bhatthars/nbme_qna huggingface dataset:
Patient Note: 35 year old female presents with 6 months of dysmennorhea. Prior to 6 months she had regular periods monthy with 3-4 days of menstrual flow. However, she now reports that she has had 2 periods in the past 5 months, that last 7 days with heavy flow on day 1 requiring tampon changes every 2 hours. Her cramping is very light. She is not taking any medications. She also reports 10-15 lb weight gain in the past 6 months. She denies any constipation, brittle hair, dry skin, or new hair growth. She also states that she does not use contraception because she cannot get pregnant. She tried for 9 years in a previous relationship to get pregnant but was never successful. She denies history of STI. She denies pain during sex, abdominal pain, fever, chills. She is up to date on cervical cancer screenings. 
No PMH or PSH
Social: drinks 1-2 beers rarely, no tobacco or illicit drugs; lives with 2 adopted children, relationship with boyfriend

Keywords and phrases relevant to diagnosis:
female
weight gain
2 periods in the past 5 months, heavy flow, periods last 7 days, tampon changes every 2 hours
does not use contraception
cannot get pregnant, tried to get pregnant but was never successful
35 year old
6 months
Patient Note: CC: Irregular periods
HPI: Ms. Tompkins is a 35 yo F with pmh of irregular periods who presents with irregular periods. She states that in the last 6 months her periods are irregular, only having 2 in the last 6 months with heavy bleeding. She states she used to have irregular periods at age 12, was controlled with birth control that she stopped 11 years ago. Denies pain. 2 sexual partners, male. Has intercourse twice a week. Denies history of stds. States she is unable to become pregnant, has tried for years. Reports weight gain and skin darkening. She is up to date on health screening and has had normal pap smears, last one 6 months ago.
ROS: negative except as stated above
PMH: None
Past surgical history: None
Meds: None
Allergies: None
Family history: breast cancer in aunt, cervical in grandmother
Social: Drinks alcohol occasionally, 1-2 times a  month. Denies tobacco or recreational drug use. Lives with 2 adopted daughters.

Keywords and phrases relevant to diagnosis:
F
weight gain
Irregular periods, irregular periods, periods irregular, heavy bleeding
unable to become pregnant
35 yo
6 months
Patient Note: Ms. Tomkins is a 35 y/o G0P0 female with concerns of heavier periods for the past 6 months. Patient notes normal periods prior to this, and states that she must know change her tampons every couple of hours. Patient denies any pain or discomfort associated with menses. Patient notes that she had unprotected sex with her ex-husband for 9 months and was unable to get pregnany. Patient denies nipple discharge, vaginal discharge, post-coital bleeding, dysuria, burning while urinating. Patient also denies fevers, chills, dizziness, lightheadedness, headaches, N/V. 
Allergies: None
Meds: None
PMH, PSH: None
FH: Grandmother with cervical cancer and Aunt with breast cancer
SH: Works as social work scheduler. Never smoker. Occasionally drinks 1-2 beers. No recreational drug use. Sexually active with no boyfriend; does not use protection.

Keywords and phrases relevant to diagnosis:
female
heavier periods, know change her tampons every couple of hours
does not use protection
unable to get pregnany
35 y/o
6 months
Patient Note: cc: "heavy periods"
Ms. Tompkins, a 35-year-old G0P0 female, presents with heavy periods for the past 6 months. They have been heavy, lasting for 7 days. She uses about 7 tampons on the first day and tapers down till 1 on the 7th day. LMP was 2 months ago. She's had only 2 periods since the past 5 months. Prior to 6 months ago, she's been having her regular monthly periods with normal flow. She's been trying for the past 9 years to conceive with her ex-husband but didnt. She has two adopted daughters. Divorced 2 years ago. Denies n/v, no diarrhea/constiption. No fever or chills. Positive for weight gain of 10-16lbs in the last 6 months.
ROS: neg except per hpi
ObGyn: G0P0, sexually active with 1 partner since the past year. 2 lifetime. STDs: none. Papsmear- 6 months ago, no abnormal ones. bc-none
Allergies:none
PMH/PSH: none
Meds: none
Social: never smoked, ETOH rarely, no IDU
FHx: aunt- breast cancer, grandma-cervical cancer

