bhatthars/nbme_qna huggingface dataset:
Patient Note: CC: 17 yo M c/o heart pounding
HPI: Patient complains of episodes of heart punding, that happen once or twice monthly, that come and go, usually lasting 3-4 minutes, sudden. During the last episode he felt chest pressure, shortness of breath and felt like passing out, it happened during a fottball game. Between the episodes, he is assymptomatic.
ROS: none
PMH: none
PSH: none
med: takes alterol - medicine for enhancing concentration that his roomate gives him
allergies: none
FH: father had heart attack at age 52, mother has thyroid problem

Keywords and phrases relevant to diagnosis:
father had heart attack
mother has thyroid problem
chest pressure
episodes, happen once or twice monthly, episodes
felt like passing out
shortness of breath
heart pounding, heart punding
17 yo
M
Patient Note: Pt is a 17yo previously healthy male who presents with heart pounding. Pt states first began having episodes of heart pounding 2-3 months ago, first time while sitting/watching TV. No associated pain, nausea or vomiting. Two days ago, did feel pressure on his chest with SOB. Episodes are sporadic, with no apparent trigger, and self-resolve within 2-3 min. Pt has not tried any medications. No syncopal episodes. No hx of travel. No hx of preceding illness/URI. He exercises and eats varied diet. No hx of congenital heart defects.
ROS: as per HPI
PMH, PSH: -
Meds: -
Fam Hx: Mom w/ thyroid issue. Dad had heart attack recently (due to poor diet). Sister healthy. No hx of heart issues or sudden cardiac death.
Social: Studying philosophy, living on college campus. Sexually active in monogamous relationship w/ gf (uses condoms). Denies tobacco or drug use (tried marijauana once few mo ago). Drinks socially on weekends. 
Allergies: -

Keywords and phrases relevant to diagnosis:
Dad had heart attack
Mom w/ thyroid issue
pressure on his chest
SOB
heart pounding
17yo
male
Patient Note: Dillon Cleveland is a 17yo male with a 3-4 month history of heart pounding. These palpitations come on suddenly and last four 3-4 minutes each. The most recent episode was accompanied by a pressure sensation in the chest and shortness of breath. The patient denies headache, chest pain, pallor, dizziness, diaphoresis, weight changes, heat/cold intolerance, hair loss. The patient drinks 3-4 cups of coffee per night and 1-2 energy drinks during the week to keep up with studying. He has also been taking his roommates prescribed Adderall, most recently twice in one day at which may have been associated with eps.
Past Medical Hx: None
Past surgical hx: None
Medications: Adderall
Social Hx: Patient is a freshman in college. He drinks 3-4 drinks over the weekend, denies smoking hx, endorses marijuana use in last month as well as a roommate's Adderall a few times a week.
Family Hx: Thyroid disease - mother, Heart attack 1 year ago - father

Keywords and phrases relevant to diagnosis:
Heart attack 1 year ago - father
Thyroid disease - mother
pressure sensation in the chest
denies heat/cold intolerance, denies hair loss
taking Adderall, Adderall, Adderall
shortness of breath
drinks coffee, drinks energy drinks
heart pounding
3-4 month history
17yo
male
Patient Note: 17 y/o M complains of increased heart rate for the last 3 months. The sensation of increased heart rate has occured 5-6 times and the last episode has been the worst. Pt says the sensation goes away on its own and is not aware of what makes it worse. Pt notes episode at basketball game with exertion as well as notes an episode at rest. Pt admits to using college roomates prescription amphetimine to increase study performance on exams. Pt also admits to increased consumption of high caffine energy drinks. Additionally Pt denies any changes in weight, heat intolerance or any changes in mood sleep or urinary or bowel habits. 
ROS (-) except above 
PSH/PMH - nc
MED- adderall 
ALL - NKDA
SSH - no tobacco, tried marijuana once, drinks EtOH socially
FH - father heart attack 52, mother thyroid problem

