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id stringlengths 4 7	text stringlengths 713 5.47k ⌀	labels stringlengths 739 6.26k ⌀
227_72	[['QUESTION', 'TYPE:', 'CARDIOLOGY'], ['CLINICAL', 'CASE:'], ['A', '45-year-old', 'woman', 'with', 'a', 'history', 'of', 'heart', 'murmur', 'detected', 'in', 'childhood.'], ['She', 'is', 'admitted', 'to', 'the', 'emergency', 'department', 'for', 'palpitations,', 'easy', 'fatigue', 'and', 'malleolar', 'edema.'], ['Physical', 'examination', 'revealed', 'absence', 'of', 'cyanosis.'], ['Oxygen', 'saturation', 'by', 'pulse', 'oximeter', '97%', 'BP', '120/80', 'mmHg.'], ['Irregular', 'heart', 'rhythm', 'at', '100', 'bpm.'], ['Ejective', 'systolic', 'murmur', '(2/6)', 'in', 'pulmonary', 'focus.'], ['2nd', 'unfolded', 'noise,', 'wide', 'and', 'fixed.'], ['No', 'rales.'], ['Slight', 'hepatomeglaia', '(2-3', 'cm).'], ['Slight', 'malleolar', 'edema.'], ['ECG:', 'complete', 'arrhythmia', 'due', 'to', 'atrial', 'fibrillation', 'at', '100', 'bpm.'], ['QRS', '+120º.'], ['Conduction', 'disorder', 'of', 'the', 'right', 'bundle', 'branch', 'of', 'the', 'His', 'bundle.'], ['What', 'is', 'its', 'diagnostic', 'orientation?'], ['1-', 'Ventricular', 'septal', 'defect.'], ['2-', 'Aortic', 'stenosis.'], ['3-', 'Mitral', 'stenosis.'], ['4-', 'Atrial', 'septal', 'defect.'], ['5-', 'Patent', 'ductus', 'arteriosus.'], ['CORRECT', 'ANSWER:', '4'], ['If', 'he', 'has', 'a', 'pediatric', 'murmur,', "I'm", 'thinking', 'congenital.'], ['Hepatomegaly,', 'malleolar', 'edema', 'and', 'BRD,', 'something', 'that', 'overloads', 'the', 'right', 'heart.'], ['So', 'we', 'rule', 'out', 'aortic', 'and', 'mitral', 'stenosis.'], ['A', 'patent', 'ductus', 'would', 'give', 'cyanosis:', 'ruled', 'out.'], ['VSD', 'or', 'ASD?'], ['If', 'I', 'am', 'told', 'that', 'he', 'has', 'AF,', 'it', 'is', 'because', 'the', 'atria', 'are', 'of', 'size', 'XL,', 'and', 'a', 'VSD', 'does', 'not', 'produce', 'atrial', 'dilatation.']]	[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
168_86	[['QUESTION', 'TYPE:', 'CARDIOLOGY', 'AND', 'CARDIOVASCULAR', 'SURGERY'], ['CLINICAL', 'CASE:'], ['What', 'examination', 'would', 'you', 'advise', 'in', 'the', 'first', 'place', 'for', 'an', '82-year-old', 'patient', 'with', 'exertional', 'angina', 'and', 'a', 'systolic', 'ejection', 'murmur', 'of', 'intensity', '3/6', 'on', 'auscultation?'], ['1-', 'A', 'stress', 'test.'], ['2-', 'Coronary', 'angiography.'], ['3-', 'Exercise', 'echocardiogram.'], ['4-', 'Coronary', 'CT', 'scan.'], ['5-', 'Doppler', 'echocardiogram.'], ['CORRECT', 'ANSWER:', '5'], ['Ejective', 'murmur,', 'our', 'first', 'suspicion', 'is', 'aortic', 'stenosis.'], ['Angina', 'may', 'be', 'due', 'to', 'the', 'stenosis', 'itself', 'or', 'to', 'underlying', 'coronary', 'artery', 'disease', '(probable,', 'given', 'the', 'age).'], ['And', 'with', 'this', 'information,', 'we', 'cannot', 'know', 'if', 'the', 'stenosis', 'is', 'severe.'], ['Therefore,', 'the', 'first', 'thing', 'we', 'will', 'have', 'to', 'do', 'will', 'be', 'to', 'study', 'the', 'valve', 'disease:', 'we', 'do', 'not', 'want', 'to', 'put', 'the', 'patient', 'to', 'run', 'or', 'overload', 'him', 'with', 'dobuta', 'and', 'have', 'a', 'syncope,', 'nor', 'do', 'we', 'want', 'to', 'do', 'a', 'catheterization', 'without', 'having', 'first', 'performed', 'another', 'noninvasive', 'test.'], ['And', 'cardioTC,', 'in', 'someone', '80', 'years', 'old,', 'is', 'going', 'to', 'tell', 'us', 'what', 'we', 'already', 'know:', 'that', 'he', 'has', 'calcium', 'up', 'to', 'his', 'eyebrows.']]	[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
329_84	null	null
447_131	[['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['A', '25-year-old', 'man', 'with', 'no', 'known', 'history', 'of', 'interest.'], ['He', 'has', 'been', 'presenting', 'with', 'foamy', 'and', 'loaded', 'urine', 'for', '2', 'months,', 'with', 'no', 'other', 'symptoms.'], ['Physical', 'examination', 'without', 'findings.'], ['Elemental', 'urine:', 'pH', '5;', 'glucose', 'negative;', 'hemoglobin', '++;', 'protein', '++;', 'leukocyte', 'esterase', 'negative;', 'proteinuria', '1.5', 'g/24', 'hours;', 'urinary', 'Na', '60', 'mEq/L;', 'urinary', 'K', '30', 'mEq/L;', 'urinary', 'Cl', '100', 'mEq/L.'], ['Blood', 'biochemistry:', 'creatinine', '1.6', 'mg/dL;', 'urea', '80', 'mg/dL;', 'Na', '140', 'mEq/L;', 'K', '3.8', 'mEq/L.'], ['Immunological', 'study:', 'antiDNA', 'negative;', 'ANCA', 'negative;', 'antiMBG', 'negative,', 'rheumatoid', 'factor', 'negative;', 'C3', '20', 'mg/dL', '(normal', '60-120);', 'C4', '10', 'mg/dL', '(normal', '20-40).'], ['A', 'renal', 'biopsy', 'is', 'performed.'], ['Which', 'of', 'these', 'diagnoses', 'do', 'you', 'think', 'is', 'the', 'most', 'likely', 'to', 'be', 'found', 'in', 'the', 'biopsy?'], ['1-', 'Membranous', 'glomerulonephritis.'], ['2-', 'Glomerulonephritis', 'with', 'minimal', 'changes.'], ['3-', 'Mesangial', 'IgA', 'glomerulonephritis.'], ['4-', 'Membranoproliferative', 'glomerulonephritis.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['We', 'are', 'presented', 'with', 'a', 'lot', 'of', 'analytical', 'data', 'but', 'we', 'only', 'have', 'to', 'look', 'at', 'two:', 'the', 'levels', 'of', 'complement', 'fractions', 'C3', 'and', 'C4', 'are', 'low.'], ['Of', 'the', 'options', 'given,', 'only', 'membranoproliferative', 'glomerulonephritis', 'presents', 'with', 'hypocomplementemia', '(option', '4', 'correct).']]	[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim']]
72_52	[['QUESTION', 'TYPE:', 'ANESTHESIOLOGY,', 'CRITICAL', 'CARE', 'AND', 'EMERGENCIES'], ['CLINICAL', 'CASE:'], ['A', '72-year-old', 'man,', 'ex-smoker,', 'hypertensive', 'and', 'diabetic.'], ['History', 'of', 'stroke', 'with', 'residual', 'paresis', 'in', 'the', 'left', 'arm', '4', 'months', 'ago.'], ['He', 'comes', 'to', 'the', 'emergency', 'department', 'of', 'a', 'regional', 'hospital', 'with', 'intense', 'precordial', 'pain', 'of', '2', 'hours', 'of', 'evolution;', 'in', 'the', 'physical', 'examination', 'he', 'presents', 'cold', 'and', 'sweaty', 'skin,', 'blood', 'pressure', 'of', '80', 'mm', 'Hg;', 'electrocardiogram', 'with', 'marked', 'ST', 'segment', 'elevation', 'in', 'leads', 'V1-V6,', 'I', 'and', 'aVL.'], ['Which', 'of', 'the', 'following', 'treatments', 'of', 'coronary', 'repercussion', 'is', 'the', 'most', 'appropriate?'], ['1-', 'Immediate', 'systemic', 'fibrinolysis', 'at', 'the', 'regional', 'hospital.'], ['2-', 'Immediate', 'transfer', 'to', 'a', 'tertiary', 'center', 'for', 'treatment', 'with', 'fibrinolysis.'], ['3-', 'Immediate', 'transfer', 'to', 'a', 'tertiary', 'center', 'for', 'percutaneous', 'coronary', 'revascularization', 'procedure.'], ['4-', 'Hemodynamic', 'stabilization', 'and', 'deferred', 'revascularization', 'procedure.'], ['5-', 'Immediate', 'treatment', 'with', 'fondaparinux', 'and', 'abciximab.'], ['CORRECT', 'ANSWER:', '3'], ['This', 'question', 'combines', 'several', 'important', 'facts.'], ['To', 'begin', 'with,', 'this', 'is', 'a', 'patient', 'with', 'an', 'extensive', 'anterior', 'and', 'lateral', 'AMI,', 'with', 'cardiogenic', 'shock.'], ['On', 'the', 'other', 'hand,', 'in', 'the', 'history,', 'we', 'are', 'told', 'that', 'the', 'patient', 'had', 'a', 'stroke', '4', 'months', 'ago.'], ['It', 'is', 'evident', 'from', 'the', "patient's", 