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
7301	7301	8-year-old was on Paxil, Adderall, Clonidine, and Trazadone. She stopped everything cold turkey and was started on Zyprexa. Two days later she came into the emergency room hypertensive (135/95) and tachycardic and tremulous. I called child psychiatry at a tertiary center and the question was, "What do I do?"	What do I do with this child who was suddenly withdrawn from clonidine?	true
7302	7302	8-year-old was on Paxil, Adderall, Clonidine, and Trazadone. She stopped everything cold turkey and was started on Zyprexa. Two days later she came into the emergency room hypertensive (135/95) and tachycardic and tremulous. I called child psychiatry at a tertiary center and the question was, "What do I do?"	Several ear infections, doesn't get over them completely. Which antibiotic now?	false
7303	7303	My partner had a 13-year-old boy with exudative tonsillitis. I (investigator) asked what the question was. She (physician) said, "What would be the differential?"	What is the differential diagnosis of exudative tonsillitis?	true
7304	7304	My partner had a 13-year-old boy with exudative tonsillitis. I (investigator) asked what the question was. She (physician) said, "What would be the differential?"	How much do you gain from hysteroscopy over fractional dilatation and curettage?	false
7305	7305	Eleven-month-old twins with otitis media. A tympanocentesis came back Hemophilus influenzae sensitive to ampicillin/sulbactam but resistant to amoxicillin/clavulanate. So which oral antibiotic should we put them on?	Which antibiotic should these twins with otitis media get?	true
7306	7306	Eleven-month-old twins with otitis media. A tympanocentesis came back Hemophilus influenzae sensitive to ampicillin/sulbactam but resistant to amoxicillin/clavulanate. So which oral antibiotic should we put them on?	What is the dose of Sporanox?	false
7307	7307	We get these young girls with periods every two weeks for a year. "When do you get concerned? When do you regulate them? When do you refer?"	What is the approach to irregular bleeding in adolescents?	true
7308	7308	We get these young girls with periods every two weeks for a year. "When do you get concerned? When do you regulate them? When do you refer?"	What antibiotic should I use for this diabetic patient's infected foot ulcer?	false
7309	7309	Six-month-old girl. That's one question that comes up. "When do you recheck ears after otitis media?"	When should you recheck ears after otitis?	true
7310	7310	Six-month-old girl. That's one question that comes up. "When do you recheck ears after otitis media?"	I wonder if this patient could have a rotator cuff thing?	false
7311	7311	What do you do with serous otitis? Long term antibiotics? Nose spray? Decongestants? I do nothing usually and then if it's persistent, when do you refer and what do you do about it?	What do you do with serous otitis?	true
7312	7312	What do you do with serous otitis? Long term antibiotics? Nose spray? Decongestants? I do nothing usually and then if it's persistent, when do you refer and what do you do about it?	Is there a support group here for this patient going blind from macular degeneration?	false
7313	7313	10-year-old boy with attention-deficit-hyperactivity disorder. "Is there less appetite suppression with Adderall than Ritalin and Concerta?"	Is there less appetite suppression with Adderall?	true
7314	7314	10-year-old boy with attention-deficit-hyperactivity disorder. "Is there less appetite suppression with Adderall than Ritalin and Concerta?"	How should I treat polymenorrhea in a 14-year-old girl?	false
7315	7315	Does Strattera really work?	Does Strattera work?	true
7316	7316	Does Strattera really work?	Boys' father has Marfan's Syndrome. Do these boys need further evaluation?	false
7317	7317	"OK, do you have to wean Strattera? I don't know."	Does Strattera need to be tapered?	true
7318	7318	"OK, do you have to wean Strattera? I don't know."	Can I use low molecular weight heparin in pregnancy (patient with deep vein thrombosis last pregnancy)?	false
7319	7319	Seven-year-old girl with eczema, no better on hydrocortisone cream. The physician asked me (investigator), "Do you know if they (meaning physicians at the university) are using Elidel?" "Is there any concern with using it in terms of toxicity? Is there any immune suppression with long term use?"	Are other physicians using Elidel for eczema?	true
7320	7320	Seven-year-old girl with eczema, no better on hydrocortisone cream. The physician asked me (investigator), "Do you know if they (meaning physicians at the university) are using Elidel?" "Is there any concern with using it in terms of toxicity? Is there any immune suppression with long term use?"	Why did they cut out the Coccidiomycosis granuloma rather than treat it medically?	false
7321	7321	"With chickenpox, when do you use Acyclovir?"	When do you use acyclovir for chickenpox?	true
7322	7322	"With chickenpox, when do you use Acyclovir?"	Can I use low molecular weight heparin in pregnancy (patient with deep vein thrombosis last pregnancy)?	false
7323	7323	Three-and-a-half-month-old boy with the worst case of infected eczema I've ever seen. "My question is, did the Elidel cause or perpetuate the infection?"	Could Elidel make infected eczema worse?	true
7324	7324	Three-and-a-half-month-old boy with the worst case of infected eczema I've ever seen. "My question is, did the Elidel cause or perpetuate the infection?"	Let's give these immunizations. That's right isn't it?	false
7325	7325	Seven-month old had a second occurrence of an abscess next to the rectum, grape sized. I (investigator) prompted the physician for what the question was. He said, "What treatment is appropriate?"	What is the treatment for a recurrent abscess near the rectum?	true
7326	7326	Seven-month old had a second occurrence of an abscess next to the rectum, grape sized. I (investigator) prompted the physician for what the question was. He said, "What treatment is appropriate?"	What antibiotic should I use for this diabetic patient's infected foot ulcer?	false
7327	7327	"Is there any relation between iron deficiency and thrombocytopenia or could iron deficiency cause the low platelets? Or could the viral illness have caused the anemia and the low platelets?"	What would cause thrombocytopenia in a child with fever?	true
