kg and is diagnosed with diabetes mellitus due to a plasma blood glucose of 322 mg/dL and a glycosylated hemoglobin of 9.8%. His physician gave him dietary recommendations, the convenience of physical exercise, and he ... | 328 | en | {
"1": "Review dietary carbohydrate distribution.",
"2": "Discontinue metformin.",
"3": "Discontinue sulfonylurea.",
"4": "Substitute metformin with a DPP4 inhibitor.",
"5": null
} | 83 | ENDOCRINOLOGY | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0659_10790",
"title": "[Sequential treatment with insulin glargine and metformin, and exenatide in a patient with newly diagnosed type-2 diabetes].",
"score": 0.018234323432343234,
"content... |
5 | {
"1": {
"exist": true,
"char_ranges": [
[
867,
1119
]
],
"word_ranges": [
[
149,
196
]
],
"text": "Applying the general rules of response in the MIR, if two options are similar except in one detail, the correct one is one of these, so we... | Stable angina in diabetics: this question is a nod to the BARI-2D study (NEJM 2009), which showed that medical management was not inferior to revascularization (in fact, the new guidelines reflect the trend that not all coronary stenosis should be systematically opened). Answer 1 is along these lines, although I miss s... | Stable angina in diabetics: this question is a nod to the BARI-2D study (NEJM 2009), which showed that medical management was not inferior to revascularization (in fact, the new guidelines reflect the trend that not all coronary stenosis should be systematically opened). Answer 1 is along these lines, although I miss s... | In a 60-year-old diabetic patient with stable angina secondary to ischemic heart disease due to subtotal obstruction in the middle third of the anterior descending coronary artery, what treatment would you propose? | 223 | en | {
"1": "Medical with vasodilators and beta-blockers to avoid angina.",
"2": "Expectorant with rigorous rest, since decreasing myocardial oxygen demand should decrease angina.",
"3": "Surgical revascularization of the ischemic myocardium by means of a left mammary artery bypass distal to the lesion in the diseased... | 62 | CARDIOLOGY | 2,014 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en010_91445",
"title": "Coronary artery bypass surgery",
"score": 0.015901482544237205,
"content": "Efficacy The 2004 ACC/AHA CABG guidelines state CABG is the preferred treatment for: D... |
4 | {
"1": {
"exist": true,
"char_ranges": [
[
354,
473
]
],
"word_ranges": [
[
60,
78
]
],
"text": "Vertebral crushing would be seen in the simple X-ray, as well as vertebral ankylosing hyperostosis and many metastases."
},
"2": {
"e... | We suspect spondylodiscitis - the febrile fever and the limitation of mobility of the spine with the acute course give the key -, and the indicated test is the MRI. "The most demonstrative test is magnetic resonance imaging (MRI), which is positive even in the first 2 weeks of the picture, which facilitates early diagn... | We suspect spondylodiscitis - the febrile fever and the limitation of mobility of the spine with the acute course give the key -, and the indicated test is the MRI. "[HIDDEN]", which facilitates early diagnosis, with a sensitivity of 90%". Vertebral crushing would be seen in the simple X-ray, as well as vertebral ankyl... | A 70-year-old man consults for non-radiating lumbar pain of 1 week's duration, of progressive intensity, accompanied by marked limitation of spinal mobility and febrile fever. The lumbar spine X-ray shows no alterations. What diagnosis should we rule out first and with what technique? | 468 | en | {
"1": "Vertebral crush with computed tomography (CT).",
"2": "Bone metastases with technetium bone scan.",
"3": "Vertebral ankylosing hyperostosis with dorsolumbar spine x-ray.",
"4": "Pyogenic spondylodiscitis with magnetic resonance imaging (MRI).",
"5": null
} | 122 | ORTHOPEDIC SURGERY AND TRAUMATOLOGY | 2,020 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0905_17675",
"title": "Radiologic Diagnosis of Spondylodiscitis, Role of Magnetic Resonance.",
"score": 0.019417475728155338,
"content": "Study aim is to report the Magnetic Resonance Imagi... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
0,
377
]
],
"word_ranges": [
[
... | Porphyria cutanea tarda (PCT) is the most common porphyria and can present with three major clinical forms: familial, sporadic and toxic. Clinically, it is characterized by marked skin fragility with the appearance of erosions, vesicles and blisters after minimal trauma. The most frequent sites are the back of the hand... | Porphyria cutanea tarda (PCT) is the most common porphyria and can present with three major clinical forms: familial, sporadic and toxic. Clinically, it is characterized by marked skin fragility with the appearance of erosions, vesicles and blisters after minimal trauma. The most frequent sites are the back of the hand... | 60-year-old male patient who refers 10 days ago the appearance of blistering lesions on dorsum of hands after sun exposure. The picture is accompanied by skin fragility. Histopathologically there is a subepidermal blister with PAS+ deposits in and around the superficial dermal vessels. The most plausible diagnosis is: | 96 | en | {
"1": "Familial benign pemphigus.",
"2": "Pemphigoid.",
"3": "Porphyria cutanea tarda.",
"4": "Pemphigus vulgaris.",
"5": "Scalded skin syndrome."
} | 170 | DERMATOLOGY, VENEREOLOGY AND PLASTIC SURGERY | 2,012 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0102_840",
"title": "[The morphology of skin damage in porphyria cutanea tarda (PCT)].",
"score": 0.01951637471439452,
"content": "Skin biopsies (fresh and old blisters) of the back of the ... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
171,
253
]
],
"word_ranges": [
[
25,
36
]
],
"text": "Coxo-femoral osteoarthrosis presents with a ne... | The most common symptomatology of a patient with coxarthrosis includes: hip pain that limits ambulation, nocturnal discomfort and even at rest, hip stiffness and locking. Coxo-femoral osteoarthrosis presents with a negative Lasegue test. Wrong answer 2. Low back pain of a neuropathic nature usually presents with unilat... | The most common symptomatology of a patient with coxarthrosis includes: hip pain that limits ambulation, nocturnal discomfort and even at rest, hip stiffness and locking. Coxo-femoral osteoarthrosis presents with a negative Lasegue test. [HIDDEN]. Low back pain of a neuropathic nature usually presents with unilateral a... | A 61-year-old woman, administrative, with a history of overweight, hypertension, dyslipidemia and metabolic syndrome, who consults for pain in both buttocks, left trochanteric region, lateral aspect of the left thigh up to the knee and left leg up to the middle third. The pain appears when the lower limb is lifted with... | 603 | en | {
"1": "Gouty arthritis of the left hip.",
"2": "Left coxofemoral arthrosis.",
"3": "Radiated low back pain / lumbosciatica.",
"4": "Claudication due to canal stenosis.",
"5": null
} | 112 | TRAUMATOLOGY | 2,022 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en029_55324",
"title": "Sacroiliac joint",
"score": 0.015396323615501698,
"content": "Signs and symptoms The following are signs and symptoms that may be associated with an SI joint (SIJ... |
4 | {
"1": {
"exist": true,
"char_ranges": [
[
611,
736
]
],
"word_ranges": [
[
92,
111
]
],
"text": "Finally, in broca's aphasia the language is non-fluent, comprehension is preserved, it does not repeat and does not nominate."
},
"2": {... | It is a semiology question that helps us to remember the types of aphasia. The following aspects should be taken into account: language emission (fluent, non-fluent, non-emission), comprehension (yes or no), repetition (yes or no) and nomination. Wernicke's aphasia or sensitive aphasia has a fluent language, does not u... | It is a semiology question that helps us to remember the types of aphasia. The following aspects should be taken into account: language emission (fluent, non-fluent, non-emission), comprehension (yes or no), repetition (yes or no) and nomination. Wernicke's aphasia or sensitive aphasia has a fluent language, does not u... | An 80-year-old woman with a history of arterial hypertension and diabetes mellitus who suddenly presents with language impairment. On arrival at the hospital, an unknown atrial fibrillation is observed, and on examination she presents fluent speech with a tendency to slurred speech, poor language comprehension, inabili... | 574 | en | {
"1": "Broca's aphasia.",
"2": "Conduction aphasia.",
"3": "Sensitive transcortical aphasia.",
"4": "Wernicke's aphasia.",
"5": null
} | 100 | NEUROLOGY | 2,022 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0206_3738",
"title": "[Crossed aphasia in right-handed patients. II. Neuropsychological and neurolinguistic study of a case. Evolution over a 2 year period].",
"score": 0.01633333333333333,
... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
754,
1059
]
],
"word_ranges": [
[
... | In principle, what you tell us does not fit with a nephritic colic. The urine is normal (without hematuria, caused by the lithiasis as it progresses), the Creat is normal (it can rise up to 1.9 in nephritic colic). The increase in LDH is non-specific and can be found in hepatic parenchymal lesions, AMI or pulmonary emb... | In principle, what you tell us does not fit with a nephritic colic. The urine is normal (without hematuria, caused by the lithiasis as it progresses), the Creat is normal (it can rise up to 1.9 in nephritic colic). The increase in LDH is non-specific and can be found in hepatic parenchymal lesions, AMI or pulmonary emb... | A 45-year-old male patient with a history of uric lithiasis and repeated expulsive nephritic colic for the past 25 years comes to the emergency room reporting palpitations and severe right lumbar pain for the past 2 hours. Urinalysis shows a pH of 5.5 and leukocyturia without proteinuria. The electrocardiogram confirms... | 67 | en | {
"1": "Plain abdominal x-ray.",
"2": "Intravenous urography.",
"3": "Spiral CT with contrast.",
"4": "Abdominal ultrasound.",
"5": "Doppler ultrasound."
} | 111 | ANESTHESIOLOGY, CRITICAL CARE AND EMERGENCY MEDICINE | 2,012 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0307_17528",
"title": "Intravenous urography revisited in the age of ultrasound and computerized tomography: diagnostic yield in cases of renal colic, suspected pelvic and abdominal malignancies, suspected ren... |
5 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
0,
230
]
],
"word_ranges": [
[
0,
37
]
],
"text": "It appears that the patient has erythema nodosum ... | It appears that the patient has erythema nodosum lesions associated with a flare of his disease, which is common. Treatment of the disease and its control usually improves the cutaneous lesions. The lesions should not be biopsied. | It appears that the patient has erythema nodosum lesions associated with a flare of his disease, which is common. Treatment of the disease and its control usually improves the cutaneous lesions. The lesions should not be biopsied. | A 17-year-old boy with Crohn's disease with colonic involvement of 2 years of evolution, in maintenance treatment with azathioprine, consults for the appearance since 5 days ago of purplish-red, hot, painful, bilateral subcutaneous nodules of pretibial location, associated with an increase in the number of stools and a... | 77 | en | {
"1": "Recommend relative rest and warm cloths on both legs and add antidepressant treatment.",
"2": "Biopsy skin areas away from the injured areas and prescribe opioid analgesics at the beginning.",
"3": "Biopsy skin areas away from the injured areas and prescribe opioid analgesics at the beginning.",
"4": "S... | 31 | DIGESTIVE SYSTEM | 2,012 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0697_18550",
"title": "An unusual cutaneous manifestation of Crohn's disease.",
"score": 0.016748366013071895,
"content": "A 61-year-old man with a 12-year history of quiescent Crohn's dise... |
2 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
141,
315
]
],
"word_ranges": [
[
19,
47
]
],
"text": "answer 2 is the false answer and, therefore, t... | Pelvic inflammatory disease is suspected, given the patient's symptoms. According to the 2006 SEGO protocol for Pelvic Inflammatory Disease, answer 2 is the false answer and, therefore, the one that should be marked. This is because hysterosalpingography can spread the infection to the pelvic and abdominal cavity. The ... | Pelvic inflammatory disease is suspected, given the patient's symptoms. According to the 2006 SEGO protocol for Pelvic Inflammatory Disease, answer 2 is [HIDDEN] and, therefore, the one that should be marked. This is because hysterosalpingography can spread the infection to the pelvic and abdominal cavity. The rest of ... | A 24-year-old woman consults for lower abdominal pain of two weeks of evolution that has worsened with the last sexual intercourse. She reports having a recent partner with whom she only occasionally uses a condom. On examination, she was in fair general condition. Temperature 38.6ºC, leukocytes 16,000/uL (85% neutroph... | 440 | en | {
"1": "We would start antibiotic treatment as soon as we suspect the diagnosis.",
"2": "We would indicate as a preferential complementary test a hysterosalpingography for tubal assessment.",
"3": "Delay in diagnosis and treatment increases the occurrence of sequelae.",
"4": "The presence of abscess would be a ... | 97 | GYNECOLOGY AND OBSTETRICS | 2,018 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0682_9090",
"title": "[Pelvic inflammatory disease: contemporary diagnostic and therapeutic approach].",
"score": 0.016666666666666666,
"content": "Pelvic inflammatory disease (PID) is poly... |
5 | {
"1": {
"exist": true,
"char_ranges": [
[
0,
240
]
],
"word_ranges": [
[
0,
38
]
],
"text": "This is a typical description of a picture of intestinal obstruction due to bridging or adhesions due to previous surgery. The correct answer is... | This is a typical description of a picture of intestinal obstruction due to bridging or adhesions due to previous surgery. The correct answer is 5 and not 1 because most of these situations resolve spontaneously with conservative treatment. | This is a typical description of a picture of intestinal obstruction due to bridging or adhesions due to previous surgery. The [HIDDEN] and not 1 because most of these situations resolve spontaneously with conservative treatment. | 55-year-old woman, operated on for appendicitis 24 years ago, who comes in because while previously well, she has started with repeated vomiting after breakfast, about 12 hours ago, associated with abdominal distention. She presented a diarrhea stool a few hours after the onset of the symptoms. Examination revealed abd... | 203 | en | {
"1": "This is a picture of intestinal flange obstruction requiring emergency laparotomy.",
"2": "Most likely we are facing a case of obstruction at the level of the large intestine.",
"3": "The fact that the patient presented a diarrheal stool allows us to exclude the diagnosis of intestinal obstruction. Furthe... | 47 | GENERAL SURGERY | 2,013 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n1081_16743",
"title": "Intestinal obstruction and ischemia by necrotic annular Meckel's diverticulum: Case report and review of the literature.",
"score": 0.014734561213434454,
"content": "... |
2 | {
"1": {
"exist": true,
"char_ranges": [
[
1471,
1885
]
],
"word_ranges": [
[
258,
334
]
],
"text": "Perhaps we could think about this one because they talk about pain in the right knee, but this picture that they present us is limited to... | We are presented with an adolescent patient who is overweight with pain in the thigh and knee, a length discrepancy of 1 cm and the limb in external rotation. This picture should automatically lead us to mark epiphysiolysis capitis femoris (proximal femoral epiphysiolysis, the fact of reading it in Latin nomina is a bi... | We are presented with an adolescent patient who is overweight with pain in the thigh and knee, a length discrepancy of 1 cm and the limb in external rotation. This picture should automatically lead us to mark epiphysiolysis capitis femoris (proximal femoral epiphysiolysis, the fact of reading it in Latin nomina is a bi... | Obese 12-year-old boy (87 kg). He has been complaining of mechanical pain in the right thigh and knee for 4 months. Clinical examination reveals a 1 cm discrepancy in the length of the lower extremities and an attitude of the right lower extremity in external rotation with loss of internal rotation. We should suspect t... | 158 | en | {
"1": "Juvenile chronic arthritis.",
"2": "Epiphysiolysis capitis femoris.",
"3": "Fracture of the femoral neck due to overload.",
"4": "Perthes disease.",
"5": "Sequelae of developmental dysplasia of the hip."
