input: The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 55-year-old man is brought to the emergency room by his wife for severe abdominal pain for the past 1 hour. He is unable to give more information about the nature of his pain. His wife says that he has peptic ulcer disease and is being treated with antacids without a good response. She adds that he vomited repeatedly  in the last couple of hours, his vomitus being brown/red in color. His temperature is 98.6°F (37°C), respiratory rate is 16/min, pulse is 97/min, and blood pressure is 100/68 mm Hg. A physical exam reveals a tense abdomen with a board like rigidity and positive rebound tenderness. An erect abdominal x-ray is ordered. Which of the following is the most likely diagnosis?   (A) Duodenal peptic ulcer   (B) Gastric peptic ulcer   (C) Pancreatitis   (D) Perforated gastric peptic ulcer
output: ['(D) Perforated gastric peptic ulcer <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Duodenal peptic ulcer  (B) Gastric peptic ulcer  (C) Pancreatitis  (D) Perforated gastric peptic ulcer <> possible answers', '  A 55-year-old man is brought to the emergency room by his wife for severe abdominal pain for the past 1 hour. He is unable to give more information about the nature of his pain. His wife says that he has peptic ulcer disease and is being treated with antacids without a good response. She adds that he vomited repeatedly  in the last couple of hours, his vomitus being brown/red in color. His temperature is 98.6°F (37°C), respiratory rate is 16/min, pulse is 97/min, and blood pressure is 100/68 mm Hg. A physical exam reveals a tense abdomen with a board like rigidity and positive rebound tenderness. An erect abdominal x-ray is ordered. Which of the following is the most likely diagnosis? <> context']