7328	7328	"Is there any relation between iron deficiency and thrombocytopenia or could iron deficiency cause the low platelets? Or could the viral illness have caused the anemia and the low platelets?"	But, brass tacks, what should you do before allowing an older person to exercise?	false
7329	7329	Three-month-old. "What is the spontaneous resolution rate of oral thrush?"	What is the spontaneous resolution rate of oral thrush?	true
7330	7330	Three-month-old. "What is the spontaneous resolution rate of oral thrush?"	Why wasn't this patient very sick? (large empyema and Haemophilus influenza in sputum)	false
7331	7331	The physician called the local mental health clinic and said, "I have just kind of a generic question. I have an 18-year-old with attention-deficit-hyperactivity disorder who was on Adderall but her obstetrician recommended stopping it. Is there anything that your psychiatrists have that we could use during pregnancy?"	What is the treatment for attention-deficit-hyperactivity disorder during pregnancy?	true
7332	7332	The physician called the local mental health clinic and said, "I have just kind of a generic question. I have an 18-year-old with attention-deficit-hyperactivity disorder who was on Adderall but her obstetrician recommended stopping it. Is there anything that your psychiatrists have that we could use during pregnancy?"	What are the doses of Solumedrol and Claforan for an 8-year-old female?	false
7333	7333	5-year-old boy with intoeing. He examined the child and as he left the room he told the father he needed to check something. He told me (investigator) "I've just got to look at the normal angles. I forgot what they are."	What is the normal hip rotation for a 5-year-old?	true
7334	7334	5-year-old boy with intoeing. He examined the child and as he left the room he told the father he needed to check something. He told me (investigator) "I've just got to look at the normal angles. I forgot what they are."	Age 4 years, has had 2 bladder infections, just treat or workup for cause?	false
7335	7335	Newborn at 38-weeks gestation, term, Cesarean section for fetal distress, uncontrolled diabetic. Oximeter was 50, not tachypneic, no murmur. I (investigator) prompted, "So the question was, what's causing the low oxygen saturations"? The physician said, "Yes, my partner said, 'I didn't have any idea what was going on.'"	What would cause low oxygen saturation in a newborn in the absence of tachypnea?	true
7336	7336	Newborn at 38-weeks gestation, term, Cesarean section for fetal distress, uncontrolled diabetic. Oximeter was 50, not tachypneic, no murmur. I (investigator) prompted, "So the question was, what's causing the low oxygen saturations"? The physician said, "Yes, my partner said, 'I didn't have any idea what was going on.'"	Patient with hypertension and abdominal bruit. Should I order an intravenous pyelogram?	false
7337	7337	I (investigator) noted an open book on the physician's desk and asked if there was an associated question recently. "I was looking up to see what the standards are for hypertension in the newborn and the workup of hypertension if it continued."	What is the evaluation of hypertension in the neonate?	true
7338	7338	I (investigator) noted an open book on the physician's desk and asked if there was an associated question recently. "I was looking up to see what the standards are for hypertension in the newborn and the workup of hypertension if it continued."	Is there a handy reference to ophthalmologic drugs?	false
7339	7339	"Are there any cardiac contraindications to Strattera?"	Are there any cardiac contraindications to Strattera?	true
7340	7340	"Are there any cardiac contraindications to Strattera?"	Can I use low molecular weight heparin in pregnancy (patient with deep vein thrombosis last pregnancy)?	false
7341	7341	A question came up yesterday . . . I don't even know how to say it . . . What is the relative risk or the incidence of streptococcal sore throat in tonsillectomized patients?	What is the probability of streptococcal pharyngitis after tonsillectomy?	true
7342	7342	A question came up yesterday . . . I don't even know how to say it . . . What is the relative risk or the incidence of streptococcal sore throat in tonsillectomized patients?	Why wasn't this patient very sick? (large empyema and Haemophilus influenza in sputum)	false
7343	7343	What is the drug of choice for onychomycosis and would griseofulvin work since it is less expensive?	What is the drug of choice for onychomycosis?	true
7344	7344	What is the drug of choice for onychomycosis and would griseofulvin work since it is less expensive?	What is the maximum dose of digoxin? (patient seen in emergency room, had digoxin level less than 0.03)	false
7345	7345	Do you need to monitor liver function tests with griseofulvin or terbinafine?	Do you need to monitor liver function tests with griseofulvin?	true
7346	7346	Do you need to monitor liver function tests with griseofulvin or terbinafine?	Why wasn't this patient very sick? (large empyema and Haemophilus influenza in sputum)	false
7347	7347	This is probably in the Framingham study or something but I'm never sure how many blood pressures you need to make a diagnosis of hypertension.	How many blood pressures are required to diagnose hypertension?	true
7348	7348	This is probably in the Framingham study or something but I'm never sure how many blood pressures you need to make a diagnosis of hypertension.	What is the success rate of various methods of endometrial biopsy? (that is, getting in)?	false
7349	7349	I've got one for you. Indications for oral versus topical therapy for impetigo.	When should oral therapy be used for impetigo?	true
7350	7350	I've got one for you. Indications for oral versus topical therapy for impetigo.	What antibiotic should I use for this diabetic patient's infected foot ulcer?	false
7351	7351	Over 90-year-old with change in bowel habits (occasional diarrhea) and guaiac positive stool on exam today. The physician said, "What would you do?" asking me (investigator).	What workup should be done for a patient over age 90 with a guaiac positive stool?	true