} | 133 | TRAUMATOLOGY AND ORTHOPEDICS | 2,012 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0077_3751",
"title": "[Delayed diagnosis of epiphysiolysis capitis femoris].",
"score": 0.01747674767476748,
"content": "The prognosis in epiphysiolysis of the head of the femur (ECF) depen... |
5 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"4": {
"exist": false,
... | The correct answer is 5. The mother should be isolated for the first 2-4 weeks of treatment, after which she would no longer be contagious. If the result of the repeat PT is still negative, the child should not be tested again. If it is positive, the X-ray (or pulmonary CT in younger children) should be repeated. | The [HIDDEN] The mother should be isolated for the first 2-4 weeks of treatment, after which she would no longer be contagious. If the result of the repeat PT is still negative, the child should not be tested again. If it is positive, the X-ray (or pulmonary CT in younger children) should be repeated. | A 1-year-old boy whose mother has just been diagnosed with bacilliferous pulmonary tuberculosis, having started correct treatment. The child is asymptomatic with a normal examination, negative tuberculin test (PT) and normal chest Rx. What would be the attitude to adopt in the child? | 46 | en | {
"1": "Only separate him from the mother until her treatment is completed (at least 6 months).",
"2": "Perform a high-resolution CT scan of the lung, and if normal, repeat PT at 8-12 weeks.",
"3": "Chemoprophylaxis with isoniazid (INH) until the mother's smear test is negative.",
"4": "Chemoprophylaxis with IN... | 155 | PEDIATRICS | 2,011 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0589_11030",
"title": "[Tuberculosis in the mother and child].",
"score": 0.017419787091491105,
"content": "Tuberculosis is a scourge in our region; it is particularly dangerous in young ch... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
0,
60
]
],
"word_ranges": [
[
... | Vasoactive intestinal peptide (VIP). VIPoma-diarrhea. The 3. | Vasoactive intestinal peptide (VIP). VIPoma-diarrhea. The 3. | A 40-year-old woman, with no personal or family history of interest, presents several days of watery diarrhea, very abundant, accompanied by loss of 10 kg of weight, flushing and facial reddening, together with lipothymias and colicky abdominal pain, with hypokalemia in the laboratory data. An abdominal ultrasound show... | 593 | en | {
"1": "Insulinoma.",
"2": "PPoma.",
"3": "VIPoma.",
"4": "Glucagonoma.",
"5": null
} | 146 | ONCOLOGY | 2,022 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n1018_125",
"title": "[Use of a somatostatin analog to improve a patient's condition and the subsequent diagnosis of pancreatic VIPoma:a case report].",
"score": 0.018129614438063987,
"conte... |
4 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"4": {
"exist": true,
"... | A gram negative stain never rules out the presence of infection. | A gram negative stain never rules out the presence of infection. | A 41-year-old man comes to the Emergency Department with three days of swelling and pain in the right knee, with functional impotence and fever Two weeks earlier he had had a self-limited diarrhea. On examination there is joint effusion, so we proceed to perform an arthrocentesis and obtain 50 cc of cloudy liquid, with... | 395 | en | {
"1": "Treatment with cloxacillin and ceftriaxone should be initiated pending the result of the fluid culture.",
"2": "It is advisable to perform daily arthrocentesis to relieve symptoms and prevent joint destruction.",
"3": "If the culture is negative, it is likely to be reactive arthritis.",
"4": "Negative G... | 136 | TRAUMATOLOGY AND ORTHOPEDICS | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0705_7704",
"title": "Approach to septic arthritis.",
"score": 0.019417475728155338,
"content": "Prompt diagnosis and treatment of infectious arthritis can help prevent significant morbidit... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
218,
424
]
],
"word_ranges": [
[
... | Young woman with secondary amenorrhea, with no history of interest. Prolactin values are normal (values above 20ngr/ml are considered hyperprolectinemia), thus ruling out hyperprolactinemia as the cause of amenorrhea. They tell us that the estrogen level is low. In this case we should suspect early ovarian failure. For... | Young woman with secondary amenorrhea, with no history of interest. Prolactin values are normal (values above 20ngr/ml are considered hyperprolectinemia), thus [HIDDEN] as the cause of amenorrhea. They tell us that the estrogen level is low. In this case we should suspect early ovarian failure. For its diagnosis we wil... | A 27-year-old woman consults for secondary amenorrhea of one year of evolution. She has no iatrogenic history. Analytically, the estradiol concentration is below normal and the prolactin value is 12 ng/mL. Indicate which of the following examinations would you request as a first step to try to identify the origin of th... | 424 | en | {
"1": "Hypothalamohypophyseal MRI.",
"2": "Karyotype.",
"3": "Basal FSH.",
"4": "Chorionic gonadotropin stimulation.",
"5": null
} | 91 | ENDOCRINOLOGY | 2,018 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0071_2794",
"title": "[Hypothalamo-hypophyseal amenorrhea. I. The clinical and laboratory manifestations].",
"score": 0.01745598057073467,
"content": "This study included 15 women 18-36 yea... |
4 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"4": {
"exist": true,
"... | At least for me, as a family physician, I usually start with the least invasive and most cost-effective tests, and in the case described, an ischemic problem in the lower limbs is the ankle-brachial index. | At least for me, as a family physician, I usually start with the least invasive and most cost-effective tests, and in the case described, an ischemic problem in the lower limbs is the ankle-brachial index. | A 70-year-old woman, hypertensive and diabetic, who has worked as a sales clerk all her life. She consults for an internal malleolar lesion in the right leg with intense pain throughout the day that worsens at night. On examination, there are uncomplicated varicose cords in both extremities and normal femoral and popli... | 169 | en | {
"1": "Venous echo-Doppler of lower limbs.",
"2": "Angioresonance of lower limbs.",
"3": "Arteriography.",
"4": "Ankle-brachial index.",
"5": "AngioCT."
} | 87 | CARDIOLOGY AND CARDIOVASCULAR SURGERY | 2,013 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0535_11111",
"title": "Does the clinical examination predict lower extremity peripheral arterial disease?",
"score": 0.017216117216117217,
"content": "Lower extremity peripheral arterial di... |
3 | {
"1": {
"exist": true,
"char_ranges": [
[
113,
191
]
],
"word_ranges": [
[
20,
35
]
],
"text": "The rest of the answers do not fit with the clinical picture or the histology."
},
"2": {
"exist": true,
"char_ranges": [
[... | The fact of being a photoinduced picture, the histology and the age make the diagnosis of PCT more probable (3). The rest of the answers do not fit with the clinical picture or the histology. | The fact of being a photoinduced picture, the histology and the age make the diagnosis of PCT more probable [HIDDEN]. The rest of the answers do not fit with the clinical picture or the histology. | A 60-year-old male patient who reported 10 days ago the appearance of blistering lesions on the dorsum of the hands after sun exposure. The picture is accompanied by skin fragility. Histopathologically there is a subepidermal blister with PAS+ deposits in and around the superficial dermal vessels. The most plausible di... | 95 | en | {
"1": "Familial benign pemphigus.",
"2": "Pemphigoid.",
"3": "Porphyria cutanea tarda.",
"4": "Pemphigus vulgaris.",
"5": "Scalded skin syndrome."
} | 170 | DERMATOLOGY, VENEREOLOGY AND PLASTIC SURGERY | 2,012 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0102_840",
"title": "[The morphology of skin damage in porphyria cutanea tarda (PCT)].",
"score": 0.01951637471439452,
"content": "Skin biopsies (fresh and old blisters) of the back of the ... |
2 | {
"1": {
"exist": true,
"char_ranges": [
[
206,
412
]
],
"word_ranges": [
[
32,
61
]
],
"text": "Radical amputation surgery has not been shown to improve survival being reserved for selected cases (invasion of neurovascular structures, pa... | In resection margins, we have: intralesional → marginal (option 3) → Extended → Radical (options 1 and 4). This is a high-grade tumor, in which extended resection including tumor-free margins is indicated. Radical amputation surgery has not been shown to improve survival being reserved for selected cases (invasion of n... | In resection margins, we have: intralesional → marginal (option 3) → Extended → Radical (options 1 and 4). This is a high-grade tumor, in which extended resection including tumor-free margins is indicated. Radical amputation surgery has not been shown to improve survival being reserved for selected cases (invasion of n... | 44-year-old patient with a rapidly growing lesion (16x8x12 cm) involving the soft tissues of the proximal third of the right thigh. He reports that he has started to notice the mass, which has a hard consistency and is adhered to deep planes, in the last 6 months. Previously, she had been a regular athlete and had even... | 537 | en | {
"1": "Hip disarticulation.",
"2": "Treatment with ifosfamide and tamoxifen for 6 cycles prior to resection surgery to reduce the size of the lesion.",
"3": "Marginal surgery removing the pseudocapsule that these tumors usually form in response to their rapid growth.",
"4": "Modified right hemipelvectomy.",
... | 1 | TRAUMATOLOGY | 2,021 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0260_17595",
"title": "[Adamantinoma of the proximal end of the tibia. A case].",
"score": 0.014558022622538752,
"content": "Adamantinoma is a rare primary tumour of long bones containing m... |
4 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"4": {
"exist": true,
"... | Acute hemolytic transfusion reactions can occur within minutes. Clinically they are characterized by chills, fever, urticaria, tachycardia, nausea and vomiting, lumbar pain, hemorrhage due to disseminated intravascular coagulation (DIC)..... We are told of a patient who, within minutes of starting a transfusion, presen... | Acute hemolytic transfusion reactions can occur within minutes. Clinically they are characterized by chills, fever, urticaria, tachycardia, nausea and vomiting, lumbar pain, hemorrhage due to disseminated intravascular coagulation (DIC)..... We are told of a patient who, within minutes of starting a transfusion, presen... | A 35-year-old patient who, due to hematemesis due to ulcus, receives a transfusion of 2 packed red blood cells. 5-10 minutes after starting the transfusion, she begins with fever, chills, hypotension and pain in the lumbar region. What would be the most likely diagnosis? | 363 | en | {
"1": "Bacterial contamination of the blood.",
"2": "Febrile reaction secondary to transfusion.",
"3": "Febrile reaction due to plasma contaminating red blood cells.",
"4": "Hemolytic transfusion reaction.",
"5": null
} | 97 | HEMATOLOGY | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en004_26469",
"title": "Blood transfusion",
"score": 0.018706293706293706,
"content": "Acute hemolytic reactions are defined according to Serious Hazards of Transfusion (SHOT) as \"fever... |
2 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
0,
187
]
],
"word_ranges": [
[
0,
32
]
],
"text": "All breast carcinomas should be accompanied by th... | All breast carcinomas should be accompanied by the study of hormone receptors and HER-2 for the prognostic implications of the tumor, as well as the adequacy of the treatment of the same, since depending on the result will apply some drugs or others. The study of relatives and the BCRA gene is not indicated since she d... | [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN] [HIDDEN]. | 67-year-old woman diagnosed with an infiltrating ductal carcinoma of the breast and no family history of neoplasia. What additional studies should be performed on the tumor for its clinical-therapeutic implications? | 339 | en | {
"1": "Complete phenotypic study by flow cytometry.",
"2": "Study of hormone receptors and HER2.",
"3": "Study of hormone receptors, e-cadherin and study of first-degree relatives.",
"4": "BRCA 1-2 study and study of first-degree relatives.",
"5": null
} | 33 | GYNECOLOGY AND OBSTETRICS | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0267_6734",
"title": "The significance of family history for patients with carcinoma of the breast.",
"score": 0.015238095238095238,
"content": "Since the risk of carcinoma of the breast is... |
1 | {
"1": {
"exist": true,
"char_ranges": [
[
25,
119
]
],
"word_ranges": [
[
5,
18
]
],
"text": "The symptoms and signs described are the biological findings associated with anorexia nervosa."
