input: The following are multiple choice questions (with answers) about medical knowledge.   **Question:** Most important initiative factor for periodontitis is:   (A) Dental plaque   (B) Calculus   (C) Trauma from occlusion   (D) Food debris layer
output: ['(A) Dental plaque <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Dental plaque  (B) Calculus  (C) Trauma from occlusion  (D) Food debris layer <> possible answers', '  Most important initiative factor for periodontitis is: <> context']