7352	7352	Over 90-year-old with change in bowel habits (occasional diarrhea) and guaiac positive stool on exam today. The physician said, "What would you do?" asking me (investigator).	80-year-old female. Why is she losing weight? Well-controlled congestive heart failure, dentures don't fit.	false
7353	7353	I've got one for you. Most common antibiotic associated with Stevens Johnson Syndrome.	Which antibiotic is most commonly associated with Stevens Johnson Syndrome?	true
7354	7354	I've got one for you. Most common antibiotic associated with Stevens Johnson Syndrome.	Boys' father has Marfan's Syndrome. Do these boys need further evaluation?	false
7355	7355	I (investigator) asked if he had to look up anything in a book in the last few days. He said, "I had a question about Hepatitis B. Recommendations for household contacts of carriers."	What are the recommendations for household contacts of hepatitis B carriers?	true
7356	7356	I (investigator) asked if he had to look up anything in a book in the last few days. He said, "I had a question about Hepatitis B. Recommendations for household contacts of carriers."	At what ages should you do a Denver Developmental Screening Test?	false
7357	7357	Seven-month-old born prematurely. Mother accused of Munchausen's by proxy, followed at a tertiary center, upset with their care, wanted a second opinion. I never know what to do with those. "How can we not accept them?" I guess would be the question.	How can a physician not accept a patient who inappropriately asks for a second opinion?	true
7358	7358	Seven-month-old born prematurely. Mother accused of Munchausen's by proxy, followed at a tertiary center, upset with their care, wanted a second opinion. I never know what to do with those. "How can we not accept them?" I guess would be the question.	How should I treat polymenorrhea in a 14-year-old girl?	false
7359	7359	Newborn with hip click. Is this hip dislocated? Study physician's partner wondered if there are any indications for x-rays when suspecting a dislocated hip, or if we only do ultrasound now.	Is there a place of plain radiographs in the diagnosis of congenital hip dislocation?	true
7360	7360	Newborn with hip click. Is this hip dislocated? Study physician's partner wondered if there are any indications for x-rays when suspecting a dislocated hip, or if we only do ultrasound now.	Several ear infections, doesn't get over them completely. Which antibiotic now?	false
7361	7361	Fourteen-year-old with keratosis pilaris. I never know what to do with that.	What is the treatment for keratosis pilaris?	true
7362	7362	Fourteen-year-old with keratosis pilaris. I never know what to do with that.	What to do for asymptomatic carotid bruits or carotid bruits in general?	false
7363	7363	Eight-year-old boy with recurrent abdominal pain. I called Doctor X (pediatric gastroenterologist) and said, "OK, what is this? I don't know what to do."	What would cause severe colicky pain in an 8-year-old boy?	true
7364	7364	Eight-year-old boy with recurrent abdominal pain. I called Doctor X (pediatric gastroenterologist) and said, "OK, what is this? I don't know what to do."	Her headaches don't fit a pattern. Are they migraines?	false
7365	7365	Why did the nurse circle the head circumference? "Is 48 centimeters big for a kids head?" This was a 3-year, 7 1/2-month-old girl.	What is the normal head circumference for a 3 year, 7 1/2-month-old girl?	true
7366	7366	Why did the nurse circle the head circumference? "Is 48 centimeters big for a kids head?" This was a 3-year, 7 1/2-month-old girl.	How do you inject the bicipital tendon?	false
7367	7367	17-year-old with institutional colon, rolling on the floor, screaming. They gave a soap suds enema but that was no help. The home was calling the physician for advice. The physician said, "What's the best treatment for institutional colon?"	What is the best treatment for institutional colon?	true
7368	7368	17-year-old with institutional colon, rolling on the floor, screaming. They gave a soap suds enema but that was no help. The home was calling the physician for advice. The physician said, "What's the best treatment for institutional colon?"	What antibiotics can he take because he's on a nevirapine study?	false
7369	7369	Four-month-old. "Positional plagiocephaly in infants. "Do you need to put that head banding thing on?" Do they need treatment?" Cranial banding. We're putting kids on their back now. Do they need that helmet?	Should head banding be used for plagiocephaly?	true
7370	7370	Four-month-old. "Positional plagiocephaly in infants. "Do you need to put that head banding thing on?" Do they need treatment?" Cranial banding. We're putting kids on their back now. Do they need that helmet?	How should I treat polymenorrhea in a 14-year-old girl?	false
7371	7371	Nurse practitioner asked the study physician about a 9-month old girl: "Is this unilateral laterothoracic exanthem?"	Does this child have unilateral laterothoracic exanthem?	true
7372	7372	Nurse practitioner asked the study physician about a 9-month old girl: "Is this unilateral laterothoracic exanthem?"	What is the patient's specialist seeing on her neck cyst?	false
7373	7373	Is gentian violet toxic when given for oral thrush?	Is gentian violet toxic when given for oral thrush?	true
7374	7374	Is gentian violet toxic when given for oral thrush?	What is the dose of Sporanox?	false
7375	7375	13-year-old boy. When you have joint custody, does that mean both parents have to agree to tests and treatment or can just one agree?	With joint custody, do both parents have to agree to treatment?	true
7376	7376	13-year-old boy with jaundice. I saw him one time and his eyes were yellow. We did a big workup and the bilirubin was 3 but everything else was normal. I asked a pediatric gastroenterologist what would give this picture and is there a test for Gilbert's disease.	Is there a test for Gilbert's disease?	true
7377	7377	13-year-old boy with jaundice. I saw him one time and his eyes were yellow. We did a big workup and the bilirubin was 3 but everything else was normal. I asked a pediatric gastroenterologist what would give this picture and is there a test for Gilbert's disease.	How should I treat polymenorrhea in a 14-year-old girl?	false
7378	7378	15-year-old boy with history of tracheoesophageal fistula, often hospitalized when younger with respiratory illnesses. One time he had respiratory syncytial virus and was very sick and I called the tertiary center. "Should I give him Ribavirin?"	What are the indications for ribavirin?	true