},
"2": {
"exist": false,
"char_ran... | The correct answer is 1. The symptoms and signs described are the biological findings associated with anorexia nervosa. The ECG disturbances are derived from electrolyte disturbances. | [HIDDEN] The symptoms and signs described are the biological findings associated with anorexia nervosa. The ECG disturbances are derived from electrolyte disturbances. | A 13-year-old girl consults us for weight loss, asthenia, secondary amenorrhea and constipation. Examination revealed a temperature of 35ºC, weight below the 3rd percentile, bradycardia and orthostatic hypotension. Laboratory tests showed anemia with mild leukopenia, cholesterol of 230 mg/dL and on the electrocardiogra... | 144 | en | {
"1": "Suspect anorexia nervosa and inquire about intake, body image, etc.",
"2": "Suspect hypothyroidism and request TSH and thyroid hormones.",
"3": "Suspect cardiomyopathy and request echocardiography.",
"4": "I would suspect celiac disease and request anti-transglutaminase IgA antibodies.",
"5": "Suspect... | 142 | PEDIATRICS | 2,012 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0858_15352",
"title": "[Anorexia with sinus bradycardia: a case report].",
"score": 0.01837336704593342,
"content": "As anorexia patients always go to the psychiatric clinic, little is conc... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
22,
153
]
],
"word_ranges": [
[
... | Chronic hypertension. This is hypertension that is detected before pregnancy or before the 20th week of pregnancy and/or persists at 12 weeks postpartum. | Chronic hypertension. This is hypertension that is detected before pregnancy or before the 20th week of pregnancy and/or persists at 12 weeks postpartum. | A pregnant woman, 10 weeks pregnant, comes to the emergency room with a blood pressure of 160/105 mmHg. She is in good general condition, with only mild headache, which is the reason for taking her blood pressure. After 4 hours of rest she presented with a blood pressure of 150/95mmHg. A complete blood count is normal ... | 356 | en | {
"1": "Moderate pre-eclampsia.",
"2": "Pregnancy-induced hypertension.",
"3": "Chronic hypertension.",
"4": "Eclampsia.",
"5": null
} | 166 | GYNECOLOGY AND OBSTETRICS | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en464_20969",
"title": "Hypertensive disease of pregnancy",
"score": 0.018447998646018447,
"content": "Preeclampsia superimposed on chronic hypertension occurs when a pregnant woman with... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
307,
380
]
],
"word_ranges": [
[
... | Typical question, conservative surgery implies radiate, for sure. High grade, and no hormone receptors or her2 (the dreaded triple negative). I was there when there were no taxanes or herceptin and I was in the trials that showed that more and more are being cured, unfortunately still not all. That is why today, anthra... | Typical question, conservative surgery implies radiate, for sure. High grade, and no hormone receptors or her2 (the dreaded triple negative). I was there when there were no taxanes or herceptin and I was in the trials that showed that more and more are being cured, unfortunately still not all. That is why today, anthra... | 65-year-old woman with no comorbidities, undergoing left breast-conserving surgery with selective sentinel lymph node biopsy. The pathological anatomy of the specimen shows an infiltrating ductal carcinoma grade III of 11 mm, two negative sentinel nodes, estrogen receptors: 0%, progesterone receptors: 0%, Ki 67: 70%, H... | 495 | en | {
"1": "Chemotherapy based on anthracyclines and taxanes, radiotherapy and trastuzumab.",
"2": "Chemotherapy based on anthracyclines and taxanes, radiotherapy and tamoxifen.",
"3": "Chemotherapy based on anthracyclines and taxanes, and radiotherapy.",
"4": "Chemotherapy based on anthracyclines and taxanes, radi... | 64 | MEDICAL ONCOLOGY | 2,020 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n1035_20793",
"title": "Clinical Characteristics and Outcome Trends of Adjuvant Anthracycline and Taxane Regimen for Early Stage Breast Cancer.",
"score": 0.01770050125313283,
"content": "Th... |
3 | {
"1": {
"exist": true,
"char_ranges": [
[
232,
469
]
],
"word_ranges": [
[
37,
71
]
],
"text": "Above 20 weeks' gestation, we would be talking about preeclampsia (if HT + proteinuria or uterine artery pulsatility index above the 95th per... | The correct answer is 3. The SEGO in its 2006 protocol "Hypertensive disorders of pregnancy" refers that this is chronic hypertension, although diagnosed in pregnancy. This is because it has been diagnosed at 10 weeks of gestation. Above 20 weeks' gestation, we would be talking about preeclampsia (if HT + proteinuria o... | The [HIDDEN] The SEGO in its 2006 protocol "Hypertensive disorders of pregnancy" refers that this is chronic hypertension, although diagnosed in pregnancy. This is because it has been diagnosed at 10 weeks of gestation. Above 20 weeks' gestation, we would be talking about preeclampsia (if HT + proteinuria or uterine ar... | A pregnant woman, 10 weeks pregnant, comes to the emergency room with a blood pressure of 160/105 mmHg. She is in good general condition, with only mild headache, which is the reason for taking her blood pressure. After 4 hours of rest she presented with a blood pressure of 150/95mmHg. A complete blood count is normal ... | 355 | en | {
"1": "Moderate preeclampsia.",
"2": "Pregnancy-induced hypertension.",
"3": "Chronic hypertension.",
"4": "Eclampsia.",
"5": null
} | 166 | GYNECOLOGY AND OBSTETRICS | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en464_20969",
"title": "Hypertensive disease of pregnancy",
"score": 0.017652928083506027,
"content": "Preeclampsia superimposed on chronic hypertension occurs when a pregnant woman with... |
5 | {
"1": {
"exist": true,
"char_ranges": [
[
589,
894
]
],
"word_ranges": [
[
84,
133
]
],
"text": "Although the use of aspirin and other NSAIDs is effective for erythema nodosum, their use in patients with inflammatory bowel disease should... | The patient's presenting picture is presumably erythema nodosum. About 10% of cases of erythema nodosum are associated with inflammatory bowel disease, both ulcerative colitis and Crohn's disease. As mentioned, in most cases, erythema nodosum has a self-limited course. When associated with inflammatory bowel disease, e... | The patient's presenting picture is presumably erythema nodosum. About 10% of cases of erythema nodosum are associated with inflammatory bowel disease, both ulcerative colitis and Crohn's disease. As mentioned, in most cases, erythema nodosum has a self-limited course. When associated with inflammatory bowel disease, e... | A 17-year-old boy with Crohn's disease with colonic involvement of 2 years of evolution, in maintenance treatment with azathioprine, consults for the appearance for 5 days of subcutaneous red purplish, hot, painful, bilateral, pretibial localization nodules, associated with an increase in the number of stools and abdom... | 94 | en | {
"1": "Recommend relative rest and warm cloths on both legs and add antidepressant treatment.",
"2": "Biopsy areas of skin away from the injured areas and prescribe opioid analgesics for entry.",
"3": "Suspect the existence of a malignant intestinal tumor lesion as a trigger of the cutaneous process.",
"4": "S... | 31 | DERMATOLOGY, VENEREOLOGY AND PLASTIC SURGERY | 2,012 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n1152_8812",
"title": "Atypical Forms of Pyoderma Gangrenosum in Inflammatory Bowel Disease: Report of Four Cases and Literature Review.",
"score": 0.01621417797888386,
"content": "Cutaneous... |
2 | {
"1": {
"exist": true,
"char_ranges": [
[
64,
118
]
],
"word_ranges": [
[
13,
23
]
],
"text": "out. 1 cannot be, because there would be infectious signs."
},
"2": {
"exist": true,
"char_ranges": [
[
577,
... | This one has been difficult for me, we are going to rule it out. 1 cannot be, because there would be infectious signs. Answer 2 is possible because bisphosphonates create mandibular necrosis. 3 seems unlikely to me because the radiotherapy that the patient received would be oriented on the breast and not on the mandibl... | This one has been difficult for me, we are going to rule it out. 1 cannot be, because [HIDDEN]. Answer 2 is possible because bisphosphonates create mandibular necrosis. 3 seems unlikely to me because [HIDDEN]. I rule out number 4, as [HIDDEN]. 5 is possible; after all, the patient already has bone metastases. So, I hes... | 60-year-old woman, diagnosed with breast cancer treated with surgery and radiotherapy 10 years ago. Currently with metastases in the dorsal spine and sacroiliac joint, for which she has received monthly treatment with i.v. zoledronic acid for the last two years. The patient presented spontaneous bone exposure at the le... | 39 | en | {
"1": "Odontogenic abscess.",
"2": "Osteonecrosis due to bisphosphonates.",
"3": "Osteoradionecrosis.",
"4": "Dental root included.",
"5": "Metastasis of breast carcinoma."
} | 134 | OTORHINOLARYNGOLOGY AND MAXILLOFACIAL SURGERY | 2,011 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0941_1822",
"title": "Successful conservative treatment of jaw osteonecrosis caused by denosumab in patients with multiple bone metastasis.",
"score": 0.01916024935826916,
"content": "We re... |
2 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
0,
156
]
],
"word_ranges": [
[
0,
20
]
],
"text": "The endoscopic appearance of trachealized esophag... | The endoscopic appearance of trachealized esophagus is very typical of eosinophilic esophagitis, which presents with dysphagia and repeated food impactions. | The endoscopic appearance of trachealized esophagus is very typical of eosinophilic esophagitis, which presents with dysphagia and repeated food impactions. | What disease would we suspect in a young patient with a frequent history of dysphagia to solids and liquids with repeated food impactions, without symptoms of heartburn and in whom oral endoscopy shows multiple concentric esophageal rings with normal mucosa (trachealized appearance)? | 252 | en | {
"1": "Herpetic esophagitis.",
"2": "Eosinophilic esophagitis.",
"3": "Candidiasis esophagitis.",
"4": "Cytomegalovirus esophagitis.",
"5": "Adenocarcinoma of the esophagus."
} | 83 | DIGESTIVE SYSTEM | 2,014 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en010_102251",
"title": "Esophagitis",
"score": 0.019424799622819428,
"content": "Some lifestyle indicators for this disease include stress, unhealthy eating, smoking, drinking, family h... |
5 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"4": {
"exist": false,
... | Anyway, I think that the clinical case is poorly stated, since before doing the CT scan, ACTH should be measured and, once ACTH is suppressed, the CT scan should be done. But since the question is "what would you do to confirm the diagnosis of suspected ACTH independent Cushing's syndrome", the answer is CT. | Anyway, I think that the clinical case is poorly stated, since before doing the CT scan, ACTH should be measured and, once ACTH is suppressed, the CT scan should be done. But since the question is "what would you do to confirm the diagnosis of suspected ACTH independent Cushing's syndrome", [HIDDEN]. | In a 42-year-old obese woman, cortisol levels in blood, urine and saliva are determined and in all the determinations they are elevated. After performing the nocturnal suppression test with dexamethasone, cortisol levels in blood remain elevated, so ACTH independent Cushing's syndrome is suspected, what additional test... | 57 | en | {
"1": "A petrosal sinus catheterization.",
"2": "A gammagraphy with labeled somatostatin (Octreoscan).",
"3": "A scan with Sesta-MIBI.",
"4": "An abdominal ultrasound.",
"5": "An adrenal CT scan."