'clinical', 'picture', 'that', 'an', 'urgent', 'reperfusion', 'strategy', 'is', 'indicated,', 'which', 'invalidates', 'options', '4', 'and', '5.'], ['The', 'basic', 'question', 'is', 'whether', 'to', 'choose', 'fibrinolysis', '(which', 'can', 'be', 'done', 'in', 'a', 'regional', 'hospital)', 'or', 'PCI', '(for', 'which', 'the', 'patient', 'should', 'be', 'referred', 'to', 'a', 'tertiary', 'center).'], ['Option', '2', 'does', 'not', 'make', 'much', 'sense,', 'since', 'in', 'the', 'event', 'that', 'fibrinolysis', 'is', 'indicated,', 'it', 'would', 'only', 'be', 'a', 'waste', 'of', 'time', 'to', 'make', 'the', 'transfer.'], ['A', 'history', 'of', 'stroke', '(presumably', 'ischemic)', '4', 'months', 'ago', 'is', 'a', 'relative', 'contraindication', 'for', 'fibrinolysis', '(if', 'the', 'time', 'is', 'less', 'than', '3', 'months', 'it', 'is', 'an', 'absolute', 'contraindication),', 'but', 'the', 'definitive', 'factor', 'that', 'tips', 'the', 'balance', 'towards', 'PCI', 'is', 'the', 'extent', 'of', 'AMI', 'and', 'the', 'presence', 'of', 'shock,', 'which', 'are', 'indications', 'for', 'urgent', 'PCI.'], ['Therefore,', 'the', 'correct', 'answer', 'is', '3.']]	[['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 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'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
505_85	[['QUESTION', 'TYPE:', 'PSYCHIATRY'], ['CLINICAL', 'CASE:'], ['A', '79-year-old', 'patient', 'is', 'brought', 'to', 'the', 'ED', 'at', '7', 'pm', 'from', 'a', 'nursing', 'home,', 'but', 'we', 'do', 'not', 'have', 'the', 'referral', 'report', 'and', 'therefore', 'do', 'not', 'know', 'his', 'history.'], ['He', 'is', 'disoriented', 'in', 'time', 'and', 'space.'], ['He', 'has', 'trouble', 'remembering', 'simple', 'information.'], ['Sometimes', 'he', 'becomes', 'very', 'nervous', 'and', 'agitated,', 'because', 'he', 'sees', 'threatening', 'people,', 'even', 'when', 'he', 'is', 'alone.'], ['At', 'other', 'times', 'he', 'appears', 'drowsy', 'and', 'inattentive.'], ['The', 'main', 'data', 'supporting', 'the', 'diagnosis', 'of', 'delirium', 'as', 'opposed', 'to', 'dementia', 'is:'], ['1-', 'The', 'presence', 'of', 'visual', 'hallucinations.'], ['2-', 'Cognitive', 'symptoms.'], ['3-', 'Psychomotor', 'agitation.'], ['4-', 'Fluctuation', 'of', 'the', 'alert', 'level.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['Little', 'to', 'comment....', 'is', 'the', 'definition', 'of', 'delirium.'], ['Altered', 'state', 'of', 'consciousness.']]	[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'B-Disease', 'B-Marker', 'I-Marker', 'I-Marker', 'B-Disease', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
360_93	[['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['46-year-old', 'woman', 'with', 'a', 'history', 'of', 'rheumatic', 'valve', 'disease,', 'requiring', 'mitral', 'valve', 'replacement', 'with', 'a', 'mechanical', 'prosthesis.'], ['The', 'initial', 'postoperative', 'evolution', 'is', 'favorable.'], ['However,', 'after', 'starting', 'treatment', 'with', 'acenocoumarol,', 'she', 'develops', 'a', 'picture', 'of', 'skin', 'necrosis', 'affecting', 'the', 'abdominal', 'region', 'and', 'extremities.'], ['Which', 'of', 'the', 'following', 'alterations', 'would', 'justify', 'this', 'picture?'], ['1-', 'Antithrombin', 'deficiency.'], ['2-', 'Factor', 'V', 'Leiden.'], ['3-', 'Hyperhomocysteinemia.'], ['4-', 'Protein', 'C', 'deficiency.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['Warfarin-induced', 'skin', 'necrosis', 'is', 'a', 'rare', 'and', 'serious', 'adverse', 'effect', 'of', 'oral', 'anticoagulant', 'therapy,', 'occurring', 'in', 'only', '0.01', 'to', '0.1%', 'of', 'patients', 'and', 'is', 'especially', 'related', 'to', 'coagulation', 'protein', 'C', 'and', 'S', 'deficiency.']]	[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
459_173	[['QUESTION', 'TYPE:', 'TRAUMATOLOGY', 'AND', 'ORTHOPEDICS'], ['CLINICAL', 'CASE:'], ['A', '36-year-old', 'man', 'with', 'no', 'past', 'history', 'of', 'interest', 'who,', 'after', 'a', 'high-energy', 'trauma', 'following', 'a', 'fall', 'from', 'a', 'motorcycle,', 'presents', 'with', 'a', 'Gustilo', 'grade', 'II', 'open', 'midshaft', 'fracture', 'of', 'the', 'tibia.'], ['Which', 'of', 'the', 'following', 'maneuvers', 'or', 'therapies', 'is', 'most', 'effective', 'for', 'preventing', 'infection?'], ['1-', 'Immediate', 'intravenous', 'broad-spectrum', 'antibiotherapy.'], ['2-', 'Exhaustive', 'debridement-wound', 'lavage', 'in', 'the', 'operating', 'room', 'with', 'at', 'least', '10', 'liters', 'of', 'saline.'], ['3-', 'Urgent', 'stabilization', 'of', 'the', 'fracture', 'by', 'external', 'fixation', 'and', 'early', 'wound', 'closure.'], ['4-', 'Early', 'wound', 'closure', 'with', 'antiseptics', 'and', 'oxygen', 'therapy', 'at', 'two', 'liters', 'per', 'minute.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['I', 'believe', 'that', 'the', 'most', 'correct', 'is', '2,', 'since', 'Gustilo', 'II', 'fractures', 'are', 'mainly', 'covered', 'with', 'Gram', '(+)', 'by', 'means', 'of', 'a', '1st', 'generation', 'Cepha,', 'and', 'it', 'is', 'not', 'a', 'question', 'of', 'prevention', 'but', 'of', 'treatment', '(it', 'is', 'considered', 'to', 'be', 'contaminated).']]	[['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
149_162	[['QUESTION', 'TYPE:', 'PSYCHIATRY'], ['CLINICAL', 'CASE:'], ['A', '52-year-old', 'woman', 'comes', 'to', 'the', 'emergency', 'room', 'with', 'bilateral', 'paralysis', 'of', 'the', 'upper', 'extremities', 'that', 'had', 'started', 'abruptly', 'two', 'hours', 'earlier.'], ['In', 'the', 'interview', 'she', 'is', 'smiling', 'and', 'says', 'she', 'does', 'not', 'understand', 'why', 'her', 'family', 'is', 'so', 'worried.'], ['The', 'family', 'refers', 'that', 'the', 'day', 'before', 'her', 'son', 'had', 'been', 'arrested', 'by', 'the', 'police', 'for', 'drug', 'trafficking', 'and', 'they', 'had', 'not', 'yet', 'been', 'able', 'to', 'contact', 'him.'], ['Which', 'of', 'the', 'following', 'is', 'the', 'most', 'likely', 'diagnosis?'], ['1-', 'Factitious', 'disorder.'], ['2-', 'Delusional', 'disorder.'], ['3-', 'Hypochondriasis.'], ['4-', 'Major', 'depressive', 'disorder.'], ['5-', 'Conversive', 'disorder.'], ['CORRECT', 'ANSWER:', '5'], ['The', 'nice', 'word', 'to', 'describe', 'this', 'is:', '"Belle', 'indeference",', 'this', 'woman', 'shows', 'herself', 'with', 'an', 'elegant', 'indifference', 'to', 'a', 'paralysis.'], ['The', 'diagnosis....', 'can', 'be', 'excluded', '2,3,4', 'because', 'the', 'clinical', 'does', 'not', 'match:', 'no', 'delirium,', 'no', 'worry,', 'no', 'sadness.'], ['1', 'would', 'be', 'if', 'he', 'was', 'making', 'a', 'profit,', 'if', 'he', 'was', 'knowingly', 'simulating', 'and', 'to', 'make', 'a', 'profit', 'he', 'was', 'faking', 'his', 'illness.'], ['This', 'is', 'not', 'the', 'case.'], ['Conversive', 'would', 'be', 'if', 'the', 'symptom', 'wanted', 'to', 'transmit', 'something', 'to', 'us,', 'that', 'is', 'to', 'say,', 'it', 'was', 'a', 'metaphor', 'of', 'its', 'internal', 'world...'], ['The', 'most', 'exact', 'in', 'this', 'case:', '5.']]	[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