Keywords and phrases relevant to diagnosis:
female
weight gain, gain of 10-16lb
heavy periods, heavy periods
LMP was 2 months ago
trying to conceive didnt
35-year-old
6 months, 6 months, 6 months
Patient Note: Obese 35yo F c/o heavy and irregular periods.  She report her periods have started becoming irregular 6 months ago. Her LMP was 2 months ago.  She has no pain other than normal cramps.  Her periods normally last 3 days but now last 7 days.  She changes her tampon q2hr.  She also reports 10lb weight gain in past 6 months. She denies urinary changes, bowel changes, fevers, chills, hirsutism, abdominal pain, or h/o STI's, pregnancy.  She has never been able to get pregnant; tried for 9 years with ex-husband.
ROS: negative except for above
allergies: none
PMH: none
PSH: none
FH: grandmother died of cervical cancer age 65; aunt died of breast cancer age 51
SH: no tabacco use, no illicit drug use, occasional beer every other month. sexually active with boyfriend only, has 2 adopted daughters.

Keywords and phrases relevant to diagnosis:
F
weight gain
irregular periods, heavy periods, periods irregular, changes her tampon q2hr
LMP was 2 months ago
never been able to get pregnant
35yo
6 months, 6 months
Patient Note: HPI: 35 F presents with irregular and heavy periods for the last 6 months. Since 6 months ago, her periods have gotten heavier, to where she is changing her tampons every 1-2 hours. The periods also last 7 days. She denies any abdominal cramping or pain. Her LMP was 5 weeks ago. Her periods used to be regular and occur every 30-35 days. She reports no vaginal discharge or spotting in between periods. She reports a weight gain of 10-15 lbs in the last 6 months. No fevers/chills/nausea/vomiting/diarrhea/constipation. She denies hot flashes, night sweats, CP, SOB. Pt report history of infertility after inability to conceive for 9 years
OBGYN: Denies history of cysts, fibroids. She has never been pregnant. She's had irregular periods for 11 yrs treated with OCP
PMH/SH: none
Meds: none
NKDA
FH: aunt with breast cancer, died at 51. Grandmother with cervical cancer.
SH: denies tobacco use, drinks 1 beer every few weeks, denies drug use.

Keywords and phrases relevant to diagnosis:
F
weight gain, gain of 10-15 lbs
heavy periods, irregular periods, periods heavier, changing her tampons every 1-2 hours
LMP was 5 weeks ago
infertility, inability to conceive
35
6 months, 6 months, 6 months
Patient Note: 35 year old female presents with menstrual period irregularities. She has been having heavy flow for the past 6 months and changing pads every few hours. Her periods have increased from month to every other month and the length has increased from 3 days to 7 days. She has also been feeling tired. She has been unable to get pregant for the past 9 years and has adopted children; this was never investigated. She has also noticed darkening of her skin in her hands and her neck. Denies vaginal dryness, itching. 

ROS: negative except as above
PMH/PSH: none
Allergies: none
Medications: none
FH: parents are healthy; breast cancer in aunt and cervical cancer in grandmother
SH: never smoked, drinks occasionall, never used drugs. Sexually active with boyfriend.

Keywords and phrases relevant to diagnosis:
female
period irregularities, heavy flow, changing pads every few hours, periods have increased from month to every other month
tired
unable to get pregant
35 year old
6 months
Patient Note: 35 y/o F with a 6 month history of heavy periods. Prior to the 6 months, she would use up to 4 pads/tampoons on the first day, now she has to change it every 2 hours. Her period used to come once a month, but now comes every other month. She has never been pregnant although she tried to becoming pregnant for 9 years with her ex-husband. She is sexually active with her boyfriend, no longer use a condom. She also reports gaining 10-15 pounds in the past 6 months. She attributes that to eating out more. Denies exercise, although she notes that she has to follow her two daughters around. 

