bhatthars/nbme_qna huggingface dataset:
Patient Note: Karen Moore is a 45 yo G2P2 f presents with feelings of nervousness/ feeling overwhelmed for the last few weeks. Reports a constant feeling, associated with increased stressors at work. Reports that her work requirements to present new lectures have made her feel increasingly overwhelmed. 
ROS: Significant for Decreased appetite, difficulty falling asleep. No vision changes, numbness, tingling, nausea, vomiting, diarrhea, constipation, headaches. 
NKA/NKDA
M: Tylenol PRN for headaches
FMH: MI (dad) 
OB/S/Sx: 2 vaginal deliveries, 17 and 19 year old sons. LMP 1 week ago, reports normal periods .Sexually active with husband, safe at home. Decreased frequency of intercourse associated with nervousness in last 2 weeks. Denies smoking, illicit drug use. 1-2 drinks socially on rare occassions. Works as English professor x15 years. 


Keywords and phrases relevant to diagnosis:
No diarrhea, No constipation
nervousness, nervousness
difficulty falling asleep
f
Decreased appetite
45 yo
Patient Note: 45 YO F -CC - Nervousness x few wks. All started after she changed her roles at work from Research to teaching as an english professor. Since then every Sun/Mon she's been having episodes of feeling overwhelmed especially since she has presentations to give on Mondays. She is also feeling stressed due to taking care of kids, her mother and husbands parents who live next door. She has some difficulty falling asleep but no change in mood or loss of intrest or concentration. No hx of Palpitations, sweating, numbess, tingling or color changes in fingers
ROS - No Headache, dizziness, Chest pain, SOB, N/V, Hair changes, or skin changes
PMH - No hx of hypothyroid or psychiatric disorders
Meds - Tyelenol coz of headaches when she reads.     PSH - None
FH - No hx of hypothyoid or psychiatric disorders.
Ob/Gyn - LMP 2 weeks back, Periods regular
SG - Married x 25 ys, 2 kids youngest 18. Nonsmoker, drinker or drug user. No travel or trauma

Keywords and phrases relevant to diagnosis:
No hx of Palpitations, No sweating, No Hair changes, No skin changes
Nervousness, feeling overwhelmed
stressed due to taking care of her mother, tressed due to taking care of husbands parents
no change in mood, no loss of intrest, no change in concentration
difficulty falling asleep
F
45 YO
Patient Note: Patient is a 45 year old female with no significant PMH presenting with constant nervousness for 3 weeks associated with a decrease in appetite and a decrease in her sex drive.  She endorses that she has been much more stressed over the past three weeks between her job as a professor, her role in taking care of her mother, her role in being the wife of her husband, and her role as being the parent of her children.  She has had difficulty falling asleep due to the nervousness, but has no problems staying asleep and averages 7 hours of sleep per night.  She has never felt that she didn't need to sleep at any point in her life.  Her only loss of interest in normal activities has been her desire for sex.  No history of physical or sexual trauma/abuse.  She has normal energy levels.  Denies homicidal and suicidal ideations.  Feels safe at home living with husband, mother, and children.  Denies audio/visual hallucinations.

Keywords and phrases relevant to diagnosis:
nervousness, nervousness
stressed taking care of her mother
Denies suicidal ideations
difficulty falling asleep
female
decrease in appetite
45 year
Patient Note: Patient is a 45 year old female with complaint of nervousness. It is persistent with little relief. She has been experiencing symptoms for a few weeks. She is having difficulty falling alseep, but sleeps through the night when she does fall asleep. She doens't feel tired throughout the day. She endorses loss of appetite. She has had increased stress after starting teaching and she is the primary care taker of her sick mother, her in-laws, and her son. She does feel supported and helped by her husband. Denies racing heart, changes in bowel movements, shortness of breath, feelings of being hot or cold, or changes in weight.

medical history- none
surgeries-none
hospitalizations- twice afet giving birth to two children
family- father had a heart attack
menstration- regular, husband only sexual partner, visectomy as birth control
No tobacco or drug use, drinks wine if out to dinner a few times a month

Keywords and phrases relevant to diagnosis:
Denies racing heart, Denies changes in bowel movements, Denies feelings of being hot or cold
nervousness
primary care taker of her sick mother, primary care taker of her in-laws
Denies changes in weight
difficulty falling alseep
female
loss of appetite
45 year
Patient Note: Pt is a 45 yo female experiencing episodes of nervousness and anxiety for the past 3 weeks. She has had changes in her job in which she now has to give lectures, the anxiety is worse on Sunday and monday prior to the work week. Feels very overhwlemed by her duties at home as well, she takes care of her mother with mobility issues. Drinks 5 cups of coffee per day.She has had a decrease in appetite and some trouble falling asleep. 
ROS: denies depressed/sad feeling, denies suicidality, homicidality, decreased energy, guilt, denies palpitations, edema, diarrhea constipation, changes in hair
PMH: none, Medications: Tylenol PRN, Family Hx: father died of MI at age 64
Social: her mother lives at home, she is a care giver for her mother, Denies drug use, denies tobacco use, social alcohol use, has one son, English Professor