} | 77 | ENDOCRINOLOGY | 2,011 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0270_19530",
"title": "[Cushing's syndrome: diagnostic exploration].",
"score": 0.018672919923571306,
"content": "The diagnosis of Cushing's syndrome is one of the most perplexing and contr... |
2 | {
"1": {
"exist": true,
"char_ranges": [
[
186,
251
]
],
"word_ranges": [
[
25,
33
]
],
"text": "Early initiation of antibiotic therapy (cefotaxime) is essential."
},
"2": {
"exist": true,
"char_ranges": [
[
252,... | Patient with suspected meningococcal sepsis. Stabilization with fluids (hypotension) according to ABCDE is essential. Blood culture can be obtained together with the initial blood test. Early initiation of antibiotic therapy (cefotaxime) is essential. However, in an unstable patient such as ours, a lumbar puncture is n... | Patient with suspected meningococcal sepsis. Stabilization with fluids (hypotension) according to ABCDE is essential. Blood culture can be obtained together with the initial blood test. Early initiation of antibiotic therapy (cefotaxime) is essential. However, in an unstable patient such as ours, a lumbar puncture is n... | A 23-month-old boy presenting with fever, hypotension, repeated vomiting, meningeal signs, petechiae, and ecchymosis. The CBC shows 25,000 leukocytes (75% neutrophils, 10% white blood cells) and 12,000 platelets/microL, and the coagulation study shows a prothrombin activity of 35%. Which option is NOT appropriate for m... | 595 | en | {
"1": "Intravenous cefotaxime administration.",
"2": "Lumbar puncture.",
"3": "Collection of blood culture.",
"4": "Intravenous fluids.",
"5": null
} | 88 | PEDIATRICS | 2,022 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n1021_13220",
"title": "[Meningococcemia: Different Serotypes in the Same Region].",
"score": 0.019334952363160844,
"content": "Meningococcal infections are important health problems causing... |
5 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"4": {
"exist": false,
... | Lichen planus is a very common dermatosis of unknown etiology characterized by the appearance of pruritic polygonal papules, with a purplish color and shiny surface, preferentially located in the distal areas of the extremities. Characteristically these papules show a symmetrical distribution and are preferentially loc... | Lichen planus is a very common dermatosis of unknown etiology characterized by the appearance of pruritic polygonal papules, with a purplish color and shiny surface, preferentially located in the distal areas of the extremities. Characteristically these papules show a symmetrical distribution and are preferentially loc... | The patient presents since 2 weeks ago a pruritic eruption consisting of multiple polygonal erythematous-violaceous papules, with flattened surface, preferentially located on the anterior aspect of the wrists, pretibial area and lumbar area. She also presents whitish reticulated lesions in the jugal mucosa. What is the... | 98 | en | {
"1": "Pityriasis versicolor.",
"2": "Mycosis fungoides.",
"3": "Psoriasis in drops.",
"4": "Pityriasis rosea of Gibert.",
"5": "Lichen planus."
} | 171 | DERMATOLOGY, VENEREOLOGY AND PLASTIC SURGERY | 2,012 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0715_21227",
"title": "Segmental lesions in pityriasis rosea: a rare presentation.",
"score": 0.018867924528301886,
"content": "A 34-year-old nonpregnant woman noted a mildly pruritic skin ... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
0,
211
]
],
"word_ranges": [
[
... | In young contacts, chemoprophylaxis should be started even if the mantoux test is negative and repeated after 2-3 months to decide whether to continue treatment for 6 months (if it turns positive) or to stop it. | In young contacts, chemoprophylaxis should be started even if the mantoux test is negative and repeated after 2-3 months to decide whether to continue treatment for 6 months (if it turns positive) or to stop it. | A 14-year-old asymptomatic boy whose father has just been diagnosed with pulmonary TB undergoes a Mantoux test, with a negative result. What is the appropriate course of action? | 118 | en | {
"1": "Reassure her that she is not at risk.",
"2": "Chest X-ray.",
"3": "Start chemoprophylaxis and repeat skin test after 3 months.",
"4": "Repeat skin test at one month.",
"5": "A sputum study should be performed before starting chemoprophylaxis with Isoniazid for 1 year."
} | 117 | INFECTOLOGY | 2,012 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0075_456",
"title": "Decision analysis, public health policy, and isoniazid chemoprophylaxis for young adult tuberculin skin reactors.",
"score": 0.019075302025615408,
"content": "As part o... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
0,
232
]
],
"word_ranges": [
[
... | We are being presented with a case of eosinophilic esophagitis (adolescent male, with heartburn and dysphagia, and a history of atopic dermatitis). Of all the tests proposed to us, the least indicated in this case would be option 3. | We are being presented with a case of eosinophilic esophagitis (adolescent male, with heartburn and dysphagia, and a history of atopic dermatitis). Of all the tests proposed to us, the least indicated in this case would be [HIDDEN]. | A 13-year-old boy presents to the pediatrics office with a feeling of heartburn during and after meals and occasional dysphagia, which increases with the ingestion of solid foods such as meat. In the family history, his mother is diagnosed with hiatal hernia. In the personal history she refers to allergy to pollens, mi... | 388 | en | {
"1": "Upper gastrointestinal endoscopy.",
"2": "Esophageal pHmetry of 24 hours.",
"3": "Carbon 13 breath test for Helicobacter pylori.",
"4": "Esophago-gastro-duodenal barium study.",
"5": null
} | 233 | PEDIATRICS | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n1088_7066",
"title": "A case of lymphocytic esophagitis in a woman with multiple allergies.",
"score": 0.015395731436193865,
"content": "Lymphocytic esophagitis is a newly recognized entity... |
4 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
422,
472
]
],
"word_ranges": [
[
... | On this occasion, we are asked about which factors have the greatest influence in order to carry out adjuvant chemotherapy in colorectal cancer. In order to do so, we must know which are the poor prognostic factors in this pathology where obstruction or intestinal perforation due to the lesion, invasion of adjacent org... | On this occasion, we are asked about which factors have the greatest influence in order to carry out adjuvant chemotherapy in colorectal cancer. In order to do so, we must know which are the poor prognostic factors in this pathology where obstruction or intestinal perforation due to the lesion, invasion of adjacent org... | A 52-year-old man was referred to the gastroenterology department for hematochezia, tenesmus and reduction of stool diameter. A series of tests were performed and a diagnosis of adenocarcinoma of the sigma without distant metastasis was made. The patient underwent surgery and was referred to the medical oncology depart... | 421 | en | {
"1": "The presence of anemia at diagnosis.",
"2": "The existence of a family history of colorectal cancer.",
"3": "The size of the primary lesion and histological differentiation.",
"4": "Perforation or adhesion of the tumor to adjacent organs.",
"5": null
} | 78 | GENERAL SURGERY | 2,018 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0736_2331",
"title": "[The primary tumour resection with extended D3 lymph node dissection, metastases of synchronous metastatic colorectal cancer].",
"score": 0.013283828382838283,
"conten... |
4 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"4": {
"exist": true,
"... | In a woman with delayed puberty and short stature we should always think about and rule out Turner syndrome, whose diagnosis is made by karyotyping (45X0). | In a woman with delayed puberty and short stature we should always think about and rule out Turner syndrome, whose diagnosis is made by karyotyping (45X0). | 15-year-old female presenting with delayed menarche and short stature. She does not have intellectual disability. Which of the following genetic tests would be routinely used for the diagnosis of this patient: | 500 | en | {
"1": "Massive sequencing (NGS).",
"2": "FISH.",
"3": "DNA and/or RNA microarrays.",
"4": "Karyotype.",
"5": null
} | 45 | PEDIATRICS | 2,020 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n1102_9340",
"title": "Genetic testing in pediatric endocrine pathology.",
"score": 0.017645245800585605,
"content": "In genetic endocrine diseases, genetic testing is necessary for a precis... |
1 | {
"1": {
"exist": true,
"char_ranges": [
[
197,
383
]
],
"word_ranges": [
[
33,
60
]
],
"text": "Cannulated screws are reserved for cases of non-displaced fractures (Wrong answer 2) so the most indicated option would be arthroplasty, in t... | We are told of a case of a 95-year-old patient with a displaced intracapsular (subcapital) hip fracture. In this case, the surgical options may be the use of cannulated screws or hip arthroplasty. Cannulated screws are reserved for cases of non-displaced fractures (Wrong answer 2) so the most indicated option would be ... | We are told of a case of a 95-year-old patient with a displaced intracapsular (subcapital) hip fracture. In this case, the surgical options may be the use of cannulated screws or hip arthroplasty. Cannulated screws are reserved for cases of non-displaced fractures ([HIDDEN]) so the most indicated option would be arthro... | 95-year-old woman living in a nursing home, independent for her basic activities of daily living, goes out to the garden for walks. She has a history of hypertension, dyslipidemia, osteoporosis and mild cognitive impairment. She suffers a fall when getting up at night to go to the bathroom. X-ray shows a displaced subc... | 611 | en | {
"1": "Hip hemiarthroplasty.",
"2": "Trochanteric nail fixation.",
"3": "Fixation with cannulated screws.",
"4": "Conservative: bed-chair life.",
"5": null
} | 116 | TRAUMATOLOGY | 2,022 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0359_688",
"title": "Ethics in practice.",
"score": 0.018706293706293706,
"content": "H. K. is a ninety-two-year-old woman with Alzheimer's disease and mild hypertension. She resides at a n... |
1 | {
"1": {
"exist": true,
"char_ranges": [
[
901,
1094
]
],
"word_ranges": [
[
129,
161
]
],
"text": "The laboratory marker that should be requested if anaphylaxis is suspected is serum tryptase in the first hour for a basal determination a... | The patient is suffering from anaphylactic shock secondary to peanut ingestion. The treatment of anaphylaxis and anaphylactic shock of first choice is intramuscular adrenaline 1mg/ml (dose 0.01 mg/kg, in adults 0.5 mg maximum). Followed by symptomatic treatment to stabilize the airway with 100% high flow O2, ensure lar... | The patient is suffering from anaphylactic shock secondary to peanut ingestion. The treatment of anaphylaxis and anaphylactic shock of first choice is intramuscular adrenaline 1mg/ml (dose 0.01 mg/kg, in adults 0.5 mg maximum). Followed by symptomatic treatment to stabilize the airway with 100% high flow O2, ensure lar... | A 25-year-old woman with a history of allergic bronchial asthma due to sensitization to grass pollens and atopic dermatitis. She suddenly presents hypotension, tachycardia, urticaria and bronchospasm after ingesting peanuts and is transferred to the emergency department. What would be the order of drugs to be administe... | 542 | en | {
"1": "Intramuscular adrenaline, followed by an inhaled bronchodilator of the SABA type and intramuscular dexchlorpheniramine. Then request serum tryptase.",
"2": "An inhaled SABA-type bronchodilator, followed by intramuscular dexchlorpheniramine and intramuscular adrenaline. Then order serum tryptase.",
"3": "I... | 38 | ALLERGOLOGY | 2,022 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0706_21864",
"title": "Assessment of bronchodilator responsiveness following methacholine-induced bronchoconstriction in children with asthma.",
"score": 0.017555859553123575,
"content": "T... |
5 | {
"1": {
"exist": true,
"char_ranges": [
[
148,
193
]
],
"word_ranges": [
[
23,
31
]
],
"text": "All the rest are typical signs of organicity,"
},
"2": {
"exist": true,
"char_ranges": [
[
148,
193
]... | Although mucus is usually more frightening in the consultation, it falls within the Rome II criteria for the diagnosis of Irritable Bowel Syndrome. All the rest are typical signs of organicity, although I think the question is poorly phrased, since any of these data (especially age) can be found in patients who in the ... | Although mucus is usually more frightening in the consultation, it falls within the Rome II criteria for the diagnosis of Irritable Bowel Syndrome. All the rest are typical signs of organicity, although I think the question is poorly phrased, since any of these data (especially age) can be found in patients who in the ... | Which of the following clinical data, recorded during the clinical history taking of a patient with diarrhea of more than 4 weeks of evolution, can be found in people without organic pathology: | 79 | en | {
"1": "Weight loss with or without rectorrhagia.",
"2": "Persistence of diarrhea during the night.",
"3": "Onset of symptoms after age 50.",
"4": "Presence of dermatitis and/or arthritis during the examination.",
"5": "Expulsion of mucus in more than 25% of defecations."
