answer_idx int64 0 4 | source stringclasses 4
values | metadata stringlengths 236 9.02k | prompt stringlengths 36 2.27k | answer_letter stringclasses 5
values | answer_string stringlengths 1 208 | reasoning stringlengths 826 29.7k | distilled_answer_string stringlengths 60 2.79k | text stringlengths 1.26k 32k | decomposer_raw_output stringlengths 186 1.33k | subproblems listlengths 0 13 | analyzer_raw_output stringlengths 25 4.15k | subproblem_analysis listlengths 0 11 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
2 | GBaker/MedQA-USMLE-4-options | {'question': "A mother brings her 3-week-old infant to the pediatrician's office because she is concerned about his feeding habits. He was born without complications and has not had any medical problems up until this time. However, for the past 4 days, he has been fussy, is regurgitating all of his feeds, and his vomit... | A mother brings her 3-week-old infant to the pediatrician's office because she is concerned about his feeding habits. He was born without complications and has not had any medical problems up until this time. However, for the past 4 days, he has been fussy, is regurgitating all of his feeds, and his vomit is yellow in ... | C | Abnormal migration of ventral pancreatic bud | Okay, let me try to work through this question. Let's start by reading it carefully.
So, the scenario is a 3-week-old infant with fussiness, regurgitating all feeds, and yellow vomit for the past 4 days. The baby was born without complications and no prior medical issues. On physical exam, the abdomen is minimally dis... | The infant’s presentation of bilious vomiting (yellow vomit) and mild abdominal distension suggests an intestinal obstruction **distal to the ampulla of Vater**, as bile enters the duodenum at this point. The key embryologic errors to consider are:
1. **Option C: Abnormal migration of ventral pancreatic bud**
Thi... | <|im_start|>system
You are Qwen, created by Alibaba Cloud. You are a helpful assistant.<|im_end|>
<|im_start|>user
A mother brings her 3-week-old infant to the pediatrician's office because she is concerned about his feeding habits. He was born without complications and has not had any medical problems up until this ti... | ```json
{
"sub_problems": [
{
"question": "The condition described (fussy, regurgitation, yellow vomit) suggests an issue with digestion or absorption. What organ system might be affected?",
"critical": true
},
{
"question": "Given the symptoms, which specific part of the digestive tract... | [
{
"critical": true,
"index": 1,
"subproblem": "The condition described (fussy, regurgitation, yellow vomit) suggests an issue with digestion or absorption. What organ system might be affected?"
},
{
"critical": true,
"index": 2,
"subproblem": "Given the symptoms, which specific part of t... | ```json
{
"analysis": [
{
"subproblem_index": 1,
"status": "incorrect",
"explanation": "Incorrectly identifies the organ system affected."
},
{
"subproblem_index": 2,
"status": "not_mentioned",
"explanation": "Does not mention or address the anatomical location of the i... | [
{
"explanation": "Incorrectly identifies the organ system affected.",
"status": "incorrect",
"subproblem_index": 1
},
{
"explanation": "Does not mention or address the anatomical location of the issues.",
"status": "not_mentioned",
"subproblem_index": 2
}
] |
2 | GBaker/MedQA-USMLE-4-options | {'question': "A 46-year-old woman comes to the physician because of a 2-week history of diplopia and ocular pain when reading the newspaper. She also has a 3-month history of amenorrhea, hot flashes, and increased sweating. She reports that she has been overweight all her adult life and is happy to have lost 6.8-kg (15... | A 46-year-old woman comes to the physician because of a 2-week history of diplopia and ocular pain when reading the newspaper. She also has a 3-month history of amenorrhea, hot flashes, and increased sweating. She reports that she has been overweight all her adult life and is happy to have lost 6.8-kg (15-lb) of weight... | C | Glycosaminoglycan accumulation in the orbit | Okay, let's see. I need to figure out the most likely cause of this patient's ocular complaints. Let's start by summarizing the information given. The main symptoms are diplopia (double vision) and ocular pain when reading, which have been present for two weeks. She also has a three-month history of amenorrhea, hot fla... | The patient's clinical presentation is consistent with Graves' disease, an autoimmune disorder causing hyperthyroidism and associated ophthalmopathy. Key findings include systemic symptoms of hyperthyroidism (weight loss, tachycardia, hypertension, tremor, hyperreflexia) and ocular manifestations (proptosis, lid retrac... | <|im_start|>system
You are Qwen, created by Alibaba Cloud. You are a helpful assistant.<|im_end|>
<|im_start|>user
A 46-year-old woman comes to the physician because of a 2-week history of diplopia and ocular pain when reading the newspaper. She also has a 3-month history of amenorrhea, hot flashes, and increased sweat... | ```json
{
"sub_problems": [
{
"question": "The patient presents with diplopia and ocular pain due to reading. What could be the underlying cause?",
"critical": true
},
{
"question": "Given the patient's symptoms and physical findings, which condition can be ruled out immediately?",
... | [
{
"critical": true,
"index": 1,
"subproblem": "The patient presents with diplopia and ocular pain due to reading. What could be the underlying cause?"