Keywords and phrases relevant to diagnosis:
denies palpitations, denies diarrhea, denies constipation, denies changes in hair
nervousness, anxiety, anxiety
Feels very overhwlemed takes care of her mother, care giver for her mother
Drinks 5 cups of coffee
denies depressed/sad feeling, denies decreased energy, denies suicidality, denies guilt
trouble falling asleep
female
decrease in appetite
45 yo
Patient Note: Karin Moore is a 45 year old woman, previously healthy, who presents with several weeks of "internal nervousness" since her job as an English professor required her to start giving lectures in front of students. Nervousness is present constantly for past few weeks. Nothing makes better, nothing makes worse. Never experienced before. Has not increased alcohol intake in this time. She also notices decreased hunger and difficulty sleeping. Other life pressures include living with elderly mother who is slowing down, checking on in-laws, caring for 2 teenage sons. 
ROS: Denies fever, racing heart, dyspnea, high energy, weight change, low mood, panic attacks. 
PMH: neg; PSH: neg; Meds: occasional tylenol for headache, not recently; no med allx.
Fam Hx: no anxiety/depression
Soc Hx: lives with husband, elderly mother. 1-2 drinks social occasions, no tobacco, no illicit drugs, sexually active, balanced diet, walks 3x/wk for exercise

Keywords and phrases relevant to diagnosis:
Denies racing heart, Denies high energy
nervousness, Nervousness
life pressures include elderly mother, life pressures include checking on in-laws
Denies low mood
Denies weight change
difficulty sleeping
woman
decreased hunger
45 year
Patient Note: hpi : 45 yo f c/o nervousness , few weeks ago , getting worse , constant , throuh the day , reports sleeping difficulty , denies any , hot flashes , weight changes , no tremor , no hot intolerence, drink 6 cup of coffee daily , 
ros : nl except above 
pmh : none
allergy : nkda
meds : tylenol 
psh : none
obs / gyn : lmp 1 w ago , no irregularities , pregnancy twice , 2 children 
sh : sexually active w/ husband , vasectomy , no smoking , drink alchol socially , no recreational drug use

Keywords and phrases relevant to diagnosis:
no tremor
nervousness
drink 6 cup of coffee daily
denies weight changes
sleeping difficulty
f
45 yo
Patient Note: Patient is a 45 year old female with no relevant PMHx who presents with nervousness and anxiety. She states her anxiety started 3-4 weeks ago, and began after she changed positions from a english literature researcher to a professor. She has anxiety about taking care of her kids, her career, and taking care of her mother. Her anxiety is worst on weekends when she knows she has to give lecture. Nothing seems to exacerbate her anxiety. She feels as if she is "losing her mind". She also reports eating less and having difficulty falling asleep. She denies any heat/cold intolerance, chest pain, palpitations, SOB, abdominal pain, diarrhea, or constipation. 

PMHx- none
Psurghx- none
PFMHx - father died of HA
medications - tylenol for occasional HA
Social hx: lives at home with kids and husband. no tobacco or illicit drug use. socially drinks alcohol

Keywords and phrases relevant to diagnosis:
denies cold intolerance, denies heat intolerance, denies palpitations, denies diarrhea, denies constipation
nervousness, anxiety, anxiety, anxiety, anxiety
anxiety about taking care of of her mother
difficulty falling asleep
female
eating less
45 year old
Patient Note: 45 YOF who presents with nervousness.  Started a few weeks ago, along with a decrease in appetite and difficulty falling asleep, denies racing thoughts.  Once she falls asleep is able to stay asleep, sleeps 7 hours on a bad night and 8 hours on a good night.  States that feels overwhelmed, has had to take care of her parents, her in-laws, and her children.  She is an english literature professor and has been lecturing more, she denies this has caused much stress.  Denies any changes in energy, weight, hair, or changes in skin.  Denies any episodes of SOB or chest pain. Denies a change in energy. Her LMP was 1 week ago. She has a menstrual period every 28 days, they last 4 days, denies any recent changes in menstural periods.
ROS: denies changes in bowel movements, fevers, vomiting, or abdominal pain. PMH: none. Medications: rare Tylenol use. Allergies: none. PSHx: none. FH: father with MI. SH: social drinker, no EtOH or drug use