} | 36 | DIGESTIVE SYSTEM | 2,012 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0071_5433",
"title": "[Chronic diarrhea: clinical aspects].",
"score": 0.017401045556385362,
"content": "A retrospective study on the syndrome of chronic diarrhea was carried out on 50 revi... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
0,
270
]
],
"word_ranges": [
[
... | On average, if 100 patients like this woman are treated with warfarin, the number of strokes is reduced by 3 (from 5.2 untreated to 3.2 treated). Therefore, if you treat 33.3 patients like this woman with warfarin, you reduce the number of strokes by 1: the NNT is 33.3. | On average, if 100 patients like this woman are treated with warfarin, the number of strokes is reduced by 3 (from 5.2 untreated to 3.2 treated). Therefore, if you treat 33.3 patients like this woman with warfarin, you reduce the number of strokes by 1: the NNT is 33.3. | An 86-year-old woman in whom nonvalvular atrial fibrillation has been detected. She has a CHADS2 score of 3 points. In the literature, similar patients on warfarin therapy have a stroke risk of 2.2% vs. 5.2% in patients without warfarin. What would be the number needed to treat (NNT) to prevent an emboligenic stroke wi... | 524 | en | {
"1": "3",
"2": "19,2.",
"3": "33,3.",
"4": "49,5.",
"5": null
} | 54 | STATISTICS | 2,021 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0803_19632",
"title": "Medical Costs of Oral Anticoagulants vs Warfarin for Atrial Fibrillation Patients with Different Stroke Risks.",
"score": 0.019142700128228614,
"content": "The Apixab... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
0,
153
]
],
"word_ranges": [
[
... | The clinical picture is typical of spondyloarthritis, and together with the digestive symptoms it is probably associated with inflammatory bowel disease. | The clinical picture is typical of spondyloarthritis, and together with the digestive symptoms it is probably associated with inflammatory bowel disease. | A 20-year-old boy consults for lumbosacral pain of inflammatory rhythm of 4 months of evolution. Also bilateral thalalgia and morning stiffness for 1 hour. In the last 2 months, onset of diarrhea with loss of 4 kg of weight. What is the most correct diagnostic approach? | 319 | en | {
"1": "Given the patient's age, he most likely suffers from non-specific low back pain and tendonitis in the feet. If the diarrhea persists, a digestive study would be performed.",
"2": "I would perform a digestive study to rule out tumor pathology. The lumbar pain may be due to visceral pathology.",
"3": "The c... | 141 | RHEUMATOLOGY | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0071_5433",
"title": "[Chronic diarrhea: clinical aspects].",
"score": 0.01793400286944046,
"content": "A retrospective study on the syndrome of chronic diarrhea was carried out on 50 revis... |
4 | {
"1": {
"exist": true,
"char_ranges": [
[
134,
207
]
],
"word_ranges": [
[
20,
34
]
],
"text": "There is no data in the statement to suggest any of the other etiologies."
},
"2": {
"exist": true,
"char_ranges": [
[
... | The pain is of mechanical characteristics, and the most frequent cause of mechanical back pain in adolescents is mechanical overload. There is no data in the statement to suggest any of the other etiologies. | The pain is of mechanical characteristics, and the most frequent cause of mechanical back pain in adolescents is mechanical overload. There is no data in the statement to suggest any of the other etiologies. | A 13-year-old boy presents dorsal pain of several months of evolution, only on standing and walking, what diagnosis should we consider? | 400 | en | {
"1": "Scheuermann's disease.",
"2": "Thoracic scoliosis.",
"3": "Malignant tumor of the vertebral body.",
"4": "It is a mechanical overload.",
"5": null
} | 147 | TRAUMATOLOGY AND ORTHOPEDICS | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0319_15354",
"title": "[One hundred years of orthopedics in the Netherlands. IV. Spinal abnormalities].",
"score": 0.017998385794995964,
"content": "In recent years there has been spectacul... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"4": {
"exist": false,
... | You are describing a Schönlein-Henoch purpura which is a vasculitic phenomenon, so the lesions are not due to plateletopenia. Scrotal edema (sometimes even torsion of Morgani's capsid of the testis) is not exceptional in males with S. Schönlein-Henoch. | You are describing a Schönlein-Henoch purpura which is a vasculitic phenomenon, so the lesions are not due to plateletopenia. Scrotal edema (sometimes even torsion of Morgani's capsid of the testis) is not exceptional in males with S. Schönlein-Henoch. | A 4-year-old boy consulted for the appearance over the last three days of skin lesions on the legs and buttocks. His parents reported that his pediatrician had diagnosed an upper respiratory tract infection 10 days earlier. In the last 12 hours she presented intense colicky abdominal pain and had two diarrheal stools. ... | 196 | en | {
"1": "Knee and ankle arthritis.",
"2": "Hematuria.",
"3": "Plateletopenia.",
"4": "Fecal occult blood.",
"5": "Scrotal edema."
} | 164 | PEDIATRICS | 2,013 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0520_9818",
"title": "A patient with abdominal distension.",
"score": 0.013776034370038293,
"content": "A 74-year-old woman was admitted to our hospital because of vomiting and abdominal pa... |
1 | {
"1": {
"exist": true,
"char_ranges": [
[
0,
251
]
],
"word_ranges": [
[
0,
38
]
],
"text": "They refer to a concept that has emerged relatively recently and is not present in all clinical guidelines as uncomplicated symptomatic divertic... | They refer to a concept that has emerged relatively recently and is not present in all clinical guidelines as uncomplicated symptomatic diverticular disease. In these cases, the therapeutic trial with rifaximin is recommended, being the true number 1. The absence of acute phase reactants in the CBC suggests that she do... | They refer to a concept that has emerged relatively recently and is not present in all clinical guidelines as uncomplicated symptomatic diverticular disease. In these cases, the therapeutic trial with rifaximin is recommended, being [HIDDEN]. The absence of acute phase reactants in the CBC suggests that she does not ha... | 83-year-old male who consults for a recurrent picture of abdominal pain in the left iliac fossa, accompanied by diarrhea of up to 6 stools per day without pathological products, of 10-15 days of evolution. No fever or general condition was reported. A recent blood test showed no leukocytosis and a negative fecal occult... | 509 | en | {
"1": "Empirical treatment with antibiotics.",
"2": "Request a preferential colonoscopy.",
"3": "Request urgent abdominal ultrasound.",
"4": "Refer to surgery to evaluate sigmoidectomy.",
"5": null
} | 150 | DIGESTIVE | 2,021 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en014_100819",
"title": "Colonoscopy",
"score": 0.015333818344619173,
"content": "Fecal occult blood is a quick test which can be done to test for microscopic traces of blood in the stoo... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
0,
57
]
],
"word_ranges": [
[
... | Discontinue lisinopril and initiate sacubitril/valsartan. | Discontinue lisinopril and initiate sacubitril/valsartan. | 75-year-old woman with a history of heart failure with an ejection fraction of 25% who comes for a check-up, being stable in NYHA functional class III. She has an implanted cardioverter defibrillator. Current medication consists of lisinopril, carvedilol and spironolactone at maximum tolerated doses. On physical examin... | 549 | en | {
"1": "Add sacubitril/valsartan.",
"2": "Add ivabradine.",
"3": "Discontinue lisinopril and start sacubitril/valsartan.",
"4": "Discontinue carvedilol and start ivabradine.",
"5": null
} | 128 | CARDIOLOGY | 2,022 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0919_5513",
"title": "Update of treatment of heart failure with reduction of left ventricular ejection fraction.",
"score": 0.019324122479462285,
"content": "Underlying and precipitating ca... |
1 | {
"1": {
"exist": true,
"char_ranges": [
[
171,
504
]
],
"word_ranges": [
[
26,
82
]
],
"text": "The Rosenthal fibers may confuse us as they are not very specific, and make us think, for example, of pleomorphic xanthoastrocytoma in which ... | A question that does not seem to have a second intention, as there are no confusing elements. The statement concisely summarizes the description of pilocytic astrocytoma. The Rosenthal fibers may confuse us as they are not very specific, and make us think, for example, of pleomorphic xanthoastrocytoma in which they can... | A question that does not seem to have a second intention, as there are no confusing elements. The statement concisely summarizes the description of pilocytic astrocytoma. The Rosenthal fibers may confuse us as they are not very specific, and make us think, for example, of pleomorphic xanthoastrocytoma in which they can... | A 20-year-old man with ataxia, headaches and solid-cystic mass in the right cerebellar hemisphere underwent surgery and a lesion was resected, histologically showing cells with long thin cytoplasmic processes, fascicular and microcystic pattern, numerous vessels and Rosenthal's fibers. The most probable anatomopatholog... | 221 | en | {
"1": "Pilocytic astrocytoma.",
"2": "Pleomorphic xanthoastrocytoma.",
"3": "Central neurocytoma.",
"4": "Liponeurocytoma.",
"5": "Prion disease."
} | 48 | ANATOMIC PATHOLOGY | 2,014 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0708_3570",
"title": "Hemorrhagic onset of cerebellar pilocytic astrocytoma in an adult: a case report and review of the literature implying a possible relation of degenerative vascular changes to the massive ... |
1 | {
"1": {
"exist": true,
"char_ranges": [
[
0,
147
]
],
"word_ranges": [
[
0,
22
]
],
"text": "Correct answer 1. 75% of patients with radiculopathy improve with non-surgical treatment, this being the treatment of choice in the initial stag... | Correct answer 1. 75% of patients with radiculopathy improve with non-surgical treatment, this being the treatment of choice in the initial stages. Magnetic resonance imaging is of choice in certain "red flags": fever, weight loss, nocturnal pain, persistence of symptoms despite conservative treatment and loss of stren... | [HIDDEN] 75% of patients with radiculopathy improve with non-surgical treatment, this being the treatment of choice in the initial stages. Magnetic resonance imaging is of choice in certain "red flags": fever, weight loss, nocturnal pain, persistence of symptoms despite conservative treatment and loss of strength ([HID... | 35-year-old male, letter carrier, with no history of interest, who comes to the emergency department for acute cervical pain of 24 hours of evolution, without previous trauma, which radiates to the left arm up to the hand and is accompanied by paresthesia in the radial border of the forearm. She presents no objectifiab... | 606 | en | {
"1": "Conservative treatment with non-steroidal anti-inflammatory drugs, local heat and relative rest.",
"2": "Urgent call to the neurosurgeon for surgical evaluation.",
"3": "Preferential request for MRI and electromyogram.",
"4": "Preferential referral to traumatology outpatients.",
"5": null
} | 113 | TRAUMATOLOGY | 2,022 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0938_6536",
"title": "Sudden Onset of Severe Cervical Pain in an Adolescent Girl: Case Report and Review of Literature.",
"score": 0.01890999910801891,
"content": "A previously healthy 13-y... |
3 | {
"1": {
"exist": true,
"char_ranges": [
[
483,
638
]
],
"word_ranges": [
[
82,
108
]
],
"text": "having had two pregnancies in these years of stay in Spain, it should be suggested that her children also be tested for the probable vertica... | The sexual route is not a means of transmission of Trypanosoma cruzi. In our environment, since the transmitting vector is not found, the most important means of transmission is the vertical route from mother to child. The woman was already infected by the parasite when she arrived in Spain, it may be correct to sugges... | The sexual route is not a means of transmission of Trypanosoma cruzi. In our environment, since the transmitting vector is not found, the most important means of transmission is the vertical route from mother to child. The woman was already infected by the parasite when she arrived in Spain, it may be correct to sugges... | A 35-year-old Bolivian woman, 3 months pregnant, who has been living in Spain for 10 years with her partner, who is Spanish and has never traveled to Latin America. The woman has two other children with her partner, born in Spain, and a brother who lives in Bolivia and another in Spain. During her pregnancy she has bee... | 436 | en | {
"1": "Recommend that their children have a T. cruzi serology because of the risk of transplacental transmission.",
"2": "Inform the patient of the risk of T. cruzi transmission and the attitude to be taken during pregnancy, delivery and postpartum.",
"3": "Recommend that her husband have T. cruzi serology becau... | 223 | INFECTIOUS DISEASES AND MICROBIOLOGY | 2,018 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0726_23953",
"title": "[Prevalence of Trypanosoma cruzi infection and vertical transmission in Latin-American pregnant women in a health area of Biscay].",
"score": 0.019327731092436976,
"c... |
4 | {
"1": {
"exist": true,
"char_ranges": [
[
88,
211
]
],
"word_ranges": [
[
17,
40
]
],
"text": "to reduce edema in these patients, it is recommended that it be low-protein and low-salt, so options 1 and 3 would be true."
},
"2": {
... | The patient in the case presents a nephrotic syndrome, so far so good. As for the diet, to reduce edema in these patients, it is recommended that it be low-protein and low-salt, so options 1 and 3 would be true. ACE inhibitors are also administered as primary treatment for nephrotic syndrome, since they decrease urinar... | The patient in the case presents a nephrotic syndrome, so far so good. As for the diet, to reduce edema in these patients, it is recommended that it be low-protein and low-salt, so options 1 and 3 would be [HIDDEN]. ACE inhibitors are also administered as primary treatment for nephrotic syndrome, since they decrease ur... | A 42-year-old man came to consultation for edema. Initial tests showed the presence of proteinuria of more than 10 grams/24 hours. Which of the following measures is NOT indicated in the treatment of this patient? | 220 | en | {
"1": "Low-protein diet.",
"2": "Administration of loop diuretics.",
"3": "Restriction of salt in the diet.",
"4": "Administration of NSAIDs.",
"5": "Administration of angiotensin-converting enzyme inhibitors."
