bhatthars/nbme_qna huggingface dataset:
Patient Note: Ms. Dolores Montgomery is a 44yo F with h/o HTN presenting with 3 years of irregular periods. She had menarche at age 14 and had regular periods every 28-29 days with moderate flow lasting 5 days until three years ago. She has noted recent discomfort with sex due to vaginal dryness, as well as the occasional hot flashes accompanied by sweating. Her last period was 2 months ago and lighter than usual. She does have an IUD in place - this is her third IUD and she did not have any problems with the previous two. Unknown age of mother's menopause. Has had regular pap smears with no irregular results.
ROS: no changes in weight, appetite, fevers or chills.
- no skin dryness, hair loss, constipation
Gyn Hx: 2 vaginal deliveries
PMH of HTN, treated with hydrochlorothiazide; no PSH
FHx: no known h/o fibroids, early menopause
SHx: sexually active with husband

Keywords and phrases relevant to diagnosis:
had regular periods, had periods every 28-29 days, had periods with moderate flow, regular periods until three years ago, periods every 28-29 days until three years ago, periods lasting 5 days until three years ago
IUD
sexually active, with sex
vaginal dryness
irregular periods
F
last period was 2 months
hot flashes
3 years of, until three years ago
sweating
44yo
Patient Note: 44yo G2P2 F with irregular menses. Patient reports 3 years of irregular menses. She reports that prior to 3 years ago her menses were regular, but now they have no pattern. They last from 2-6 days, occur every 3wks-4mos, and range from heavy to light bleeding. Patient reports decreased menstrual cramps. Patient denies abdominal pain, but did have some nausea and vomiting last week, thought to be food poisoning. She took two at home pregnancy tests that were negative. Patient also reports hot flashes and diaphoresis. Patient denies increased hair growth, palpitations, breast tenderness.
ROS:  as above
meds:  HCTZ; NKDA
PMHx: HTN; PSHx:  none
OBGYN:  G2P2002; uncomplicated vaginal deliveries 10 and 14 years ago; sexually active with husband, patient has an IUD (placed 4 yrs ago)
FH:  mom- osteoarthritis
SH: investment manager; rare alcohol use, no tobacco or drug use

Keywords and phrases relevant to diagnosis:
prior menses were regular, reports that prior to 3 years ago her menses were regular
IUD, patient has an IUD
sexually active, sexually active with husband
irregular menses, now they have no pattern
nausea and vomiting last week
decreased menstrual cramps, reports decreased menstrual cramps
F, G2P2 F
hot flashes, also reports hot flashes
They last from 2-6 days, occur every 3wks-4mos, range from heavy to light bleeding, last from 2-6 days
3 years of, prior to 3 years ago her menses were regular, Patient reports 3 years of irregular menses
diaphoresis, also reports diaphoresis
44yo
Patient Note: 44 year old G2P2 female with a history of HTN who presents with irregular periods. She has had irregular periods for the past 3 years. They have become unpredictable with no pattern, lasting from 2-6 days with an unpredictable flow. Previously, she had her period every 28-29 days, lasting 5 days, with moderate flow, with 2 days of PMS symptoms directly preceeding each period. First period at 14 yo. She has not had PMS symptoms for 3 years but with her most recent period 2 months ago, had them again. She has hot flashes with sweating 1-2 times per month and vaginal dryness. No nipple discharge. Last week, she also notes 48 hours of some kind of illness (nausea/vomiting) and woke up drenched in sweat. Other, ROS is negative.
PMH: HTN
PSH: None
Meds: HCTZ
Allergies: None
FH: brother with HTN, mother with obesity and osteoarthritis and unknown when she had menopaus
SH: no smoking, no drinking, social alcohol use (a few times a year)

Keywords and phrases relevant to diagnosis:
Previously, she had her period every 28-29 days
vaginal dryness
irregular periods, irregular periods, unpredictable with no pattern
Last week, she also notes 48 hours of some kind of illness (nausea/vomiting)
She has not had PMS symptoms
female
most recent period 2 months ago
hot flashes
for the past 3 years
sweating, drenched in sweat
44
Patient Note: Mrs. Dolores Montgomery is a 44 year female who presents with irregular periods. Notes it began 3 years ago with bleeding that ranged from 2-6 days in length and from light to heavy periods. 1 year ago she started to experience hot flashes and sweating that continues to persist. Denies weight changes. and trauma She also notes vaginal dryness and discomfort during sex. Denies stressors and changes in visual fields. 