7379	7379	15-year-old boy with history of tracheoesophageal fistula, often hospitalized when younger with respiratory illnesses. One time he had respiratory syncytial virus and was very sick and I called the tertiary center. "Should I give him Ribavirin?"	Can I use low molecular weight heparin in pregnancy (patient with deep vein thrombosis last pregnancy)?	false
7380	7380	Patient with ingrown toenail. What is Cutivate? (The chart said he was on this.)	What is Cutivate?	true
7381	7381	Patient with ingrown toenail. What is Cutivate? (The chart said he was on this.)	Patient with transient ischemic attacks; I'm always uncomfortable with how quickly to pursue a workup.	false
7382	7382	Is the coccyx fractured? This was the question as the physician was looking at the x-ray of a young girl (about 7 years old).	Is the coccyx fractured?	true
7383	7383	Is the coccyx fractured? This was the question as the physician was looking at the x-ray of a young girl (about 7 years old).	Why did they cut out the Coccidiomycosis granuloma rather than treat it medically?	false
7384	7384	18-month-old male with cervical and supraclavicular adenopathy that persisted for 6 months. I get this a lot. Concerns from the mother. I (investigator) prompted, "What is the question?" He said, "I'm looking for more guidelines. Information in the books is meager."	What are the guidelines for evaluation of cervical lymphadenopathy?	true
7385	7385	18-month-old male with cervical and supraclavicular adenopathy that persisted for 6 months. I get this a lot. Concerns from the mother. I (investigator) prompted, "What is the question?" He said, "I'm looking for more guidelines. Information in the books is meager."	How often does amoxicillin cause a rash in someone with infectious mononucleosis?	false
7386	7386	35-year-old woman with multiple antibiotic allergies. There are only certain antibiotics she can take. Just a couple of quinolones. "But the question is, if she had been positive for streptococcus, I don't know if quinolones . . . what anti . . . ?"	Are quinolones effective for streptococcal sore throat?	true
7387	7387	35-year-old woman with multiple antibiotic allergies. There are only certain antibiotics she can take. Just a couple of quinolones. "But the question is, if she had been positive for streptococcus, I don't know if quinolones . . . what anti . . . ?"	What size pills does digoxin come in?	false
7388	7388	9-year-old boy with history of recurrent abdominal pain. So I guess it's more of a diagnostic question. Is the duodenitis causing the pain or the migraine? If it is migraine, what other drug treatment, abortive or prophylactic, could we use?	Is the duodenitis causing the pain?	true
7389	7389	9-year-old boy with history of recurrent abdominal pain. So I guess it's more of a diagnostic question. Is the duodenitis causing the pain or the migraine? If it is migraine, what other drug treatment, abortive or prophylactic, could we use?	Meniere's Disease worse on generic alprazolam. Is worsening due to generic form?	false
7390	7390	This is more of a psychosocial or medical-legal question. Nine-month-old boy in foster care with recurrent wheezing. Visits grandparents every 2 weeks for 1-2 hours. In two days they are going to court and want my recommendation. The wheezing is aggravated after a visit to the smoking grandparents. Most books don't say whether it's really passive smoking or if you just don't smoke when the child is there, is that OK?	If adults smoke in the house, but not when the child is visiting, is that associated with asthma?	true
7391	7391	This is more of a psychosocial or medical-legal question. Nine-month-old boy in foster care with recurrent wheezing. Visits grandparents every 2 weeks for 1-2 hours. In two days they are going to court and want my recommendation. The wheezing is aggravated after a visit to the smoking grandparents. Most books don't say whether it's really passive smoking or if you just don't smoke when the child is there, is that OK?	How should you adjust the birth control pill if someone has spotting on it?	false
7392	7392	15-month-old born prematurely with Potter's syndrome. Now has poorly functioning kidneys. "I don't know if the failure to thrive is secondary to the foster mother or the renal problems."	Is the failure to thrive due to emotional deprivation?	true
7393	7393	15-month-old born prematurely with Potter's syndrome. Now has poorly functioning kidneys. "I don't know if the failure to thrive is secondary to the foster mother or the renal problems."	What is in Ortho Novum 1/35?	false
7394	7394	Similac Advance and Enfamil Lipil. Docosahexaenoic acid and arachidonic acid. I (investigator) prompted him for the question. He said, "Is it really needed or is there an added benefit?	Is there any added benefit from the new infant formulas?	true
7395	7395	Similac Advance and Enfamil Lipil. Docosahexaenoic acid and arachidonic acid. I (investigator) prompted him for the question. He said, "Is it really needed or is there an added benefit?	Can I use low molecular weight heparin in pregnancy (patient with deep vein thrombosis last pregnancy)?	false
7396	7396	Four-day-old male under bililights. The congenital adrenal hyperplasia test came back positive. How do I deal with this?	How do I deal with a positive congenital adrenal hyperplasia screen?	true
7397	7397	Four-day-old male under bililights. The congenital adrenal hyperplasia test came back positive. How do I deal with this?	Nine-year-old girl was at Wacky Waters, clear vesicles on hands, what is it?	false
7398	7398	I had a baby with a club foot and the question was, "What should I do?" The question was whether this can wait or needs to be referred soon.	What should I do with this baby with club foot?	true
7399	7399	I had a baby with a club foot and the question was, "What should I do?" The question was whether this can wait or needs to be referred soon.	Patient with pleural effusions, confusion, pCO2 50. Could that pCO2 explain confusion?	false
7400	7400	I haven't really seen a patient with congenital hip dysplasia. How soon do we need to refer them to orthopedics? Is it a matter of days or weeks?	How soon does congenital hip dysplasia need to be referred?	true