PMH: None
Meds: None
Allergies: None
PSh: None
FH: Aunt died of breast cancer, and grandmother died of cervical cancer
SH: Drinks 1-2 beers rarely; denies tobacco or drug use

Keywords and phrases relevant to diagnosis:
F
gaining 10-15 pounds
heavy periods, pads/tampoons change it every 2 hours
no use a condom
never been pregnant tried to becoming pregnant
35 y/o
6 month, 6 months, 6 months
Patient Note: 35 yo f come to the clinic with c/o irregular periods since 6 months, gradual onset associated with heavy bleeding on first day as she chages tampons every hr but no passage of clots, occassional abd cramps during her period. she feels tired but no chest pain, sob. She has gained 10 - 15 pounds in past 6 months and she has not conceived even with a trial of 9 years for conception. she has no changes in mood, no hot flashes and she is sexually active with her boyfriend. there is no fever, heat or cold intolerance. 
ROS: - EXCEPT AS ABOVE
MH: non
PSH: none
SH: sexually active with husband, doesnt use contraceptives as trying to conceive, doesnt smoke, no rec drugs, occassional drinker, 
ALL: NKA
F

Keywords and phrases relevant to diagnosis:
f
gained 10 - 15 pounds
irregular periods, chages tampons every hr
doesnt use contraceptives
tired
not conceived even with a trial for conception
35 yo
6 months, 6 months
Patient Note: HPI: 35YO FEMALE PRESENTS FOR HEAVY MENSTRUAL PERIODS FOR THE LAST 6 MONTHS. PATIENT STATES THAT HER FLOW HAS BEEN HEAVY, OCCURS EVERY COUPLE MONTHS AND NOW LASTS 7 DAYS. PREVIOUS CYCLES OCCURED EVERY MONTH AND LASTED 3 DAYS. PATIENT DESCRIBES INCREASED FATIGUE AND 10LB WEIGHT GAIN IN THE LAST 6 MONTHS. SHE DENIES ANY ABDOMINAL PAIN, CHEST PAIN, FEVER/CHILLS, NAUSEA OR VOMITING.  
ROS: NEGATIVE EXCEPT AS ABOVE.
OB-GYN: LMP 5 WEEKS AGO, OCCURS EVERY OTHER MONTH, LASTS 7 DAYS, 1 TAMPOM EVERY COUPLE HOURS FOR THE FIRST FEW DAYS OF CYCLE 
PMH: NONE
ALLERGIES: NKDA
MEDICATIONS: NONE
SHX: NONE
FAMILY HX: AUNT - BREAST CANCER, GRANDMA - CERVICAL CANCER 
SH: NO ALCOHOL.


Keywords and phrases relevant to diagnosis:
FEMALE
WEIGHT GAIN, 10LB GAIN
HEAVY MENSTRUAL PERIODS, FLOW HEAVY, 1 TAMPOM EVERY COUPLE HOURS
LMP 5 WEEKS AGO
FATIGUE
35YO
6 MONTHS, 6 MONTHS
Patient Note: HPI - 35 year old G0P0 presented with 6 month history of oligmenorrhoea with increase in bleeding. Previously her menstrual cycles were 4-5 weeks, regular and 5 days of menstruation. Currently she has only had 2 menstrual peroids in the last 6 months with bleeding being much heavier and longer (7 days). She denies any significant dysmenorrhoea. She denies headaches, visual changes, lactation or breast changes or hot flashes. She denies vaginal dryness and dyspareunia. She noticed a change in her skin over the last 1 year and has gained 10-15 pounds in the last 6 months. She feels tired but denies SOB or lightheadedness. Reports previously subfertile. 
ROS - negative except above. 
Allergies - none 
Meds - none 
PMHx - none 
PSHx - none 
SHx - sexually active with husband, no previous history of STIs. Has 2 adopted children at home ages 3 and 5. 


Keywords and phrases relevant to diagnosis:
gained 10-15 pounds
oligmenorrhoea, increase in bleeding, 2 menstrual peroids in the last 6 months, bleeding being much heavier, bleeding longer
tired
35 year old
6 month
Patient Note: 35 yo female patient presenting for problems with her period for the past 6 months. The patient reports heavy flow and that she needs to change her tampon every 2 hours. Last menstrual period was 2 mo ago. She didn't have similar problems before. Her menstrual cycle is regular. Her first menses occured at the age of 12. No vaginal discharge or blood clots reported. Multiple failed attempts of getting pregnant reported. Her last pap smear was normal  6 months ago. She reports weight gain of 10 pounds recently with an increased appetite. No cold intolerance, tremors, low mood, constipation, or bloating reported. She reports being anxious at work.
ROS: as listed above
PMH/PSH: none
Medication and allergies: none
FH: negative for spontaneous abortions or heavy bleeds
SH: non smoker, occasional drinker, no illicit drug use, she lives with her 2 adopted daughters, divorced, sexually active with her boyfriend with no contraceptive use