},
{
"critical": false,
"index": 2,
"subproblem": "Given the patient's symptoms and physical findings, which condition can be ruled out i... | ```json
{
"analysis": [
{"subproblem_index": 1, "status": "correct", "explanation": "Identifies the underlying cause as Graves' disease."},
{"subproblem_index": 2, "status": "not_mentioned", "explanation": "Does not mention any conditions to be ruled out explicitly."}
]
}
``` | [
{
"explanation": "Identifies the underlying cause as Graves' disease.",
"status": "correct",
"subproblem_index": 1
},
{
"explanation": "Does not mention any conditions to be ruled out explicitly.",
"status": "not_mentioned",
"subproblem_index": 2
}
] |
1 | GBaker/MedQA-USMLE-4-options | {'question': 'A 68-year-old man comes to the physician because of recurrent episodes of nausea and abdominal discomfort for the past 4 months. The discomfort is located in the upper abdomen and sometimes occurs after eating, especially after a big meal. He has tried to go for a walk after dinner to help with digestion,... | A 68-year-old man comes to the physician because of recurrent episodes of nausea and abdominal discomfort for the past 4 months. The discomfort is located in the upper abdomen and sometimes occurs after eating, especially after a big meal. He has tried to go for a walk after dinner to help with digestion, but his compl... | B | Cardiac stress test | Okay, let's start thinking through this case. So, the patient is a 68-year-old man with recurrent nausea and upper abdominal discomfort, especially after big meals. Walking after eating makes it worse. He also has trouble climbing stairs for the past three weeks. His history includes type 2 diabetes, hypertension, peri... | The patient's presentation of upper abdominal discomfort associated with both postprandial and exertional triggers, alongside significant cardiac risk factors (diabetes, hypertension, smoking, obesity, peripheral arterial disease), raises concern for coronary artery disease (CAD) manifesting as atypical angina. Diabeti... | <|im_start|>system
You are Qwen, created by Alibaba Cloud. You are a helpful assistant.<|im_end|>
<|im_start|>user
A 68-year-old man comes to the physician because of recurrent episodes of nausea and abdominal discomfort for the past 4 months. The discomfort is located in the upper abdomen and sometimes occurs after ea... | ```json
{
"sub_problems": [
{
"question": "The patient's age suggests what potential underlying condition?",
"critical": true
},
{
"question": "What is the duration of the patient's symptoms, and how does this relate to common causes?",
"critical": true
},
{
"question... | [
{
"critical": true,
"index": 1,
"subproblem": "The patient's age suggests what potential underlying condition?"
},
{
"critical": true,
"index": 2,
"subproblem": "What is the duration of the patient's symptoms, and how does this relate to common causes?"
},
{
"critical": false,
... | ```json
{
"analysis": [
{
"subproblem_index": 1,
"status": "correct",
"explanation": "Addresses the patient's age as suggesting a higher risk for cardiovascular conditions."