Keywords and phrases relevant to diagnosis:
ather heart attack
mother thyroid problem
occured 5-6 times
denies heat intolerance
amphetimine, adderall
consumption caffine
increased heart rate, increased heart rate
last 3 months, for the last 3 months
17 y/o
M
Patient Note: HPI: 17 YO M C/O PALPITATIPN X 2-3 MONTHS AGO. IT'S INTERMITTENT ( 5-6 EPISODES/2-3 MONTHS) , LAST ABOUT 1 MIN, AND IT'S NOT PROGRESSIVE. ALLEVIATED AND AGGRAVATED BY NOTHING. HE TOOK ADDERRAL 1 PILL/LAST WEEK DUE TO SUDYING FO FINAL EXAM. HE DENIES CHEST PAIN, SOB,  SWEATING, COUGH, EDEMA IN LEGS, NAUSEA, VOMITING, FEVER, FATIGUE, NIGHT SWEAT, CHANGES IN SKIN/HAIR, CHANGES IN WEIGHT OR APPETITE. NO TRAUMA, RECENT INFECTION OR TRAVEL. HE USED POT 1 TIME LAST MONTH IN FRIEND'S PARTY. HIS MOOD AND SLEEP IS NL. HE IS NOT WORRY ABOUT FUTURE  EPISODES. NO ANXIETY.
ROS: NEG EXCEPT AS ABOVE.
NKDA. MEDS: ADDERRAL.
FH: MOTHER HAS THYROID DISEASE. FATHER HAD MI.
SSH: SEXUALLY ACTIVE WITH GIRLFRIEND. USES CONDOMS. NO SMOKING.  USED POT 1 TIME LAST MONTH. ETOH OCCASIONALLY. FULL TIME STUDENT, NO STRESS OR RECENT CHANGES IN LIFE.

Keywords and phrases relevant to diagnosis:
FATHER HAD MI
MOTHER HAS THYROID DISEASE
INTERMITTENT, EPISODES
DENIES CHANGES IN HAIR
ADDERRAL, ADDERRAL
PALPITATIPN
X 2-3 MONTHS
17 YO
M
Patient Note: Patient is a 17 yo M presenting with 3-4 months of intermittent heart pounding and beating fast. Patient report that the symptoms have been getting worse. Episodes would last 3-4 minutes but the most recent episdoe 2 days ago during a soccer match lasted 10 minutes with associated chest tightness. Does not notice a pattern to the symptoms. Denies headache, vision changes, LOC, n/v, orthostatic hypotension, recent illness. Reports feeling behind with college and use of adderall to manage workload
PMH: n/a
PSH: n/a
meds: adderall from a friend few times/week
Allergies: n/a
Family hx: mother with thyroid issue; father had heart attack at 52 years old last year; no hx of unexpected deaths in family; no hx of other heart problems in family
social hx: denies tobacco use. Drinks 3-4 drinks/week. counceled on drinking and adderall use. tried marijuana in college

Keywords and phrases relevant to diagnosis:
father heart attack
mother thyroid issue
chest tightness
intermittent, Episodes
adderall, adderall, adderall
heart pounding, heart beating fast
3-4 months of
17 yo
M
Patient Note: 17-year-old male presenting with heart palpitations for the past few months. He endorses that these episodes occur randomly are not associated with any particular activity. The episodes last 3-4 minutes and occur once-twice/month. He denies alleviating and provoking factors. His most recent episode occurred two days ago and he also experienced chest pressure that lasted for 10 minutes and a sensation that he was going to pass out when he was playing goalie in a soccer game, which resolved spontaneously. He denies headache, vision changes and weakness. He denies a family history of sudden cardiac death. 
ROS: negative except as noted above
PMH: none
PSH: none
Meds: uses friend's adderoll before tests
All: NKDA
FHx: mother with hypothyroidism, father had an MI at 52 and is now fine/quit smoking
SHx: freshman in college studying marketing, lives with roommate, no alcohol, other drug use, sexually active with girlfriend, uses condoms

Keywords and phrases relevant to diagnosis:
father had an MI
mother with hypothyroidism
chest pressure
episodes occur randomly
uses adderoll
heart palpitations
past few months
17-year-old
male
Patient Note: 17 y.o. male presents with 2-3 month history of heart pounding. The heart pounding and chest pressure occurs for about 3-4 minutes and has happened 5-6 times since the first episode. Last episode was 2 days ago, he felt significant pressure in the chest, SOB, and light headedness. The episodes can occur while sitting down (most times) or while active. Pt denies any recent stressors, weight change, nausea/vomiting, diaphoresis.
PMHx: No hospitalizations, chronic medical conditions, trauma or surgeries
Meds: NKDA, no prescription meds, no OTCs or vitamins
FHx: Heart attack in father, denies any family history of sudden death of syncope
PSHx: 1st year college student. 3-4 beer on weekend socially, Sexually active with 1 partner(girlfriend), Denies smoking or tobacco history. Used marijuana 1x. Takes friends adderal 3-4x per week. Has been doing so fo1 year. Pt is active on his basketball team, this is not associated with his symptoms.

