input: The following are multiple choice questions (with answers) about medical knowledge.   **Question:** Effect of thumb sucking:   (A) Localized anterior open bite.   (B) Increase overjet.   (C) Constricted maxilla   (D) All of the above.
output: ['(D) All of the above. <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Localized anterior open bite.  (B) Increase overjet.  (C) Constricted maxilla  (D) All of the above. <> possible answers', '  Effect of thumb sucking: <> context']