bigbio/mediqa_rqe · Datasets at Hugging Face

id stringlengths 1 4	document_id stringlengths 1 4	text_1 stringlengths 15 613	text_2 stringlengths 0 214	label stringclasses 2 values
501	501	65-year-old man with chronic obstructive pulmonary disease, status post coronary artery bypass graft, chronic cough, congestive heart failure, rales at bases. Gave him Lasix, but that has not worked for the cough. Now what to do?	Chronic obstructive pulmonary disease, coronary artery bypass graft, chronic cough, congestive heart failure, rales at bases. Lasix no help. Now what?	true
502	502	65-year-old man with chronic obstructive pulmonary disease, status post coronary artery bypass graft, chronic cough, congestive heart failure, rales at bases. Gave him Lasix, but that has not worked for the cough. Now what to do?	Is this rash shingles or staphylococcal impetigo?	false
503	503	Patient with periodic hyperkalemic paralysis. Episodes every 2-3 weeks require her to come by ambulance, get admitted for albuterol, D50 (50 percent dextrose), insulin. Why can't we give her albuterol and insulin every day as prevention, not just treatment?	Why can't we give her albuterol and insulin every day as prevention, not treatment?	true
504	504	Patient with periodic hyperkalemic paralysis. Episodes every 2-3 weeks require her to come by ambulance, get admitted for albuterol, D50 (50 percent dextrose), insulin. Why can't we give her albuterol and insulin every day as prevention, not just treatment?	Can I use low molecular weight heparin in pregnancy (patient with deep vein thrombosis last pregnancy)?	false
505	505	I saw a 30-year-old man and admitted him with meningismus. I was sure he did not have meningitis but wanted to cover him with Claforan intravenously and ampicillin. Turned out to be a urinary tract infection. Don't know why he had meningismus. I had to look up dose of Claforan.	Why did he have meningismus? 30-year-old man admitted with urinary tract infection.	true
506	506	I saw a 30-year-old man and admitted him with meningismus. I was sure he did not have meningitis but wanted to cover him with Claforan intravenously and ampicillin. Turned out to be a urinary tract infection. Don't know why he had meningismus. I had to look up dose of Claforan.	Should we do a head CT (computerized tomography) with contrast tomorrow (Saturday) or MRI (magnetic resonance imaging) Monday?	false
507	507	This 25-year-old woman wants to start a family. Her brother has spina bifida. I can't remember the recommendation for folic acid when you have a family history of spina bifida (1 milligram versus 4 milligrams every day).	25-year-old female wants to start family, brother has spina bifida. Folic acid 1 or 4 milligrams?	true
508	508	This 25-year-old woman wants to start a family. Her brother has spina bifida. I can't remember the recommendation for folic acid when you have a family history of spina bifida (1 milligram versus 4 milligrams every day).	Can I use low molecular weight heparin in pregnancy (patient with deep vein thrombosis last pregnancy)?	false
509	509	How much folic acid is in Zenate?	How much folic acid is in Zenate?	true
510	510	How much folic acid is in Zenate?	Why did she get Coccidiomycosis?	false
511	511	Woman in early 30's with chest pain. I know in my gut she doesn't have heart disease, but I had a woman in her 20's who died of a myocardial infarction. How far do you go with the workup? Doctors practice medicine according to their last disaster.	Woman in early 30's with chest pain. Know in my gut she doesn't have heart disease. How far to workup?	true
512	512	Woman in early 30's with chest pain. I know in my gut she doesn't have heart disease, but I had a woman in her 20's who died of a myocardial infarction. How far do you go with the workup? Doctors practice medicine according to their last disaster.	Why wasn't this patient very sick? (large empyema and Haemophilus influenza in sputum)	false
513	513	How do you deal with a patient who is going South next week for the winter and she needs a follow up thyroid function test in 6 weeks?	Patient going south for the winter, needs a thyroid test in 6 weeks? What to do?	true
514	514	How do you deal with a patient who is going South next week for the winter and she needs a follow up thyroid function test in 6 weeks?	How should I treat polymenorrhea in a 14-year-old girl?	false
515	515	How much vomiting is normal in an infant (for example, reflux) and how much should make you think of pyloric stenosis?	How much vomiting is normal in an infant (reflux), how much to think of pyloric stenosis?	true
516	516	How much vomiting is normal in an infant (for example, reflux) and how much should make you think of pyloric stenosis?	How do you use Redux? What are the indications?	false
517	517	How do you approach serous otitis in terms of treatment?	How do you approach serous otitis in terms of treatment?	true
518	518	How do you approach serous otitis in terms of treatment?	How should I treat polymenorrhea in a 14-year-old girl?	false
519	519	The child received an injection of Phenergan for nausea and vomiting -- 25 milligrams. Question asked of Dr. X's nurse was what size and concentration do the vials come in? She just double checked this so she would know the amount (in cubic centimeter's) of the injection.	What size and concentration do Phenergan vials come in?	true
520	520	This child was admitted to the hospital for intravenous hydration. How much fluid replacement and at what rate should Dr. X order? (patient weighs 42 pounds, down from 45 pounds normally)	How much intravenous fluid replacement dehydrated patient (child weight 42 pounds, down from 45 pounds)?	true
521	521	This child was admitted to the hospital for intravenous hydration. How much fluid replacement and at what rate should Dr. X order? (patient weighs 42 pounds, down from 45 pounds normally)	Can I use low molecular weight heparin in pregnancy (patient with deep vein thrombosis last pregnancy)?	false
522	522	18-year-old male with hematuria. The question was how to interpret the antistreptolysin O (ASO) titer results. He was worried about acute glomerulonephritis in this patient. The antistreptolysin O titer on this patient was elevated.	18-year-old male, hematuria. How do I interpret this elevated antistreptolysin O (ASO) titer?	true