},
{
"subproblem_index": 2,
"status": "not_mentioned",
"explanation": "Does not discuss the dura... | [
{
"explanation": "Addresses the patient's age as suggesting a higher risk for cardiovascular conditions.",
"status": "correct",
"subproblem_index": 1
},
{
"explanation": "Does not discuss the duration of symptoms or their relation to common causes.",
"status": "not_mentioned",
"subproble... |
0 | GBaker/MedQA-USMLE-4-options | {'question': 'A previously healthy 36-year-old man comes to the physician for a yellow discoloration of his skin and dark-colored urine for 2 weeks. He does not drink any alcohol. Physical examination shows jaundice. Abdominal and neurologic examinations show no abnormalities. Serum studies show increased levels of ala... | A previously healthy 36-year-old man comes to the physician for a yellow discoloration of his skin and dark-colored urine for 2 weeks. He does not drink any alcohol. Physical examination shows jaundice. Abdominal and neurologic examinations show no abnormalities. Serum studies show increased levels of alanine aminotran... | A | Bullous changes of the lung bases on chest CT | Okay, let's take a look at this case. So we have a 36-year-old man who is previously healthy but presents with jaundice, dark urine for two weeks. No alcohol use, which probably rules out alcoholic liver disease. The physical exam shows jaundice, but the abdominal and neuro exams are normal. His serum ALT and AST are e... | The patient presents with jaundice, elevated transaminases (ALT/AST), and a liver biopsy showing PAS-stained findings. The absence of alcohol use and neurologic symptoms, combined with the histologic clues, points to **alpha-1 antitrypsin deficiency**. This condition is characterized by abnormal protein accumulation in... | <|im_start|>system
You are Qwen, created by Alibaba Cloud. You are a helpful assistant.<|im_end|>
<|im_start|>user
A previously healthy 36-year-old man comes to the physician for a yellow discoloration of his skin and dark-colored urine for 2 weeks. He does not drink any alcohol. Physical examination shows jaundice. Ab... | ```json
{
"sub_problems": [
{
"question": "What is the first concept that needs to be understood?",
"critical": true
},
{
"question": "What calculation or analysis should be performed?",
"critical": true
},
{
"question": "What is the key relationship to identify?",
... | [
{
"critical": true,
"index": 1,
"subproblem": "What is the first concept that needs to be understood?"
},
{
"critical": true,
"index": 2,
"subproblem": "What calculation or analysis should be performed?"
},
{
"critical": false,
"index": 3,
"subproblem": "What is the key r... | ```json
{
"analysis": [
{
"subproblem_index": 1,
"status": "incorrect",
"explanation": "The reasoning text incorrectly states that 'no alcohol use' rules out alcoholic liver disease."
},
{
"subproblem_index": 2,
"status": "correct",
"explanation": "The reasoning text pr... | [
{
"explanation": "The reasoning text incorrectly states that 'no alcohol use' rules out alcoholic liver disease.",
"status": "incorrect",
"subproblem_index": 1
},
{
"explanation": "The reasoning text provides a clear step-by-step process to calculate the amount of oxygen consumed during exercise... |
0 | GBaker/MedQA-USMLE-4-options | {'question': 'A 42-year-old woman is in the hospital recovering from a cholecystectomy performed 3 days ago that was complicated by cholangitis. She is being treated with IV piperacillin-tazobactam. She calls the nurse to her room because she says that her heart is racing. She also demands that someone come in to clean... | A 42-year-old woman is in the hospital recovering from a cholecystectomy performed 3 days ago that was complicated by cholangitis. She is being treated with IV piperacillin-tazobactam. She calls the nurse to her room because she says that her heart is racing. She also demands that someone come in to clean the pile of g... | A | Delirium tremens | Okay, let's tackle this question step by step. The patient is a 42-year-old woman who's post-op day 3 from a cholecystectomy complicated by cholangitis. She's on IV piperacillin-tazobactam. She presents with racing heart, delirium (disoriented to place and time), sweating, restlessness, and she's seeing garbage and fli... | The patient presents with tachycardia, hypertension, low-grade fever, visual hallucinations (perceiving garbage and flies), disorientation, restlessness, and sweating following a cholecystectomy complicated by cholangitis. Key considerations include:
1. **Delirium Tremens (DT)**: Classic features of autonomic hyperact... | <|im_start|>system
You are Qwen, created by Alibaba Cloud. You are a helpful assistant.<|im_end|>
<|im_start|>user
A 42-year-old woman is in the hospital recovering from a cholecystectomy performed 3 days ago that was complicated by cholangitis. She is being treated with IV piperacillin-tazobactam. She calls the nurse ... | ```json
{
"sub_problems": [
{
"question": "What is the first concept that needs to be understood?",
"critical": true,
"answer": "The patient's symptoms suggest an acute illness requiring immediate attention."
