input: The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 57-year-old woman comes to the physician because of a 3-month history of fatigue. She also reports generalized itchiness that started approximately 2 months ago. Two weeks ago, she noticed yellowing of her eyes. She does not smoke or drink alcohol. She uses eyedrops for persistent dryness of the eyes. Her vital signs are within normal limits. Physical examination shows jaundice of the conjunctivae and skin. The mucous membranes of the mouth are dry. The abdomen is soft. The liver edge is palpable 3 cm below the right costal margin. There are generalized skin excoriations. Laboratory studies show: Hemoglobin 15 g/dL Leukocyte count 7,700/mm3 Platelet count 332,000/mm3 Serum Glucose 122 mg/dL Total bilirubin 3.1 mg/dL Direct 2.5 mg/dL Alkaline phosphatase 452 U/L AST 155 U/L ALT 168 U/L Hepatitis B surface antigen negative Hepatitis B core IgM antibody negative Hepatitis B surface antibody positive Hepatitis C antibody negative Ultrasonography of the abdomen shows mildly increased echogenicity of the liver. Which of the following additional findings is most likely to be found in this patient?"   (A) Inferior vena cava thrombosis   (B) Cutaneous xanthomas   (C) Increased CA 19-9 levels   (D) Kayser-Fleischer rings "
output: ['(B) Cutaneous xanthomas <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Inferior vena cava thrombosis  (B) Cutaneous xanthomas  (C) Increased CA 19-9 levels  (D) Kayser-Fleischer rings" <> possible answers', '  A 57-year-old woman comes to the physician because of a 3-month history of fatigue. She also reports generalized itchiness that started approximately 2 months ago. Two weeks ago, she noticed yellowing of her eyes. She does not smoke or drink alcohol. She uses eyedrops for persistent dryness of the eyes. Her vital signs are within normal limits. Physical examination shows jaundice of the conjunctivae and skin. The mucous membranes of the mouth are dry. The abdomen is soft. The liver edge is palpable 3 cm below the right costal margin. There are generalized skin excoriations. Laboratory studies show:\nHemoglobin 15 g/dL\nLeukocyte count 7,700/mm3\nPlatelet count 332,000/mm3\nSerum\nGlucose 122 mg/dL\nTotal bilirubin 3.1 mg/dL\nDirect 2.5 mg/dL\nAlkaline phosphatase 452 U/L\nAST 155 U/L\nALT 168 U/L\nHepatitis B surface antigen negative\nHepatitis B core IgM antibody negative\nHepatitis B surface antibody positive\nHepatitis C antibody negative\nUltrasonography of the abdomen shows mildly increased echogenicity of the liver. Which of the following additional findings is most likely to be found in this patient?" <> context']