Keywords and phrases relevant to diagnosis:
female
weight gain, gain of 10 pounds
problems with her period, heavy flow, change her tampon every 2 hours
Last menstrual period was 2 mo ago
no contraceptive use
Multiple failed attempts of getting pregnant
35 yo
6 months
Patient Note: 35-year-old female complaining of problems with her periods. Patient states that for the last 6 months her periods have been irregular and heavy. 2 periods in 5 months each lasting 7d, very heavy especially on day 1 changing tampons every few hours. Never experienced this before, periods previously normal. Denies nausea/vomiting/change in appetite/bowel/bladder habits. Denies pain w/intercourse/vaginal discharge. Does state that she "is unable to get pregnant", tried for years with ex-husband, not sure why. Over the last two years she has noticed increased fatigue dailiy and darkening of skin on her neck/knuckles. Denies increased thirst/ cold/heat intolerance. Monogamous w/boyfriend does not use protection
PMH: unknown repro issue
PSH: none
Meds: none
NKDA
Fam: denies endocrine/repro
Social: desk job, only exercise is chasing adopted kids, doesn't pay attention to her diet, rare beer, denies drugs/tobacco, 1 cup coffee daily

Keywords and phrases relevant to diagnosis:
female
problems with her periods, periods have been irregular, periods have been heavy, 2 periods in 5 months, lasting 7d, changing tampons every few hours
does not use protection
fatigue
unable to get pregnant
35-year-old
6 months
Patient Note: 35 yo F c/o having problems with her periods
She has been having an increase on the bleeding recently, denies dyspareunia, nausea or vomiting
Has increased the number of tampoons due to the bleeding 
Has gained weight due to a recent vacation overseas, feels fatigued and tired
She has 2 little girls at home that are adopted as she cannot get pregnant 
Has bleeding after itercourse

ROS: Negative Except as above
OBGYN: P-0, P0, increased in number of tampoons, cannont get pregnant, No h/o STD's
Meds: None
Allergies: None
SH: Negative


Keywords and phrases relevant to diagnosis:
F
gained weight
increase on the bleeding, increased the number of tampoons, increased in number of tampoons
fatigued, tired
cannot get pregnant, cannont get pregnant
35 yo
Patient Note: CC; abnormal periods
HPI: the patient is a 35 yo G0 woman with no past medical history presenting with abnormal periods for the past 6 monsths, baseline periods every 4-5 weeks for 3-4 days using 4 tampons,  last 6 months periods do not come monthly,  heavy last 7 days with multiple tampon changes up to every hour on the girst day. NO clots whith periods, abdominal pain, vaginal discharge or odor. Last pap smear 9months ago normal, never had abnormal pap, no history of sexually trasmitted infections. Patient previously on othrotrycyclen birth control periods, last used 11 years ago, wstopped to try to have children but unsuccessfull, adopted 2 kids
ROS: no fevers, nausea, vomiting, diarrhea, brest tenderness, hirsutism, chest pain, shortness of breath, palpitations  Past meedical history: none, PSH none, Meds: none Allergies: none FAm mom in good health, grandmother with cervical cancer, aunt with breast cancer, no alcohol/drugs