523	523	18-year-old male with hematuria. The question was how to interpret the antistreptolysin O (ASO) titer results. He was worried about acute glomerulonephritis in this patient. The antistreptolysin O titer on this patient was elevated.	How should I treat polymenorrhea in a 14-year-old girl?	false
524	524	What is the cause of this child's fever? Has been worked up recently at tertiary center and all was negative (virus). Mom came with record of fevers.	What is the cause of this child's fever? Recent negative workup at tertiary center.	true
525	525	What is the cause of this child's fever? Has been worked up recently at tertiary center and all was negative (virus). Mom came with record of fevers.	Should we do a head CT (computerized tomography) with contrast tomorrow (Saturday) or MRI (magnetic resonance imaging) Monday?	false
526	526	Are there any contraindications to changing a patient's Ativan to Xanax? Patient is also on Paxil.	Any contraindications to changing patient's Ativan to Xanax? Also on Paxil.	true
527	527	Are there any contraindications to changing a patient's Ativan to Xanax? Patient is also on Paxil.	Let's give these immunizations. That's right isn't it?	false
528	528	8-year-old male patient. Question was the dose of erythromycin for a pediatric patient.	What is the dose of erythromycin for this 8-year-old male?	true
529	529	8-year-old male patient. Question was the dose of erythromycin for a pediatric patient.	Why did she get Coccidiomycosis?	false
530	530	This was Dr. X's partner's patient yesterday so he doesn't know name, age, et cetera, but he helped look up information. They looked up the American Diabetes Association's definition of Type 2 diabetes. Patient with elevated blood sugar. Does he have diabetes?	Doctor X's partner's patient. What is the American Diabetes Association's definition of Type 2 diabetes?	true
531	531	This was Dr. X's partner's patient yesterday so he doesn't know name, age, et cetera, but he helped look up information. They looked up the American Diabetes Association's definition of Type 2 diabetes. Patient with elevated blood sugar. Does he have diabetes?	Can you use Prozac along with lithium?	false
532	532	This was Dr. X's partner's patient seen yesterday so he doesn't know name, age, et cetera, but he helped look up information. What is the reason for the inverted p waves on electrocardiogram?	Doctor X's partner's patient. What is the reason for the inverted p waves on electrocardiogram?	true
533	533	This was Dr. X's partner's patient seen yesterday so he doesn't know name, age, et cetera, but he helped look up information. What is the reason for the inverted p waves on electrocardiogram?	I wonder if this patient could have a rotator cuff thing?	false
534	534	What is the policy for post-exposure needlestick injuries?	What is the policy for post-exposure needlestick injuries?	true
535	535	What is the policy for post-exposure needlestick injuries?	How should I treat polymenorrhea in a 14-year-old girl?	false
536	536	This was discussed with patient today but relates to question from a few months ago. Patient had been on regular prednisone (not a burst) and he wondered how to wean her off the prednisone. She is now on inhaled steroids and doing well.	Patient on chronic daily prednisone for asthma. How to wean her off prednisone?	true
537	537	This was discussed with patient today but relates to question from a few months ago. Patient had been on regular prednisone (not a burst) and he wondered how to wean her off the prednisone. She is now on inhaled steroids and doing well.	Boys' father has Marfan's Syndrome. Do these boys need further evaluation?	false
538	538	38-year-old female seen this morning. How to workup case of suspected infectious mononucleosis in someone with a history of infectious mononucleosis?	38-year-old female. How to workup suspected infectious mononucleosis in a patient with a history of infectious mononucleosis?	true
539	539	38-year-old female seen this morning. How to workup case of suspected infectious mononucleosis in someone with a history of infectious mononucleosis?	I wonder if this patient could have a rotator cuff thing?	false
540	540	He brought up a concern about a 1-year-old female with cytomegalovirus who also has a younger brother. Not a current question but this came up with prior office visits because his nurse was pregnant at the time.	1-year-old girl with cytomegalovirus. Doctor's nurse was pregnant. How to handle this?	true
541	541	What is causing his fatigue? Long lasting viral entity? Not sure of diagnosis. Differential diagnosis includes viral illness, arthritis.	What is causing his fatigue? Long lasting viral entity? Not sure of diagnosis.	true
542	542	What is causing his fatigue? Long lasting viral entity? Not sure of diagnosis. Differential diagnosis includes viral illness, arthritis.	How do you inject the bicipital tendon?	false
543	543	What is Uristat (it's over the counter)? Is it the same thing as pyridium?	What is Uristat (it's over the counter)? Is it the same thing as pyridium?	true
544	544	Will the urine still be good for culture if it sits overnight in the refrigerator before going to the reference laboratory?	Will the urine still be good for culture if it sits overnight in the refrigerator?	true
545	545	Will the urine still be good for culture if it sits overnight in the refrigerator before going to the reference laboratory?	Should I wait until baby certain age before I do renal ultrasound for single umbilical artery?	false
546	546	Do I gain anything with Bactrim over amoxicillin in terms of coverage? He was on amoxicillin a month ago and now has a second episode of otitis media. Should I be using a second line agent (for example, Augmentin) or does Bactrim have increased coverage over amoxicillin?	Do I gain anything with Bactrim over amoxicillin in terms of coverage for otitis media?	true
547	547	Do I gain anything with Bactrim over amoxicillin in terms of coverage? He was on amoxicillin a month ago and now has a second episode of otitis media. Should I be using a second line agent (for example, Augmentin) or does Bactrim have increased coverage over amoxicillin?	What size pills does digoxin come in?	false
548	548	This morning I saw a 70-year-old man with left-sided shoulder pain and numbness. His biceps and triceps were weak and he had atrophy of his triceps. Got cortisone injection by orthopedist 2 weeks ago with no improvement, normal x-rays. High dose nonsteroidal anti-inflammatory drug no help. I didn't know what to make of it. Neuropathy? I called a neurologist and ended up referring him.	What is causing this 70-year-old man's left-sided shoulder pain and numbness?	true