},
{
"question": "What calculation or analysis should be performed?",
... | [
{
"critical": true,
"index": 1,
"subproblem": "What is the first concept that needs to be understood?"
},
{
"critical": true,
"index": 2,
"subproblem": "What calculation or analysis should be performed?"
},
{
"critical": false,
"index": 3,
"subproblem": "What is the key r... | ```json
{
"analysis": [
{
"subproblem_index": 1,
"status": "correct",
"explanation": "Identifies the primary condition that needs to be considered based on the patient's symptoms."
},
{
"subproblem_index": 2,
"status": "not_mentioned",
"explanation": "Does not provide a... | [
{
"explanation": "Identifies the primary condition that needs to be considered based on the patient's symptoms.",
"status": "correct",
"subproblem_index": 1
},
{
"explanation": "Does not provide a calculation or analysis related to the provided information.",
"status": "not_mentioned",
"... |
0 | GBaker/MedQA-USMLE-4-options | {'question': 'A 43-year-old woman presents to the emergency department complaining of palpitations, dry cough, and shortness of breath for 1 week. She immigrated to the United States from Korea at the age of 20. She says that her heart is racing and she has never felt these symptoms before. Her cough is dry and is asso... | A 43-year-old woman presents to the emergency department complaining of palpitations, dry cough, and shortness of breath for 1 week. She immigrated to the United States from Korea at the age of 20. She says that her heart is racing and she has never felt these symptoms before. Her cough is dry and is associated with sh... | A | A bacterium that induces complete lysis of the red cells of a blood agar plate with an oxygen-sensitive cytotoxin | Okay, let's try to work through this problem step by step. So we have a 43-year-old woman who presented with palpitations, dry cough, and shortness of breath for a week. She's from Korea, immigrated when she was 20. Her symptoms include racing heart, dry cough, SOB on exertion. Exam findings are bibasilar crackles, a m... | The patient's presentation of mitral stenosis (mid-diastolic rumble at the apex), heart failure symptoms (jugular vein distention, bibasilar crackles, bilateral pitting edema), and history of immigration from an area with higher prevalence of rheumatic fever strongly suggest rheumatic heart disease. This condition is a... | <|im_start|>system
You are Qwen, created by Alibaba Cloud. You are a helpful assistant.<|im_end|>
<|im_start|>user
A 43-year-old woman presents to the emergency department complaining of palpitations, dry cough, and shortness of breath for 1 week. She immigrated to the United States from Korea at the age of 20. She say... | ```json
{
"sub_problems": [
{
"question": "What type of bacteria is involved?",
"critical": true
},
{
"question": "How does the bacterial growth require an anaerobic environment?",
"critical": true
},
{
"question": "What symptom indicates the presence of heme degradat... | [
{
"critical": true,
"index": 1,
"subproblem": "What type of bacteria is involved?"
},
{
"critical": true,
"index": 2,
"subproblem": "How does the bacterial growth require an anaerobic environment?"