Keywords and phrases relevant to diagnosis:
changes in skin Denies, denies changes in bowel movements, Denies any changes in hair
nervousness
had to take care of her parents, had to take care of her parents in-laws
Denies changes in energy, Denies a change in energy
Denies changes weight
difficulty falling asleep
F
decrease in appetite
45 YO
Patient Note: 45yo complains of increased nervousness during the past few weeks, mostly on Sundays related to Monday teaching activities (she is a professor), she is also concerned about her in-laws since she must now take care of them at home during her free time. She has decreased appetite. She denies any N/V, increased bowel movement, weight loss, eye problems, increased sweating, abdominal pain, headaches, or increased temperature.
PMH:She has no history of prior illness, surgery, trauma and was only hospitalized when her two kids were born.
She does not take any drugs or have any allergies.
FH: Her father dies of MI aged 65, she is an only child.
Sx: Sexually active with husband, only sexual partner. No STD history.
OBG: G2P2
SH: Professor, drinks socially does not smoke or do drugs. Two kids, aged 21 and 18, dont present a worry to her.

Keywords and phrases relevant to diagnosis:
denies increased bowel movement, denies increased sweating
nervousness
concerned about her in-laws since she must now take care of them
denies weight loss
decreased appetite
45yo
Patient Note: 45YO female c/o nervousness for the past few weeks....feels as if she is "loosing my mind". Seems to notice these feelings mostly on Sunday evenings as she prepares for work on Monday morning. Has had difficulty falling asleep and a decreased appetite as well. Has never had similar symptoms. Denies feeling as if she is an anxious person at baseline. No previous psych hx or care. Has been under a lot of stress lately since changing positions in her job and with demands at home. Denies recent illness, fevers, chills, CP, palpitations, SOB, Abd pain, N/V/D/C, bowel or bladder changes, rashes, or swelling. 
ROS: Neg except as mentioned above. 
PMH: neg
PSH: neg
Meds: Tylenol
Allergies: NKDA
Social: Denies tobacco or illicit drug use; Occasional/social alcohol use; Drinks 5-6cups of coffee per day, no recent increase in amount. Is married. English professor. Cares for mother and child at home. Assist w/ care of inlaws. 
Fly hx: neg

Keywords and phrases relevant to diagnosis:
Denies palpitations, Denies bowel changes
nervousness
Cares for mother Assist w/ care of inlaws
5-6cups of coffee
difficulty falling asleep
female
decreased appetite
45YO
Patient Note: Ms. Moore is a 45 year old female who presents to clinic complaining of increased nervousness. She states that she has been more nervous at her baseline for the past two weeks, but is then even more nervous Sunday night and Monday morning as the work week approaches. She reports that the things she feels nervous about include her care of her children, care of her inlaws, and care of her elderly mother, along with lectures she has to prepare for her job as a literature professor. She denies any change in support in the past two weeks, denies loss of interest in activities, denies loss of energy, denies feelings of hopelessness or slowed movement. She admits to trouble falling asleep- it now takes her 30 minutes when previously it took her just a few. She denies change in cafffiene intake. PMH: non contributory. Denies surg. No allergies. Social: 2-3 glasses of wine/month, no tobacco use, or ilicit drugs. Family hx: dad died of MI at 65.

Keywords and phrases relevant to diagnosis:
nervousness, nervous, nervous, nervous
care of her inlaws, care of her elderly mother
denies loss of interest, denies loss of energy, denies feelings of hopelessness
trouble falling asleep
female
45 year old
Patient Note: 45 Y/O F C/O NERVIOUSNESS SINCE FEW WEEKS, IT IS CONSTANT, AND PROGRESSIVE, AND IS PRESENT AT MULIPLE SETTING. SHE REPORTED THAT SHE IS ANXIOUS ABOUT HER PARENT, FAMILY, IN LAWS, AND EVERYONE, SHE ALSO REPORTED THAT SHE HAS CHANGE HER WORK ENVIROMENT FROM RESEARCH TO TEACHING RECENTLY. SHE ALSO REPORTED THAT SHE FINDS DIFFICULTY IN FALLING ASLEEP.
PT DENIES RACING OF HEART, GUILT, DECREASE IN ENERGY, LOSS OF INTEREST, CHANGE IN HER MOOD/BOWEL/BLADDER/DIET/WEIGHT RECENTLY.
ROS: -VE EXCEPT ABOVE.
PMH/PSH: NONE.
OBGYN: LMP 2 WEEKS BACK, CYCLES ARE REGULAR.
SH: SEXUALLY ACTIVE WITH HUSBAND ONLY, DENIES, SMOKING/ILLICIT DRUGS USE. 1-2 GLASS OF WINE OCCASSIONALY