549	549	This morning I saw a 70-year-old man with left-sided shoulder pain and numbness. His biceps and triceps were weak and he had atrophy of his triceps. Got cortisone injection by orthopedist 2 weeks ago with no improvement, normal x-rays. High dose nonsteroidal anti-inflammatory drug no help. I didn't know what to make of it. Neuropathy? I called a neurologist and ended up referring him.	In this patient with transient ischemic attacks and no murmur, should I do an echocardiogram anyway?	false
550	550	Let's find out more about T'ai Chi (said to nurse).	Let's find out more about T'ai Chi (said to nurse).	true
551	551	What is the over-the-counter cream she is using for her intertrigo? Sounds like "Tofenate."	What is the over-the-counter cream she is using for her intertrigo? Sounds like "Tofenate."	true
552	552	What is the over-the-counter cream she is using for her intertrigo? Sounds like "Tofenate."	How should I treat polymenorrhea in a 14-year-old girl?	false
553	553	What is the prep (preparation) for a gallbladder ultrasound?	What is the preparation for a gallbladder ultrasound?	true
554	554	What is the prep (preparation) for a gallbladder ultrasound?	How should I treat polymenorrhea in a 14-year-old girl?	false
555	555	Can Ultram cause edema or constipation?	Can Ultram cause edema or constipation?	true
556	556	Man seen 2 days ago for hypertension. Needs more medications for hypertension. Dr. X wants to add a diuretic. Asked his nurse to find out how much diuretic is in Hyzaar which he is already on.	Has hypertension, wants to add diuretic, on Hyzaar now. How much diuretic in Hyzaar?	true
557	557	Man seen 2 days ago for hypertension. Needs more medications for hypertension. Dr. X wants to add a diuretic. Asked his nurse to find out how much diuretic is in Hyzaar which he is already on.	Patient, all her aunts (5 or 6) had ovarian cancer. Is there a study to refer her to?	false
558	558	Could the cause of her weakness and dizziness be that she gets bradycardia at times from her medications? She's on Calan SR, a beta blocker and Lanoxin. Her pulse now is 88 but maybe it gets slow at times.	Could her weakness and dizziness be from bradycardia from her medications?	true
559	559	Did I write the prescription correctly for Synalar lotion? I think there is just one strength, I think it's medium potency, I think it comes in 15 cc (cubic centimeter) bottles.	Did I write the prescription correctly for Synalar lotion?	true
560	560	This is a 12 year-old girl with a repetitive nervous habit of twirling her hair. (Mother had the same habit as a child) How should I manage this problem?	12-year-old girl, nervous habit of twirling hair. How should I manage this problem?	true
561	561	This patient found out about a drug called "coumarin" for chronic lymphedema on the World Wide Web (New England Journal of Medicine, Oct 14, 1993) and wants to know if it is safe. Dr. X said she didn't know but would look into it.	Is "coumarin" safe for chronic lymphedema?	true
562	562	He has sleep apnea. They recommended using a continuous-positive-airway-pressure (CPAP) mask but before I noticed that, the question came to mind, how should I treat his sleep apnea? Continuous-positive-airway-pressure?	How should I treat his sleep apnea? Continuous-positive-airway-pressure (CPAP) mask?	true
563	563	He has sleep apnea. They recommended using a continuous-positive-airway-pressure (CPAP) mask but before I noticed that, the question came to mind, how should I treat his sleep apnea? Continuous-positive-airway-pressure?	Can I use low molecular weight heparin in pregnancy (patient with deep vein thrombosis last pregnancy)?	false
564	564	Patient was on penicillin for 4 days for an infected pierced ear lobe. Now seen today for sore throat and streptococcal culture positive. The question is, why is the streptococcal culture still positive, what percent of streptococci are resistant to penicillin?	Patient on penicillin for 4 days for infected ear lobe. Now has streptococcal sore throat. Why?	true
565	565	Patient was on penicillin for 4 days for an infected pierced ear lobe. Now seen today for sore throat and streptococcal culture positive. The question is, why is the streptococcal culture still positive, what percent of streptococci are resistant to penicillin?	What antibiotic should I use for this diabetic patient's infected foot ulcer?	false
566	566	How long do I let diarrhea go before doing a stool culture?	How long do I let diarrhea go before doing a stool culture?	true
567	567	How long do I let diarrhea go before doing a stool culture?	Why did she get Coccidiomycosis?	false
568	568	For long standing fluid behind the ear drum, should I order steroids? Patient says ears feel plugged up.	For long standing fluid behind the ear drum, should I order steroids?	true
569	569	For long standing fluid behind the ear drum, should I order steroids? Patient says ears feel plugged up.	How should I treat polymenorrhea in a 14-year-old girl?	false
570	570	Is diarrhea a frequent side effect of Cleocin (pediatric)? Patient is a 17-month-old male with pharyngitis for 5 days, a week ago.	Is diarrhea a frequent side effect of Cleocin (Pediatric)?	true
571	571	Is diarrhea a frequent side effect of Cleocin (pediatric)? Patient is a 17-month-old male with pharyngitis for 5 days, a week ago.	Can I use low molecular weight heparin in pregnancy (patient with deep vein thrombosis last pregnancy)?	false
572	572	17-month-old male with pharyngitis, home from hospital and noted on Thanksgiving Day that 8 to 10 hours after starting steroids, he had noted an increased appetite. Question is do steroids increase appetite that quickly?	Do steroids increase appetite that quickly (within 8 to 10 hours)?	true
573	573	17-month-old male with pharyngitis, home from hospital and noted on Thanksgiving Day that 8 to 10 hours after starting steroids, he had noted an increased appetite. Question is do steroids increase appetite that quickly?	How should I treat polymenorrhea in a 14-year-old girl?	false
574	574	Is Verelan 240 milligrams scored? Verelan is expensive and this would be a way to cut costs (split the larger pill in half).	Is Verelan 240 milligram scored? It's expensive and this would cut costs.	true