7301

8-year-old was on Paxil, Adderall, Clonidine, and Trazadone. She stopped everything cold turkey and was started on Zyprexa. Two days later she came into the emergency room hypertensive (135/95) and tachycardic and tremulous. I called child psychiatry at a tertiary center and the question was, "What do I do?"

What do I do with this child who was suddenly withdrawn from clonidine?

true

7302

8-year-old was on Paxil, Adderall, Clonidine, and Trazadone. She stopped everything cold turkey and was started on Zyprexa. Two days later she came into the emergency room hypertensive (135/95) and tachycardic and tremulous. I called child psychiatry at a tertiary center and the question was, "What do I do?"

Several ear infections, doesn't get over them completely. Which antibiotic now?

false

7303

My partner had a 13-year-old boy with exudative tonsillitis. I (investigator) asked what the question was. She (physician) said, "What would be the differential?"

What is the differential diagnosis of exudative tonsillitis?

true

7304

My partner had a 13-year-old boy with exudative tonsillitis. I (investigator) asked what the question was. She (physician) said, "What would be the differential?"

How much do you gain from hysteroscopy over fractional dilatation and curettage?

false

7305

Eleven-month-old twins with otitis media. A tympanocentesis came back Hemophilus influenzae sensitive to ampicillin/sulbactam but resistant to amoxicillin/clavulanate. So which oral antibiotic should we put them on?

Which antibiotic should these twins with otitis media get?

true

7306

Eleven-month-old twins with otitis media. A tympanocentesis came back Hemophilus influenzae sensitive to ampicillin/sulbactam but resistant to amoxicillin/clavulanate. So which oral antibiotic should we put them on?

What is the dose of Sporanox?

false

7307

We get these young girls with periods every two weeks for a year. "When do you get concerned? When do you regulate them? When do you refer?"

What is the approach to irregular bleeding in adolescents?

true

7308

We get these young girls with periods every two weeks for a year. "When do you get concerned? When do you regulate them? When do you refer?"

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

false

7309

Six-month-old girl. That's one question that comes up. "When do you recheck ears after otitis media?"

When should you recheck ears after otitis?

true

7310

Six-month-old girl. That's one question that comes up. "When do you recheck ears after otitis media?"

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

false

7311

What do you do with serous otitis? Long term antibiotics? Nose spray? Decongestants? I do nothing usually and then if it's persistent, when do you refer and what do you do about it?

What do you do with serous otitis?

true

7312

What do you do with serous otitis? Long term antibiotics? Nose spray? Decongestants? I do nothing usually and then if it's persistent, when do you refer and what do you do about it?

Is there a support group here for this patient going blind from macular degeneration?

false

7313

10-year-old boy with attention-deficit-hyperactivity disorder. "Is there less appetite suppression with Adderall than Ritalin and Concerta?"

Is there less appetite suppression with Adderall?

true

7314

10-year-old boy with attention-deficit-hyperactivity disorder. "Is there less appetite suppression with Adderall than Ritalin and Concerta?"

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

false

7315

Does Strattera really work?

Does Strattera work?

true

7316

Does Strattera really work?

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

false

7317

"OK, do you have to wean Strattera? I don't know."

Does Strattera need to be tapered?

true

7318

"OK, do you have to wean Strattera? I don't know."

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

false

7319

Seven-year-old girl with eczema, no better on hydrocortisone cream. The physician asked me (investigator), "Do you know if they (meaning physicians at the university) are using Elidel?" "Is there any concern with using it in terms of toxicity? Is there any immune suppression with long term use?"

Are other physicians using Elidel for eczema?

true

7320

Seven-year-old girl with eczema, no better on hydrocortisone cream. The physician asked me (investigator), "Do you know if they (meaning physicians at the university) are using Elidel?" "Is there any concern with using it in terms of toxicity? Is there any immune suppression with long term use?"

Why did they cut out the Coccidiomycosis granuloma rather than treat it medically?

false

7321

"With chickenpox, when do you use Acyclovir?"

When do you use acyclovir for chickenpox?

true

7322

"With chickenpox, when do you use Acyclovir?"

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

false

7323

Three-and-a-half-month-old boy with the worst case of infected eczema I've ever seen. "My question is, did the Elidel cause or perpetuate the infection?"

