In this task, you are given a multiple-choice question about healthcare. Answer the question based on your information and classify your answers into '1', '2', '3', and '4'.

Ex Input:
Question: The limitation of the therapeutic effort refers to:
Options: <1> Palliative sedation <2> Assisted suicide. <3> To the rejection to the treatment. <4> To the non-therapeutic fierceness. <5> To double effect therapy.

Ex Output:
4

Ex Input:
Question: The differential modification of RNA:
Options: <1> It can result in multiple products from one gene. <2> It occurs thanks to the transcription bubble. <3> It is catalyzed by RNA polymerase I. <4> It is catalyzed by RNA polymerase II. <5> It is catalyzed by RNA polymerase III.

Ex Output:
1

Ex Input:
Question: A 62-year-old man with type 2 diabetes mellitus of 10 years of evolution performs treatment with metformin and sitagliptin. Does little physical exercise and performs a proper diet. In the last 6 months he has lost weight and has more asthenia. Their glycemic controls have deteriorated, going from basal glycemia of 110-140 mg / dl to glycemias of 170-200 mg / dl, as well as their glycosylated hemoglobin, which has gone from 7.1 to 8.5%. The most appropriate therapeutic measure to perform is:
Options: <1> Increase the intake of protein and long chain carbohydrates in the diet to improve asthenia and weight loss. <2> Associate a dose of basal insulin with the treatment. <3> Associate acarbose treatment. <4> Replace sitagliptin with pioglitazone. <5> Replace metformin with glimepiride.

Ex Output:
2