},
{
"critical": false,
"index": 3,
"subproblem": "What symptom indicates ... | ```json
{
"analysis": [
{"subproblem_index": 1, "status": "correct", "explanation": "The reasoning text clearly states that the bacteria involved is Group A Streptococcus."},
{"subproblem_index": 2, "status": "not_mentioned", "explanation": "The reasoning text does not explicitly discuss how bacterial growth ... | [
{
"explanation": "The reasoning text clearly states that the bacteria involved is Group A Streptococcus.",
"status": "correct",
"subproblem_index": 1
},
{
"explanation": "The reasoning text does not explicitly discuss how bacterial growth requires an anaerobic environment.",
"status": "not_m... |
3 | GBaker/MedQA-USMLE-4-options | {'question': "A 21-year-old man presents to the emergency department after sustaining a stab wound to the neck at a local farmer's market. The patient is otherwise healthy and is complaining of pain. The patient is able to offer the history himself. His temperature is 97.6°F (36.4°C), blood pressure is 120/84 mmHg, pul... | A 21-year-old man presents to the emergency department after sustaining a stab wound to the neck at a local farmer's market. The patient is otherwise healthy and is complaining of pain. The patient is able to offer the history himself. His temperature is 97.6°F (36.4°C), blood pressure is 120/84 mmHg, pulse is 90/min, ... | D | CT angiogram | Okay, let's tackle this question. So, it's a 21-year-old man with a stab wound to the neck. The location is 1 cm inferior to the mastoid process on the right side. So, I need to recall the anatomy of that area. The mastoid process is part of the temporal bone, right? And structures near there... Well, the carotid arter... | The most appropriate next step in the management of this stable patient with a stab wound to the neck is **CT angiogram**. While Zone II injuries (between the cricoid cartilage and angle of the mandible) were historically managed with surgical exploration, current guidelines favor imaging in hemodynamically stable pati... | <|im_start|>system
You are Qwen, created by Alibaba Cloud. You are a helpful assistant.<|im_end|>
<|im_start|>user
A 21-year-old man presents to the emergency department after sustaining a stab wound to the neck at a local farmer's market. The patient is otherwise healthy and is complaining of pain. The patient is able... | ```json
{
"sub_problems": [
{
"question": "What is the primary condition leading to the patient's injury?",
"critical": true
},
{
"question": "How can we determine if the laceration requires surgical intervention?",
"critical": true
},
{
"question": "Is there an immed... | [
{
"critical": true,
"index": 1,
"subproblem": "What is the primary condition leading to the patient's injury?"
},
{
"critical": true,
"index": 2,
"subproblem": "How can we determine if the laceration requires surgical intervention?"
},
{
"critical": false,
"index": 3,
"su... | ```json
{
"analysis": [
{
"subproblem_index": 1,
"status": "correct",
"explanation": "Identifies the primary condition as a stab wound to the neck."
},
{
"subproblem_index": 2,
"status": "not_mentioned",
"explanation": "Doesn't mention how to determine if a laceration r... | [
{
"explanation": "Identifies the primary condition as a stab wound to the neck.",
"status": "correct",
"subproblem_index": 1
},
{
"explanation": "Doesn't mention how to determine if a laceration requires surgical intervention.",
"status": "not_mentioned",
"subproblem_index": 2
},
{
... |
2 | GBaker/MedQA-USMLE-4-options | {'question': "A 48-year-old man with HIV comes to the physician because of skin lesions over his face and neck for 2 weeks. They are not itchy or painful. He does not have fever or a sore throat. He was treated for candidal esophagitis 3 months ago. He is sexually active with his wife, who knows of his condition, and u... | A 48-year-old man with HIV comes to the physician because of skin lesions over his face and neck for 2 weeks. They are not itchy or painful. He does not have fever or a sore throat. He was treated for candidal esophagitis 3 months ago. He is sexually active with his wife, who knows of his condition, and uses condoms co... | C | Poxvirus | Okay, let's try to work through this case step by step. So, the patient is a 48-year-old man with HIV who presents with skin lesions on his face and neck for two weeks. The lesions aren't itchy or painful. He doesn't have a fever or sore throat. He had candidal esophagitis three months ago. He's on antiretroviral thera... | The patient's presentation of multiple skin-colored papules with central umbilication (dimpled centers) and cervical lymphadenopathy in the context of HIV and a CD4+ T-lymphocyte count of 312/mm³ strongly suggests **Molluscum contagiosum**, caused by a poxvirus. Key factors supporting this diagnosis include:
1. **Clin... | <|im_start|>system
You are Qwen, created by Alibaba Cloud. You are a helpful assistant.<|im_end|>
<|im_start|>user
A 48-year-old man with HIV comes to the physician because of skin lesions over his face and neck for 2 weeks. They are not itchy or painful. He does not have fever or a sore throat. He was treated for cand... | ```json
{
"sub_problems": [
{
"question": "What is the first concept that needs to be understood?",
"critical": true
},
{
"question": "What calculation or analysis should be performed?",
"critical": true
},
{
"question": "What is the key relationship to identify?",
... | [
{
"critical": true,
"index": 1,
"subproblem": "What is the first concept that needs to be understood?"