Could Elidel make infected eczema worse?

true

7324

Three-and-a-half-month-old boy with the worst case of infected eczema I've ever seen. "My question is, did the Elidel cause or perpetuate the infection?"

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

false

7325

Seven-month old had a second occurrence of an abscess next to the rectum, grape sized. I (investigator) prompted the physician for what the question was. He said, "What treatment is appropriate?"

What is the treatment for a recurrent abscess near the rectum?

true

7326

Seven-month old had a second occurrence of an abscess next to the rectum, grape sized. I (investigator) prompted the physician for what the question was. He said, "What treatment is appropriate?"

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

false

7327

"Is there any relation between iron deficiency and thrombocytopenia or could iron deficiency cause the low platelets? Or could the viral illness have caused the anemia and the low platelets?"

What would cause thrombocytopenia in a child with fever?

true

7328

"Is there any relation between iron deficiency and thrombocytopenia or could iron deficiency cause the low platelets? Or could the viral illness have caused the anemia and the low platelets?"

But, brass tacks, what should you do before allowing an older person to exercise?

false

7329

Three-month-old. "What is the spontaneous resolution rate of oral thrush?"

What is the spontaneous resolution rate of oral thrush?

true

7330

Three-month-old. "What is the spontaneous resolution rate of oral thrush?"

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

false

7331

The physician called the local mental health clinic and said, "I have just kind of a generic question. I have an 18-year-old with attention-deficit-hyperactivity disorder who was on Adderall but her obstetrician recommended stopping it. Is there anything that your psychiatrists have that we could use during pregnancy?"

What is the treatment for attention-deficit-hyperactivity disorder during pregnancy?

true

7332

The physician called the local mental health clinic and said, "I have just kind of a generic question. I have an 18-year-old with attention-deficit-hyperactivity disorder who was on Adderall but her obstetrician recommended stopping it. Is there anything that your psychiatrists have that we could use during pregnancy?"

What are the doses of Solumedrol and Claforan for an 8-year-old female?

false

7333

5-year-old boy with intoeing. He examined the child and as he left the room he told the father he needed to check something. He told me (investigator) "I've just got to look at the normal angles. I forgot what they are."

What is the normal hip rotation for a 5-year-old?

true

7334

5-year-old boy with intoeing. He examined the child and as he left the room he told the father he needed to check something. He told me (investigator) "I've just got to look at the normal angles. I forgot what they are."

Age 4 years, has had 2 bladder infections, just treat or workup for cause?

false

7335

Newborn at 38-weeks gestation, term, Cesarean section for fetal distress, uncontrolled diabetic. Oximeter was 50, not tachypneic, no murmur. I (investigator) prompted, "So the question was, what's causing the low oxygen saturations"? The physician said, "Yes, my partner said, 'I didn't have any idea what was going on.'"

What would cause low oxygen saturation in a newborn in the absence of tachypnea?

true

7336

Newborn at 38-weeks gestation, term, Cesarean section for fetal distress, uncontrolled diabetic. Oximeter was 50, not tachypneic, no murmur. I (investigator) prompted, "So the question was, what's causing the low oxygen saturations"? The physician said, "Yes, my partner said, 'I didn't have any idea what was going on.'"

Patient with hypertension and abdominal bruit. Should I order an intravenous pyelogram?

false

7337

I (investigator) noted an open book on the physician's desk and asked if there was an associated question recently. "I was looking up to see what the standards are for hypertension in the newborn and the workup of hypertension if it continued."

What is the evaluation of hypertension in the neonate?

true

7338

I (investigator) noted an open book on the physician's desk and asked if there was an associated question recently. "I was looking up to see what the standards are for hypertension in the newborn and the workup of hypertension if it continued."

Is there a handy reference to ophthalmologic drugs?

false

7339

"Are there any cardiac contraindications to Strattera?"

Are there any cardiac contraindications to Strattera?

true

7340

"Are there any cardiac contraindications to Strattera?"

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

false

7341

A question came up yesterday . . . I don't even know how to say it . . . What is the relative risk or the incidence of streptococcal sore throat in tonsillectomized patients?

What is the probability of streptococcal pharyngitis after tonsillectomy?

true

7342

A question came up yesterday . . . I don't even know how to say it . . . What is the relative risk or the incidence of streptococcal sore throat in tonsillectomized patients?

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

false

7343

What is the drug of choice for onychomycosis and would griseofulvin work since it is less expensive?

What is the drug of choice for onychomycosis?

true

7344

What is the drug of choice for onychomycosis and would griseofulvin work since it is less expensive?

What is the maximum dose of digoxin? (patient seen in emergency room, had digoxin level less than 0.03)

false

7345

Do you need to monitor liver function tests with griseofulvin or terbinafine?

Do you need to monitor liver function tests with griseofulvin?

true

7346

Do you need to monitor liver function tests with griseofulvin or terbinafine?

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

false

7347

This is probably in the Framingham study or something but I'm never sure how many blood pressures you need to make a diagnosis of hypertension.

How many blood pressures are required to diagnose hypertension?

true

7348

This is probably in the Framingham study or something but I'm never sure how many blood pressures you need to make a diagnosis of hypertension.

What is the success rate of various methods of endometrial biopsy? (that is, getting in)?

false

7349

I've got one for you. Indications for oral versus topical therapy for impetigo.

When should oral therapy be used for impetigo?

true

7350

I've got one for you. Indications for oral versus topical therapy for impetigo.

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

false

7351

Over 90-year-old with change in bowel habits (occasional diarrhea) and guaiac positive stool on exam today. The physician said, "What would you do?" asking me (investigator).