Keywords and phrases relevant to diagnosis:
woman
abnormal periods, abnormal periods, periods heavy, 7 days, multiple tampon changes up to every hour
try to have children but unsuccessfull
35 yo
6 monsths
Patient Note: HPI: 35 YO F PRESENTED WITH C/O IRREGULAR PERIOD X 6 MONTHS ASSOCIATED WITH HEAVY BLLEDING DURING MENSTRUATION. PREVIOUSLY HER PERIODS WERE REGULAR OCCURING EVER 4-5 WEEKS BUT NOW IN THE PAST 6 MONTHS SHE HAS HAD ONLY 2 PERIODS. SHE ALSO COMPLAINS OF TIREDNESS IN THE LAST 2 YRS HAVING TO TAKE CARE OF 2 ADOPTED CHILDREN. SHE WANTS TO GET PREGNANT BUT IS UNABLE TO CONCEIVE. HER APPETITE IS NORMAL BUT REPORTS WEIGHT GAIN IN THE LAST 6 MONTHS. SHE HAS A RASH IN HER NECK AND ARMS THAT SHE THINKS IS DUE TO SUNBURN.
SHE DENIES FEVER, ABDOMINAL PAIN, CHANGES IN BLADDER AND BOWEL HABITS.
ROS: NEG EXCEPT AS ABOVE
ALLERGIES: NKA/NKDA
MEDS: NONE
PMH/PSH: NONE
FH: AUNT HAD BREAST CANCER, GRANDMOTHER HAD CERVICAL CANCER
SH: MONOGAMOUS WITH BOYFRIEND, DOESNT USE CONDOMS, NONSMOKER, DOESNT CONSUME ETOH
OB/GYN: LMP 2 MONTHS BACK
UP TO DAT EWITH SCREENING

Keywords and phrases relevant to diagnosis:
F
WEIGHT GAIN
IRREGULAR PERIOD, HEAVY BLLEDING
LMP 2 MONTHS
DOESNT USE CONDOMS
TIREDNESS
UNABLE TO CONCEIVE
35 YO
6 MONTHS, 6 MONTHS, 6 MONTHS
Patient Note: Angela Tompkins is a G0P0 35 year old female with a past medical history of infertility (unclear if from her or exhusband) who presents with heavy menstrual bleeding. Her periods started at the age of 12 and typically occurred every 30-35 days with 3 days of bleeding and about 4 tampons per day. She previously was on birth control for irreglar periods at menarche but stopped years ago. Over the last six months she is having irregular periods that last for 7 days, occur every other day, and require her to change tampons every 2 hours. She has fatigue and 15 lbs weight gain but no fever, chest pain, palpitations, heat or cold intolerance, vaginal discharge, dysuria, urinary frequency, urine color change, nausea, vomit, diarrhea. Last pap 6 months ago normal. 
PMH: Infertility (? from her or exhusband)
No prior surgeries
Meds: none
Allergies: none
FH: Aunt died of breast cancer at 51, grandma of cervical cancer at 62.

Keywords and phrases relevant to diagnosis:
female
weight gain
heavy menstrual bleeding, irregular periods, tampons every 2 hours
fatigue
infertility, Infertility
35 year old
six months
Patient Note: CC: heavy irregular periods
HPI: Angela Tompkins is a 35 year old female with no PMH who presents with 6 months of heavy, irregular menstrual bleeding. Normally, her periods last for 3-4 days and occur every 4-5 weeks with minimal pain. Over the last 6 months, she has had only 2 periods, and they lasted for 7 days with very heavy bleeding (tampon change every 2 hours). Menarche was at age 12 with irregular periods that became regular with oral contraceptives (OCPs). She stopped taking OPCs 11 years ago to become pregnant, but she and her husband could not conceive. She has also noted weight gain of 10-15 lbs in 6 months despite normal appetite. Notes dark patches on neck/hand. Feels more tired than usual. Denies abdominal pain, headaches, and any other bleeding. Normal bowel movements and urination. Had normal paps.
ROS: neg except per HPI
PMH: no
PSH: no
Meds: no
Family: Aunt -breast cancer. Grandmother -cervical cancer. 
Soc:

Keywords and phrases relevant to diagnosis:
female
weight gain
irregular periods, heavy periods, heavy menstrual bleeding, irregular menstrual bleeding, last 6 months 2 periods, periods lasted for 7 days, heavy bleeding, tampon change every 2 hours
tired
35 year old
6 months
Patient Note: HPI: 35 YO F C/O PERIODS PROBLES X 6 MONTHS.
- LMP WAS 2 MONTH AGO, SHE HAS 2 MENSES IN LAST 5 MONTHS
- MENSES WERE HEAVY, GAINED 10 -15 LBS X 6 NMONTHS, HAS HYPERPIGMENTATIONS ON HANDS AND NECK
- DENIES SKIN DRYNESS, BOWEL MOTIONS CHANGES, HEAT/COLD INTOLERANCE, BREAST TENDERNESS, MORNING SICKNESS
- TRIED TO GET PREGNANT UNSUCCESSFLLY. SHE PRACTICE SEX WITHOUT CONDOMS . NO OCPS
ROS: AS IN HPI
PMH: NONE
ALLERGY: NKDA
MEDS: NONE
FH: AUNT WITH BREAST CANCER, GRAND MOTHER WITH CERVICAL CANCER
SH: DRINKS ALCOHOL OCCASIONALLY, SEXUALLY ACTIVE WITH HER BOYFRIEND ADOPTED 2 KIDS