Keywords and phrases relevant to diagnosis:
Heart attack in father
chest pressure, pressure in the chest
happened 5-6 times
light headedness
Takes adderal
SOB
heart pounding, heart pounding
2-3 month history
17 y.o.
male
Patient Note: A 17 YO M COLLEGE STUDENT C/O HEART POUNDING X 2-3 MONTHS
- INTERMITTENT, NOT PROGRESSIVE, NOTHING MAKES IT BETTER OR WORSE
- ASSOCIATED WITH SOB X 2 DAYS
- DENES CHEST PAIN, LOC, FATIGUE, ANXIOUS, SWEATING, NECK SWELLING, HEAT INTOLERANCE, RASH, LEG SWELLING, SLEEP DISTURBANCE, EXCESSIVE CAFFEINE INTAKE, HEADACHE AND CHANGES IN BOWEL MOVEMENT
ROS: NEGATIVE EXCEPT ABOVE
ALLERGY: NKDA
MEDS: ADDREALL FOR STUDY
PMH & PSH: NONE
FH: MOTHER HAD THYROID DIEASE AND FATHER HAD HEART ATTACK
SH: NO SMOKING, USED MARIJJANA 1 MONTH AGO, 2-4 DRINKS/WEKEND, SEXUALLY ACTIVE WITH GIRLFRIEND, NO STI, PERSISTENT CONDOM USED

Keywords and phrases relevant to diagnosis:
FATHER HAD HEART ATTACK
MOTHER HAD THYROID DIEASE
INTERMITTENT
DENES HEAT INTOLERANCE
ADDREALL
SOB
HEART POUNDING
X 2-3 MONTHS
17 YO
M
Patient Note: Mr. Cole is a 17 m with c/o heart pounding. He has had 5-6 episodes of his heart "jumping out of his chest". These episodes last 3-4 mintues normally, but the last one lasted 10 mintues. He also felt chest pressure, SOB, and lightheaded with the last episode. It has happened while exercising and while sitting around. Of note, this last episode occurred after he took some of his friends adderrall for a test. He has not had any pain, pounding elsewhere in the body, vision changes, appetite changes, weight loss, abdominal pain, or bowel movement changes.  
ROS: negative unless in HPI
Meds: adderrall 2 per week, no allergies
Med Hx: none
Surg Hx: none
Family Hx: MI at 52 for father, mother healthy
Social Hx: at college, lives in dorms, feels safe. No tobacco use, drinks 3-4 beers per weekend. Smoked marijuana once. Sex with girlfriend, use condoms.

Keywords and phrases relevant to diagnosis:
MI at 52 for father
chest pressure
5-6 episodes, episodes, episode
lightheaded
adderrall, adderrall
SOB
heart pounding, heart "jumping out of his chest
17
m
Patient Note: HPI: 17 yo m presents with episodic palpitation for the past 2 - 3 months. It is progressive worsening, 5-6 times over 3 months, lasting for 2-3 minutes, and with no exacerbating or alleviating factors. He reports SOB , lightheadedness and chest pressure with last episode. He denies any weight loss, tremors, hot intolerance, recent stress, numbness, tingling, diarrhea, wheezing, and cough.
ROS: Negative except as above
PMH: None
Med: amphetamine
PSH: None
Allergy: NKDA
FH: mother has hypothyroidism, father has MI
SH: no smoking,used illicit drug once, sexually active with his girlfriend