What workup should be done for a patient over age 90 with a guaiac positive stool?

true

7352

Over 90-year-old with change in bowel habits (occasional diarrhea) and guaiac positive stool on exam today. The physician said, "What would you do?" asking me (investigator).

80-year-old female. Why is she losing weight? Well-controlled congestive heart failure, dentures don't fit.

false

7353

I've got one for you. Most common antibiotic associated with Stevens Johnson Syndrome.

Which antibiotic is most commonly associated with Stevens Johnson Syndrome?

true

7354

I've got one for you. Most common antibiotic associated with Stevens Johnson Syndrome.

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

false

7355

I (investigator) asked if he had to look up anything in a book in the last few days. He said, "I had a question about Hepatitis B. Recommendations for household contacts of carriers."

What are the recommendations for household contacts of hepatitis B carriers?

true

7356

I (investigator) asked if he had to look up anything in a book in the last few days. He said, "I had a question about Hepatitis B. Recommendations for household contacts of carriers."

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

false

7357

Seven-month-old born prematurely. Mother accused of Munchausen's by proxy, followed at a tertiary center, upset with their care, wanted a second opinion. I never know what to do with those. "How can we not accept them?" I guess would be the question.

How can a physician not accept a patient who inappropriately asks for a second opinion?

true

7358

Seven-month-old born prematurely. Mother accused of Munchausen's by proxy, followed at a tertiary center, upset with their care, wanted a second opinion. I never know what to do with those. "How can we not accept them?" I guess would be the question.

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

false

7359

Newborn with hip click. Is this hip dislocated? Study physician's partner wondered if there are any indications for x-rays when suspecting a dislocated hip, or if we only do ultrasound now.

Is there a place of plain radiographs in the diagnosis of congenital hip dislocation?

true

7360

Newborn with hip click. Is this hip dislocated? Study physician's partner wondered if there are any indications for x-rays when suspecting a dislocated hip, or if we only do ultrasound now.

Several ear infections, doesn't get over them completely. Which antibiotic now?

false

7361

Fourteen-year-old with keratosis pilaris. I never know what to do with that.

What is the treatment for keratosis pilaris?

true

7362

Fourteen-year-old with keratosis pilaris. I never know what to do with that.

What to do for asymptomatic carotid bruits or carotid bruits in general?

false

7363

Eight-year-old boy with recurrent abdominal pain. I called Doctor X (pediatric gastroenterologist) and said, "OK, what is this? I don't know what to do."

What would cause severe colicky pain in an 8-year-old boy?

true

7364

Eight-year-old boy with recurrent abdominal pain. I called Doctor X (pediatric gastroenterologist) and said, "OK, what is this? I don't know what to do."

Her headaches don't fit a pattern. Are they migraines?

false

7365

Why did the nurse circle the head circumference? "Is 48 centimeters big for a kids head?" This was a 3-year, 7 1/2-month-old girl.

What is the normal head circumference for a 3 year, 7 1/2-month-old girl?

true

7366

Why did the nurse circle the head circumference? "Is 48 centimeters big for a kids head?" This was a 3-year, 7 1/2-month-old girl.

How do you inject the bicipital tendon?

false

7367

17-year-old with institutional colon, rolling on the floor, screaming. They gave a soap suds enema but that was no help. The home was calling the physician for advice. The physician said, "What's the best treatment for institutional colon?"

What is the best treatment for institutional colon?

true

7368

17-year-old with institutional colon, rolling on the floor, screaming. They gave a soap suds enema but that was no help. The home was calling the physician for advice. The physician said, "What's the best treatment for institutional colon?"

What antibiotics can he take because he's on a nevirapine study?

false

7369

Four-month-old. "Positional plagiocephaly in infants. "Do you need to put that head banding thing on?" Do they need treatment?" Cranial banding. We're putting kids on their back now. Do they need that helmet?

Should head banding be used for plagiocephaly?

true

7370

Four-month-old. "Positional plagiocephaly in infants. "Do you need to put that head banding thing on?" Do they need treatment?" Cranial banding. We're putting kids on their back now. Do they need that helmet?

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

false

7371

Nurse practitioner asked the study physician about a 9-month old girl: "Is this unilateral laterothoracic exanthem?"

Does this child have unilateral laterothoracic exanthem?

true

7372

Nurse practitioner asked the study physician about a 9-month old girl: "Is this unilateral laterothoracic exanthem?"

What is the patient's specialist seeing on her neck cyst?

false

7373

Is gentian violet toxic when given for oral thrush?

true

7374

Is gentian violet toxic when given for oral thrush?

What is the dose of Sporanox?

false

7375

13-year-old boy. When you have joint custody, does that mean both parents have to agree to tests and treatment or can just one agree?

With joint custody, do both parents have to agree to treatment?

true

7376

13-year-old boy with jaundice. I saw him one time and his eyes were yellow. We did a big workup and the bilirubin was 3 but everything else was normal. I asked a pediatric gastroenterologist what would give this picture and is there a test for Gilbert's disease.

Is there a test for Gilbert's disease?

true

7377

13-year-old boy with jaundice. I saw him one time and his eyes were yellow. We did a big workup and the bilirubin was 3 but everything else was normal. I asked a pediatric gastroenterologist what would give this picture and is there a test for Gilbert's disease.