Keywords and phrases relevant to diagnosis:
DENIES RACING OF HEART, DENIES CHANGE IN BOWEL
NERVIOUSNESS, ANXIOUS
ANXIOUS ABOUT IN LAWS
DENIES GUILT, DENIES LOSS OF INTEREST, DENIES CHANGE IN HER MOOD, DENIES DECREASE IN ENERGY
DENIES CHANGE IN WEIGHT
DIFFICULTY IN FALLING ASLEEP
F
45 Y/O
Patient Note: HPI: 45 yo F comes to office due to episodes of nervousness. Patient relates constant state of nervousness, high level of stress due to work, family, children. Indicates the episodes are getting worse. Indicates a loss of appetite, but forces herself to eat. Indicates severe insomnia, as she has a hard time falling asleep. Denies trauma, violence, panic attacks, and SOB. Indicates decreased sexual activity since the nervousness started.  Indicates nervousness increase before going to present lectures at school. Nothing decrease level of nervousness. 
OB/GYN: G2T2 vaginal deliveryx2, uncomplicated; LMP 1 wk ago, menache at 13 yo, periods usually last 5 days, regular, moderate flow. Pap smear was 10 months ago, no abonormalites. 
ROS: negative except for above
Allergies: none
PMH: none
PSH: none
SH: English proffesor; occasional drink alcohol in social events
FH:  Father died MI at 65

Keywords and phrases relevant to diagnosis:
nervousness, nervousness, nervousness, nervousness, nervousness
stress family
insomnia, hard time falling asleep
F
loss of appetite
45 yo
Patient Note: Ms. Karin Moore is a 45F who presents to the clinic for episodes of nervouseness. It started few weeks ago. She takes care of her mom who lives with her, works as an english professor with new added responsibilities, takes care of kids and inlaws. She has decreased appetite and insomnia. Trouble falling asleep.
Denies palpitations, weight changes, dysphagia, pain, headache, depressive mood, decreased interest, agitation, suicidal or homicidal ideation, visual or audio hallucinations.

PMH and PSH: none
FH: dad passed at age 65 of sudden MI
Meds: tylenol for occasional headaches
Denies drug use and smoking. drinks 1-2 drinks socially. Has a support system of her husband. Lives with husband, son, and mother. Works as an english professor.

Keywords and phrases relevant to diagnosis:
Denies palpitations
nervouseness
takes care of her mom, takes care of inlaws
Denies depressive mood, Denies decreased interest, Denies suicidal ideation
Denies weight changes
decreased insomnia, Trouble falling asleep
F
decreased appetite
45
Patient Note: 45 yo F c/o nervousness for a few weeks
-feels nervous on sundays and mondays thinking about oncoming week,no exacerbating or relieving factors,constantly present,progressively wrosening,associated feeling of losing her mind and worrying about all her responsibilities at home and work
-assocaited decrease in apetite and inability to fall asleep for a few weeks
-increased intake of caffeine throughout the day
-feels overwhelmed by responsibilities,headache sometimes with reading
-no palpitations,weight changes,urine problems,mood changes
ROS:as above
PMH:Admitted for 2 normal deliveries Takes tylenol for headache
FH:Father died of MI.
SSH:Teacher,recently changed job decscription,no etoh,smoking,drugs.

Keywords and phrases relevant to diagnosis:
no palpitations
nervousness, nervous, feeling of losing her mind, feels overwhelmed
worrying about all her responsibilities at home
increased intake of caffeine
no mood changes
no weight changes
inability to fall asleep
F
decrease in apetite
45 yo
Patient Note: Ms Moore is a 45 year old woman who has been experiencing feelings of nervousness the past two weeks.  She describes it as constant and unbearable. She feels overwhelmed taking care of her son, her mother who lives at home with her, and her two in-law parents. She drives and does activities of daily for all three of her elderly parents in addition to teaching english literature. She recently began having to perform lectures and teach students in the last two weeks, whereas she was primarily doing independent research beforehand. HAs had decreased appetite. Denies weight loss, shortness of breath, diarrhea, chest pain, or palpitations.
No past medical history
Taking tylenol for occasional headache
No surgeries
FH - father died of MI at 65
No smoking, drugs. 2 ETOH/month.
Recent decrease in libido (2 weeks). Husband has vasectomy. LMP 1 week ago.
G2P2, both uncomplicated vaginal deliveries.

