bhatthars/nbme_qna huggingface dataset:
Patient Note: Patient is a 17 year old male no PMH complaining of rapid heart beating in his chest. He has felt this for many months, 1-2 times per week, 3-4 minutes per episode. He is unsure of what brings them on or stops them. The most recent episode occurred 2 days ago while playing soccer and was associated with pressure in the center of his chest, non-radiating, as well as lightheadedness, after which he sat down and it stopped in ten minutes. In the past year, he has used his roommate's adderall frequently. He drinks 3-4 cups of coffee per night and 1-2 energy drinks per week. Denies recent heat intolerance, sweating, anxiety, weight loss. 
Meds: None
Allergies: None
PMH: None
FH: Mom has "thyroid problems", dad had a heart attack at age 52 and is still alive.
SH: Uses roommate's adderall frequently. 3-4 beers per weekend day, CAGE 0/4. Marijuana once months ago. Currently freshman in college.

Keywords and phrases relevant to diagnosis:
dad had a heart attack
Mom has "thyroid problems
pressure in the center of his chest
1-2 times per week
lightheadedness
Denies heat intolerance
adderall, Uses adderall
drinks coffee, drinks energy drinks
rapid heart beating
many months
17 year old
male
Patient Note: Dillon Cleveland is a 17 year old male presenting with a chief complaint of "heart pounding." He has had 6 episodes over the last 2-3 months, all lasting about 3-4 minutes and then self-resolving. The episodes occur at rest and with exercise, although the last one during a basketball game was associated with a dull chest pressure, shortness of breath, and presyncope. He denies any radiation of the pressure. He denies any aggravating or alleviating factors.

PMH/PSH: none

FH: Father had an MI at 52; Mother has "thyroid issue"; No known history of hypertrophic cardiomyopathy or atrial fibrillation, or other "heart rhythm" disorders

SH: Slightly more stressed; tried marijuana once but no other recreational drugs; alcohol 3-4 drinks on the weekend; no tobacco products. Plays basketball

ROS: no nausea or vomiting, weight changes, dairrhea, constipation, hair loss

Keywords and phrases relevant to diagnosis:
Father had an MI
Mother has "thyroid issue
chest pressure
episodes, episodes
presyncope
no hair loss
shortness of breath
heart pounding
over the last 2-3 months
17 year old
male
Patient Note: Mr. Dillon Cleveland is a 17 year old male who presents for heart pounding. 
- Started occuring 3 months ago, with 3-4 minute episodes of heart racing and pounding.
- Nothing seems to specifically bring on the episodes, relieving factors include resting in a sitting position for a few minutes
- He denies sweating, nervousness, anxiousness, heat intolerance
- Of note, he was playing in a basketball game recently and acutely felt lightheaded like he was going to pass out. He required rest to resolve this issues.
Past medical history and surgical history and allergies to medications was all negative
Family history: Mother: thyroid problem; Father: Myocardial infarction at 51 years old
Medications: Adderal 2-3 times a week (not prescribed to patient), coffee and caffeine 3-4 times a week
Social: Patient is a college student studying philosophy, drinks 3-4 beers on the weekend, 0-4 CAGE questions, does not smoke, and rare marijuana

Keywords and phrases relevant to diagnosis:
Father: Myocardial infarction
Mother: thyroid problem
lightheaded
denies heat intolerance
Adderal
coffee, caffeine
heart pounding, heart racing, heart pounding
Started 3 months ago
17 year old
male
Patient Note: This is a 17 year old male presenting with palpitations. Began 2-3 months ago, described as "heart pounding". States symptoms occur randomly and may happen at rest or with activity, lasts about 15 minutes at a time
-One episode recently included shortness of breath while playing basketball, patient had difficulty catching his breath which resolved on its ownHe denies any syncope but complains of some dizziness during a recent episode during. Has not taken anything for his symptoms, nothing makes them better or worse, symptoms usually resolve "on their own"
-denies any weight loss, fatigue, changes in bowel habits
-He states he has been taking adderall from his friends perscription for several years a few times a week, denies any other drug use
PMH:
-No medical problems, no surgery
-Takes adderall from friend 2-3x per week