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

false

7378

15-year-old boy with history of tracheoesophageal fistula, often hospitalized when younger with respiratory illnesses. One time he had respiratory syncytial virus and was very sick and I called the tertiary center. "Should I give him Ribavirin?"

What are the indications for ribavirin?

true

7379

15-year-old boy with history of tracheoesophageal fistula, often hospitalized when younger with respiratory illnesses. One time he had respiratory syncytial virus and was very sick and I called the tertiary center. "Should I give him Ribavirin?"

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

false

7380

Patient with ingrown toenail. What is Cutivate? (The chart said he was on this.)

What is Cutivate?

true

7381

Patient with ingrown toenail. What is Cutivate? (The chart said he was on this.)

Patient with transient ischemic attacks; I'm always uncomfortable with how quickly to pursue a workup.

false

7382

Is the coccyx fractured? This was the question as the physician was looking at the x-ray of a young girl (about 7 years old).

Is the coccyx fractured?

true

7383

Is the coccyx fractured? This was the question as the physician was looking at the x-ray of a young girl (about 7 years old).

Why did they cut out the Coccidiomycosis granuloma rather than treat it medically?

false

7384

18-month-old male with cervical and supraclavicular adenopathy that persisted for 6 months. I get this a lot. Concerns from the mother. I (investigator) prompted, "What is the question?" He said, "I'm looking for more guidelines. Information in the books is meager."

What are the guidelines for evaluation of cervical lymphadenopathy?

true

7385

18-month-old male with cervical and supraclavicular adenopathy that persisted for 6 months. I get this a lot. Concerns from the mother. I (investigator) prompted, "What is the question?" He said, "I'm looking for more guidelines. Information in the books is meager."

How often does amoxicillin cause a rash in someone with infectious mononucleosis?

false

7386

35-year-old woman with multiple antibiotic allergies. There are only certain antibiotics she can take. Just a couple of quinolones. "But the question is, if she had been positive for streptococcus, I don't know if quinolones . . . what anti . . . ?"

Are quinolones effective for streptococcal sore throat?

true

7387

35-year-old woman with multiple antibiotic allergies. There are only certain antibiotics she can take. Just a couple of quinolones. "But the question is, if she had been positive for streptococcus, I don't know if quinolones . . . what anti . . . ?"

What size pills does digoxin come in?

false

7388

9-year-old boy with history of recurrent abdominal pain. So I guess it's more of a diagnostic question. Is the duodenitis causing the pain or the migraine? If it is migraine, what other drug treatment, abortive or prophylactic, could we use?

Is the duodenitis causing the pain?

true

7389

9-year-old boy with history of recurrent abdominal pain. So I guess it's more of a diagnostic question. Is the duodenitis causing the pain or the migraine? If it is migraine, what other drug treatment, abortive or prophylactic, could we use?

Meniere's Disease worse on generic alprazolam. Is worsening due to generic form?

false

7390

This is more of a psychosocial or medical-legal question. Nine-month-old boy in foster care with recurrent wheezing. Visits grandparents every 2 weeks for 1-2 hours. In two days they are going to court and want my recommendation. The wheezing is aggravated after a visit to the smoking grandparents. Most books don't say whether it's really passive smoking or if you just don't smoke when the child is there, is that OK?

If adults smoke in the house, but not when the child is visiting, is that associated with asthma?

true

7391

This is more of a psychosocial or medical-legal question. Nine-month-old boy in foster care with recurrent wheezing. Visits grandparents every 2 weeks for 1-2 hours. In two days they are going to court and want my recommendation. The wheezing is aggravated after a visit to the smoking grandparents. Most books don't say whether it's really passive smoking or if you just don't smoke when the child is there, is that OK?

How should you adjust the birth control pill if someone has spotting on it?

false

7392

15-month-old born prematurely with Potter's syndrome. Now has poorly functioning kidneys. "I don't know if the failure to thrive is secondary to the foster mother or the renal problems."

Is the failure to thrive due to emotional deprivation?

true

7393

15-month-old born prematurely with Potter's syndrome. Now has poorly functioning kidneys. "I don't know if the failure to thrive is secondary to the foster mother or the renal problems."

What is in Ortho Novum 1/35?

false

7394

Similac Advance and Enfamil Lipil. Docosahexaenoic acid and arachidonic acid. I (investigator) prompted him for the question. He said, "Is it really needed or is there an added benefit?

Is there any added benefit from the new infant formulas?

true

7395

Similac Advance and Enfamil Lipil. Docosahexaenoic acid and arachidonic acid. I (investigator) prompted him for the question. He said, "Is it really needed or is there an added benefit?

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

false

7396

Four-day-old male under bililights. The congenital adrenal hyperplasia test came back positive. How do I deal with this?

How do I deal with a positive congenital adrenal hyperplasia screen?

true

7397

Four-day-old male under bililights. The congenital adrenal hyperplasia test came back positive. How do I deal with this?

Nine-year-old girl was at Wacky Waters, clear vesicles on hands, what is it?

false

7398

I had a baby with a club foot and the question was, "What should I do?" The question was whether this can wait or needs to be referred soon.

What should I do with this baby with club foot?

true

7399

I had a baby with a club foot and the question was, "What should I do?" The question was whether this can wait or needs to be referred soon.

Patient with pleural effusions, confusion, pCO2 50. Could that pCO2 explain confusion?

false

7400

I haven't really seen a patient with congenital hip dysplasia. How soon do we need to refer them to orthopedics? Is it a matter of days or weeks?

How soon does congenital hip dysplasia need to be referred?

true