} | 126 | NEPHROLOGY | 2,014 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0268_21890",
"title": "[The effect of a low-protein diet and certain pharmaceutical agents on the course of ablation nephropathy in rats].",
"score": 0.01743396226415094,
"content": "The be... |
2 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
30,
70
]
],
"word_ranges": [
[
3,
9
]
],
"text": "amiodarone (the dose is correct, 300mg),"
},
"... | Controversial question, since amiodarone (the dose is correct, 300mg), is administered after the third shock, and not after the first defibrillation, which is what we are told in the statement. Although, be careful, that is what the guidelines say. I am sure that more than one of us has administered amiodarone as soon ... | Controversial question, since amiodarone (the dose is correct, 300mg), is administered after the third shock, and not after the first defibrillation, which is what we are told in the statement. Although, be careful, that is what the guidelines say. I am sure that more than one of us has administered amiodarone as soon ... | A 22-year-old woman presents with sudden cardiac arrest with a rhythm that is considered amenable to defibrillation. Chest compressions and ventilations are being performed, a defibrillator shock has been delivered, and a peripheral venous line has been cannulated. Which of the following would be correct next: | 483 | en | {
"1": "Administration of 150 mg of intravenous amiodarone.",
"2": "Administration of 300 mg of intravenous amiodarone.",
"3": "Administration of 1 mg of intravenous atropine.",
"4": "Administer 2 mg of intravenous atropine.",
"5": null
} | 174 | CRITICAL CARE | 2,020 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en176_11464",
"title": "Pediatric advanced life support",
"score": 0.0178585665311329,
"content": "Defibrillations/shocks first shock should be 2 J/kg second shock should be 4 J/kg all o... |
5 | {
"1": {
"exist": true,
"char_ranges": [
[
830,
863
]
],
"word_ranges": [
[
131,
137
]
],
"text": "in thalassemia the ADE is normal."
},
"2": {
"exist": true,
"char_ranges": [
[
109,
266
]
],
... | With the data we are given, the first thing that comes to mind is that it is an arregenerative anemia, since the bone marrow has not responded with an exaltation of erythropoiesis; in this way we have already eliminated the options that speak of regenerative anemia. The next thing that orients us towards the cause is t... | With the data we are given, the first thing that comes to mind is that it is an arregenerative anemia, since the bone marrow has not responded with an exaltation of erythropoiesis; [HIDDEN] The next thing that orients us towards the cause is that it is microcytic and hypochromic, which is characteristic of iron deficie... | A 35-year-old healthy woman consults for asthenia. The CBC shows microcytic and hypochromic anemia (hemoglobin 7 g/dL, mean corpuscular volume 68 fl, mean corpuscular hemoglobin 24 pg) with an elevated red cell distribution amplitude (ADE 20%), decreased reticulocytes (0.3%, 30000/l absolute), decreased hemoglobin cont... | 113 | en | {
"1": "Thalassemic trait.",
"2": "Central anemia, arregenerative, due to folic acid deficiency.",
"3": "Peripheral, regenerative, hemolytic anemia.",
"4": "Peripheral anemia, regenerative, due to acute active hemorrhage.",
"5": "Central anemia, arregenerative, due to iron deficiency."
} | 93 | HEMATOLOGY | 2,012 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en022_91106",
"title": "Iron-deficiency anemia",
"score": 0.01809771141048531,
"content": "Blood tests Anemia is often discovered by routine blood tests. A sufficiently low hemoglobin by... |
1 | {
"1": {
"exist": true,
"char_ranges": [
[
0,
148
]
],
"word_ranges": [
[
0,
25
]
],
"text": "Obviously, it is the only answer that encompasses all the causes of sudden loss of consciousness and that allows us to somehow filter the diagno... | Obviously, it is the only answer that encompasses all the causes of sudden loss of consciousness and that allows us to somehow filter the diagnosis. | Obviously, [HIDDEN] and that allows us to somehow filter the diagnosis. | A 47-year-old male patient who consults the emergency department for sudden loss of consciousness Which of the following has a higher diagnostic yield? | 59 | en | {
"1": "Clinical history.",
"2": "Electrocardiogram.",
"3": "Holter recording.",
"4": "EEG.",
"5": "Cranial CT scan."
} | 51 | ANESTHESIOLOGY AND CRITICAL CARE | 2,011 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0482_9183",
"title": "[Syncope: many studies and few diagnoses?].",
"score": 0.019049346879535557,
"content": "Syncope is a frequent disorder shows diagnostic difficulties, so that an impor... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
0,
576
]
],
"word_ranges": [
[
... | The maternal grandmother carried the mutation in one copy of the gene on an X chromosome (we are not told that she had the disease, but a son of hers, Isabel's maternal uncle, did have the disease). Isabel's mother continues to carry it, since one of Isabel's brothers has suffered from the disease but not her father. T... | The maternal grandmother carried the mutation in one copy of the gene on an X chromosome (we are not told that she had the disease, but a son of hers, Isabel's maternal uncle, did have the disease). Isabel's mother continues to carry it, since one of Isabel's brothers has suffered from the disease but not her father. T... | Elizabeth has three sons and one daughter (Mary), all of whom are healthy. A brother and a maternal uncle of Isabel died of Duchenne disease: an X-linked recessive disease. At present, Maria wants to become pregnant and wants to know the risk of transmitting the disease to her offspring. With the data collected, what i... | 412 | en | {
"1": "2/3.",
"2": "1/2.",
"3": "1/4.",
"4": "Less than 1/4.",
"5": null
} | 54 | BIOSTATISTICS | 2,018 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en021_104757",
"title": "Preimplantation genetic diagnosis",
"score": 0.01960972796308757,
"content": "In the case of families at risk for X-linked diseases, patients are provided with a... |
2 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
20,
196
]
],
"word_ranges": [
[
2,
28
]
],
"text": "Peri- or menopause: - Due to the high prevalence... | Endometrial biopsy. Peri- or menopause: - Due to the high prevalence of organic pathology during this period it is necessary to systematically perform endometrial biopsy (Cornier or Hysteroscopy). | Endometrial biopsy. Peri- or menopause: - Due to the high prevalence of organic pathology during this period it is necessary to systematically perform endometrial biopsy (Cornier or Hysteroscopy). | 69-year-old woman who comes to your office referring genital bleeding of several months of evolution. She denies hormone replacement therapy and anticoagulation. She provides normal cervicovaginal cytology. General and genital physical examination without findings of interest. BMI of 38kg/m2. Indicate the most correct ... | 347 | en | {
"1": "Prescribe cyclic progesterone.",
"2": "Endometrial biopsy.",
"3": "Random biopsies of the cervix.",
"4": "Hormonal assessment with FSH, LH and estradiol.",
"5": null
} | 159 | GYNECOLOGY AND OBSTETRICS | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0356_10102",
"title": "Transvaginal ultrasonography of the endometrium in women with postmenopausal bleeding: is it always necessary to perform an endometrial biopsy?",
"score": 0.01827436582109479,
... |
1 | {
"1": {
"exist": true,
"char_ranges": [
[
31,
170
]
],
"word_ranges": [
[
6,
28
]
],
"text": "the indications for cardiac surgery include the appearance of heart failure or new conduction disorders, and in this case it presents both."
... | The correct answer is 1, since the indications for cardiac surgery include the appearance of heart failure or new conduction disorders, and in this case it presents both. | [HIDDEN] since the indications for cardiac surgery include the appearance of heart failure or new conduction disorders, and in this case it presents both. | A 54-year-old patient is admitted for thermometric fever of 38°C in the previous five days and dyspnea at rest (NYHA lV) that appeared 6 hours before coming to the hospital. Examination in the emergency room was compatible with heart failure and the ECG showed complete atrioventricular block with an escape ventricular ... | 325 | en | {
"1": "Cardiac surgery for aortic valve replacement by mechanical prosthesis with antibiotic therapy according to antibiogram.",
"2": "Antibiotic therapy according to antibiogram and implantation of intra-aortic balloon counterpulsation and transient pacemaker for up to 3 weeks, after which a permanent pacemaker w... | 56 | CRITICAL, PALLIATIVE AND EMERGENCY CARE | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0413_8692",
"title": "Complete heart block resulting from quadricuspid aortic valve penicillin-resistant pneumococcal endocarditis: a case report.",
"score": 0.01905453225660103,
"content":... |
4 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
39,
171
]
],
"word_ranges": [
[
4,
23
]
],
"text": "both hydrochlorothiazide and lisinopril can also... | Paroxetine; complicated question since both hydrochlorothiazide and lisinopril can also produce falls in the elderly, but they would generally be accompanied by dizziness. | Paroxetine; complicated question since both hydrochlorothiazide and lisinopril can also produce falls in the elderly, but they would generally be accompanied by dizziness. | An 88-year-old man comes for consultation because he has fallen 3 times in the last 6 months. None of the falls was accompanied by dizziness or syncope. One fall occurred while he was walking in the garden. His medical history includes hypertension without postural changes in blood pressure, gout, osteoarthritis, and d... | 335 | en | {
"1": "Allopurinol.",
"2": "Hydrochlorothiazide.",
"3": "Lisinopril.",
"4": "Paroxetine.",
"5": null
} | 175 | PHARMACOLOGY | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0298_4063",
"title": "Prevalence and persistency of orthostatic blood pressure fall in older patients with isolated systolic hypertension. Syst-Eur Investigators.",
"score": 0.01739782527184102,
... |
5 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
233,
291
]
],
"word_ranges": [
[
41,
51
]
],
"text": "And certainly she does not have symptoms or cl... | In this case I believe that the correct answer is 5. The 1 should not be because although the clinical picture is suggestive, it does not present lymphocytosis. It does not seem to be an allergic exanthema from the clinical picture. And certainly she does not have symptoms or clinical signs compatible with malaria or t... | In this case I believe that [HIDDEN]. The 1 should not be [HIDDEN] although the clinical picture is suggestive, it does not present lymphocytosis. It does not seem to be an allergic exanthema from the clinical picture. And certainly she does not have symptoms or clinical signs compatible with malaria or typhoid fever. ... | A 32-year-old woman has traveled to Cuba from where she arrived three days ago. The day after her return, she goes to her family doctor for high fever, intense arthromyalgia and headache that had started before the return trip and he prescribes her paracetamol. Three days later and with no improvement, he presented in ... | 19 | en | {
"1": "Infectious mononucleosis.",
"2": "Allergic exanthema.",
"3": "P. falciparum malaria.",
"4": "Typhoid fever.",
"5": "Dengue fever."