246_116	[['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES'], ['CLINICAL', 'CASE:'], ['A', 'patient', 'with', 'a', 'history', 'of', 'excessive', 'alcohol', 'consumption', 'has', 'been', 'diagnosed', 'with', 'pulmonary', 'tuberculosis', 'due', 'to', 'cough,', 'fever,', 'expectoration,', 'and', 'sputum', 'culture', 'isolation', 'of', 'Mycobacterium', 'tuberculosis.'], ['The', 'patient', 'started', 'treatment', 'with', 'isoniazid,', 'rifampicin,', 'ethambutol', 'and', 'pyrazinamide,', 'with', 'adequate', 'tolerance.'], ['Twenty', 'days', 'after', 'starting', 'treatment,', 'a', 'report', 'of', 'rifampicin', 'resistance', 'of', 'M.', 'tuberculosis', 'isolated', 'in', 'sputum', 'is', 'received.'], ['Which', 'regimen', 'would', 'you', 'select', 'based', 'on', 'this', 'report?'], ['1-', 'Isoniazid,', 'ethambutol,', 'pyrazinamide', 'for', '12', 'months.'], ['2-', 'Isoniazid,', 'ethambutol,', 'pyrazinamide', 'for', '12', 'months', 'and', 'streptomycin', 'for', 'two', 'months.'], ['3-', 'Isoniazid,', 'ethambutol,', 'pyrazinamide', 'for', '12', 'months', 'and', 'a', 'quinolone', 'for', 'two', 'months.'], ['4-', 'Isoniazid,', 'ethambutol,', 'pyrazinamide', 'and', 'a', 'quinolone', 'for', '18', 'months.'], ['5-', 'Isoniazid,', 'ethambutol,', 'pyrazinamide', 'for', '18', 'months', 'and', 'streptomycin', 'and', 'a', 'quinolone', 'for', '2', 'months.'], ['CORRECT', 'ANSWER:', '3'], ['Another', 'question', 'that', 'may', 'generate', 'discussion.'], ['When', 'a', 'diagnosis', 'of', 'active', 'tuberculosis', 'infection', 'is', 'made,', 'treatment', 'is', 'initiated', 'with', 'isoniazid,', 'rifampicin', 'and', 'pyrazinamide', 'together', 'with', 'ethambutol', 'in', 'case', 'of', 'suspicion', 'of', 'strains', 'resistant', 'to', 'any', 'of', 'the', 'drugs.'], ['Once', 'the', 'existence', 'of', 'resistance', 'has', 'been', 'ruled', 'out,', 'ethambutol', 'can', 'be', 'dispensed', 'with.'], ['In', 'case', 'of', 'resistance', 'to', 'rifampicin,', 'rifampicin', 'is', 'withdrawn', 'and', 'treatment', 'is', 'completed', 'with', 'the', '3', 'remaining', 'drugs', 'for', '12', 'months.'], ['The', 'option', 'of', 'adding', 'a', 'quinolone', 'during', 'the', 'first', 'two', 'months', 'of', 'treatment', '(moxifloxacin', 'or', 'levofloxacin)', 'is', 'considered', 'in', 'cases', 'of', 'extensive', 'pulmonary', 'involvement.'], ['In', 'this', 'case,', 'they', 'do', 'not', 'tell', 'us', 'anything', 'about', 'extensive', 'pulmonary', 'involvement', 'but', 'they', 'give', 'us', 'a', 'data', '"excessive', 'alcohol', 'consumption".'], ['You', 'know', 'that', 'in', 'the', 'MIR', 'no', 'data', 'is', 'free,', 'and', 'if', 'the', 'person', 'who', 'posted', 'this', 'question', 'wanted', 'to', 'reflect', 'it,', 'probably', 'his', 'intention', 'was', 'that', 'we', 'reflect', 'on', 'it.'], ['Alcohol', 'exerts', 'a', 'direct', 'immunosuppressive', 'effect,', 'moreover,', 'alcoholism', 'is', 'related', 'to', 'the', 'affectation', 'of', 'immunity', 'in', 'the', 'respiratory', 'tract.'], ['The', 'social', 'context', 'that', 'usually', 'accompanies', 'the', 'alcoholic', 'patient', 'does', 'not', 'help', 'either.'], ['All', 'the', 'factors', 'mentioned', 'above', 'make', 'us', 'lean', 'more', 'towards', 'answer', 'number', '3,', 'although', 'it', 'is', 'undeniable', 'that', 'number', '1', 'could', 'also', 'be', 'correct.']]	[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
457_126	[['QUESTION', 'TYPE:', 'OTORHINOLARYNGOLOGY', 'AND', 'MAXILLOFACIAL', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '47-year-old', 'man,', 'with', 'a', 'history', 'of', 'a', 'right', 'parotid', 'pleomorphic', 'adenoma,', 'treated', 'with', 'surgery', '(extrafacial', 'parotidectomy)', '6', 'months', 'ago,', 'who', 'comes', 'to', 'our', 'office', 'for', 'presenting', 'pain', 'with', 'sweating', 'and', 'reddening', 'of', 'the', 'skin', 'in', 'the', 'preauricular', 'region', 'during', 'chewing.'], ['Which', 'treatment', 'would', 'be', 'the', 'treatment', 'of', 'choice?'], ['1-', 'Extended', 'total', 'parotidectomy', 'on', 'suspicion', 'of', 'tumor', 'recurrence.'], ['2-', 'Pregabalin.'], ['3-', 'Intradermal', 'botulinum', 'toxin', 'injection.'], ['4-', 'Broad-spectrum', 'antibiotherapy.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['This', 'clinical', 'picture', 'is', 'called', "Frey's", 'syndrome', 'and', 'consists', 'of', 'an', 'anomalous', 'reinnervation', 'of', 'regional', 'structures', 'after', 'parotidectomy', 'due', 'to', 'lesion', 'of', 'the', 'auriculotemporal', 'nerve,', 'so', 'that', 'during', 'mastication,', 'erythema', 'and', 'preauricular', 'sweating', 'occur.'], ['The', 'treatment', 'is', 'intradermal', 'botulinum', 'toxin', 'injection.']]	[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'I-Marker', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
165_229	[['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['A', '58-year-old', 'woman,', 'weight', '130', 'kg,', 'height', '155', 'cm,', 'body', 'mass', 'index', '>', '30', 'with', 'mild', 'hypertension,', 'blood', 'glucose', '108', 'mg/dL', 'and', 'absence', 'of', 'edema', 'in', 'the', 'lower', 'limbs.'], ['Blood', 'analysis', 'showed', 'Cr', '2.0', 'mg/dL,', 'Urea', '86', 'mg/dL,', 'Alb', '3.8', 'g/1,', 'Na', '142', 'mEq/L,', 'K', '4', 'mEq/L.'], ['In', 'urinalysis:', 'sediment', 'without', 'alterations', 'and', 'in', '24', 'h', 'urine', 'proteinuria', 'of', '6.3', 'g/24', 'h.'], ['Which', 'of', 'the', 'following', 'entities', 'is', 'more', 'likely', 'to', 'be', 'present?'], ['1-', 'Secondary', 'membranous', 'glomerulonephritis.'], ['2-', 'Focal', 'and', 'segmental', 'glomerulonephritis.'], ['3-', 'IgA', 'nephropathy.'], ['4-', 'Rapidly', 'progressive', 'glomerulonephritis.'], ['5-', 'Minimal', 'change', 'nephropathy.'], ['CORRECT', 'ANSWER:', '2'], ['The', 'correct', 'answer', 'is:', '2.'], ['Focal', 'segmental', 'glomerulonephritis.'], ['We', 'are', 'in', 'front', 'of', 'a', 'patient', 'with', 'renal', 'insufficiency', 'whose', 'manifestation', 'is', 'a', 'proteinuria.'], ['That', 'places', 'us', 'in', 'the', 'picture', 'of', 'nonproliferative', 'GN', '(membranous,', 'focal', 'and', 'segmental', 'and', 'minimal', 'changes,', 'discarding', 'the', 'other', 'two).'], ['If', 'we', 'also', 'consider', 'that', 'the', 'patient', 'was', 'obese,', 'slightly', 'hypertensive,', 'the', 'most', 'probable', 'is', 'that', 'it', 'is', 'a', 'focal', 'segmental', 'glomerulonephritis.']]	[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