Keywords and phrases relevant to diagnosis:
Denies palpitations, Denies diarrhea
nervousness, overwhelmed
overwhelmed taking care mother who lives at home with her, and her two in-law parents, does activities of daily for all three of her elderly parents, feels overwhelmed taking care of her mother two in-law parents
Denies weight loss
woman
had decreased appetite, decreased appetite
45 year, 45 year old
Patient Note: Karin Moore is a 45yoF with no PMHx presenting with c/o nervousness. The patients states that for the last couple of weeks she has felt a sense of nervousness that has been constant. She recalls no inciting factor. She states that she has to cope with the stresses of working as an English professor and taking care of her mother at home. She states that she is able to get by each day, but the feeling of nervousness is bothersome. Endorses decreased appetite, but denies any loss of interest, endorses good energy, and good sleep w/o nightmares. Denies tremors, headaches, weight gain/loss, dry skin/hair, diarrhea, constipation, sweatin. Endorses feeling supportive.
PMHx: none. Tylenol for occasional headaches, no allergies, NSVD x 2 in hospital, no surgeries, immunizations UTD.
Family hx: Dad had MI at 65 
Social: negative for tobacco or drugs. 1-2 drinks on occasion. Works as english professor. Lives with husband, two kids, and mother.

Keywords and phrases relevant to diagnosis:
Denies tremors, Denies dry skin, Denies dry hair, Denies diarrhea, Denies constipation, Denies sweatin
nervousness, nervousness, nervousness
stresses of taking care of her mother
denies any loss of interest
Denies weight gain, Denies weight loss
F
decreased appetite
45yo
Patient Note: 45 yo otherwise healthy female w/ several weeks of "nervousness" that she feels "all the time". She feels "overwhelmed" by her responsibilities which include taking care of her mother who lives w/ her family, keeping up with the responsibilities of her family, checking in on her in-laws who live nearby, and working full time as an english professor. She has recently been given increased responsibilities at work and is lecturing in front of a class. Although she finds this stressful, her anxiousness is not limited to public speaking. She has a visiting RN 2x/wk to help w/ her mom. She walks 3x/wk for her health. She has regular menstral cycles and has no concerns or changes in her periods. She has also noticed difficulty falling asleep and decreased appetite. She denies chest pain, dyspnea, dizziness, feelings of sadness, ETOH/drug use, weight loss.

PMH: none
Rx: none
Allergies: none
SH: Never smoker, rare ETOH, no drugs


Keywords and phrases relevant to diagnosis:
nervousness, feels "overwhelmed", anxiousness
overwhelmed taking care of her mother, overwhelmed checking in on her in-laws
denies feelings of sadness
denies weight loss
difficulty falling asleep
decreased appetite
45 yo
Patient Note: CC: nervousness
HPI: ms moore is a 45 yo f who complains of 3 weeks of anxiety. She has had constant anxiety that is worsened sunday and mondays prior to her classes teaching. She recenltly changed roles at her job which now requires public speaking. She has had difficulty sleeping during this same time as well as loss of appetite. She has never had any episodes like this prior to 3 weeks ago. she has not taken any medication for any of her current problems. No factors relieve the anxiety. 
ROS: negative, denies palpitations or chest pain
PMH: none
PSH: none
MEDS: occasional tylenol
Allergies: none
FH: Father died of MI at 65
SH: English professor recently switched from research to teaching. Denies tobacco and drugs. Social drinker. Sexually active with husband. Has 2 children.

Keywords and phrases relevant to diagnosis:
denies palpitations
anxiety, anxiety, anxiety, nervousness
difficulty sleeping
f
loss of appetite
45 yo
Patient Note: 45 yo F w/ anxiety for the past 2 weeks. Pt describes nervousness as constant but especially increased on weekends just prior to giving college lectures as an English Lit professor that she has not had to do for a while now. Nothing helps the anxiety. Pt also has many responsibilities at home. Pt also endorses decreased appetite especially on weekends but pt makes sure she eats and has not had weight change. Pt denies heat intolerance, palpitations. Has difficulty falling asleep. Pt denies recent fevers, chills, vision changes, headaches, chest pain, SOB, abdominal pain.
ROS: negative except as above Allergy: none Meds: rarely tylenol PMH: none PH: hospialized for birth of 2 children FamHx: father died of MI (10 yrs ago) Menstrual: last menstrual period last week, regular, no changes. SH: no EtOH, smoking, decreased sexual activity with husband d/t to decreased desire

Keywords and phrases relevant to diagnosis:
denies heat intolerance, denies palpitations
anxiety, nervousness
has not had weight change
difficulty falling asleep
F
decreased appetite
45 yo