575	575	What are the normal limits for age of menopause so you can say this is within normal limits (age 36) and you don't have to worry about it?	What are normal limits for age of menopause so you can say this is normal (36-year-old)?	true
576	576	What are the normal limits for age of menopause so you can say this is within normal limits (age 36) and you don't have to worry about it?	Let's give these immunizations. That's right isn't it?	false
577	577	Patient with polycythemia vera seen this morning. Brought in because incoherent, lethargic, uncoordinated, headache. Could carbon monoxide poisoning do this? (Had history consistent with recent carbon monoxide poisoning.)	Could carbon monoxide poisoning cause this patient's lethargy, headache, et cetera?	true
578	578	Is the pain in her legs from intermittent claudication or is it from diabetic neuropathy?	Is the pain in her legs from intermittent claudication or diabetic neuropathy?	true
579	579	Is the pain in her legs from intermittent claudication or is it from diabetic neuropathy?	Let's give these immunizations. That's right isn't it?	false
580	580	Coronary angioplasty and stent placed last week. Started on Ticlid, looks like she's allergic to it. She's supposed to be on Ticlid one more week. Obviously we've got to stop it. Do they want her on something else or just stop it?	Patient started on Ticlid, now allergic to it. Change to something else or just stop?	true
581	581	Coronary angioplasty and stent placed last week. Started on Ticlid, looks like she's allergic to it. She's supposed to be on Ticlid one more week. Obviously we've got to stop it. Do they want her on something else or just stop it?	How should I treat polymenorrhea in a 14-year-old girl?	false
582	582	General question that comes up -- what to do when a patient insists on a prescription for an antibiotic when it is probably a virus and will resolve on its own?	What to do when a patient insists on an antibiotic when it is probably a virus?	true
583	583	General question that comes up -- what to do when a patient insists on a prescription for an antibiotic when it is probably a virus and will resolve on its own?	At what ages should you do a Denver Developmental Screening Test?	false
584	584	Called in order for Antabuse to pharmacist. Double checked with pharmacist on dosage and frequency.	Double checked with pharmacist on dose and frequency of Antabuse on called prescription.	true
585	585	Called in order for Antabuse to pharmacist. Double checked with pharmacist on dosage and frequency.	How should I treat polymenorrhea in a 14-year-old girl?	false
586	586	Woman in her 90's. Is there a mass in her cecum? At her age, if there is a mass, should she undergo a major surgery? She has had RLQ pain for about a year that she hasn't mentioned before. She refuses barium enema.	Woman in her 90's. Is there a mass in her cecum?	true
587	587	Woman in her 90's. Is there a mass in her cecum? At her age, if there is a mass, should she undergo a major surgery? She has had RLQ pain for about a year that she hasn't mentioned before. She refuses barium enema.	Let's give these immunizations. That's right isn't it?	false
588	588	Why are his platelets so low? 27 is the lowest they have been. No petechiae or signs of bleeding noted.	Idiopathic thrombocytopenic purpura, status post splenectomy. Why are platelets so low (27)? No petechiae or bleeding.	true
589	589	Why are his platelets so low? 27 is the lowest they have been. No petechiae or signs of bleeding noted.	Why did she get Coccidiomycosis?	false
590	590	What is this rash? (Physician's assistant asked him, and he didn't know either.)	What is this rash? (physician's assistant asked him, and he didn't know either.)	true
591	591	What is this rash? (Physician's assistant asked him, and he didn't know either.)	Is melatonin good for anything? What is the dose?	false
592	592	Phone call with patient. She was on Procardia and blood pressure still elevated so he added Vasotec and blood pressure went higher. Question is why did blood pressure go up with addition of Vasotec?	Why did the blood pressure go up with addition of Vasotec? (Was already on Procardia.)	true
593	593	Phone call from patient. Does Zoloft cause stomach upset?	Does Zoloft cause stomach upset?	true
594	594	Phone call from patient. Does Zoloft cause stomach upset?	How should I treat polymenorrhea in a 14-year-old girl?	false
595	595	Which drug that the Staphylococcus aureus (causing urinary tract infection) is sensitive to, would be safe in pregnancy?	Which drug (for Staphylococcus aureus urinary tract infection), would be safe in pregnancy?	true
596	596	Which drug that the Staphylococcus aureus (causing urinary tract infection) is sensitive to, would be safe in pregnancy?	What are long-term options for hemorrhagic gastritis beyond H2 blockers?	false
597	597	The cardiologist said in his letter that the patient has a distinct fourth heart sound. Why aren't I hearing the fourth heart sound? I couldn't hear it -- I guess I need to review heart sounds.	Cardiologist heard a distinct S4 (fourth heart sound). Why don't I hear an S4.	true
598	598	The cardiologist said in his letter that the patient has a distinct fourth heart sound. Why aren't I hearing the fourth heart sound? I couldn't hear it -- I guess I need to review heart sounds.	How should I treat polymenorrhea in a 14-year-old girl?	false
599	599	This morning I saw a premature infant born at 27-weeks gestation, 3 months ago. The discharge instructions said continue oral iron until the hemoglobin is "nice." What hemoglobin should we use to decide when to stop iron? How to consider this 3-month-old who is just now at his due date? Not directly answered but a reference said 12 grams normal for 3 month old so I used that. I almost called someone, but didn't have time so just decided 12 would be good enough.	Premature baby born at 27 weeks, 3 months ago. What is normal hemoglobin?	true
600	600	This morning I saw a premature infant born at 27-weeks gestation, 3 months ago. The discharge instructions said continue oral iron until the hemoglobin is "nice." What hemoglobin should we use to decide when to stop iron? How to consider this 3-month-old who is just now at his due date? Not directly answered but a reference said 12 grams normal for 3 month old so I used that. I almost called someone, but didn't have time so just decided 12 would be good enough.	What antibiotic should I use for this diabetic patient's infected foot ulcer?	false

