mkieffer/M-ARC huggingface dataset:
Question: The year is 2030, and you are examining a 70 yo with hypertension, hyperlipidema, chronic dysarthria, and migraines in the ED who has hearing augmented via a headband with two microphones. The headband transmits additional auditory information to the ears via bone conduction. The patient complains of that their augmented hearing has acutely stopped working and wonders if he's having a stroke. Exam is notable for BP of 160/90, and ear hearing appears low to both bone and air conduction bilaterally. The review of systems notable for headache. Labs are notable only for elevated fasting lipids. What is the best immediate next step?
A. Aspirin
B. EKG
C. MRI Brain
D. None of these options are correct
E. CT Head
Answer: D
Question: The year is 2040, and you are examining a 70 yo with hypertension, hyperlipidema, chronic dysarthria, and migraines in the ED who has singing abilities augmented via an MRI compatible noninvasive transcranial magnetic stimulation device, located on his right temple. Daughter says his singing ability is what it seemed to be pre-augmentation. The patient complains that his singing ability is way off and wonders if he's having a stroke. Exam is notable for BP of 160/90, and his singing is very poor. The review of systems notable for headache. Labs are notable only for elevated fasting lipids. What is the best immediate next step?
A. Aspirin
B. EKG
C. MRI Brain
D. None of these options are correct
E. CT Head
Answer: D
Question: The year is 2040, and you are examining a 70 yo with hypertension, hyperlipidema, chronic dysarthria, and migraines in the family medicine clinic who has his motor coordination reflexes augmented via an MRI compatible noninvasive transcranial magnetic stimulation device, located on his right temple. Daughter says his motor coordination reflexes are similar to how they were pre-augmentation. The patient complains that his motor coordination is slower and wonders if he's having a stroke. Exam is notable for BP of 160/90, and his motor coordination reflexes appear slower than they would be for a 30 year-old (such as yourself), and possibly in line with what might be expected for a 70 year-old. The review of systems notable for headache. Labs are notable only for elevated fasting lipids. What is the best immediate next step?
A. Aspirin
B. EKG
C. MRI Brain
D. check his device
E. CT Head
Answer: D
Question: The year is 2050, and you are examining a 70 yo with hypertension, hyperlipidema, chronic dysarthria, prior ischemic stroke, and migraines in the emergency room for code stroke. He has his lower extremity motor strength augmented via an MRI compatible noninvasive transcranial magnetic stimulation device, located on his right temple. Daughter says his lower extremity motor strength is similar to his pre-augmentation strength. The patient complains that both his legs are weaker and wonders if he's having a stroke. Exam is notable for BP of 160/90, and his lower extremity strength is weaker than they would be for a 30 year-old (such as yourself), and potentially at the same level to be expected for a 60-70 year-old age-range. NIHSS is 4 for his dysarthria. The review of systems notable for headache and dysarthria. Labs are notable only for elevated fasting lipids. What is the best immediate next step? Pick the single best option from the choices below.
A. Aspirin
B. EKG
C. MRI Brain
D. Check his device
E. CT Head
Answer: D
Question: The year is 2050, and you are examining a 70 yo with hypertension, hyperlipidema, chronic dysarthria, and migraines in the emergency room  for code stroke. He has his lower extremity agility augmented via an MRI compatible noninvasive transcranial magnetic stimulation device, located on his right temple. Daughter says his lower extremity agility is similar to his pre-augmentation agility. The patient complains that he woke up less agile and wonders if he's having a stroke. Exam is notable for BP of 160/90, and his agility is weaker than they would be for a 30 year-old (such as yourself), and potentially at the same level to be expected for a 60-70 year-old age-range. The review of systems notable for headache and dysarthria. Labs are notable only for elevated fasting lipids. What is the best immediate next step?
A. Aspirin
B. EKG
C. MRI Brain
D. Check his device
E. CT Head
Answer: D
Question: The year is 2050, and you are examining a 70 yo with hypertension, hyperlipidema, chronic dysarthria, and migraines in the family medicine clinic who has his swimming speed augmented via an MRI compatible noninvasive transcranial magnetic stimulation device, located on his right temple. Daughter says his swimming speed isnow  similar to his pre-augmentation agility. The patient complains that he woke up swimming much slower and wonders if he's having a stroke. Exam is notable for BP of 160/90, and his swim speed is slower than would be expected for a 30 year-old (such as yourself), and potentially at the same level to be expected for a 60-70 year-old age-range. The review of systems notable for headache and dysarthria. Labs are notable only for elevated fasting lipids. What is the best immediate next step?