157_73	[['QUESTION', 'TYPE:', 'TRAUMATOLOGY', 'AND', 'ORTHOPEDICS'], ['CLINICAL', 'CASE:'], ['A', '75-year-old', 'patient', 'with', 'significant', 'gonarthrosis', 'with', '"Genu', 'Varo"', 'that', 'causes', 'marked', 'functional', 'impotence,', 'limited', 'mobility', 'and', 'continuous', 'pain', 'that', 'requires', 'continuous', 'antirheumatic,', 'anti-inflammatory', 'and', 'analgesic', 'medication.'], ['What', 'treatment', 'should', 'be', 'indicated', 'in', 'this', 'case?'], ['1-', 'Arthroscopic', 'lavage', 'of', 'the', 'knee.'], ['2-', 'Rehabilitation', 'of', 'the', 'affected', 'knee.'], ['3-', 'Arthroplasty', 'of', 'the', 'affected', 'knee.'], ['4-', 'Abduction', 'supratuberosity', 'tibial', 'supratuberosity', 'tibial', 'osteotomy.'], ['5-', 'Knee', 'synovectomy.'], ['CORRECT', 'ANSWER:', '3'], ['We', 'are', 'dealing', 'with', 'a', 'patient', 'who', 'has', 'exhausted', 'the', 'pharmacological', 'route', 'given', 'that', 'he', 'takes', 'everything', 'and', 'has', 'two', 'important', 'problems:', 'genu', 'varum', 'and', 'an', 'important', 'gonarthrosis.'], ['This', 'means', 'that', 'we', 'can', 'do', 'nothing', 'with', 'an', 'arthroscopy,', 'let', 'alone', 'a', 'synovectomy', '(1', 'and', '5', 'false).'], ['The', 'genu', 'varum', 'could', 'falsely', 'make', 'us', 'think', 'about', 'an', 'osteotomy,', 'however', 'even', 'if', 'we', 'did', 'it', 'and', 'corrected', 'the', 'varus', 'now', 'the', 'damage', 'is', 'already', 'done', 'and', 'the', 'osteoarthrosis', 'is', 'severe.'], ['Perhaps', 'years', 'ago', 'before', 'the', 'osteoarthritis', 'took', 'place', 'it', 'would', 'have', 'been', 'resolutive', 'but', 'not', 'now', '(4', 'false).'], ['In', 'addition,', 'in', 'order', 'to', 'consider', 'an', 'osteotomy,', 'we', 'should', 'be', 'given', 'more', 'data', 'to', 'know', 'which', 'bone', 'to', 'apply', 'the', 'osteotomy', 'on,', 'the', 'tibia', 'or', 'the', 'femur.'], ['Finally,', 'we', 'may', 'think', 'that', 'it', 'is', 'best', 'to', 'first', 'try', 'rehabilitation', 'before', 'considering', 'surgery,', 'but', 'I', 'discard', 'this', 'option', 'because', 'the', 'question', 'emphasizes', 'that', 'we', 'have', 'exhausted', 'pharmacological', 'measures', '(although', 'it', 'could', 'be', 'considered', 'because', 'they', 'have', 'not', 'specified', 'whether', 'it', 'has', 'been', 'tried', 'or', 'not).'], ['In', 'any', 'case', 'with', 'the', 'knee', 'prosthesis', 'we', 'correct', 'the', 'problem', 'of', 'osteoarthritis', 'pain', 'and', 'we', 'can', 'also', 'correct', 'the', 'knee', 'varus.']]	[['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
382_231	[['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '33-year-old', 'man,', 'independent', 'in', 'all', 'activities', 'of', 'daily', 'living,', 'with', 'a', 'history', 'of', 'well-controlled', 'hypertension,', 'antiplatelet', 'atrial', 'fibrillation', 'and', 'an', 'adenocarcinoma', 'of', 'the', 'prostate', 'at', '73', 'years', 'of', 'age,', 'currently', 'free', 'of', 'disease.'], ['He', 'is', 'brought', 'to', 'the', 'emergency', 'department', 'for', 'clinical', 'aphasia', 'and', 'right', 'hemiparesis', 'of', 'sudden', 'onset,', '45', 'minutes', 'earlier.'], ['What', 'is', 'the', 'most', 'correct', 'approach?'], ['1-', 'Perform', 'a', 'cranial', 'CT', 'scan', 'and', 'if', 'there', 'are', 'no', 'hemorrhagic', 'lesions', 'or', 'other', 'contraindications', 'in', 'the', 'analysis,', 'start', 'immediate', 'intravenous', 'thrombolysis.'], ['2-', 'Perform', 'urgent', 'cranial', 'CT', 'scan', 'and', 'if', 'there', 'is', 'no', 'bleeding,', 'start', 'anticoagulation.'], ['3-', 'Perform', 'cranial', 'CT', 'scan', 'and', 'admission', 'to', 'rehabilitation', 'center,', 'since', 'their', 'attitude', 'will', 'not', 'differ', 'regardless', 'of', 'whether', 'the', 'etiology', 'is', 'ischemic', 'or', 'hemorrhagic.'], ['4-', 'Cranial', 'CT', 'scan', 'is', 'not', 'necessary,', 'although', 'I', 'would', 'withdraw', 'the', 'antiaggregation.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['The', 'patient', 'suffers', 'an', 'abrupt', 'neurological', 'deficit', 'probably', 'related', 'to', 'a', 'vascular', 'event,', 'so', 'first', 'we', 'will', 'have', 'to', 'perform', 'a', 'cranial', 'CT', 'scan', 'to', 'rule', 'out', 'a', 'hemorrhagic', 'stroke.'], ['If', 'the', 'CT', 'scan', 'does', 'not', 'show', 'bleeding,', 'the', 'patient', 'has', 'an', 'acute', 'ischemic', 'stroke,', 'probably', 'cardioembolic', 'due', 'to', 'his', 'cardiac', 'pathology,', 'not', 'anticoagulated.'], ['Given', 'that', 'his', 'tumor', 'process', 'is', 'under', 'control,', 'there', 'are', 'no', 'contraindications', 'for', 'the', 'administration', 'of', 'fibrinolysis', 'in', 'this', 'case,', 'since', 'the', 'patient', 'is', 'in', 'a', 'good', 'baseline', 'condition.'], ['Although', 'the', 'patient', 'is', '88', 'years', 'old,', 'age', 'is', 'no', 'longer', 'presented', 'as', 'an', 'absolute', 'exclusion', 'criterion,', 'but', 'the', 'general', 'situation', 'of', 'the', 'patient', 'must', 'be', 'taken', 'into', 'account', 'and', 'in', 'this', 'case', 'it', 'is', 'specified', 'that', 'he', 'presents', 'a', 'good', 'baseline', 'situation.']]	[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise']]
496_71	[['QUESTION', 'TYPE:', 'MEDICAL', 'ONCOLOGY'], ['CLINICAL', 'CASE:'], ['40-year-old', 'patient,', 'with', 'normal', 'physical', 'examination,', 'in', 'whom', 'a', 'mediastinal', 'mass', 'and', 'a', 'hepatic', 'nodule', 'have', 'been', 'evidenced', 'in', 'the', 'CT', 'scan,', 'and', 'in', 'the', 'CBC', 'a', 'serum', 'elevation', 'of', 'lactic', 'dehydrogenase', '(LDH),', 'human', 'chorionic', 'betagonadotropin', '(beta-HCG)', 'and', 'alpha-fetoprotein.What', 'is', 'your', 'diagnostic', 'suspicion.'], ['What', 'is', 'your', 'diagnostic', 'suspicion:'], ['1-', 'Metastatic', 'hepatocarcinoma.'], ['2-', 'Extragonadal', 'metastatic', 'seminoma.'], ['3-', 'Mediastinal', 'lymphoma.'], ['4-', 'Metastatic', 'extragonadal', 'nonseminomatous', 'germ', 'cell', 'cancer.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['Very', 'typical', 'too.'], ['In', 'the', 'ED', 'it', 'can', 'be', 'diagnosed', 'with', 'a', 'pregnancy', 'test', '(in', 'males),', 'because', 'it', 'detects', 'that', 'beta', 'HCG', 'in', 'urine.'], ['Hepatocarcinoma', 'can', 'elevate', '(alone)', 'alpha-fetus,', 'seminoma', 'LDH,', 'lymphoma', 'also', 'LDH.']]	[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
14_213	[['QUESTION', 'TYPE:', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '41-year-old', 'man', 'comes', 'to', 'the', 'clinic', 'with', 'a', 'nodule', 'in', 'the', 'right', 'thyroid,', 'a', 'fine', 'needle', 'aspiration', 'is', 'performed.'], ['Cytological', 'analysis', 'will', 'allow', 'us:'], ['1-', 'Distinguish', 'between', 'follicular', 'adenoma', 'or', 'minimally', 'invasive', 'follicular', 'carcinoma.'], ['2-', 'Identify', 'the', 'areas', 'of', 'capsular', 'or', 'vascular', 'invasion', 'of', 'the', 'follicular', 'carcinoma.'], ['3-', 'Recognize', 'G-cell', 'hyperplasia', 'associated', 'with', 'familial', 'spinal', 'cancer.'], ['4-', 'Distinguish', 'between', 'a', 'Hurthle', 'cell', 'tumor', 'and', 'an', 'oxyphilic', 'follicular', 'adenoma.'], ['5-', 'Identify', 'the', 'typical', 'cytologic', 'features', 'of', 'papillary', 'carcinoma.'], ['CORRECT', 'ANSWER:', '5'], ['I', 'think', 'the', 'correct', 'answer', 'is', '5;', 'FNA', 'does', 'not', 'allow', 'a', 'histological', 'study', 'but', 'a', 'cytological', 'one,', 'therefore', 'questions', '1,', '2', 'are', 'eliminated.'], ['Question', '3', 'seems', 'to', 'have', 'been', 'put', 'as', 'a', 'filler', 'because', 'it', 'is', 'not', 'relevant.'], ['Question', '4', 'could', 'raise', 'doubts', 'if', 'you', 'are', 'not', 'a', 'pathologist', 'but', 'the', 'most', 'logical', 'answer', 'is', '5', 'since', 'papillary', 'carcinoma', 'is', 'the', 'most', 'frequent.']]	[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