501

65-year-old man with chronic obstructive pulmonary disease, status post coronary artery bypass graft, chronic cough, congestive heart failure, rales at bases. Gave him Lasix, but that has not worked for the cough. Now what to do?

Chronic obstructive pulmonary disease, coronary artery bypass graft, chronic cough, congestive heart failure, rales at bases. Lasix no help. Now what?

true

502

65-year-old man with chronic obstructive pulmonary disease, status post coronary artery bypass graft, chronic cough, congestive heart failure, rales at bases. Gave him Lasix, but that has not worked for the cough. Now what to do?

Is this rash shingles or staphylococcal impetigo?

false

503

Patient with periodic hyperkalemic paralysis. Episodes every 2-3 weeks require her to come by ambulance, get admitted for albuterol, D50 (50 percent dextrose), insulin. Why can't we give her albuterol and insulin every day as prevention, not just treatment?

Why can't we give her albuterol and insulin every day as prevention, not treatment?

true

504

Patient with periodic hyperkalemic paralysis. Episodes every 2-3 weeks require her to come by ambulance, get admitted for albuterol, D50 (50 percent dextrose), insulin. Why can't we give her albuterol and insulin every day as prevention, not just treatment?

Can I use low molecular weight heparin in pregnancy (patient with deep vein thrombosis last pregnancy)?

false

505

I saw a 30-year-old man and admitted him with meningismus. I was sure he did not have meningitis but wanted to cover him with Claforan intravenously and ampicillin. Turned out to be a urinary tract infection. Don't know why he had meningismus. I had to look up dose of Claforan.

Why did he have meningismus? 30-year-old man admitted with urinary tract infection.

true

506

I saw a 30-year-old man and admitted him with meningismus. I was sure he did not have meningitis but wanted to cover him with Claforan intravenously and ampicillin. Turned out to be a urinary tract infection. Don't know why he had meningismus. I had to look up dose of Claforan.

Should we do a head CT (computerized tomography) with contrast tomorrow (Saturday) or MRI (magnetic resonance imaging) Monday?

false

507

This 25-year-old woman wants to start a family. Her brother has spina bifida. I can't remember the recommendation for folic acid when you have a family history of spina bifida (1 milligram versus 4 milligrams every day).

25-year-old female wants to start family, brother has spina bifida. Folic acid 1 or 4 milligrams?

true

508

This 25-year-old woman wants to start a family. Her brother has spina bifida. I can't remember the recommendation for folic acid when you have a family history of spina bifida (1 milligram versus 4 milligrams every day).

Can I use low molecular weight heparin in pregnancy (patient with deep vein thrombosis last pregnancy)?

false

509

How much folic acid is in Zenate?

true

510

How much folic acid is in Zenate?

Why did she get Coccidiomycosis?

false

511

Woman in early 30's with chest pain. I know in my gut she doesn't have heart disease, but I had a woman in her 20's who died of a myocardial infarction. How far do you go with the workup? Doctors practice medicine according to their last disaster.

Woman in early 30's with chest pain. Know in my gut she doesn't have heart disease. How far to workup?

true

512

Woman in early 30's with chest pain. I know in my gut she doesn't have heart disease, but I had a woman in her 20's who died of a myocardial infarction. How far do you go with the workup? Doctors practice medicine according to their last disaster.

Why wasn't this patient very sick? (large empyema and Haemophilus influenza in sputum)

false

513

How do you deal with a patient who is going South next week for the winter and she needs a follow up thyroid function test in 6 weeks?

Patient going south for the winter, needs a thyroid test in 6 weeks? What to do?

true

514

How do you deal with a patient who is going South next week for the winter and she needs a follow up thyroid function test in 6 weeks?

How should I treat polymenorrhea in a 14-year-old girl?

false

515

How much vomiting is normal in an infant (for example, reflux) and how much should make you think of pyloric stenosis?

How much vomiting is normal in an infant (reflux), how much to think of pyloric stenosis?

true

516

How much vomiting is normal in an infant (for example, reflux) and how much should make you think of pyloric stenosis?

How do you use Redux? What are the indications?

false

517

How do you approach serous otitis in terms of treatment?

true

518

How do you approach serous otitis in terms of treatment?

How should I treat polymenorrhea in a 14-year-old girl?

false

519

The child received an injection of Phenergan for nausea and vomiting -- 25 milligrams. Question asked of Dr. X's nurse was what size and concentration do the vials come in? She just double checked this so she would know the amount (in cubic centimeter's) of the injection.

What size and concentration do Phenergan vials come in?

true

520

This child was admitted to the hospital for intravenous hydration. How much fluid replacement and at what rate should Dr. X order? (patient weighs 42 pounds, down from 45 pounds normally)

How much intravenous fluid replacement dehydrated patient (child weight 42 pounds, down from 45 pounds)?

true

521

This child was admitted to the hospital for intravenous hydration. How much fluid replacement and at what rate should Dr. X order? (patient weighs 42 pounds, down from 45 pounds normally)

Can I use low molecular weight heparin in pregnancy (patient with deep vein thrombosis last pregnancy)?

false

522

18-year-old male with hematuria. The question was how to interpret the antistreptolysin O (ASO) titer results. He was worried about acute glomerulonephritis in this patient. The antistreptolysin O titer on this patient was elevated.

