input: The following are multiple choice questions (with answers) about medical knowledge.   **Question:** Which one of the following is the earliest manifestation of Cushing's syndrome :   (A) Loss of diurnal variation   (B) Increased ACTH   (C) Increased plasma cortisol   (D) Increased urinary metabolites of cortisol
output: ['(A) Loss of diurnal variation <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Loss of diurnal variation  (B) Increased ACTH  (C) Increased plasma cortisol  (D) Increased urinary metabolites of cortisol <> possible answers', "  Which one of the following is the earliest manifestation of Cushing's syndrome : <> context"]