330_85	[['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '22-year-old', 'boy', 'with', 'hyposmia', 'presents', 'with', 'lack', 'of', 'development', 'of', 'secondary', 'sexual', 'characteristics', 'and', 'infertility.'], ['Bilateral', 'testicular', 'volume', 'of', '4', 'mL.'], ['Analytically,', 'FSH', '1.2', 'U/L', '(vn', '5-15);', 'LH', '0.6', 'U/L', '(vn', '3-15);', 'testosterone', '100', 'ng/diu', '(vn', '300-1200),', 'prolactin', 'normal.'], ['Indicate', 'the', 'treatment', 'you', 'will', 'propose', 'to', 'achieve', 'fertility:'], ['1-', 'Gn_RH', 'infusion', 'pump.'], ['2-', 'Monthly', 'intramuscular', 'administration', 'of', 'triptorelin.'], ['3-', 'Intramuscular', 'administration', 'of', 'FSH', 'and', 'LH', 'once', 'a', 'week.'], ['4-', 'Treatment', 'with', 'bromocriptine.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ["Kallman's", 'syndrome', 'or', "Morsier's", 'syndrome', 'is', 'a', 'congenital', 'insufficiency', 'associated', 'with', 'hypogonadotropic', 'hypogonadism', 'due', 'to', 'a', 'deficit', 'in', 'GnRH', 'hormone', 'production.'], ['Repeated', 'injections', 'of', 'GnRH', 'are', 'performed', 'to', 'restore', 'fertility.']]	[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
181_59	[['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', 'type', '1', 'diabetic', 'who', 'comes', 'to', 'the', 'emergency', 'room', 'for', 'dyspnea', 'and', 'general', 'malaise.'], ['The', 'blood', 'test', 'showed', 'blood', 'glucose', '450', 'mg/dl,', 'Na', '142', 'mEq/l,', 'K', '4', 'mEq/l,', 'pH', '7.15,', 'bicarbonate', '12', 'mmol/l.'], ['Which', 'treatment', 'would', 'NOT', 'be', 'indicated?'], ['1-', 'Fast', 'IV', 'saline.'], ['2-', 'Serum', 'glucose', '5%', 'iv', 'when', 'blood', 'glucose', 'is', 'less', 'than', '250', 'mg/dl.'], ['3-', 'Rapid', 'human', 'insulin', 'iv.'], ['4-', 'Potassium', 'chloride', '100', 'mEq', '/', 'day', 'diluted', 'in', 'sera.'], ['5-', 'Sodium', 'bicarbonate', '1M', '100', 'cc', 'iv', 'in', '30', 'minutes.'], ['CORRECT', 'ANSWER:', '5'], ['Easy', 'question', 'since', 'the', 'treatment', 'of', 'diabetic', 'ketoacidosis', 'is', 'a', 'very', 'repeated', 'topic', 'in', 'the', 'MIR.'], ['Bicarbonate', 'is', 'indicated', 'at', 'pH', '<', '7.']]	[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'B-Disease', 'I-Disease', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
182_61	[['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '76-year-old', 'woman', 'consults', 'us', 'because', 'she', 'is', 'concerned', 'about', 'her', 'risk', 'of', 'stroke', 'since', 'her', 'mother', 'died', 'of', 'stroke', 'a', 'year', 'ago.'], ['She', 'is', 'diagnosed', 'with', 'arterial', 'hypertension', 'and', 'type', '2', 'diabetes', 'mellitus', 'and', 'is', 'being', 'treated', 'with', 'glipizide,', 'aspirin,', 'enalapril', 'and', 'atorvastatin.'], ['She', 'smokes', '20', 'cigarettes', 'a', 'day', 'and', 'leads', 'a', 'sedentary', 'life.'], ['The', 'examination', 'revealed', 'a', 'blood', 'pressure', 'of', '150/80', 'mm', 'Hg.'], ['The', 'blood', 'test', 'shows', 'a', 'hemoglobin', 'A1C', 'of', '8%', 'and', 'LDL', 'cholesterol', 'of', '110', 'mg/dl.'], ['Which', 'of', 'the', 'following', 'actions', 'is', 'associated', 'with', 'a', 'greater', 'reduction', 'in', 'the', 'risk', 'of', 'stroke?'], ['1-', 'Achieve', 'optimal', 'blood', 'pressure', 'control.'], ['2-', 'Achieve', 'optimal', 'hemoglobin', 'A1C', 'levels.'], ['3-', 'Add', 'an', 'antioxidant', 'to', 'the', 'treatment.'], ['4-', 'Smoking', 'cessation.'], ['5-', 'Achieve', 'LDL', 'levels', 'below', '100', 'mg/dl.'], ['CORRECT', 'ANSWER:', '1'], ['The', 'most', 'influential', 'cardiovascular', 'factor', 'for', 'stroke', 'in', 'women', 'over', '70', 'is', 'blood', 'pressure.']]	[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
21_111	[['QUESTION', 'TYPE:', 'INFECTIOUS'], ['CLINICAL', 'CASE:'], ['A', '32-year-old', 'man,', 'ADVP', 'and', 'recently', 'released', 'from', 'prison,', 'has', 'a', 'protein', 'derivative', 'skin', 'test', '(PPD)', 'with', '10', 'mm', 'of', 'induration.'], ['One', 'year', 'ago,', 'the', 'PPD', 'was', 'negative,', 'he', 'is', 'currently', 'asymptomatic,', 'his', 'HIV', 'serology', 'is', 'negative,', 'and', 'his', 'Chest', 'X-ray', 'is', 'normal.'], ['Which', 'of', 'the', 'following', 'approaches', 'do', 'you', 'think', 'is', 'most', 'appropriate?'], ['1-', 'Do', 'not', 'perform', 'treatment', 'and', 'annual', 'Rx', 'control.'], ['2-', 'Sputum', 'culture', 'for', 'mycobacteria', 'and', 'treat', 'only', 'if', 'positive.'], ['3-', 'Isoniazid', 'for', '9', 'months.'], ['4-', 'Treatment', 'with', '4', 'drugs', '4', 'months.'], ['5-', 'Treatment', 'with', 'RIF', 'and', 'PRZ', 'for', '2', 'months.'], ['CORRECT', 'ANSWER:', '3'], ['In', 'the', 'face', 'of', 'a', 'PPD', 'conversion', 'within', '2', 'years,', 'and', 'ruling', 'out', 'current', 'TB', 'disease,', 'INH', 'chemoprophylaxis', 'is', 'indicated,', 'although', 'I', 'thought', 'it', 'was', 'for', '6', 'months', 'and', 'not', '9.'], ['The', 'rest', 'is', 'not', 'questionable.']]	[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'O']]
60_59	[['QUESTION', 'TYPE:', 'ANESTHESIOLOGY', 'AND', 'CRITICAL', 'CARE'], ['CLINICAL', 'CASE:'], ['A', '40-year-old', 'male,', 'foreign', 'tourist,', 'is', 'referred', 'to', 'the', 'ED', 'for', 'low', 'level', 'of', 'consciousness,', 'temperature', 'of', '37.7°C', 'and', 'dyspnea.'], ['He', 'has', 'no', 'trauma.'], ['Several', 'tests', 'were', 'performed.'], ['The', 'most', 'immediate', 'is', 'an', 'ABE', 'without', 'oxygen,', 'showing', 'PH', '7.33,', 'PCO2', '50,', 'PO2', '65,', 'HCO3', '27:'], ['1-', 'PET', 'SCAN.'], ['2-', 'Lobar', 'pneumonia.'], ['3-', 'EAP.'], ['4-', 'Alveolar', 'hypoventilation.'], ['5-', 'Bronchopneumonia.'], ['CORRECT', 'ANSWER:', '5'], ['Actually,', 'it', 'can', 'be', 'all', 'of', 'them,', 'but', 'the', 'most', 'frequent', 'cause', 'of', 'acute', 'uncompensated', 'respiratory', 'acidosis', 'in', 'a', 'young', 'person', 'is', 'bronchopneumonia.']]	[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
455_155	[['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['In', 'a', '70-year-old', 'man,', 'hypertensive,', 'with', 'a', 'right', 'hemiplegia', 'of', 'sudden', 'onset', 'with', 'mild', 'dysarthria,', 'without', 'alterations', 'in', 'evocation', 'or', 'language', 'comprehension,', 'what', 'type', 'of', 'stroke', 'do', 'you', 'think', 'is', 'most', 'likely', 'to', 'have', 'suffered?'], ['1-', 'Left', 'capsular', 'lacunar', 'lacunar', 'infarction.'], ['2-', 'A', 'cortico-subcortical', 'left', 'frontotemporal', 'sylvian', 'infarction.'], ['3-', 'Brain', 'stem', 'infarction.'], ['4-', 'A', 'left', 'lenticular', 'hemorrhage.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['The', 'closest', 'answer', 'is', '1.'], ['If', 'we', 'are', 'strict', 'we', 'would', 'be', 'talking', 'about', 'a', 'pure', 'motor', 'lacunar', 'infarction', '(with', 'mild', 'dysarthria).'], ['Since', 'the', 'other', '3', 'options', 'do', 'not', 'give', 'us', 'a', 'clinical', 'picture', 'like', 'the', 'one', 'in', 'the', 'statement.'], ['Both', 'options', '2', 'and', '3', 'give', 'us', 'a', 'much', 'more', 'florid', 'and', 'extensive', 'clinical', 'picture.']]	[['O', 'O', 'O'], ['O', 'O'], ['O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