18-year-old male, hematuria. How do I interpret this elevated antistreptolysin O (ASO) titer?

true

523

18-year-old male with hematuria. The question was how to interpret the antistreptolysin O (ASO) titer results. He was worried about acute glomerulonephritis in this patient. The antistreptolysin O titer on this patient was elevated.

How should I treat polymenorrhea in a 14-year-old girl?

false

524

What is the cause of this child's fever? Has been worked up recently at tertiary center and all was negative (virus). Mom came with record of fevers.

What is the cause of this child's fever? Recent negative workup at tertiary center.

true

525

What is the cause of this child's fever? Has been worked up recently at tertiary center and all was negative (virus). Mom came with record of fevers.

Should we do a head CT (computerized tomography) with contrast tomorrow (Saturday) or MRI (magnetic resonance imaging) Monday?

false

526

Are there any contraindications to changing a patient's Ativan to Xanax? Patient is also on Paxil.

Any contraindications to changing patient's Ativan to Xanax? Also on Paxil.

true

527

Are there any contraindications to changing a patient's Ativan to Xanax? Patient is also on Paxil.

Let's give these immunizations. That's right isn't it?

false

528

8-year-old male patient. Question was the dose of erythromycin for a pediatric patient.

What is the dose of erythromycin for this 8-year-old male?

true

529

8-year-old male patient. Question was the dose of erythromycin for a pediatric patient.

Why did she get Coccidiomycosis?

false

530

This was Dr. X's partner's patient yesterday so he doesn't know name, age, et cetera, but he helped look up information. They looked up the American Diabetes Association's definition of Type 2 diabetes. Patient with elevated blood sugar. Does he have diabetes?

Doctor X's partner's patient. What is the American Diabetes Association's definition of Type 2 diabetes?

true

531

This was Dr. X's partner's patient yesterday so he doesn't know name, age, et cetera, but he helped look up information. They looked up the American Diabetes Association's definition of Type 2 diabetes. Patient with elevated blood sugar. Does he have diabetes?

Can you use Prozac along with lithium?

false

532

This was Dr. X's partner's patient seen yesterday so he doesn't know name, age, et cetera, but he helped look up information. What is the reason for the inverted p waves on electrocardiogram?

Doctor X's partner's patient. What is the reason for the inverted p waves on electrocardiogram?

true

533

This was Dr. X's partner's patient seen yesterday so he doesn't know name, age, et cetera, but he helped look up information. What is the reason for the inverted p waves on electrocardiogram?

I wonder if this patient could have a rotator cuff thing?

false

534

What is the policy for post-exposure needlestick injuries?

true

535

What is the policy for post-exposure needlestick injuries?

How should I treat polymenorrhea in a 14-year-old girl?

false

536

This was discussed with patient today but relates to question from a few months ago. Patient had been on regular prednisone (not a burst) and he wondered how to wean her off the prednisone. She is now on inhaled steroids and doing well.

Patient on chronic daily prednisone for asthma. How to wean her off prednisone?

true

537

This was discussed with patient today but relates to question from a few months ago. Patient had been on regular prednisone (not a burst) and he wondered how to wean her off the prednisone. She is now on inhaled steroids and doing well.

Boys' father has Marfan's Syndrome. Do these boys need further evaluation?

false

538

38-year-old female seen this morning. How to workup case of suspected infectious mononucleosis in someone with a history of infectious mononucleosis?

38-year-old female. How to workup suspected infectious mononucleosis in a patient with a history of infectious mononucleosis?

true

539

38-year-old female seen this morning. How to workup case of suspected infectious mononucleosis in someone with a history of infectious mononucleosis?

I wonder if this patient could have a rotator cuff thing?

false

540

He brought up a concern about a 1-year-old female with cytomegalovirus who also has a younger brother. Not a current question but this came up with prior office visits because his nurse was pregnant at the time.

1-year-old girl with cytomegalovirus. Doctor's nurse was pregnant. How to handle this?

true

541

What is causing his fatigue? Long lasting viral entity? Not sure of diagnosis. Differential diagnosis includes viral illness, arthritis.

What is causing his fatigue? Long lasting viral entity? Not sure of diagnosis.

true

542

What is causing his fatigue? Long lasting viral entity? Not sure of diagnosis. Differential diagnosis includes viral illness, arthritis.

How do you inject the bicipital tendon?

false

543

What is Uristat (it's over the counter)? Is it the same thing as pyridium?

true

544

Will the urine still be good for culture if it sits overnight in the refrigerator before going to the reference laboratory?

Will the urine still be good for culture if it sits overnight in the refrigerator?

true

545

Will the urine still be good for culture if it sits overnight in the refrigerator before going to the reference laboratory?

Should I wait until baby certain age before I do renal ultrasound for single umbilical artery?

false

546

Do I gain anything with Bactrim over amoxicillin in terms of coverage? He was on amoxicillin a month ago and now has a second episode of otitis media. Should I be using a second line agent (for example, Augmentin) or does Bactrim have increased coverage over amoxicillin?

Do I gain anything with Bactrim over amoxicillin in terms of coverage for otitis media?

true

547

Do I gain anything with Bactrim over amoxicillin in terms of coverage? He was on amoxicillin a month ago and now has a second episode of otitis media. Should I be using a second line agent (for example, Augmentin) or does Bactrim have increased coverage over amoxicillin?

What size pills does digoxin come in?

false

548

This morning I saw a 70-year-old man with left-sided shoulder pain and numbness. His biceps and triceps were weak and he had atrophy of his triceps. Got cortisone injection by orthopedist 2 weeks ago with no improvement, normal x-rays. High dose nonsteroidal anti-inflammatory drug no help. I didn't know what to make of it. Neuropathy? I called a neurologist and ended up referring him.