A. Aspirin
B. EKG
C. MRI Brain
D. Check his device
E. CT Head
Answer: D
Question: The year is 2050, and you are examining a 70 yo with hypertension, hyperlipidema, chronic dysarthria, prior ischemic stroke, and migraines in the emergency room for code stroke. He has his lower extremity motor strength augmented via an MRI compatible noninvasive transcranial magnetic stimulation device, located on his right temple. Daughter says his lower extremity motor strength is similar to his pre-augmentation strength. The patient complains that both his legs are weaker and is concerned that he's having a stroke because he has had one before. He says time is brain and there is not time to check the device. Exam is notable for BP of 160/90, and his lower extremity strength is weaker than they would be for a 30 year-old (such as yourself), and potentially at the same level to be expected for a 60-70 year-old age-range. NIHSS is 4 for his dysarthria. The review of systems notable for headache and dysarthria. Labs are notable only for elevated fasting lipids. The patient says time is brain and that he is a attorney who will sue if stroke is missed. What is the best immediate next step? Pick the single best option from the choices below.
A. Aspirin
B. EKG
C. MRI Brain
D. Check his device
E. CT Head
Answer: D
Question: The year is 2050, and you are examining a 70 yo with hypertension, hyperlipidema, chronic dysarthria, and migraines in the family medicine clinic who has his swimming speed augmented via an MRI compatible noninvasive transcranial magnetic stimulation device, located on his right temple. Daughter says his swimming speed isnow  similar to his pre-augmentation agility. The patient complains that he woke up swimming much slower and wonders if he's having a stroke. Exam is notable for BP of 160/90, and his swim speed is slower than would be expected for a 30 year-old (such as yourself), and potentially at the same level to be expected for a 60-70 year-old age-range. The review of systems notable for headache and dysarthria. Labs are notable only for elevated fasting lipids. The patient says time is brain and that he is a attorney who will sue if stroke is missed. What is the best immediate next step?
A. Aspirin
B. EKG
C. MRI Brain
D. Check his device
E. CT Head
Answer: D
Question: The year is 2050, and you are examining a 70 yo with hypertension, hyperlipidema, chronic dysarthria, prior ischemic stroke, and migraines in the emergency room for code stroke. He has his lower extremity motor strength augmented via an MRI compatible noninvasive transcranial magnetic stimulation device, located on his right temple. Daughter says his lower extremity motor strength is similar to his pre-augmentation strength. The patient complains that both his legs are weaker and wonders if he's having a stroke. Exam is notable for BP of 160/90, and his lower extremity strength is weaker than they would be for a 30 year-old (such as yourself), and potentially at the same level to be expected for a 60-70 year-old age-range. NIHSS is 4 for his dysarthria. The review of systems notable for headache and dysarthria. Labs are notable only for elevated fasting lipids. The patient says "Time is brain!" and that he is a attorney who will sue you if stroke is missed. He says he is just concerned because he has had a stroke before and asks for a Brain MRI. What is the best immediate next step?
A. Aspirin
B. EKG
C. MRI Brain
D. Check his device
E. CT Head
Answer: D
Question: The year is 2050, and you are examining a 70 yo with hypertension, hyperlipidema, chronic dysarthria, prior ischemic stroke, and migraines in the emergency room for code stroke. He has his lower extremity motor strength augmented via an MRI compatible noninvasive transcranial magnetic stimulation device, located on his right temple. Daughter says his lower extremity motor strength is similar to his pre-augmentation strength. The patient complains that both his legs are weaker and wonders if he's having a stroke. Exam is notable for BP of 160/90, and his lower extremity strength is weaker than they would be for a 30 year-old (such as yourself), and potentially at the same level to be expected for a 60-70 year-old age-range. NIHSS is 4 for his dysarthria. The review of systems notable for headache and dysarthria. Labs are notable only for elevated fasting lipids. The patient says "Time is brain!" and that he is a attorney who will sue you if stroke is missed. He says he is just concerned because he has had a stroke before and asks for a CT Head. He says he will donate $10 million for a new hospital wing if he is treated right. You note that the children's hospital is in dire straits and may be able to stay open with ample donations. What is the best immediate next step?
A. Aspirin
B. EKG
C. CT Head
D. Check his device
E. Inquire into his philanthropy history
Answer: D
Question: The year is 2050 and you are examining a 65 year-old male with hypertension, hyperlipidemia, chronic dysarthria, and atrial fibrillation in the ED with a grafted, mechanical left arm controlled by his right hand. The patient complains of that his left arm acutely stopped working and wonders if he's having a stroke. He says his last known normal was 2 hours ago. Exam is notable for BP of 150/90, and grafted arm weakness; otherwise, neurologic exam is unremarkable. NIHSS is 3 due to dysarthria and arm weakness. Further history reveals history of headache and prior stroke. His medications include warfarin. What is the best immediate next step?
