input: The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A previously healthy 17-year-old female college student comes to the emergency department because of a 1-day history of fever, chills, and severe headache. Her temperature is 39.4°C (103°F). Physical examination shows nuchal rigidity and photophobia. Blood cultures are obtained and a lumbar puncture is performed. A Gram stain of cerebrospinal fluid shows gram-negative cocci in pairs. Which of the following virulence factors was most likely involved in the initial step of this patient's infection?   (A) Protein A   (B) Lipooligosaccharides   (C) Adhesive pili   (D) Biofilm formation
output: ['(C) Adhesive pili <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Protein A  (B) Lipooligosaccharides  (C) Adhesive pili  (D) Biofilm formation <> possible answers', "  A previously healthy 17-year-old female college student comes to the emergency department because of a 1-day history of fever, chills, and severe headache. Her temperature is 39.4°C (103°F). Physical examination shows nuchal rigidity and photophobia. Blood cultures are obtained and a lumbar puncture is performed. A Gram stain of cerebrospinal fluid shows gram-negative cocci in pairs. Which of the following virulence factors was most likely involved in the initial step of this patient's infection? <> context"]