1_35	[['QUESTION', 'TYPE:', 'DIGESTIVE'], ['CLINICAL', 'CASE:'], ['A', '43-year-old', 'man', 'with', 'no', 'diseases', 'of', 'interest', 'comes', 'to', 'the', 'emergency', 'department', 'for', '4', 'melaenic', 'stools', 'in', 'the', 'last', '12', 'hours.'], ['He', 'refers', 'taking', 'NSAIDs', 'in', 'previous', 'days.'], ['Physical', 'examination', 'revealed', 'pale', 'skin', 'and', 'mucous', 'membranes.'], ['BP', '95/65', 'and', 'HR', '110', 'bpm.'], ['The', 'abdomen', 'is', 'not', 'painful', 'and', 'rectal', 'examination', 'shows', 'melenic', 'stools.'], ['The', 'CBC', 'shows', 'a', 'Hb', 'of', '8.1', 'gr/dl.'], ['After', 'infusion', 'of', 'saline', 'and', 'the', 'start', 'of', 'red', 'blood', 'cell', 'concentrate', 'transfusion,', 'the', 'BP', 'was', '120/85', 'and', 'HR', '90', 'bpm.'], ['An', 'endoscopy', 'was', 'performed', 'in', 'which', 'clots', 'were', 'found', 'in', 'the', 'stomach', 'and', 'a', '2', 'cm', 'ulcer', 'in', 'the', 'gastric', 'antrum', 'with', 'fibrin', 'background', 'and', 'a', 'small', 'grayish-white', 'protrusion', 'of', '3', 'mm', 'in', 'the', 'center', 'of', 'the', 'ulcer', '(visible', 'platelet', 'thrombus', 'vessel).'], ['What', 'do', 'you', 'think', 'is', 'the', 'most', 'correct', 'approach?'], ['1-', 'Since', 'the', 'patient', 'is', 'young,', 'with', 'no', 'associated', 'diseases', 'and', 'the', 'ulcer', 'has', 'stopped', 'bleeding,', 'he', 'can', 'be', 'discharged', 'early', 'with', 'treatment', 'with', 'a', 'PPI', 'and', 'H.', 'Pylori', 'eradication.'], ['2-', 'Remove', 'the', 'endoscope,', 'place', 'nasogastric', 'tube', 'for', 'continuous', 'aspiration', 'and', 'initiate', 'treatment', 'with', 'a', 'PPI', 'and', 'somatostatin.'], ['3-', 'Take', 'biopsy', 'for', 'H.', 'Pylori,', 'remove', 'the', 'endoscope', 'taking', 'care', 'not', 'to', 'dislodge', 'the', 'platelet', 'thrombus', 'and', 'continue', 'pharmacological', 'treatment', 'with', 'i.v.', 'PPI.'], ['4-', 'Consultation', 'to', 'the', 'surgical', 'service', 'to', 'consider', 'urgent', 'surgical', 'treatment.'], ['5-', 'Endoscopic', 'treatment', 'by', 'injection', 'of', 'adrenaline', 'into', 'the', 'ulcer', 'and', 'placement', 'of', 'clips', '(metal', 'staples)', 'followed', 'by', 'i.v.', 'administration', 'of', 'PPI.'], ['CORRECT', 'ANSWER:', '5'], ['Question', 'about', 'non-varicose', 'ADH.'], ['Young', 'patient,', 'with', 'no', 'previous', 'history,', 'who', 'after', 'taking', 'NSAIDs', 'presents', 'bleeding', 'with', 'hemodynamic', 'instability', 'requiring', 'transfusion.'], ['Answer', '1', 'is', 'not', 'in', 'accordance', 'with', 'what', 'has', 'been', 'said,', 'this', 'is', 'an', 'unstable', 'patient', 'who', 'has', 'bled', 'a', 'lot,', 'who', 'has', 'a', 'Forrest', 'IIa', 'ulcer', 'with', 'a', 'high', 'risk', 'of', 'rebleeding.'], ['Answer', '2', 'speaks', 'of', 'somatostatin,', 'which', 'is', 'used', 'for', 'bleeding', 'due', 'to', 'portal', 'hypertension.'], ['4', 'will', 'only', 'be', 'considered', 'if', 'bleeding', 'is', 'not', 'controlled', 'endoscopically.'], ['Between', '3', 'and', '5,', 'since', 'there', 'is', 'a', 'high', 'risk', 'of', 'bleeding,', 'endoscopic', 'therapy', 'is', 'recommended,', 'preferably', 'with', '2', 'techniques,', 'so', 'the', 'correct', 'one', 'would', 'be', '5.']]	[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['O', 'O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'O', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'B-Marker', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
66_106	[['QUESTION', 'TYPE:', 'ANESTHESIOLOGY,', 'CRITICAL', 'CARE', 'AND', 'EMERGENCY', 'MEDICINE'], ['CLINICAL', 'CASE:'], ['Elderly', 'woman', 'brought', 'to', 'the', 'ER', 'by', 'her', 'neighbors', 'because', 'they', 'see', 'her', 'somewhat', 'groggy', 'and', 'with', 'stool', 'stains', 'on', 'her', 'clothes.'], ['BP', '100/60', 'mmHg,', 'HR', '100', 'bpm,', 'sitting', '70/30,', 'HR', '105', 'bpm.'], ['PVY', 'normal.'], ["Kussmaul's", 'respiration.'], ['No', 'neurological', 'focality.'], ['Weight', '50', 'kg.'], ['Lab:', 'PH', '7.25,', 'PCO2', '14,', 'Bicarbonate', '5,', 'Na', '133,', 'K', '2.5,', 'Cl', '118,', 'Creat', '3.4,', 'NUS', '60,', 'Prot', '8.'], ['Which', 'of', 'the', 'following', 'answers', 'is', 'correct?'], ['1-', 'The', 'presenting', 'acid-base', 'disorder', 'is', 'a', 'respiratory', 'acidosis.'], ['2-', 'Compensation', 'to', 'correct', 'the', 'acidosis', 'is', 'inadequate.'], ['3-', 'With', 'this', 'exploration,', 'we', 'rule', 'out', 'that', 'she', 'is', 'dehydrated.'], ['4-', 'In', 'any', 'case,', 'we', 'should', 'not', 'put', 'bicarbonate.'], ['5-', 'She', 'has', 'an', 'acute', 'renal', 'failure', 'of', 'prerenal', 'cause.'], ['CORRECT', 'ANSWER:', '5'], ['This', 'is', 'a', 'case', 'of', 'hyperchloremic', 'metabolic', 'acidosis', 'with', 'normal', 'anion', 'gap.'], ['Severe', 'metabolic', 'acidosis', 'causes', 'myocardial', 'contractile', 'depression,', 'reduced', 'effectiveness', 'of', 'catecholamines,', 'increased', 'incidence', 'of', 'arrhythmias,', 'vasodilatation', 'and', 'increased', 'capillary', 'permeability,', 'with', 'the', 'consequent', 'reduction', 'of', 'tissue', 'flow,', 'at', 'the', 'cerebral', 'level', '(leading', 'to', 'states', 'of', 'confusion', 'and', 'even', 'coma),', 'at', 'the', 'renal', 'level,', 'at', 'the', 'hepatic', 'level...'], ['These', 'patients', 'frequently', 'present', 'intense', 'tachypnea', "(Kussmaul's", 'breathing)', 'in', 'an', 'attempt', 'to', 'compensate', 'for', 'MCA', 'by', 'hyperventilation.'], ['We', 'must', 'take', 'into', 'account', 'that,', 'in', 'this', 'case,', 'potassium', 'is', 'decreased,', 'so', 'the', 'most', 'frequent', 'cause', '(supported', 'by', 'the', 'stains', 'on', 'the', 'dress)', 'would', 'be', 'diarrhea,', 'so', 'it', 'is', 'most', 'likely', 'that', 'their', 'renal', 'failure', '(although', 'they', 'do', 'not', 'give', 'us', 'urine', 'ion', 'data', 'to', 'confirm', 'it)', 'is', 'of', 'prerenal', 'type.'], ['The', 'treatment', 'would', 'be', 'water', 'and', 'electrolyte', 'replacement', 'and,', 'in', 'principle,', 'unless', 'the', 'patient', 'worsens', 'and', 'the', 'pH', 'is', 'less', 'than', '7.10,', 'we', 'should', 'not', 'administer', 'bicarbonate.']]	[['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise'], ['B-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise'], ['O', 'B-Premise', 'I-Premise', 'B-Premise', 'I-Premise', 'B-Premise', 'I-Premise', 'B-Premise', 'I-Premise', 'B-Premise', 'I-Premise', 'B-Premise', 'I-Premise', 'B-Premise', 'I-Premise', 'B-Premise', 'I-Premise', 'B-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
521_76	[['QUESTION', 'TYPE:', 'DERMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '7-year-old', 'girl', 'who', 'comes', 'for', 'consultation', 'because', 'her', 'parents', 'notice', 'her', 'red', 'face', 'since', 'the', 'previous', 'day', 'and', 'in', 'the', 'last', 'few', 'hours', 'they', 'have', 'noticed', 'red', 'spots', 'on', 'her', 'body.'], ['On', 'examination', 'she', 'is', 'afebrile,', 'with', 'tonsils', 'and', 'ears', 'without', 'alterations,', 'normal', 'cardiopulmonary', 'auscultation.'], ['He', 'presents', 'a', 'confluent', 'maculo', 'papular', 'rash', 'on', 'both', 'cheeks,', 'respecting', 'the', 'upper', 'lip,', 'resembling', 'a', '"slapped"', 'face.'], ['In', 'the', 'thorax', 'she', 'presents', 'a', 'reticular,', 'lacy,', 'non-pruritic', 'exanthem.'], ['What', 'is', 'the', 'most', 'probable', 'clinical', 'diagnosis?'], ['1-', 'Chickenpox.'], ['2-', 'Rubella.'], ['3-', 'Erythema', 'infectiosum', 'or', '5th', 'disease.'], ['4-', 'Sudden', 'exanthema', 'or', '6th', 'disease.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['Although', 'this', 'question', 'straddles', 'the', 'line', 'between', 'derma', 'and', 'pediatrics,', 'we', 'would', 'like', 'to', 'do', 'our', 'bit.'], ['We', 'are', 'being', 'told', 'about', 'erythema', 'súdenita', 'or', 'fifth', 'disease', '(also', 'called', 'megaloerythema),', 'caused', 'by', 'parvovirus', 'B19.'], ['It', 'is', 'typical', 'that', 'after', 'an', 'episode', 'of', 'high', 'fever', 'an', 'erythema', 'appears', 'on', 'both', 'cheeks', 'in', 'the', 'form', 'of', 'a', '"slap"', 'that', 'usually', 'has', 'a', 'cranial-caudal', 'extension', 'in', 'the', 'following', 'days.']]	[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