Keywords and phrases relevant to diagnosis:
father MI
mother hypothyroidism
chest pressure
episodic
lightheadedness
denies hot intolerance
amphetamine
SOB
palpitation
for the past 2 - 3 months
17 yo
m
Patient Note: HPI: Dillon Cleveland is a 17 yo M with a 3-4 month history of heart pounding. He feels his heart beating quickly like it's coming out of his chest. These episodes occur 1-2x/month with no provoking factors or specific pattern and resolve on their own in 3-4 minutes. Last episode was 2 days ago during a soccer game and was associated with chest pressure, SOB, and lightheadness. He has never passed out or lost consciousness. He notes starting college recently was hectic but he was able to transition well.
ROS: no weight changes, diarrhea, tremors, heat intolerance, anxiety
PMH: negative
Medications: takes his roommate's Addral a few times/wk
Allergies: NKDA
FHx: mom - thyroid problem, dad - heart attack last year
Social: freshman in college, lives with his roommate; denies tobacco use, drinks occasionally, tried marijuna a few times, no other drug use, drinks 3-4 cups of coffee/day, sexually active with one F partner,uses condoms


Keywords and phrases relevant to diagnosis:
dad - heart attack
mom - thyroid problem
chest pressure
lightheadness
no heat intolerance
Addral
SOB
drinks coffee
heart pounding
3-4 month history
17 yo
M
Patient Note: 17 yr old m comes in with CC of "heart beating/pounding too fast". For the past month has been having random episodes of tachycardia that last 3-4 minutes at a time. Patient denies LOC, sweating, palpitations, tremors, chills, fever, numbness or tingling. He has never experienced this before. Pt is a freshmen in college and has been using adderall to keep up with his studies. Last use was 3 days ago, last episode of tachycardia was 2 days ago. States he feels light headed duing these episodes.  Patient denies cold intolerance,weight loss, diarrhea, urinary changes, headaches and nausea.
ROS: negative except above.
Meds: occasionally takes adderall. NKDA
PMH: none
FH: mother has thyroid disease, Father had an MI 1 year ago
Social: freshmen in college. does not use tobacco. drinks 3-4 beers on the weekend. No Illicits. Adderall. Exercise: runs a few miles a week, no relation to tachy.

Keywords and phrases relevant to diagnosis:
Father had an MI
mother has thyroid disease
random episodes
light headed
denies cold intolerance
using adderall, takes adderall, Adderall
heart pounding, tachycardia
17 yr old
m
Patient Note: Dillon is a 17 yo M with no PMH c/o heart pounding. he has had 1-2 episodes a month for the last 3- 4 months and have been lasting longer. The episodes typically last 3-4 minutes and self resolve, there is no consistent percipitating factor. The last episode was 2 days ago during a soccer match where the patient felt SOB and lightheaded. He has not had any syncopal episodes,  dizziness, N/V, Chest Pain, diarrhea, abdominal pain, headaches, sleep changes, sweating, sense of doom or vision changes.  

PMHX: none
surgical: none
Family: mom has thyroid issues, dad had MI
med: occasionally uses friends adderal
SHX: does not smoke, alcohol 3-4 drinks a weekend smokes marijuana occasionally
exercise: plays soccer for school
Caffeine- 3-4 cups of coffee a night, 1-2 red bulls/energy drinks a week
sexual: sexually active with gf uses condoms

Keywords and phrases relevant to diagnosis:
dad MI
mom has thyroid issues
episodes, episodes, episode
lightheaded
has not had sweating
adderal
SOB
Caffeine, coffee, energy drinks, red bulls
heart pounding
for the last 3- 4 months
17 yo
M
Patient Note: CC: Heart pounding
HPI: The patient is a 17-year-old male who presents with intermittent episodes of heart pounding. This has occurred 5-6 times over the last 2-3 months with each event lasting 3-4 minutes. There is nothing that brings them on and they resolve on their own. During the last event 2 days ago, he had associated chest pressure, SOB, and light-headedness. No diaphoresis or syncope during this event.
ROS: Negative for headache, sore throat, chest pain, nausea, vomiting, constipation, diarrhea.
PMH: Negative
Rx: None
All: NDKA
Sx: None
FMH: Father-recently had an MI. Mother-has thyroid problems
Soc: Is a full-time student. Denies tobacco use. Drinks 3-4 beers on weekends (0/4 CAGE). Reports using his friend's Adderall a few times per week with his last use being 3 days ago. He also reports smoking marijuana a month ago.