} | 109 | INFECTIOUS DISEASES | 2,011 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "Pharmacology_Katzung_5664",
"title": "Pharmacology_Katzung",
"score": 0.017331932773109245,
"content": "Philip J. Rosenthal, MD A 5-year-old American girl presents with a 1-week history of intermitt... |
4 | {
"1": {
"exist": true,
"char_ranges": [
[
43,
205
]
],
"word_ranges": [
[
8,
34
]
],
"text": "As for Scheuermann and scoliosis, we should be given some physical data because the patient presents with a specific examination that would giv... | A malignant tumor would also hurt at rest. As for Scheuermann and scoliosis, we should be given some physical data because the patient presents with a specific examination that would give us the diagnosis. | A malignant tumor would also hurt at rest. As for Scheuermann and scoliosis, we should be given some physical data because the patient presents with a specific examination that would give us the diagnosis. | A 13-year-old boy presents dorsal pain of several months of evolution, only when standing and walking, what diagnosis should we consider? | 401 | en | {
"1": "Scheuermann's disease.",
"2": "Thoracic scoliosis.",
"3": "Malignant tumor of the vertebral body.",
"4": "It is a mechanical overload.",
"5": null
} | 147 | TRAUMATOLOGY AND ORTHOPEDICS | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0746_22232",
"title": "Back pain during growth.",
"score": 0.018187830687830687,
"content": "It is wrong to believe that back pain only burdens adults: the yearly incidence during growth ra... |
2 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
0,
158
]
],
"word_ranges": [
[
0,
21
]
],
"text": "Clinical suspicion of chronic compartment syndrom... | Clinical suspicion of chronic compartment syndrome (CCS). The diagnosis is made by obtaining compartment pressures at rest, during exercise and post-exercise. | Clinical suspicion of chronic compartment syndrome (CCS). The diagnosis is made by obtaining compartment pressures at rest, during exercise and post-exercise. | A 27-year-old male, a regular athlete, complains of pain in the right leg after continuous running. He has visited a physiotherapist on several occasions and has been diagnosed with an overload in the calf muscles. Several months have passed, he has not improved and refers intense pain after physical activity that subs... | 607 | en | {
"1": "Positron emission tomography with 18 FDG.",
"2": "Determination of posterior compartment pressure immediately after activity.",
"3": "Doppler ultrasound to rule out a circulatory disorder of the lower extremity.",
"4": "Magnetic resonance spectroscopy.",
"5": null
} | 115 | TRAUMATOLOGY | 2,022 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0489_6509",
"title": "[MR-Imaging of lower leg muscle perfusion].",
"score": 0.01809771141048531,
"content": "This article describes the potential of dynamic contrast- enhanced magnetic res... |
4 | {
"1": {
"exist": true,
"char_ranges": [
[
0,
332
]
],
"word_ranges": [
[
0,
62
]
],
"text": "If they are talking about a young man 20-30 years old, with tremor and dystonia, whether or not he has a family history, and especially if one o... | If they are talking about a young man 20-30 years old, with tremor and dystonia, whether or not he has a family history, and especially if one of the options tells me about copper in urine, they are telling me to think of Wilson's disease. I do not think of juvenile Parkinson's, nor an epileptic clinic. So the correct ... | If they are talking about a young man 20-30 years old, with tremor and dystonia, whether or not he has a family history, and especially if one of the options tells me about copper in urine, they are telling me to think of Wilson's disease. I do not think of juvenile Parkinson's, nor an epileptic clinic. So [HIDDEN]. | A 25-year-old man consults for tremor. Examination reveals dysarthria and dystonia. He has a family history of psychiatric illness and movement disorders. Which diagnostic test do you consider most accurate? | 453 | en | {
"1": "DATS CAN.",
"2": "Nerve conduction study.",
"3": "Electroencephalogram.",
"4": "Copper in urine of 24.",
"5": null
} | 150 | NEUROLOGY | 2,018 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n1040_16743",
"title": "[A case suspected of dystonia with marked cerebellar atrophy with torsion dystonia of the neck and cerebellar ataxia that developed during pharmacologic schizophrenia treatment].",
... |
4 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"4": {
"exist": true,
"... | We describe a young patient with criteria of nephrotic syndrome with excellent response to corticosteroids. Without biopsy, the clinical presentation and evolution suggest a nephropathy with minimal changes, which usually presents with normal or slightly altered renal function together with nephrotic syndrome, and whic... | We describe a young patient with criteria of nephrotic syndrome with excellent response to corticosteroids. Without biopsy, the clinical presentation and evolution suggest a nephropathy with minimal changes, which usually presents with normal or slightly altered renal function together with nephrotic syndrome, and whic... | An 18-year-old patient consulted for edema. A complete blood test showed proteinuria of 8 g/day without microhematuria, hypoalbuminemia and hypercholesterolemia with normal renal function. He was empirically administered corticosteroids. After one month, the clinical picture has completely disappeared. What is your dia... | 529 | en | {
"1": "Amyloidosis.",
"2": "IgA nephropathy or Berger's disease.",
"3": "Alport syndrome.",
"4": "Nephropathy with minimal changes.",
"5": null
} | 166 | NEPHROLOGY | 2,021 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en026_25249",
"title": "IgA nephropathy",
"score": 0.01951637471439452,
"content": "A subset of IgA nephropathy patients, who have minimal change disease on light microscopy and clinical... |
2 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
127,
324
]
],
"word_ranges": [
[
20,
49
]
],
"text": "Patient poorly controlled with metformin and s... | To associate a basal insulin dose to the treatment. Expected question on a very important subject: diabetes and its treatment. Patient poorly controlled with metformin and sitagliptin with discrete cardinal symptoms (weight loss, asthenia). The best option is insulin to control cardinal symptoms and decrease HbA1c to <... | To associate a basal insulin dose to the treatment. Expected question on a very important subject: diabetes and its treatment. Patient poorly controlled with metformin and sitagliptin with discrete cardinal symptoms (weight loss, asthenia). The best option is insulin to control cardinal symptoms and decrease HbA1c to <... | A 62-year-old man with type 2 diabetes mellitus of 10 years of evolution is treated with metformin and sitagliptin. He does little physical exercise and follows an adequate diet. In the last 6 months he has lost weight and has more asthenia. Her glycemic controls have deteriorated from baseline blood glucose levels of ... | 258 | en | {
"1": "Increase dietary protein and long-chain carbohydrate intake to improve asthenia and weight loss.",
"2": "To associate a basal insulin dose to the treatment.",
"3": "Associate with ascarbose treatment.",
"4": "Substitute sitagliptin for pioglitazone.",
"5": "Substitute metformin for glimepiride."
} | 96 | ENDOCRINOLOGY | 2,014 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0650_13044",
"title": "[Therapeutic behavior to follow in the following clinical case: treatment of type 2 diabetes].",
"score": 0.01672449687716863,
"content": "A 62-year old woman with ob... |
2 | {
"1": {
"exist": true,
"char_ranges": [
[
275,
360
]
],
"word_ranges": [
[
46,
62
]
],
"text": "the first cannot be because we have not been told what the initial headache was like;"
},
"2": {
"exist": true,
"char_ranges": [
... | The picture they describe of intense headache with orthostatism that disappears when lying down, although it is true that the most typical presentation is between the first 24-48 hours and in this case it is somewhat earlier. Even so, the rest of the answers are improbable: the first cannot be because we have not been ... | The picture they describe of intense headache with orthostatism that disappears when lying down, although it is true that the most typical presentation is between the first 24-48 hours and in this case it is somewhat earlier. Even so, the rest of the answers are improbable: the first cannot be because we have not been ... | A 45-year-old patient under study for possible meningitis, with fever, headache and vomiting of 2 days of evolution. A brain MRI and lumbar puncture were performed. Twenty hours later, on getting up to go to the bathroom, he complains of severe headache, very marked when he sits up but disappears when he lies down. She... | 375 | en | {
"1": "Meningitis remains the fundamental cause of her headache, as it is the same type of headache as at the onset of symptoms.",
"2": "It is a post lumbar puncture headache.",
"3": "It is necessary to look for a different cause to this headache, because it is not typical of post-lumbar puncture syndrome or men... | 128 | NEUROLOGY | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0304_5255",
"title": "[Spontaneous intracranial hypotension with severe headache and typical neuroradiological findings: report of two cases].",
"score": 0.018207282913165264,
"content": "I... |
2 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
25,
248
]
],
"word_ranges": [
[
5,
43
]
],
"text": "We are facing a suspicion of endometriosis, due ... | The correct answer is 2. We are facing a suspicion of endometriosis, due to the symptoms and signs given in the statement. We are asked for a diagnosis of certainty, and the Gold Standard for the diagnosis of this disease is diagnostic laparoscopy. | [HIDDEN] We are facing a suspicion of endometriosis, due to the symptoms and signs given in the statement. We are asked for a diagnosis of certainty, and the Gold Standard for the diagnosis of this disease is diagnostic laparoscopy. | A 27-year-old woman referred to the gynecology office for evaluation referring dyspareunia for about 8 months, along with dyschezia and occasional rectorrhagia coinciding with menstruation for 3-4 months. She also reports dysmenorrhea for years, which she controls well with ibuprofen. She has been trying to get pregnan... | 352 | en | {
"1": "Transvaginal ultrasound.",
"2": "Diagnostic laparoscopy.",
"3": "Magnetic resonance imaging.",
"4": "Colonoscopy.",
"5": null
} | 161 | GYNECOLOGY AND OBSTETRICS | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n1003_10794",
"title": "Sonographic Evaluation for Endometriosis in Routine Pelvic Ultrasound.",
"score": 0.011924083336093537,
"content": "To show how the evaluation for endometriosis can b... |
1 | {
"1": {
"exist": true,
"char_ranges": [
[
308,
564
]
],
"word_ranges": [
[
44,
84
]
],
"text": "The current classification is the 2017 ILAE classification that would describe this seizure as focal seizure with altered level of consciousn... | The clinical case makes a textbook description of a medial temporal seizure. The aura of ascending epigastric sensation and olfactory alteration and the subsequent description of the seizure with alteration of the level of consciousness (disconnection from the environment) with oral and manual automatisms. The current ... | The clinical case makes a textbook description of a medial temporal seizure. The aura of ascending epigastric sensation and olfactory alteration and the subsequent description of the seizure with alteration of the level of consciousness (disconnection from the environment) with oral and manual automatisms. The current ... | A 29-year-old woman with a history of febrile seizures and a heavy smoker. She consults for frequent, stereotyped episodes that begin with an ascending epigastric sensation and an unpleasant odor, followed by disconnection from the environment. Family members who are with her observe that she makes sucking movements an... | 575 | en | {
"1": "Complex focal temporal lobe seizures.",
"2": "Transient ischemic attacks in right carotid territory.",
"3": "Simple focal motor seizures.",
"4": "Episodes of transient global amnesia.",
"5": null
} | 102 | NEUROLOGY | 2,022 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0956_24813",
"title": "[A case of painful seizure accompanying ictal paresis and homonymous hemianopia due to post-stroke epilepsy].",
"score": 0.015686515748031496,
"content": "A 69-year-o... |
2 | {
"1": {
"exist": true,
"char_ranges": [
[
98,
191
]
],
"word_ranges": [
[
16,
32
]
],
"text": "At no time are atypical cellular features mentioned, so we can safely rule out tumor lesions,"
},
"2": {
"exist": true,
"char_rang... | After reading the question and the possible answers, we have two tumor and two non-tumor options. At no time are atypical cellular features mentioned, so we can safely rule out tumor lesions, leaving doubts between answers 2 and 3. In this case, we would have to opt for IMMATURE TERATOMA, mentioning the presence of emb... | After reading the question and the possible answers, we have two tumor and two non-tumor options. At no time are atypical cellular features mentioned, so [HIDDEN], leaving doubts between answers 2 and 3. In this case, we would have to opt for IMMATURE TERATOMA, mentioning the presence of embryonic remains. | A 20-year-old woman with a 15 cm solid-cystic ovarian tumor detected by ultrasound after presenting with non-specific abdominal symptoms. In the anatomopathological study of the corresponding specimen, teeth, hairs, areas of intestinal epithelium, areas of squamous epithelium (15%) and bronchial epithelium, as well as ... | 278 | en | {
"1": "Teratocarcinoma.",
"2": "Immature teratoma.",
"3": "Mature cystic teratoma.",
"4": "Dysgerminoma.",
"5": null
} | 31 | PATHOLOGICAL ANATOMY | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0721_21912",
"title": "Malignant transformation of ovarian mature cystic teratoma with a predominant pulmonary type small cell carcinoma component.",
"score": 0.016359508547008548,
"content... |
5 | {
"1": {
"exist": true,
"char_ranges": [
[
448,
496
]
],
"word_ranges": [
[
77,
88
]
],
"text": "Option 1 is ruled out: it is not a complete AVB."
},
"2": {
"exist": true,
"char_ranges": [
[
497,
596
... | What are these findings in the Holter? If the sinus node fails, the AV node takes over and stimulates the ventricle. In 10% of people there is retrograde conduction, so that beat generated in the AVN stimulates both ventricles and atria, giving a retrograde P as reported in the study. In this sense, no problem. Likewis... | What are these findings in the Holter? If the sinus node fails, the AV node takes over and stimulates the ventricle. In 10% of people there is retrograde conduction, so that beat generated in the AVN stimulates both ventricles and atria, giving a retrograde P as reported in the study. In this sense, no problem. Likewis... | An 82-year-old patient presents with sudden and frequent dizziness, without prodromes, of short duration and which subsides spontaneously, without ever presenting syncope. Physical examination and baseline electrocardiogram are normal. In an ambulatory electrocardiogram recording during 24 hours, short phases of absenc... | 225 | en | {
"1": "The patient has a third-degree AVB and requires pacemaker implantation.",
"2": "The absence of periods of asystole >3 seconds excludes a cardiac cause of dizziness.",
"3": "Drug treatment to increase conduction in the AV node would be indicated.",
"4": "The patient presents sinus dysfunction with sinoat... | 64 | CARDIOLOGY | 2,014 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0131_3652",
"title": "[Clinical and electrophysiological aspects of median intra-His bundle block with normal electrocardiogram at rest].",
"score": 0.016057203788496517,
"content": "The cl... |
1 | {
"1": {
"exist": true,
"char_ranges": [
[
0,
123
]
],
"word_ranges": [
[
0,
20
]
],
"text": "In a digital hypokratitis of recent onset in a smoking patient, the first option to rule out is bronchopulmonary carcinoma."
