input: The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 24-year-old woman presents to a physician with a history of exposure to a close friend who was diagnosed with meningococcal meningitis. She was told by her friend that she need to see a physician because she needs to be treated as well, even if she is not having symptoms yet. She currently denies any headaches, vision changes, nausea or vomiting, or neck stiffness. Her physical exam is within normal limits. Her vital signs are stable. She is prescribed rifampin for prophylaxis with specific instructions on when to follow up if symptoms develop. When asked about the possibility of pregnancy, she mentioned that she uses combination oral contraceptive pills (OCPs) for contraception. The physician suggested that her husband should use condoms for contraception as she requires antibiotic therapy. Which of the following mechanisms best explains the need for additional contraception?   (A) Rifampin alters normal gastrointestinal flora, which leads to a decrease in the enterohepatic circulation of estrogens.   (B) Rifampin inhibits CYP3A4, which metabolizes progestins.   (C) Rifampin alters normal gastrointestinal flora, which leads to a decrease in the enterohepatic circulation of progestins.   (D) Rifampin directly interferes with intestinal absorption of estrogens.
output: ['(A) Rifampin alters normal gastrointestinal flora, which leads to a decrease in the enterohepatic circulation of estrogens. <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Rifampin alters normal gastrointestinal flora, which leads to a decrease in the enterohepatic circulation of estrogens.  (B) Rifampin inhibits CYP3A4, which metabolizes progestins.  (C) Rifampin alters normal gastrointestinal flora, which leads to a decrease in the enterohepatic circulation of progestins.  (D) Rifampin directly interferes with intestinal absorption of estrogens. <> possible answers', '  A 24-year-old woman presents to a physician with a history of exposure to a close friend who was diagnosed with meningococcal meningitis. She was told by her friend that she need to see a physician because she needs to be treated as well, even if she is not having symptoms yet. She currently denies any headaches, vision changes, nausea or vomiting, or neck stiffness. Her physical exam is within normal limits. Her vital signs are stable. She is prescribed rifampin for prophylaxis with specific instructions on when to follow up if symptoms develop. When asked about the possibility of pregnancy, she mentioned that she uses combination oral contraceptive pills (OCPs) for contraception. The physician suggested that her husband should use condoms for contraception as she requires antibiotic therapy. Which of the following mechanisms best explains the need for additional contraception? <> context']