Family Hx:
-Thyroid disease in mother
-CAD in father
Social - drinks occasionally on weekends, no drug


Keywords and phrases relevant to diagnosis:
CAD in father
Thyroid disease in mother
occur randomly, episode
dizziness
adderall, adderall
shortness of breath, difficulty catching his breath
palpitations, heart pounding
Began 2-3 months ago
17 year old
male
Patient Note: Case of a 17 yo male that comes due to chest palpitations since 3 months ago. He states he has had around 6 episodes total. They come completely at random with no particular inciting event and end rather quickly. Patient refers no improving or worsening factors. He does refer they have been progressing, with the last episode (about 2 days ago) having additional features of chest pressure, SOB, and lightheadedness. He denies: nausea, vomiting, fever, bowel or urinary pattern changes, abdominal pain, chest pain, hair loss, feelings of anxiety, tremors, or sweating. 
PMHx: unremarkable
All.: NKDA
PSHx: none
FMHx: mother has a thyroid disease. Father suffer an MI at age 52.
Social Hx: He is a full time college student. He drinks 3 - 4 weeks a week. Denies smoking. Admits drug use only once (marijuana) with no similar complaints. He refers a healthy and active lifestyle. Currently sexually active and uses condoms. No STDs

Keywords and phrases relevant to diagnosis:
Father suffer an MI
mother has a thyroid disease
chest pressure
6 episodes
lightheadedness
SOB
chest palpitations
since 3 months
17 yo
male
Patient Note: 17 YO M C/O RACING OF HEART FOR 3 MONTHS, EPISODIC,  LAST EPISODE 2 DAYS BACK WHEN PLAYING BASKET BALL ASSOCIATED WITH SOB, LIGHTHEADEDNESS. HE ALSO REPORT TAKING CAFFENATED DRINKS (4-5 DRINKS PER DAY), AND ADDERAL( LAST INTAKE WAS 2 DAYS BACK). HE HAS NO HISTORY OF PASSING OUT, OR HAS NOT NOTICED ANY SKIP BEATS.
DENIES CHEST PAIN, N/V, SKIN CHANGES, TEMPERATURRE INTORELANCE, CHANGE IN BOWEL OR BLADDER HABIT, NO CHANGE IN SLEEP
ROS: NEGATIVE EXCEPT ABOVE
FH: FATHER HAD HEART ATTACK
ALLERGIES/PSH/PMH: NONE
MEDS: ADERRAL
SH: NO SMOKE, DRINK IN WEEKEND 3-4 BEER, SEXUALLY ACTIVE WITH GIRLFRIEND, NO OTHER DRUGS BESIDE ADDERRAL

Keywords and phrases relevant to diagnosis:
FATHER HAD HEART ATTACK
EPISODIC
LIGHTHEADEDNESS
DENIES TEMPERATURRE INTORELANCE
ADDERAL, ADERRAL
SOB
CAFFENATED DRINKS
RACING OF HEART
FOR 3 MONTHS
17 YO
M
Patient Note: 17 yo pat. presents with heart pounding and racing. Symptoms began 2-3 months ago and have occured 5-6 times during this period. Two days ago the patient had an episode that was also accompanied by chest pressure and dyspnea. No cough, fever, N/V, angina, abdominal pain, changes in bowel or urinary habits. No rashes or edema. Pat. uses roommates Aderol 2-3 times/wk as a study aid. 
ROS: neg. except as above. 
PMH/PSH/Hospitalisations: none
Meds: Roommate's aderol 1-2x/wk
NKDA
EtOH 3-4 beers/weekend, no tobacco, Drugs: marijuana once, no reg. consume
FH: Mother thyroid problem, Father had a MI one year ago. 
No travel or sick contacts
SH: student, lives in dorms
Excercise: basketball adn running 3-4x/wk
Sexual hx: active with girlfriend, condoms, 1 partner/past year, no prior STI, last screening negative.