},
"2": {
"... | In a digital hypokratitis of recent onset in a smoking patient, the first option to rule out is bronchopulmonary carcinoma. Other pathologies can also occur but not so suddenly. | In a digital hypokratitis of recent onset in a smoking patient, the first option to rule out is bronchopulmonary carcinoma. Other pathologies can also occur but not so suddenly. | A former smoker patient, previously diagnosed with COPD comes in for a checkup. The physical examination reveals digital hypokratism of recent onset. What is the most acceptable explanation for this finding in the clinical context described? | 370 | en | {
"1": "Pulmonary carcinoma.",
"2": "Bronchiectasis.",
"3": "Pulmonary fibrosis.",
"4": "Cyanotic heart disease.",
"5": null
} | 125 | PULMONOLOGY AND THORACIC SURGERY | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n1002_20528",
"title": "Generalized emphysema and chronic obstructive pulmonary disease in a farmer, non-smoker - the more we seek, the more we find.",
"score": 0.013846438825599704,
"conten... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": true,
"char_ranges": [
[
0,
253
]
],
"word_ranges": [
[
... | Urinary hydroxyproline: Urinary hydroxyproline excretion reflects the degradation of bone collagen, but is also influenced by the metabolism of other tissues (cartilage, skin) and by the absorption of products rich in collagen, such as meat or gelatins. Due to its diverse tissue origin and metabolic pattern, it correla... | Urinary hydroxyproline: Urinary hydroxyproline excretion reflects the degradation of bone collagen, but is also influenced by the metabolism of other tissues (cartilage, skin) and by the absorption of products rich in collagen, such as meat or gelatins. Due to its diverse tissue origin and metabolic pattern, it correla... | In a routine workup of a 59-year-old woman, a smoker of 20 cigarettes/day for 25 years, hypercalcemia of 11.3 mg/dL with a phosphorus of 3.4 mg/dL is detected. It would NOT be efficient at the outset: | 332 | en | {
"1": "Determine serum PTH levels.",
"2": "Determine serum vitamin D levels.",
"3": "Determination of hydroxyprolinuria.",
"4": "Plain chest X-ray.",
"5": null
} | 88 | ENDOCRINOLOGY | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "article-23158_12",
"title": "Hypercalcemia -- Evaluation",
"score": 0.012718697702723263,
"content": "Most cases of hypercalcemia are detected on routine testing. Work up for etiology includes obtai... |
3 | {
"1": {
"exist": true,
"char_ranges": [
[
158,
418
]
],
"word_ranges": [
[
25,
69
]
],
"text": "The existence of clinical symptoms suggestive of pathology of the upper digestive tract has led us to begin the study with upper endoscopy, b... | We have a case of chronic iron deficiency anemia, without obvious bleeding. The first cause of iron deficiency anemia is occult bleeding of digestive origin. The existence of clinical symptoms suggestive of pathology of the upper digestive tract has led us to begin the study with upper endoscopy, but there is no pathol... | We have a case of chronic iron deficiency anemia, without obvious bleeding. The first cause of iron deficiency anemia is occult bleeding of digestive origin. The existence of clinical symptoms suggestive of pathology of the upper digestive tract has led us to begin the study with upper endoscopy, but there is no pathol... | A 55-year-old postmenopausal woman consults for asthenia and dyspnea on exertion. In the anamnesis she reported slight epigastralgia and occasional heartburn. No metrorrhagia. Laboratory tests: Hb6 gr/dL, MCV 69 fl, sideremia 13 micrograms/dL, ferritin 4 ngr/mL. Gastrointestinal endoscopy: small sliding hiatal hernia w... | 78 | en | {
"1": "Administer oral iron and monitor the evolution of anemia.",
"2": "Treat with proton pump inhibitors and evaluate at three months.",
"3": "Recommend a complete colonoscopy.",
"4": "Perform an endoscopic capsule study.",
"5": "Request a gynecological evaluation."
} | 33 | DIGESTIVE SYSTEM | 2,012 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0608_23519",
"title": "[A 68-year-old woman with iron deficiency anemia].",
"score": 0.019419306184012067,
"content": "A 68-year-old woman with iron deficiency anemia (due to gastrointestin... |
3 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
0,
199
]
],
"word_ranges": [
[
0,
29
]
],
"text": "You present with coxarthrosis (no further imaging... | You present with coxarthrosis (no further imaging tests are needed), and conservative options are exhausted before opting for surgical treatment. Weak opioids are not the initial treatment of choice. | You present with coxarthrosis (no further imaging tests are needed), and conservative options are exhausted before opting for surgical treatment. Weak opioids are not the initial treatment of choice. | You assess a 66-year-old patient with accentuated groin pain with prolonged standing a few days a month. A plain radiograph of the hips shows narrowing of the femoroacetabular joint space, sclerosis and osteophytes. What is your attitude? | 397 | en | {
"1": "I make the diagnosis of coxarthrosis and send to the traumatologist to place a hip prosthesis.",
"2": "Start treatment with weak opioids that have shown evidence of halting disease progression.",
"3": "I instigate treatment with paracetamol, explain that the evolution is very variable and the surgical ind... | 140 | TRAUMATOLOGY AND ORTHOPEDICS | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n1162_86",
"title": "Editorial Commentary: Routine Preoperative Magnetic Resonance Imaging for Hip Arthroscopy Is Wasting Health Care Dollars and Delaying Surgical Intervention: Decision Making Should Be at the... |
3 | {
"1": {
"exist": true,
"char_ranges": [
[
280,
373
]
],
"word_ranges": [
[
43,
59
]
],
"text": "The rest are treatments that can wait for improvement (they do not speak of tension ascites)."
},
"2": {
"exist": true,
"char_ran... | This is spontaneous bacterial peritonitis (SBP), defined by the presence of > 250 polymorphonuclears/mL in the ascitic fluid (in this case there are 1,380, which is 60% of 2,300). It is an indication to start 3rd generation cephalosporins (ceftriaxone or cefotaxime) and albumin. The rest are treatments that can wait fo... | This is spontaneous bacterial peritonitis (SBP), defined by the presence of > 250 polymorphonuclears/mL in the ascitic fluid (in this case there are 1,380, which is 60% of 2,300). It is an indication to start 3rd generation cephalosporins (ceftriaxone or cefotaxime) and albumin. The rest are treatments that can wait fo... | A 67-year-old man, diagnosed with cirrhosis of the liver and an active drinker, is admitted for progressive abdominal distension with diffuse malaise, of two weeks of evolution. He reported no fever or other symptoms. On examination, there was a changeable dullness on abdominal percussion, with absence of edema. A diag... | 275 | en | {
"1": "Salt and fluid restriction.",
"2": "Diuretic treatment with oral spironolactone.",
"3": "Treatment with a third generation cephalosporin.",
"4": "Evacuative paracentesis.",
"5": null
} | 74 | DIGESTIVE SYSTEM | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0540_2449",
"title": "Spontaneous bacterial peritonitis: a therapeutic update.",
"score": 0.018089960886571055,
"content": "Spontaneous bacterial peritonitis (SBP) is one of the main infect... |
1 | {
"1": {
"exist": true,
"char_ranges": [
[
722,
877
]
],
"word_ranges": [
[
117,
144
]
],
"text": "In a high number of cases, after the resolution of the symptoms, the outbreaks are reduced and they can be prevented with diet and hygienic... | We are asked about the management of a very common pathology, diverticulitis. And we are asked about the different therapeutic options depending on how advanced it is. The correct answer is 1, it does not meet the criteria to require drainage by guided puncture (the abscess is not larger than 5-6 cm). Discharge colosto... | We are asked about the management of a very common pathology, diverticulitis. And we are asked about the different therapeutic options depending on how advanced it is. [HIDDEN], it does not meet the criteria to require drainage by guided puncture (the abscess is not larger than 5-6 cm). Discharge colostomy in this case... | An 80-year-old woman comes to the emergency room with abdominal pain starting in the epigastrium and radiating later to the left iliac fossa. An abdominal CT scan is performed, showing inflammation in the walls of the sigma and mesenteric abscess of 2 cm. The treatment of choice is: | 418 | en | {
"1": "Admission to the ward with absolute diet and broad-spectrum antibiotic treatment.",
"2": "Discharge colostomy.",
"3": "Drainage by laparoscopic surgery.",
"4": "Urgent surgery with sigmoidectomy and colorectal anastomosis.",
"5": null
} | 77 | GENERAL SURGERY | 2,018 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0724_25325",
"title": "Danish national guidelines for treatment of diverticular disease.",
"score": 0.018518518518518517,
"content": "In order to elaborate evidence-based, national Danish g... |
4 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": true,
"char_ranges": [
[
133,
268
]
],
"word_ranges": [
[
23,
42
]
],
"text": "An iron profile, thyroid hormone and vitamin d... | The diagnosis is based on clinical criteria, so muscle biopsy is only performed to rule out other diseases, not to confirm this one. An iron profile, thyroid hormone and vitamin determinations should be performed to rule out other diseases with similar symptomatology. Treatment is symptomatic and is instituted when it ... | The diagnosis is based on clinical criteria, so muscle biopsy is only performed to rule out other diseases, not to confirm this one. An iron profile, thyroid hormone and vitamin determinations should be performed to rule out other diseases with similar symptomatology. Treatment is symptomatic and is instituted when it ... | A 75-year-old woman consults for insomnia. She reports that for years she has been waking up at night with a tingling, burning sensation in the legs and sometimes in the arms; these symptoms also occur in the afternoon. She notices improvement when moving her legs, but the symptoms recur during rest, so she cannot fall... | 200 | en | {
"1": "The diagnosis of this affectation is based on clinical criteria.",
"2": "A basic blood test including iron profile, thyroid hormones and B 12 and folic acid should be performed.",
"3": "The treatment would be indicated in patients who present alteration of sleep or quality of life but does not alter the c... | 75 | NEUROLOGY | 2,013 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "wiki20220301en012_17921",
"title": "Restless legs syndrome",
"score": 0.018779756656674307,
"content": "Diagnosis There are no specific tests for RLS, but non-specific laboratory tests are used to r... |
4 | {
"1": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"2": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"3": {
"exist": false,
"char_ranges": [],
"word_ranges": [],
"text": ""
},
"4": {
"exist": true,
"... | A new approach is currently being developed for the treatment of these patients, which tries to coordinate from the beginning the activity of the different sectors involved, avoiding that the transfer of the patient from one to another takes place at the end of the treatment of each part. This idea gave rise to the so-... | A new approach is currently being developed for the treatment of these patients, which tries to coordinate from the beginning the activity of the different sectors involved, avoiding that the transfer of the patient from one to another takes place at the end of the treatment of each part. This idea gave rise to the so-... | 93-year-old woman with a history of COPD, AHT, dyslipidemia, atrial fibrillation and ischemic heart disease. She lives alone. She has ventricular ejection fraction 53%, creatinine 1.5 mg/dL, normal coagulation. She receives treatment with inhaled bronchodilators and ASA 100 mg per day. She suffers a fall in the street,... | 469 | en | {
"1": "Admission for transthoracic ultrasound, assessment by Cardiology and then closed reduction and fixation with plate screw.",
"2": "Admission for evaluation by Nephrology and Cardiology, and then Traumatology will decide whether to use an arthroplasty or a trochanteric nail.",
"3": "Admission to Internal Me... | 137 | ORTHOPEDIC SURGERY AND TRAUMATOLOGY | 2,020 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n0351_10159",
"title": "[Late onset of heparin-induced thrombocytopenia with recurrent arterial thromboses and amputation].",
"score": 0.015455864300859278,
"content": "An 80-year-old woman ... |
1 | {
"1": {
"exist": true,
"char_ranges": [
[
0,
275
]
],
"word_ranges": [
[
0,
45
]
],
"text": "The characterization of cognitive deterioration processes is still clinical, with imaging tests (MRI or PET) being a support tool in some occasi... | The characterization of cognitive deterioration processes is still clinical, with imaging tests (MRI or PET) being a support tool in some occasions. The first option would be the correct one because it allows us to measure in a standardized way each of the cognitive domains, which will allow us to frame the patient's d... | The characterization of cognitive deterioration processes is still clinical, with imaging tests (MRI or PET) being a support tool in some occasions. The first option would be [HIDDEN] because it allows us to measure in a standardized way each of the cognitive domains, which will allow us to frame the patient's deficits... | A 72-year-old patient presents with progressive memory loss and word finding difficulty of one year's duration. What is the most useful examination to characterize the type of cognitive deficit he presents with? | 378 | en | {
"1": "Neuropsychological evaluation.",
"2": "Brain magnetic resonance imaging.",
"3": "Positron Emission Tomography.",
"4": "Electroencephalogram.",
"5": null
} | 132 | NEUROLOGY | 2,016 | {
"clinical_case_options": {
"MedCorp": {
"RRF-2": [
{
"id": "pubmed23n1048_10214",
"title": "Progressive amnestic cognitive impairment in a middle-aged patient with developmental language disorder: a case report.",
"score": 0.014085205574567276,
"content": "D... |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.