input: The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 53-year-old man comes to the physician because of a 3-month history of cough and progressively worsening difficulty walking up the stairs in his apartment. He has noticed that it is easier for him to climb the stairs after he has exercised. He has also had a 4.6-kg (10.1-lb) weight loss over the past 6 months. He has smoked one pack of cigarettes daily for 35 years. Examination shows dry mucous membranes. The pupils are equal and react sluggishly to light. Muscle strength in the proximal lower extremity is initially 3/5 but increases to 5/5 after repeated muscle tapping. His achilles reflex is 1+. Which of the following is the most likely diagnosis?   (A) Polymyalgia rheumatica   (B) Dermatomyositis   (C) Hypothyroidism   (D) Lambert-Eaton syndrome
output: ['(D) Lambert-Eaton syndrome <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Polymyalgia rheumatica  (B) Dermatomyositis  (C) Hypothyroidism  (D) Lambert-Eaton syndrome <> possible answers', '  A 53-year-old man comes to the physician because of a 3-month history of cough and progressively worsening difficulty walking up the stairs in his apartment. He has noticed that it is easier for him to climb the stairs after he has exercised. He has also had a 4.6-kg (10.1-lb) weight loss over the past 6 months. He has smoked one pack of cigarettes daily for 35 years. Examination shows dry mucous membranes. The pupils are equal and react sluggishly to light. Muscle strength in the proximal lower extremity is initially 3/5 but increases to 5/5 after repeated muscle tapping. His achilles reflex is 1+. Which of the following is the most likely diagnosis? <> context']