Keywords and phrases relevant to diagnosis:
Father-recently had an MI
Mother-has thyroid problems
chest pressure
intermittent episodes, occurred 5-6 times
light-headedness
Adderall
SOB
Heart pounding, heart pounding
over the last 2-3 months
17-year-old
male
Patient Note: Mr. Cleveland is a 17yoM presenting with palpitations. Started 2-3months ago, getting worse, intermittent episodes with sudden onset and no triggers. Nothing makes better or worse. Episodes happen during exertion and rest, last 3-4min, self resolve. Most recent was 2 days ago, with SOB, chest pressure (at midline chest), and lightheadedness while playing basketball. States never had those symptoms before. Endorsed adderol use this morning prior to episode. Denies relation of palpatations to adderol usage. Denies other chest pain, SOB, cough, Headache, fatigue, fevers, weight change, appetite change, or body pains. 
PMX: none
meds: none
allergies: none
surgeries: none
family: father has heart issue and had MI at 52yo. Mom has thyroid issue.
substances: never smoker, drinks 3-4x/week, adderol started 6-7 months ago, uses occassionally, most recently prior to episode stated above. Also marijuana used once.
Social: goes to school.

Keywords and phrases relevant to diagnosis:
father had MI
Mom has thyroid issue
chest pressure
intermittent episodes
lightheadedness
adderol, adderol
SOB
palpitations
2-3months ago
17yo
M
Patient Note: HPI: Mr. Cleveland is a 17yo M who presents with 2-3 months of heart pounding. Was sitting and watching TV when it first started. Sensation has been stable and unchanging since onset. Episodes last 3-4 minutes, self-resolve. Occurs randomly, no alleviating or aggravating factors. Had one episode 2 days ago during basketball game with midline chest pressure and lightheadedness. No loss of consciousness. He has a basketball game tomorrow and is worried the symptoms may return.
ROS: No headache, vision changes, cold/heat sensitivity, abdominal pain, diarrhea, constipation, nausea, vomiting, urinary symptoms, weight changes, appetite changes, fever, chills
PMH: None
PSH: None
Medications: Adderall 2-3 weekly 
Allergies: NKDA
Fam Hx: Mom with thyroid disease, Dad 
Soc Hx: college student, sexually active with girlfriend, regular condom use, drinks 3-4 beers each weekend 0/4 CAGE, no tobacco or other drug use, tried marijuana once

Keywords and phrases relevant to diagnosis:
Mom with thyroid disease
chest pressure
Occurs randomly
lightheadedness
No cold/heat sensitivity
Adderall
heart pounding
2-3 months
17yo
M
Patient Note: HPI- 17 YO M WITH C/O HEART PALPITATIONS FOR 3 MONTHS WHICH WAS SUDDEN IN ONSET, INTERMITTENT AND PROGRESSIVE. HE HAD A SEVERE EPISODE 2 DAYS AGO WHERE HE HAD CHEST TIGHTNESS AND SOB. HE IS STRESSED OUT ABOUT COLLEGE AND IS  TAKING ADY WHICH HIS FRIEND PROVOIDED TO HIM.  HE ALSO CONSUMES 3 TO 4 CUPS OF COFFEE EACH DAY. DENIES FEVER, CHEST PAIN, SLEEP CHANGES COUGH,  SKIN CHANGES, CHANGES IN WEIGHT OR APPETITE, TREMORS, SOB ON EXERTION, CHANGES IN URINARY OR BOWEL HABITS.
PMH/PSH- NONE
ALLERGIES- NKA
MEDS- NONE
FH- MOTHER HAS THYROID PROBLEMS AND FATHER HAD MI
SH- DRINKS 3 TO 4 BEERS/WEEKEND, DENIES TOBACCO, SMOKED POT ONCE, PLAYS BASKETBALL AND DOES EXERCISE. 
SEXUAL- MONOGAMOUS AND USES CONDOMS.