Keywords and phrases relevant to diagnosis:
Father MI
Mother thyroid problem
chest pressure
occured 5-6 times
Aderol
dyspnea
heart pounding, heart racing
Symptoms began 2-3 months ago, began 2-3 months ago
17 yo
Patient Note: 17 y/o M in student clinic c/o heart pounding x 2-3 months. Started suddenly, the palpitations are wosening, occurs 5-6 times in last 2-3 months. Last episode was 2 days ago precipitated by taking Adderall to concentrate. A/w stress in school, pressure like discomfort in chest, 5-6/10 in intensity, non radiating. The palpitations resolve spontaneously. Denies LOC, dizziness, fainting, cough, colds, association of discomfort to inspiration/exertion, hot/cold intolearance.
ROS Negative except as above
PMH/PSH/Hosp/Trauma None, Meds Adderrall since high school, currently takes it 2x/week, Last intake 2 days ago in AM; NKA
FH Mom had thyroid problems, Dad had heart attack at age 52
SH college student, has good grades but has been stressed in school, no smoking, drinks 3-4 beers/weekend, took Potts once months ago, sexaully active with girlfriend only, no STDs, uses protection regularly


Keywords and phrases relevant to diagnosis:
Dad had heart attack
Mom had thyroid problems
pressure like discomfort in chest
5-6 times
Denies hot/cold intolearance
Adderall, Adderrall
heart pounding, palpitations, palpitations
x 2-3 months, in last 2-3 months
17 y/o
M
Patient Note: Pt is a 17 yo M who presents with heart pounding and racing x3-4 months. He reports these events occur about 1-2/month and last for about 3-4 minutes before resolving spontaneously. His most recent episode occured 2 days ago, and he had associated chest pressure and SOB and notes that he felt he may pass out. Of note, he had taken a dose of his friends' adderal the night prior and the morning of the episode. He is unsure of any other preceding events that have caused prior episodes. He denies any recent fevers, chills, fatigue, weight loss, heat intolerance, cough, or changes in bowel habits. 

ROS: Neg other than HPI
PMH: None
PSH: None
Allergies: None
Meds: Adderall a few times a week. Borrows from friend.
SH: Freshman student in college. Lifetime non-smoker. Drinks 3-4 beers at parties on weekends. Tried marijuana in past but no recent recreational drug use. 
FH: Mother - "thyroid problem" (pt unsure). Father - MI at age 52

Keywords and phrases relevant to diagnosis:
Father - MI
Mother - "thyroid problem
chest pressure
occur about 1-2/month
adderal, Adderall
SOB
heart pounding
3-4 months
17 yo
M
Patient Note: 17 year old male presenting with heart pounding and racing. This has happened 5-6 times over the past 2-3 months. Endorses some stress from college. Reports taking his friend's Addirall to help him study and 2-3 cups of coffee per day. The most recent episode was 2 days ago, when he also had substernal chest pain and felt lightheaded. ROS: denies cold/heat intolerance, constipation/diarrhea, energy changes, headache during episodes, weight change, sleep problems. 

PMH: none
PSH: none
meds: Taking his friend's Addirall a few times a week to help with studying. Willing to schedule f/u appointment to discuss this further. 
FH: mom with thyroid problem, father with herat attack one year ago (smoker)
SH: college student. Alcohol 3-4 beers per night on the weekend. Tried marijuana 1x. Denies other drug use. Sexually active with girlfriend, always use condoms. Feels safe in relationships.

Keywords and phrases relevant to diagnosis:
father with herat attack
mom with thyroid problem
chest pain
happened 5-6 times, episode
lightheaded
denies cold/heat intolerance
Addirall, Addirall
coffee
heart pounding, heart racing
over the past 2-3 months
17 year old
male
Patient Note: 17 yo male presents with 3 months of heart palpitations. He states that they occur without association to any activity or time of day. Each event is associated with sob and last about 3-4 minutes. nothing makes it better or worse. 2 days ago he had a severe episode that lasted 10 minutes and was accompanied by chest pressure and lightheadedness while playing basketball. He mentions that he started college 8 months ago and has started taking his roommates adderal 2xweek to aid in studying for the last 7 months. denies any diarrhea, weightloss, appetite changes, or diaphoresis. 

ros: neg except for hpi
pmhx: none
pshx: none
fhx: mother with "thyroid problem" and father with MI at 57yo
medications: adderal (no prescription)  
social hx: started college no declared major yet, lives with roommate in doorms, drinks 3-4 beers or mixed drinks on weekends, no smoking, sexually active with girlfriend of one year. uses condoms. no stds.