},
{
"critical": true,
"index": 2,
"subproblem": "What calculation or analysis should be performed?"
},
{
"critical": false,
"index": 3,
"subproblem": "What is the key r... | ```json
{
"analysis": [
{"subproblem_index": 1, "status": "correct", "explanation": "Identifies the first concept as 'HIV' based on the patient's history."},
{"subproblem_index": 2, "status": "not_mentioned", "explanation": "Does not provide details on what specific calculations or analyses were performed."}
... | [
{
"explanation": "Identifies the first concept as 'HIV' based on the patient's history.",
"status": "correct",
"subproblem_index": 1
},
{
"explanation": "Does not provide details on what specific calculations or analyses were performed.",
"status": "not_mentioned",
"subproblem_index": 2
... |
1 | GBaker/MedQA-USMLE-4-options | "{'question': 'A new screening test utilizing a telemedicine approach to diagnosing diabetic retinop(...TRUNCATED) | "A new screening test utilizing a telemedicine approach to diagnosing diabetic retinopathy has been (...TRUNCATED) | B | Sensitivity = 95%, Specificity = 83%, PPV = 80%, NPV = 96% | "Okay, let me try to figure out this statistics problem. It's about calculating sensitivity, specifi(...TRUNCATED) | "To determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive(...TRUNCATED) | "<|im_start|>system\nYou are Qwen, created by Alibaba Cloud. You are a helpful assistant.<|im_end|>\(...TRUNCATED) | "```json\n{\n \"sub_problems\": [\n {\n \"question\": \"What is the first concept that need(...TRUNCATED) | [{"critical":true,"index":1,"subproblem":"What is the first concept that needs to be understood?"},{(...TRUNCATED) | "```json\n{\n \"analysis\": [\n {\"subproblem_index\": 1, \"status\": \"correct\", \"explanation(...TRUNCATED) | [{"explanation":"Identifies the first concept needed to understand.","status":"correct","subproblem_(...TRUNCATED) |
2 | GBaker/MedQA-USMLE-4-options | "{'question': 'A healthy 22-year-old male participates in a research study you are leading to compar(...TRUNCATED) | "A healthy 22-year-old male participates in a research study you are leading to compare the properti(...TRUNCATED) | C | Increase of tension in all phases | "Okay, let's tackle this multiple-choice question step by step. The question involves understanding (...TRUNCATED) | "To analyze the tension and electrical activity in each phase:\n\n**Phase 1 (Biceps lifting 2.3 kg w(...TRUNCATED) | "<|im_start|>system\nYou are Qwen, created by Alibaba Cloud. You are a helpful assistant.<|im_end|>\(...TRUNCATED) | "```json\n{\n \"sub_problems\": [\n {\n \"question\": \"What is the first concept that need(...TRUNCATED) | [{"critical":true,"index":1,"subproblem":"What is the first concept that needs to be understood?"},{(...TRUNCATED) | "```json\n{\n \"analysis\": [\n {\"subproblem_index\": 1, \"status\": \"correct\", \"explanation(...TRUNCATED) | [{"explanation":"The text clearly identifies the first concept as 'basic physiology concepts' relate(...TRUNCATED) |
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