Keywords and phrases relevant to diagnosis:
FATHER MI
MOTHER THYROID PROBLEMS
CHEST TIGHTNESS
INTERMITTENT, EPISODE
SOB
CONSUMES COFFEE, COFFEE
HEART PALPITATIONS
FOR 3 MONTHS
17 YO
M
Patient Note: HPI: 17 yo M presents with c/o heart pounding. Started 2 months ago and has experiences 5-6 episodes each lasting 3-4 minutes
-Describes pain as substernal pressure and denies radiation of presure.
-Most severr episode occurred 2 days ago. reported chest pounding and SOB
-ROS: Denies LOC, observed seuizure like activity, change with position, relation to food. Denies bowle or bladder incontinence
-PMH: none
-Meds: Uses roomates Adderall a few times a week 
-All: NKDA
-PSH: none
-SHx: College student studying philosophy. Lives on campus. Drinks 3-4 beers on weekends. Tried marijuana 1x. Denies use of other ilicit drugs. Denies personal stressors. Sexually active with one female partner
-FH: Dad- alive, MI @ 55 yo. Mom- alive, Hyperthyroid


Keywords and phrases relevant to diagnosis:
Dad MI
Mom Hyperthyroid
substernal pressure
5-6 episodes
Uses Adderall
SOB
heart pounding, chest pounding
Started 2 months ago
17 yo
M
Patient Note: 17yo male. presents with paroxysmal episodes of "heart pounding". onset of symptoms 2-3 months ago. was sudden onset while watching television at home. has had 5-6 episodes in total. episodes last 2-3 minutes and are self-remitting. no identifiable triggers. last episode was 2 days ago. episode 2 days ago was accompanied by light-headedness, shortness of breath and central chest pressure. 
No recent illnesses. no sick contacts. no travel. no pets. no infective symptoms. no weight changes
ROS: no syncopal events. 
        no cough or wheeze. no haemoptysis
        no headaches or altered mentation. no diaphoresis
MHx: nil
Medications: nil prescribed, however takes his friend's adderall for studying. takes these a few times per week since highschool. 
nil known allergies. 
Social Hx: nonsmoker. drinks 3-4stds/weekend. smoked cannabis once a few months ago. denies other drug use.
FHx: mother - thyroid issue. father - heart issue.

Keywords and phrases relevant to diagnosis:
mother - thyroid issue
chest pressure
5-6 episodes
light-headedness
takes adderall
shortness of breath
2-3 months ago
17yo
male
Patient Note: 17 y.o male p/w 2-3 month history of intermittent episodes in which patient has the sensation his heart is 'pounding' and 'racing'. These episodes have occured 5-6 times over the interval and have lasted for ~3-4 minutes. The most recent episodes two days ago was also associated with SoB and occured several minutes into a game of basketball. Otherwise the patient does not attribute these episodes to any particular activity. Notably, the patient is a college freshman and reports taking street-adderal several times a week and has been doing so for the past two years. No other pertinent PMH, surgical, family, or social history. Pt denies LOC, HA, N/V, chest pain, and SOB only in the most recent episode. Paitient was counseled to avoid adderal and other stimulants, and to avoid strenuous physical activity until next clinic appointment.

Keywords and phrases relevant to diagnosis:
intermittent episodes, 5-6 times
adderal
SoB, SOB
"heart is pounding", heart racing
2-3 month
17 y.o
male
Patient Note: CC: Heart Pounding 
HPI: Episodes of heart pounding that began a few months ago and last for 4-5mins at a time. The episodes occurr every couple weeks and have recently been accompanied by some mild lighheadeness. Patient states he needed to sit down on the last episode which happened while he was playing basketball. Patient denies chest pain but has been having some heaviness on his chest during the episodes. Denies any feelings of dread or panic, but has had some SOB. He has been recently trying adderall from his roommate every couple days, but there doesn't seem to be a relation to the drug use. He has never had syncope. 
PMH: none
PSH: None
Meds: Aderall
allergies: none
Social: Sexually active wears condom every time, no tobacco use, only drug use is the aderall and one time tried THC. Never Cocaine or PCP. He is full time student who just started 
ROS: No cough or congestion, no fatigue or diarrhea
FM: Dad had MI at 52yr

Keywords and phrases relevant to diagnosis:
Dad had MI
heaviness on his chest
Episodes, episodes, episodes
lighheadeness
adderall, Aderall, aderall
SOB
Heart Pounding, heart pounding
began a few months ago