Keywords and phrases relevant to diagnosis:
father with MI
mother with "thyroid problem
chest pressure
lightheadedness
adderal, adderal
sob
heart palpitations
3 months
17 yo
Patient Note: HPI: 17yo,m,c/o palpitations,started suddenly,intermittent,5-6times in a week,nothing makes it better or worse.He drinks a few cups of coffee in a week,he also has dyspnea in his last episode of palpitations.He denies fever/urinary problems/changes in his appetite/weight changes/bowel changes/skin changes/chest pain/loss of consciousness/tremors/sweating/eye problem/temperature intolerance.Mood is good, no stress recently
ROS: Neg apart from the above symptoms
PMh : No similar symptoms,No other medical problems,Allergy: NKDA,NKA
Meds: Adderall for exam, 1 pill a week
Hospitalization : no ill contact/surgery/trauma
FH: father has heart problem,mother has thyroid problem
SH : No smoking/EtOH/rec drugs - used Pop, last 2 mos ago at a party, work : college student, Sexually active with girlfriend, uses condomas

Keywords and phrases relevant to diagnosis:
father has heart problem
mother has thyroid problem
intermittent
denies temperature intolerance
Adderall
dyspnea
drinks coffee
palpitations, palpitations
17yo
m
Patient Note: 17 y.o. M presents with a few months history of episodes of palpatations and dyspnea. the episodes have been getting worse. the worst episode occured 2 days ago during which he felt presyncopal, he was also short of breath and had pressure in his chest. He denies any Loss of consciousness, headache, dizziness, tremor, heat intolerance, bowel or urinary symptoms.
ROS: negative except as above
PMH: none
PSH: none
FH: mother has a Thyroid problem, father had an MI
SH: nonsmoker, drinks on the weekends, has tried marijuana, sexually active with his girlfriend and uses condoms. Sometimes uses adderall which he gets from him friend.
Meds: none
Allergies: NKDA


Keywords and phrases relevant to diagnosis:
father had an MI
mother has a Thyroid problem
pressure in his chest
episodes, episodes, episode
presyncopal
denies heat intolerance
adderall
short of breath
palpatations
few months history
17 y.o
M
Patient Note: HPI
Pt is a 17 yo M presenting with 2 months of intermittant palpitations. Reports 5-6 episodes of palpitations that last 3-4 minutes and resolve spontaneously. Reports most recent episode was at a basketball game where he had chest pressure, dyspnea, and lightheadedness. Normaly, these episodes have no palpitations, chest pain, shortness of breath, loss of conciousness, syncope. symptoms have never happened before. Denies any chest pain, or abdominal pain. No known precipitant. 
ROS -neg unless above
Med/surg hist - none
Med- took a couple pills of roommates adderall
allergies -none
SocialH-no tobacco, 3/4 drinks of alcohol a week, tried marijuana once, lives with roomate in college.
Sexhist-1 partner, wheres condoms, never tested for STDs, denies hist of STD symptoms.
fam hist- Dad had heart attack at 52, mom has hypothyriod

Keywords and phrases relevant to diagnosis:
Dad had heart attack
chest pressure
intermittant palpitations, 5-6 episodes
lightheadedness
mom has hypothyriod
adderall
dyspnea
palpitations
2 months
17 yo
M
Patient Note: 17 yo M c/o heart pounding.
Reported 5-6 episodes heart pounding in 2-3 months, last 3-4 mins each episode, but last episode lasted almost 10 mins, associated chest tightness, mild SOB during baskerball game. Denies dizziness, intolerance to heat, diaphoresis, hand tremor, change of bowel movements. No severe change in life but in new semester in college. 
PMH:none
PSH?hospitalization:none
Meds: Adderral, and ponds once 
NKDA
FH: father had heart disease, mother had diarrhea related disease
SH: No smoking, social drinker, Adderal use and last dose 2 days ago. 
Sexually active with GF only, with condom and pills protection.