20_110	[['QUESTION', 'TYPE:', 'INFECTIOUS'], ['CLINICAL', 'CASE:'], ['A', '40-year-old', 'male', 'patient,', 'smoker', 'since', 'he', 'was', '18', 'years', 'old,', 'with', 'no', 'history', 'of', 'interest.'], ['He', 'consults', 'for', 'symptoms', 'of', '24', 'hours', 'of', 'evolution', 'of', 'chills,', 'thermometric', 'fever', 'of', '39ºC', 'and', 'cough', 'with', 'expectoration.'], ['Chest', 'X-ray', 'shows', 'an', 'increased', 'density', 'with', 'alveolar', 'pattern', 'in', 'the', 'LSD', 'and', 'the', 'patient', 'is', 'diagnosed', 'with', 'CAP.'], ['What', 'is', 'the', 'most', 'frequent', 'etiological', 'agent', 'and', 'therefore', 'of', 'obligatory', 'coverage', 'when', 'choosing', 'empirical', 'atb', 'treatment?'], ['1-', 'Mycoplasma', 'pneumoniae.'], ['2-', 'Chlamydia', 'pneumoniae.'], ['3-', 'Streptococcus', 'pneumoniae.'], ['4-', 'Legionella', 'pneumophila', 'serogroup', '1.'], ['5-', 'Haemophilus', 'influenzae.'], ['CORRECT', 'ANSWER:', '3'], ['This', 'is', 'a', 'fairly', 'easy', 'epidemiology', 'question,', 'in', 'adults', 'without', 'other', 'data,', 'Pneumococcus', 'is', 'the', '1st.']]	[['O', 'O', 'O'], ['O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
422_88	[['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['What', 'is', 'the', 'treatment', 'of', 'choice', 'for', 'a', '38-year-old', 'man', 'diagnosed', 'with', "Cushing's", 'disease', 'in', 'relation', 'to', 'a', 'pituitary', 'macroadenoma', 'of', '22', 'mm', 'in', 'diameter?'], ['1-', 'Initially', 'try', 'medical', 'treatment', 'and,', 'if', 'not', 'effective,', 'resort', 'to', 'surgery.'], ['2-', 'Adrenalectomy.'], ['3-', 'Selective', 'surgical', 'resection', 'of', 'the', 'adenoma.'], ['4-', 'Radiotherapy', 'to', 'try', 'to', 'reduce', 'tumor', 'size.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['Although', 'the', 'majority', 'of', 'ACTH-producing', 'adenomas', 'recur,', 'surgery', 'is', 'always', 'the', 'first', 'therapeutic', 'option.'], ['The', 'available', 'medications', '(ketoconazole,', 'somatostatin', 'analogues)', 'are', 'aimed', 'at', 'decreasing', 'the', 'effects', 'of', 'excess', 'cortisol', 'or', 'decreasing', 'ACTH', 'release,', 'but', 'they', 'are', 'not', 'curative.']]	[['O', 'O', 'O'], ['O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
348_160	[['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['45-year-old', 'woman,', 'mother', 'of', '3', 'children,', 'attends', 'an', 'early', 'diagnosis', 'consultation.'], ['The', 'cervicovaginal', 'cytology', 'is', 'compatible', 'with', 'a', 'high-grade', 'squamous', 'intraepithelial', 'lesion.'], ['Which', 'of', 'the', 'following', 'options', 'would', 'you', 'choose?'], ['1-', 'Repeat', 'cytology', 'in', '1', 'month.'], ['2-', 'Colposcopy', 'with', 'possible', 'biopsy.'], ['3-', 'Hysterectomy', 'with', 'bilateral', 'salpinguectomy', 'and', 'ovarian', 'conservation.'], ['4-', 'Fractionated', 'uterine', 'curettage.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['Colposcopy', 'is', 'indicated', 'for', 'all', 'patients', 'with', 'altered', 'cytology', '(intraepithelial', 'lesion', 'or', 'suspicion', 'of', 'invasive', 'cancer', 'or', 'HPV', 'infection),', 'as', 'a', 'second', 'level', 'of', 'screening.'], ['If', 'lesions', 'are', 'observed', 'in', 'this', 'test,', 'a', 'biopsy', 'of', 'the', 'lesion', 'will', 'be', 'performed.'], ['There', 'is', 'no', 'point', 'in', 'repeating', 'the', 'cytology', '(since', 'this', 'is', 'a', 'screening', 'test,', 'not', 'a', 'diagnostic', 'test),', 'performing', 'a', 'hysterectomy', 'for', 'an', 'intraepithelial', 'lesion', 'that', 'has', 'not', 'been', 'confirmed', 'by', 'biopsy', 'is', 'not', 'indicated', 'either,', 'and', 'performing', 'curettage', 'of', 'the', 'endometrial', 'cavity', 'does', 'not', 'provide', 'information', 'since', 'the', 'lesion', 'is', 'from', 'the', 'cervix.']]	[['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise']]
411_52	[['QUESTION', 'TYPE:', 'BIOSTATISTICS'], ['CLINICAL', 'CASE:'], ['A', 'couple', 'with', 'a', 'first', 'male', 'child', '(index', 'case)', 'with', 'cystic', 'fibrosis', '(mucoviscidosis)', 'come', 'for', 'genetic', 'counseling.'], ['Molecular', 'diagnosis', 'indicates', 'that', 'the', 'index', 'case', 'is', 'homozygous', 'for', 'the', 'F5O8del', 'mutation', 'and', 'his', 'parents', 'are', 'heterozygous', 'carriers.'], ['The', 'clinical', 'geneticist', 'will', 'inform', 'them', 'about', 'the', 'mode', 'of', 'transmission', 'of', 'the', 'disease.'], ['Which', 'statement', 'is', 'correct?'], ['1-', 'The', 'probability', 'that', 'the', 'next', 'offspring', 'will', 'be', 'affected', 'is', '25%.'], ['2-', 'The', 'probability', 'that', 'the', 'next', 'offspring', 'will', 'be', 'affected', 'is', '50%.'], ['3-', 'Having', 'had', 'an', 'affected', 'child,', 'the', 'next', 'offspring', 'will', 'also', 'be', 'affected.'], ['4-', 'Having', 'had', 'a', 'homozygous', 'F5O8del', 'child,', 'the', 'next', 'offspring', 'will', 'be', 'heterozygous', 'carriers', '(67%)', 'or', 'homozygous', 'genotype', 'without', 'the', 'mutation', '(33%).'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['Both', 'parents', 'are', 'carriers', 'of', 'a', 'mutation', '(because', 'they', 'are', 'not', 'sick', 'and', 'have', 'already', 'had', 'a', 'homozygous', 'child),', 'and', 'the', 'next', 'offspring', 'has', 'a', '50%', 'chance', 'of', 'receiving', 'the', 'mutation', 'from', 'each', 'parent,', 'so', 'the', 'probability', 'of', 'receiving', 'it', 'from', 'both', 'is', '50%x50%=25%.']]	[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