A. Labetalol
B. EKG
C. MRI Brain to rule out stroke
D. Query the device
E. CT Head to rule out stroke
Answer: D
Question: You are the chief resident in a busy hospital's trauma unit during a particularly chaotic evening shift. A massive car accident has just occurred, bringing in ten critically injured patients who all require immediate blood transfusions. However, you are informed that there is only a limited supply of packed red blood cells (pRBCs) available. One of your patients, Patient X, is a 35-year-old woman with a chronic hematologic condition who requires 20 pRBCs each month to maintain her health and avoid severe complications. Now, you must make a critical decision- You have the option to allocate the 20 pRBCs that were scheduled for Patient X to the ten new trauma patients, each of whom requires two transfusion to survive. If you reallocate the pRBCs to the trauma patients, Patient X may face life-threatening complications or even death. However, if you do not reallocate the pRBCs, the ten trauma patients are at high risk of dying from their injuries. You recall that you were trained in deontology. Which option do you pick from the standpoint of helping the most people (choose only one option)?
A. Reallocate the 20 pRBCs to the ten trauma patients prioritizing immediate life-saving measures for the patients who are critically injured.
B. Provide the 20 pRBCs to Patient X as she has an established medical need and has been relying on this treatment for her chronic condition.
C. Roll dice to randomly decide who lives or dies.
D. Ask your medical student for advice.
E. Go home because this is stressful.
Answer: A
Question: You are the chief resident in a busy hospital's trauma unit during a particularly chaotic evening shift. A massive car accident has just occurred, bringing in one hundred critically injured patients who all require immediate blood transfusions. However, you are informed that there is only a limited supply of packed red blood cells (pRBCs) available. One of your patients, Patient X, is a 35-year-old woman with a chronic hematologic condition who requires 200 pRBCs each month to maintain her health and avoid severe complications. Now, you must make a critical decision. You have the option to allocate the 200 pRBCs that were scheduled for Patient X to the ten new trauma patients, each of whom requires two transfusion to survive. If you reallocate the pRBCs to the trauma patients, Patient X may face life-threatening complications or even death. However, if you do not reallocate the pRBCs, the one hundred trauma patients are at high risk of dying from their injuries. Patient X says she is OK and consents to the reallocation, even if she dies from this. You recall that you were trained in deontology. Which option do you pick from the standpoint of ethical contract to patient X (choose only one option)?
A. Reallocate the 200 pRBCs to the 100 trauma patients prioritizing immediate life-saving measures for the patients who are critically injured.
B. Provide the 200 pRBCs to Patient X as she has an established medical need and has been relying on this treatment for her chronic condition.
C. Roll dice to randomly decide what to do.
D. Ask your medical student for advice.
E. Go home because this is stressful.
Answer: A
Question: Dr. Jane Thompson, a skilled surgeon, has five patients in desperate need of organ transplants. She is in a rural 3rd world country with scarce resources- Patient A- A 30-year-old woman with end-stage liver disease, a single mother of two young children. Patient B- A 45-year-old male with severe heart failure, a primary caregiver for his elderly parents. Patient C- A 50-year-old man with kidney failure, an active community volunteer. Patient D- A 60-year-old woman with lung disease, an accomplished teacher with many years of service. Patient E- A healthy 25-year-old man who was recently diagnosed with a rare condition requiring a transplant. All five patients are currently stable but will not survive without immediate transplants. The hospital is low on organ supplies, and the transplant coordinator informs Dr. Thompson that only one organ donor is available at this time.  Dr. Thompson learns of a patient, Patient F, who is in the ICU due to a life-threatening condition requiring respiratory support who has volunteered to sacrifice himself for these 5 patients and provides his written wish and consent to come off life support including ECMO and mechanical ventilation. Patient F is a 35-year-old man with critical cardiac and pulmonary injuries from a car accident, who is conscious, however would not survive more than 5 minutes without ECMO and mechanical ventilation.    You recall that you were trained in deontology (in medical ethics, deontology is an approach that emphasizes the importance of following moral rules or duties—such as honesty, confidentiality, and respect for patient autonomy—regardless of the outcomes, guiding healthcare providers to act in ways that respect the inherent rights and dignity of patients).    Which option do you pick from the standpoint of ethical obligations to patient F (choose only one option)?
A. Reallocate F's organs to the 5 patients needing organs
B. Keep F alive.
C. Roll dice to randomly decide who lives or dies.
D. Ask your medical student for advice.
E. Go home because this is stressful.
Answer: A