Keywords and phrases relevant to diagnosis:
father had heart disease
chest tightness
5-6 episodes
Denies intolerance to heat
Adderral, Adderal use
SOB
heart pounding, heart pounding
2-3 months
17 yo
M
Patient Note: 17 yr Old M comes to clinic with c/o Heart Pounding, which started 2-3 Months. Symptoms comes and goes and last 3-4 min. Pt had 5-6 episodes so far and goes away on its on. Also feeling chest pressure which is in center x 2 days and difficulty in breathing x 2 days. Denies headache, diaphoresis, loss of consciouness, flushing, diarrhea, constipation, hair and skin chages. Diet and Appetite is normal. Pt is on Health plan for diet and eats fruits, veggies and protein meal.
ROS negative except above
PMH None Meds  Takes addrall from room mate, NKDA
PSH none   Hospital none   No trauma
FH Mother had thyroid condition, Father has heart problem
SH student, No smoking, ETOH occasional, Recreational drugs Pot one time
SEX H Active with GF, Use condom and NO STD.

Keywords and phrases relevant to diagnosis:
Mother had thyroid condition
chest pressure
Symptoms comes and goes, 5-6 episodes
Denies hair chages
Takes addrall
Heart Pounding
started 2-3 Months
17 yr Old
M
Patient Note: CC" "My heart has been pounding"
HPI: Mr. Cleveland is a 17 year old male with no PMH who presents for the sensation of his heart pounding. For the past 3-4months he has had episodes of feeling as if his heart is racing. They happen sporadically and self resolve within 3-4 minutes. There is no recognizable trigger, including stress or exertion. The most recent epsidoe happened while playing soccer and was assciated with a midsternal pressure type pain that was non-radiating. They are not associated with dizziness or sweating.  He has not had any recent unexplained weight loss. 
PMH: none
Meds: none persribed
Family hx: mom has thyroid issues, dad had a heart attack at 52
SH: 3-4 beers on weekend, non smoker, does take roommates adderall (took some the night before and morning of the last episode that had associated chest pain)

Keywords and phrases relevant to diagnosis:
dad had a heart attack
mom has thyroid issues
midsternal pressure
happen sporadically
adderall
My heart has been pounding, heart pounding, heart is racing
past 3-4months
17 year old
male
Patient Note: Mr. Cleveland is 17 year old Male who came to student health clinic for complaints of chest pounding that has been going on for about 5 or 6 months and states that he feels the episodes are getting worse. He states that the episodes seem to be random but when further questioned he admits to taking his roommates adderall on occasion. He admits that the last episode occurred on the same day that he took some adderall. He denies palpitations but endoreses some chest pressure and SOB.
ROS: all other ROS negative unless stated above. 

PMHx: none
Medication: none
SurgHx: none
FamHx: father MI at age 52, mother has a thyroid disorder
SocialHx: patient drinkds 3-4 mixed drinks or beer on weekends, smoke marijuana once at a party, endorses occassional non perscription aderall use
Allergies: none

Keywords and phrases relevant to diagnosis:
father MI
mother has a thyroid disorder
chest pressure
episodes random
adderall, took adderall
SOB
chest pounding
5 or 6 months
17 year old
Male
Patient Note: Mr Cleveland is a 17 yo male c/o heart punding. It happened yesterday, started suddenly, lasted for 3-4 minutes and went away by itself. It has been about 3 months he has been having such episodes, for a total of 5-6. In this last episode he also felt dizzy, short of breath and had some chest pressure. He finds that the last episode might have been linked to aderol intake. Denies loss of consciousness, any nausea or vomit. Denies any sweating. 
ROS: as per HPI. 
PMH: none. PSH: none. NKA. Meds: he has been taking aderol before tests to improve his performance. No hospitalizations, injuries or surgeries. Immunizations up to date. FH: mother has thyroid problems, father had a MI recently. SH: college student, denies any smoke, occasional drinking on the weekends, has tried pot once. Sexually active with his girlfriend, regular condom use.