Keywords and phrases relevant to diagnosis:
F
GAINED 10 -15 LBS
MENSES HEAVY
LMP WAS 2 MONTH AGO
SEX WITHOUT CONDOMS, SEX NO OCPS
TRIED TO GET PREGNANT UNSUCCESSFLLY
35 YO
6 MONTHS, 5 MONTHS, 6 NMONTHS
Patient Note: 35 yo F c/o Irregular periods for 6 months. Occurs around every 8 wks now, lasts 7 days, change pads every hrs. Not on contraception, sexually active with boyfriend. Pap smear 6 months back was normal. Noticed darkening of skin, gained 10 pounds over 6 months, feels fatigued. Usually eats outside. No change in vision, headache, discharge from breast, strias in belly. No hot/cold intolerance, hirsutism, dysparunia, abdominal discomfort, vaginal discharge, hot flashes. NO change in desire of sex, axillary or pubic hair changes.
ROS: negative except as above
Allergies: none
Meds: none
PMH/PSH: none
FH: Aunt died of breast cancer, grandmother died of cervical cancer
SH: Sexually active with boyfriend, no contraception, no smoking/etoh/drugs


Keywords and phrases relevant to diagnosis:
F
gained 10 pounds
Irregular periods, now, lasts 7 days, periods every 8 wks
Not on contraception, no contraception
fatigued
35 yo
6 months
Patient Note: Ms. Tompkins is a 35 yo F who presents with menstrual irregularities. She previously had normal periods, but has only had 2 periods over the past 6 months. Her LMP was 2 months ago. Her periods have been very heavy during this time, and she is changing her tampon every 2 hours for  the first couple days. She is sexually active with her boyfriend, and they are not using any form of contraception as the paitent believes she cannot get pregant. She reports trying for 2 years with her ex husband with no success, but had no infertility workup. She has gained 10-15 lbs over the past 6 months with no change in diet or appetite and feels more fatigued. She denies hirtuism, virilization, cold intolerance, hair changes, vaginal or nipple discharge. Denies history of STIs or abnormal paps
PMHx- none
Meds - none 
Allergies - none
FH - breast cancer in aunt, grandmother with cervical cancer
SH - rare alcohol no smoking

Keywords and phrases relevant to diagnosis:
F
gained 10-15 lbs
menstrual irregularities, only had 2 periods over the past 6 months, periods have been very heavy, changing her tampon every 2 hours
LMP was 2 months ago
not using contraception
fatigued
cannot get pregant, infertility, trying for 2 years with no success
35 yo
Patient Note: 35 yo F with no PMH presents for "problems with her periods." She states that beginning 6 months ago periods became heavier, lasting 7 days, and requireing more frequent change of her tamponds than usual. She has only had 2 periods in the last 6 months and LMP was 2 months ago. Menarche 2 months ago. Before this change, periods used to come every 4-5 weeks, lasting 3-4 days, and requiring only 4 changes of tampons. No excessive cramping noted before or after this change. Patient has never been pregnant before. No change in appetite but has gained 10-15 pounds since 6 months ago. She also has a non-pruritic rash on her hands and neck.
ROS: no headaches, breast tenderness or discharge, no intermenstrual spotting, no vaginal discharge, no palpitations, changes in bowel or urinary habits
PMH: none
past surgical history: none
Meds: none
Allergy: NKDA
FH: breast cancer in aunt, grandmother with cervical cancer
sH: no smoking or drinkin

Keywords and phrases relevant to diagnosis:
F
gained 10-15 pounds
periods heavier, more frequent change of her tamponds
LMP was 2 months ago
35 yo
6 months, 6 months, 6 months