What is causing this 70-year-old man's left-sided shoulder pain and numbness?

true

549

This morning I saw a 70-year-old man with left-sided shoulder pain and numbness. His biceps and triceps were weak and he had atrophy of his triceps. Got cortisone injection by orthopedist 2 weeks ago with no improvement, normal x-rays. High dose nonsteroidal anti-inflammatory drug no help. I didn't know what to make of it. Neuropathy? I called a neurologist and ended up referring him.

In this patient with transient ischemic attacks and no murmur, should I do an echocardiogram anyway?

false

550

Let's find out more about T'ai Chi (said to nurse).

true

551

What is the over-the-counter cream she is using for her intertrigo? Sounds like "Tofenate."

true

552

What is the over-the-counter cream she is using for her intertrigo? Sounds like "Tofenate."

How should I treat polymenorrhea in a 14-year-old girl?

false

553

What is the prep (preparation) for a gallbladder ultrasound?

What is the preparation for a gallbladder ultrasound?

true

554

What is the prep (preparation) for a gallbladder ultrasound?

How should I treat polymenorrhea in a 14-year-old girl?

false

555

Can Ultram cause edema or constipation?

true

556

Man seen 2 days ago for hypertension. Needs more medications for hypertension. Dr. X wants to add a diuretic. Asked his nurse to find out how much diuretic is in Hyzaar which he is already on.

Has hypertension, wants to add diuretic, on Hyzaar now. How much diuretic in Hyzaar?

true

557

Man seen 2 days ago for hypertension. Needs more medications for hypertension. Dr. X wants to add a diuretic. Asked his nurse to find out how much diuretic is in Hyzaar which he is already on.

Patient, all her aunts (5 or 6) had ovarian cancer. Is there a study to refer her to?

false

558

Could the cause of her weakness and dizziness be that she gets bradycardia at times from her medications? She's on Calan SR, a beta blocker and Lanoxin. Her pulse now is 88 but maybe it gets slow at times.

Could her weakness and dizziness be from bradycardia from her medications?

true

559

Did I write the prescription correctly for Synalar lotion? I think there is just one strength, I think it's medium potency, I think it comes in 15 cc (cubic centimeter) bottles.

Did I write the prescription correctly for Synalar lotion?

true

560

This is a 12 year-old girl with a repetitive nervous habit of twirling her hair. (Mother had the same habit as a child) How should I manage this problem?

12-year-old girl, nervous habit of twirling hair. How should I manage this problem?

true

561

This patient found out about a drug called "coumarin" for chronic lymphedema on the World Wide Web (New England Journal of Medicine, Oct 14, 1993) and wants to know if it is safe. Dr. X said she didn't know but would look into it.

Is "coumarin" safe for chronic lymphedema?

true

562

He has sleep apnea. They recommended using a continuous-positive-airway-pressure (CPAP) mask but before I noticed that, the question came to mind, how should I treat his sleep apnea? Continuous-positive-airway-pressure?

How should I treat his sleep apnea? Continuous-positive-airway-pressure (CPAP) mask?

true

563

He has sleep apnea. They recommended using a continuous-positive-airway-pressure (CPAP) mask but before I noticed that, the question came to mind, how should I treat his sleep apnea? Continuous-positive-airway-pressure?

Can I use low molecular weight heparin in pregnancy (patient with deep vein thrombosis last pregnancy)?

false

564

Patient was on penicillin for 4 days for an infected pierced ear lobe. Now seen today for sore throat and streptococcal culture positive. The question is, why is the streptococcal culture still positive, what percent of streptococci are resistant to penicillin?

Patient on penicillin for 4 days for infected ear lobe. Now has streptococcal sore throat. Why?

true

565

Patient was on penicillin for 4 days for an infected pierced ear lobe. Now seen today for sore throat and streptococcal culture positive. The question is, why is the streptococcal culture still positive, what percent of streptococci are resistant to penicillin?

What antibiotic should I use for this diabetic patient's infected foot ulcer?

false

566

How long do I let diarrhea go before doing a stool culture?

true

567

How long do I let diarrhea go before doing a stool culture?

Why did she get Coccidiomycosis?

false

568

For long standing fluid behind the ear drum, should I order steroids? Patient says ears feel plugged up.

For long standing fluid behind the ear drum, should I order steroids?

true

569

For long standing fluid behind the ear drum, should I order steroids? Patient says ears feel plugged up.

How should I treat polymenorrhea in a 14-year-old girl?

false

570

Is diarrhea a frequent side effect of Cleocin (pediatric)? Patient is a 17-month-old male with pharyngitis for 5 days, a week ago.

Is diarrhea a frequent side effect of Cleocin (Pediatric)?

true

571

Is diarrhea a frequent side effect of Cleocin (pediatric)? Patient is a 17-month-old male with pharyngitis for 5 days, a week ago.

Can I use low molecular weight heparin in pregnancy (patient with deep vein thrombosis last pregnancy)?

false

572

17-month-old male with pharyngitis, home from hospital and noted on Thanksgiving Day that 8 to 10 hours after starting steroids, he had noted an increased appetite. Question is do steroids increase appetite that quickly?

Do steroids increase appetite that quickly (within 8 to 10 hours)?

true

573

17-month-old male with pharyngitis, home from hospital and noted on Thanksgiving Day that 8 to 10 hours after starting steroids, he had noted an increased appetite. Question is do steroids increase appetite that quickly?

How should I treat polymenorrhea in a 14-year-old girl?

false

574

Is Verelan 240 milligrams scored? Verelan is expensive and this would be a way to cut costs (split the larger pill in half).