Keywords and phrases relevant to diagnosis:
father MI
mother thyroid problems
chest pressure
episodes
Denies any sweating
aderol
short of breath
heart punding
3 months been having
17 yo
male
Patient Note: Dillon Cleveland is a 70 yo male with no pertinent pmh who is presenting with 2-3 mo of irregular heartbeat/ pounding in his chest. It has happened 5-6 times over the past 2-3 months. Doesn't radiate. Feels like heart is going to jump out of his chest. 6/10 in  severity. Unsure if anything makes it better or worse. No sugeries, hospitalizations, trauma. Up to date on immunizations. No sick contacts. Student at UH undeclared major; states transition to college was stressful and takes lots of tests at school (has coping measures and good support system). Alcohol on weekends (3-4 beers/ mixed drinks). No tobacco. Tried marijuana in past. Denies recreational drugs (ex. cocaine). No RX medications; uses friends adderall 2-3 times a week. No allergies. Takes protein supplements; no pre-workout. Eats healthy. Mom hx of thyroid (unsure hyper or hypo). Dad hx MI at 52. ROS otherwise negative (denies SOB, fever, chills, nausea, vomitting).

Keywords and phrases relevant to diagnosis:
Dad hx MI
Mom hx of thyroid
5-6 times
adderall
irregular heartbeat, pounding in his chest, heart is going to jump out of his chest
2-3 mo, 2-3 months
male
Patient Note: HPI: 17 YO M CAME WITH SUDDEN ONSET OF EPISODIC PALPITATIONS FOR THE PAST 2 MONTHS. HE HAS HAD 5-6 EPISODES WITHOUT AGGRAVATING OR RELIEVING FACTORS. LAST EPISODE WAS ASSOCIATED WITH CHEST PRESSURE, AND SOB. HE DENIES SWEATING, COUGH, FEVER. HE DRINKS 3-4 CUPS OF COFFEE/DAY AND 2 ENERGY DRINKS/WEEK. HE RECENTLY JOINED A NEW COLLEGE AND HAS SOME STRESS IN HIS COLLEGE IN ADJUSTING TO NEW ENVIRONMENT. HE IS MILDY WORRIED ABOUT HAVING NEXT EPISODE. HE DENIES SKIN/HAIR CHANGES, TEMPERATURE INTOLERANCE, CHEST PAIN. NORMAL MOOD, SLEEP, WEIGHT, BLADDER AND BOWEL HABITS.
ROS: AS PER HPI.
PMH/PSH/ALLERGIES: NONE
MEDS: NONE
FH: FATHER HAS HEART PROBLEM, MOTHER HAS THYROID PROBLEM
SH: USES ADERRAL TWICE A WEEK/7 MONTHS; NO SMOKING; OCCASIONAL ETOH INTAKE; SEXUALLY ACTIVE WITH GIRLFRIEND; USES CONDOMS

Keywords and phrases relevant to diagnosis:
FATHER HAS HEART PROBLEM
MOTHER HAS THYROID PROBLEM
CHEST PRESSURE
EPISODIC, EPISODES
DENIES TEMPERATURE INTOLERANCE, DENIES SKIN/HAIR CHANGES
ADERRAL
SOB
COFFEE, ENERGY DRINKS
PALPITATIONS
FOR THE PAST 2 MONTHS
17 YO
M
Patient Note: Mr. Dillon Cleveland is a 17 y/o boy with no significant pmh presenting with 5-6 episodes of palpitations over the last few months. Most recently this occurred a few days ago while he was playing basketball. At that time it was associated wtih lightheadedness, shortness of breath, and chest pressure. Previously also had palpitations when resting quietly. This would last 3-4 minutes and subside spontaneously. IT was not associated wtih any activities or time of day. Of note, pt takes friends' adderall prescription 3x/week for extra focus while studying. baseline he denies difficulty concentrating.
ROS: denies chest pain, cough, abdominal pain, N/V/D/bloody/black stools/dysuria, and all otherwise negative
PMH: none, takes no medications other than friends' adderall non-prescribed, no allergies
SOC: studies philosophy in school, drinks up to 3-4 drinks/week, sexually active weith girlfriend, uses condoms

Keywords and phrases relevant to diagnosis:
chest pressure
5-6 episodes
lightheadedness
takes adderall
shortness of breath
palpitations, palpitations
over the last few months
17 y/o
boy