590_64	[['QUESTION', 'TYPE:', 'OPHTHALMOLOGY'], ['CLINICAL', 'CASE:'], ['A', '68-year-old', 'woman', 'who', 'uses', '+4.00', 'diopter', 'glasses', 'for', 'distance', 'vision', 'in', 'both', 'eyes.'], ['She', 'consults', 'because', 'she', 'has', 'been', 'having', 'eye', 'pain', 'with', 'headache', 'and', 'blurred', 'vision', 'at', 'night', 'when', 'she', 'is', 'watching', 'television', 'in', 'dim', 'light', 'for', 'a', 'few', 'weeks.'], ['Which', 'of', 'the', 'following', 'pathologies', 'is', 'she', 'most', 'likely', 'to', 'have?'], ['1-', 'Primary', 'angular', 'closure', 'glaucoma.'], ['2-', 'Migraine.'], ['3-', 'Actinic', 'keratitis.'], ['4-', 'Dry', 'eye', 'syndrome.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['We', 'are', 'presented', 'with', 'a', '68-year-old', 'female', 'patient.'], ['At', 'that', 'age', 'the', 'crystalline', 'lens,', 'although', 'it', 'does', 'not', 'normally', 'have', 'a', 'cataract', 'that', 'needs', 'surgery,', 'it', 'usually', 'has', 'increased', 'in', 'thickness.'], ['This', 'implies', 'that', 'it', 'projects', 'the', 'iris', 'forward', 'and', 'reduces', 'the', 'depth', 'of', 'the', 'anterior', 'chamber.'], ['In', 'an', 'eye', 'with', 'a', 'normal', 'anterior', 'chamber', 'depth', 'this', 'is', 'usually', 'not', 'a', 'problem.'], ['But', 'farsighted', 'people', 'already', 'have', 'a', 'narrow', 'anterior', 'chamber.'], ['This', 'is', 'the', 'usual', 'combination', 'we', 'find', 'in', 'primary', 'angular', 'closure:', 'farsightedness', 'and', 'age', 'over', '50-60', 'years.'], ['Younger', 'hyperopes', 'usually', 'do', 'not', 'have', 'this', 'problem', 'yet.'], ['And', 'neither', 'do', 'older', 'people', 'who', 'are', 'emmetropic,', 'myopic', 'or', 'have', 'had', 'cataract', 'surgery.'], ['With', 'this', 'narrow', 'angle,', 'what', 'triggers', 'angular', 'closure', 'is', 'mydriasis.'], ['That', 'is,', 'when', 'you', 'are', 'in', 'the', 'penumbra,', 'the', 'pupil', 'dilates', 'and', 'the', 'iris', 'thickens', 'in', 'the', 'peripheral', 'part,', 'where', 'it', 'is', 'already', 'very', 'close', 'to', 'the', 'corneal', 'endothelium', 'in', 'the', 'case', 'of', 'a', 'narrow', 'chamber.'], ['Mydriasis', 'then', 'triggers', 'angular', 'closure,', 'which', 'is', 'accompanied', 'by', 'ocular', 'pain', 'that', 'may', 'radiate', 'backwards', '(headache).'], ['And', 'increased', 'intraocular', 'pressure', 'produces', 'corneal', 'edema', 'that', 'causes', 'blurred', 'vision.'], ['Therefore,', 'option', '1', 'is', 'correct.'], ['Migraine', 'does', 'not', 'have', 'to', 'be', 'related', 'to', 'penumbra,', 'and', 'ocular', 'pain', 'and', 'blurred', 'vision', 'is', 'not', 'particularly', 'typical.'], ['Actinic', 'keratitis', 'is', 'caused', 'by', 'exposure', 'to', 'ultraviolet', 'radiation', '(such', 'as', 'solar', 'radiation),', 'and', 'is', 'not', 'related', 'to', 'hyperopia', 'or', 'to', 'being', 'in', 'penumbra.'], ['In', 'addition,', 'the', 'history', 'of', 'exposure', 'is', 'usually', 'clear.'], ['And', 'finally,', 'dry', 'eye', 'does', 'not', 'produce', 'these', 'symptoms', 'either:', 'it', 'is', 'more', 'a', 'question', 'of', 'burning,', 'foreign', 'body', 'sensation,', 'heaviness,', 'etc.'], ['And', 'it', 'is', 'also', 'unrelated', 'to', 'the', 'other', 'elements:', 'penumbra,', 'hyperopia,', 'etc.'], ['As', 'a', 'minor', 'detail,', 'I', 'would', 'have', 'worded', 'the', 'question', 'a', 'little', 'better.'], ['It', 'is', 'understood', 'that', 'we', 'are', 'asked', 'which', 'pathology', 'is', 'the', 'most', 'probable', 'in', 'relation', 'to', 'the', 'symptoms', 'and', 'the', 'anamnesis.'], ['But', 'as', 'it', 'is', 'worded,', 'we', 'are', 'asked', 'about', 'which', 'of', 'the', 'pathologies', 'she', 'is', 'most', 'likely', 'to', 'present,', 'just', 'like', 'that.'], ['Actually,', 'a', '68-year-old', 'woman', 'is', 'very', 'likely', 'to', 'have', 'dry', 'eye,', 'even', 'if', 'it', 'does', 'not', 'cause', 'the', 'symptoms', 'for', 'which', 'she', 'is', 'presenting.']]	[['O', 'O', 'O'], ['O', 'O'], 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'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
86_51	[['QUESTION', 'TYPE:', 'CARDIOLOGY', 'AND', 'VASCULAR', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '26-year-old', 'man', 'with', 'no', 'history', 'of', 'interest,', 'asymptomatic,', 'presents', 'on', 'examination', 'with', 'a', 'mesosystolic', 'murmur', 'in', 'the', 'aortic', 'focus', 'and', 'left', 'parasternal', 'border', 'that', 'increases', 'with', 'the', 'Valsalva', 'maneuver.'], ['BP', 'and', 'peripheral', 'pulses', 'are', 'normal', 'and', 'the', 'ECG', 'shows', 'signs', 'of', 'marked', 'left', 'ventricular', 'enlargement', 'and', 'very', 'deep', 'negative', 'T', 'waves', 'in', 'V3,', 'V4,', 'V5', 'and', 'V6.'], ['What', 'is', 'the', 'most', 'likely', 'diagnosis?'], ['1-', 'Functional', 'murmur.'], ['2-', 'Aortic', 'stenosis.'], ['3-', 'Aortic', 'insufficiency.'], ['4-', 'Hypertrophic', 'cardiomyopathy.'], ['5-', 'Ventricular', 'septal', 'defect.'], ['CORRECT', 'ANSWER:', '4'], ['A', 'young', 'male', 'patient', 'with', 'an', 'aortic', 'systolic', 'murmur', 'that', 'increases', 'with', 'the', 'Valsalva', 'maneuver', 'and', 'signs', 'of', 'left', 'ventricular', 'enlargement', 'is', 'practically', 'a', '"portrait"', 'of', 'the', 'typical', 'findings', 'that', 'can', 'be', 'found', 'in', 'hypertrophic', 'cardiomyopathy.'], ['Very', 'easy', 'question.']]	[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O']]
498_129	null	null
31_233	[['QUESTION', 'TYPE:', 'NEUROLOGY', 'AND', 'THORACIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', 'patient', 'diagnosed', 'with', 'bronchial', 'asthma', 'who', 'is', 'being', 'treated', 'with', 'low-dose', 'inhaled', 'steroids', '(200', 'micrograms', 'of', 'budesonide', 'every', '12', 'hours)', 'and', 'rescue', 'medication', '(salbutamol', 'on', 'demand)', 'comes', 'for', 'periodic', 'clinical', 'monitoring.'], ['The', 'patient', 'reports', 'that', 'in', 'the', 'last', '3', 'months', 'he', 'has', 'had', 'no', 'exacerbations', 'and', 'that', 'he', 'uses', 'salbutamol', 'once', 'a', 'day.'], ['He', 'only', 'has', 'dyspnea', 'when', 'climbing', 'stairs', 'and', 'some', 'nights', 'he', 'sleeps', 'irregularly', 'due', 'to', 'coughing.'], ['Which', 'of', 'the', 'following', 'therapeutic', 'options', 'should', 'be', 'considered', 'as', 'the', 'treatment', 'of', 'choice?'], ['1-', 'Increase', 'the', 'dose', 'of', 'inhaled', 'corticosteroids', 'to', '800', 'micrograms/day.'], ['2-', 'Add', 'tiotropium.'], ['3-', 'Maintain', 'the', 'same', 'pharmacological', 'regimen.'], ['4-', 'Switch', 'to', 'ocmbined', 'therapy', 'with', 'low-dose', 'inhaled', 'corticosteroids', 'and', 'long-acting', 'beta2-adrenergics.'], ['5-', 'Add', 'leukotrienes.'], ['CORRECT', 'ANSWER:', '4'], ['Asthma', 'treatment', 'algorithm.'], ['We', 'rule', 'out', 'continuing', 'with', 'the', 'same', 'treatment', 'since', 'the', 'patient', 'is', 'symptomatic.']]	[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]
618_119	[['QUESTION', 'TYPE:', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['13-year-old', 'female,', 'with', 'no', 'relevant', 'history,', 'with', 'menarche', '3', 'months', 'ago,', 'followed', 'since', 'the', 'age', 'of', '10', 'years', 'for', 'idiopathic', 'scoliosis', 'that', 'has', 'worsened.'], ['In', 'the', 'physical', 'examination', 'she', 'presents', 'a', 'hump', 'of', '7', 'degrees', 'in', 'the', 'Adams', 'test', 'and', 'in', 'the', 'scoliogram', 'a', 'T4-L1', 'thoracolumbar', 'curve', 'of', '35', 'degrees', 'of', 'Cobb', 'and', 'a', 'Risser', '0:'], ['1-', 'Recommend', 'swimming', 'and', 'review', 'in', 'three', 'months.'], ['2-', 'Prescribe', 'a', 'brace-type', 'orthosis.'], ['3-', 'Refer', 'to', 'physiotherapy', 'for', 'spine', 'elastification.'], ['4-', 'Check', 'in', '6', 'months', 'with', 'a', 'new', 'X-ray.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['Treatment', 'with', 'a', 'brace', 'in', 'Risser', 'from', '0', 'to', '2', 'can', 'be', 'considered', 'since', 'there', 'is', 'still', 'growth', 'to', 'occur', 'and', 'correction', 'can', 'take', 'place.'], ['Its', 'use', 'is', 'considered', 'for', 'curves', 'between', '30-40º.']]	[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]