Is Verelan 240 milligram scored? It's expensive and this would cut costs.

true

575

What are the normal limits for age of menopause so you can say this is within normal limits (age 36) and you don't have to worry about it?

What are normal limits for age of menopause so you can say this is normal (36-year-old)?

true

576

What are the normal limits for age of menopause so you can say this is within normal limits (age 36) and you don't have to worry about it?

Let's give these immunizations. That's right isn't it?

false

577

Patient with polycythemia vera seen this morning. Brought in because incoherent, lethargic, uncoordinated, headache. Could carbon monoxide poisoning do this? (Had history consistent with recent carbon monoxide poisoning.)

Could carbon monoxide poisoning cause this patient's lethargy, headache, et cetera?

true

578

Is the pain in her legs from intermittent claudication or is it from diabetic neuropathy?

Is the pain in her legs from intermittent claudication or diabetic neuropathy?

true

579

Is the pain in her legs from intermittent claudication or is it from diabetic neuropathy?

Let's give these immunizations. That's right isn't it?

false

580

Coronary angioplasty and stent placed last week. Started on Ticlid, looks like she's allergic to it. She's supposed to be on Ticlid one more week. Obviously we've got to stop it. Do they want her on something else or just stop it?

Patient started on Ticlid, now allergic to it. Change to something else or just stop?

true

581

Coronary angioplasty and stent placed last week. Started on Ticlid, looks like she's allergic to it. She's supposed to be on Ticlid one more week. Obviously we've got to stop it. Do they want her on something else or just stop it?

How should I treat polymenorrhea in a 14-year-old girl?

false

582

General question that comes up -- what to do when a patient insists on a prescription for an antibiotic when it is probably a virus and will resolve on its own?

What to do when a patient insists on an antibiotic when it is probably a virus?

true

583

General question that comes up -- what to do when a patient insists on a prescription for an antibiotic when it is probably a virus and will resolve on its own?

At what ages should you do a Denver Developmental Screening Test?

false

584

Called in order for Antabuse to pharmacist. Double checked with pharmacist on dosage and frequency.

Double checked with pharmacist on dose and frequency of Antabuse on called prescription.

true

585

Called in order for Antabuse to pharmacist. Double checked with pharmacist on dosage and frequency.

How should I treat polymenorrhea in a 14-year-old girl?

false

586

Woman in her 90's. Is there a mass in her cecum? At her age, if there is a mass, should she undergo a major surgery? She has had RLQ pain for about a year that she hasn't mentioned before. She refuses barium enema.

Woman in her 90's. Is there a mass in her cecum?

true

587

Woman in her 90's. Is there a mass in her cecum? At her age, if there is a mass, should she undergo a major surgery? She has had RLQ pain for about a year that she hasn't mentioned before. She refuses barium enema.

Let's give these immunizations. That's right isn't it?

false

588

Why are his platelets so low? 27 is the lowest they have been. No petechiae or signs of bleeding noted.

Idiopathic thrombocytopenic purpura, status post splenectomy. Why are platelets so low (27)? No petechiae or bleeding.

true

589

Why are his platelets so low? 27 is the lowest they have been. No petechiae or signs of bleeding noted.

Why did she get Coccidiomycosis?

false

590

What is this rash? (Physician's assistant asked him, and he didn't know either.)

What is this rash? (physician's assistant asked him, and he didn't know either.)

true

591

What is this rash? (Physician's assistant asked him, and he didn't know either.)

Is melatonin good for anything? What is the dose?

false

592

Phone call with patient. She was on Procardia and blood pressure still elevated so he added Vasotec and blood pressure went higher. Question is why did blood pressure go up with addition of Vasotec?

Why did the blood pressure go up with addition of Vasotec? (Was already on Procardia.)

true

593

Phone call from patient. Does Zoloft cause stomach upset?

Does Zoloft cause stomach upset?

true

594

Phone call from patient. Does Zoloft cause stomach upset?

How should I treat polymenorrhea in a 14-year-old girl?

false

595

Which drug that the Staphylococcus aureus (causing urinary tract infection) is sensitive to, would be safe in pregnancy?

Which drug (for Staphylococcus aureus urinary tract infection), would be safe in pregnancy?

true

596

Which drug that the Staphylococcus aureus (causing urinary tract infection) is sensitive to, would be safe in pregnancy?

What are long-term options for hemorrhagic gastritis beyond H2 blockers?

false

597

The cardiologist said in his letter that the patient has a distinct fourth heart sound. Why aren't I hearing the fourth heart sound? I couldn't hear it -- I guess I need to review heart sounds.

Cardiologist heard a distinct S4 (fourth heart sound). Why don't I hear an S4.

true

598

The cardiologist said in his letter that the patient has a distinct fourth heart sound. Why aren't I hearing the fourth heart sound? I couldn't hear it -- I guess I need to review heart sounds.

How should I treat polymenorrhea in a 14-year-old girl?

false

599

This morning I saw a premature infant born at 27-weeks gestation, 3 months ago. The discharge instructions said continue oral iron until the hemoglobin is "nice." What hemoglobin should we use to decide when to stop iron? How to consider this 3-month-old who is just now at his due date? Not directly answered but a reference said 12 grams normal for 3 month old so I used that. I almost called someone, but didn't have time so just decided 12 would be good enough.

Premature baby born at 27 weeks, 3 months ago. What is normal hemoglobin?

true

600

This morning I saw a premature infant born at 27-weeks gestation, 3 months ago. The discharge instructions said continue oral iron until the hemoglobin is "nice." What hemoglobin should we use to decide when to stop iron? How to consider this 3-month-old who is just now at his due date? Not directly answered but a reference said 12 grams normal for 3 month old so I used that. I almost called someone, but didn't have time so just decided 12 would be good enough.

What antibiotic should I use for this diabetic patient's infected foot ulcer?

false