PMH: HTN, well controlled 
GH: Non-contributory 
Meds: HCTZ
Allergies: None
SHX: sexually active with her husband- 1 partner 
Social History: Office Manager, lives with husband and 2 sons 
OB/Gyn History: 2 Vaginal deliveries

Keywords and phrases relevant to diagnosis:
sexually active
vaginal dryness
irregular periods
Mrs, female
hot flashes
ranged from 2-6 days, from light to heavy periods
began 3 years ago
sweating
44 year
Patient Note: Ms. Montgomery is a 44 yo G2P2 female ho presents for evaluation of irregular periods. Pt reports 3 yrs of irregular periods, occurring at upredictable times and lasting 2-6 days with light to heavy bleeding. She has also experiences hot flashes and sweating mostly during the day but once at night in the past year. LMP was 2 months ago lasting 4 days and associated w/ mild menstrual cramps. Previous periods were regular every 28-29 days, last 5 days with mod flow. Periods were associateed with mild PMS sx - breast tenderness, back pain, mild menstrual cramps. She is concerned about hot flashes. 
ROS: No fever/chillls, weight loss, headache/visual changes, nipple discharge, intermenstrual bleeding. Denies palpitations, skin and hair changes, and diarrhea/constipation. 
PMH: HTN. 2 vag deliv no compl, no surg
FHx: HTN brother, obesity/osteoporosis mother. No cancer.
SHx: 
Meds: HCTZ, All: NKDA
SHx: No smoking, EtOH, drugs. 2 kids

Keywords and phrases relevant to diagnosis:
Previous periods were regular, Previous periods were every 28-29 days, Previous periods last 5 days, Previous periods with mod flow
irregular periods, irregular periods
Ms, female
LMP was 2 months ago
hot flashes, hot flashes
occurring at upredictable times, lasting 2-6 days, with light to heavy bleeding
3 yrs of
sweating
44 yo
Patient Note: Dolores Montgomery is a 44 yo F presenting with irregular periods. this began 3 years ago with no precipitating factors. Her periods occur between every 3 weeks and 4 months lasting anywhere from 2 to 6 days, sometimes her flow is heavy other times it is light. Her last LMP was 2 months ago. prior to these episodes her periods were regular. She denies any remedies that make her periods more or less regular. She admits to nausea and vomiting for two days as well as hot flashes and diaphoresis for 1 year. She denies any weight gain or loss, irritability, or intermenstrual bleeding. 
ROS: denies headaches, vision changes, chills, CP, SOB abd pain, changes in bowel or bladder habits.
allergies: NKDA
meds: HCTZ x 6yrs
pmhx: HTN x 6 yrs
psurghx: none
fhx: mother has OA and is overweight, brother has HTN
shx: nonsmoker, 1 glass of wine on occasion, no drugs, office manager high stress, sexually active, no STI hx. G2P2

Keywords and phrases relevant to diagnosis:
prior periods were regular
sexually active
irregular periods
nausea and vomiting for two days
F
LMP was 2 months ago
hot flashes
occur between every 3 weeks and 4 months, lasting from 2 to 6 days, sometimes flow is heavy other times it is light
began 3 years ago
diaphoresis
44 yo
Patient Note: Ms. Montgomery is a 44 year old female complaining of irregular periods. The change is her periods began approximately 3 years ago, and they have been unpredictable in terms of their onset and duration. Her last menstrual period was 2 months ago. When they do occur, they range from 2-6 days and range from low to high flow. In the past, she has had menstrucal cramps and breast tenderness, but has not had these symptoms consistently over the last few years. but they did occur during her last period. She denies any weight change, nipple discharge, or mood changes., but endorses experiencing hot flashes, sweating, and an episode of night sweats.
Sexual history: 2 prior pregancies, full term, with no complications. Has Intrauterine device for contraception.
Denies discharge
Med hx: HTN, controlled with HCTZ
Family hx: no pertinent family history
No prior surgeries, or allergies
No drug, tobacco use

Keywords and phrases relevant to diagnosis:
Intrauterine device
irregular periods, change is her periods, periods have been unpredictable
had menstrucal cramps and breast tenderness, but has not had these symptoms
Ms, female
last menstrual period was 2 months ago
hot flashes
periods unpredictable in terms of their onset, periods unpredictable in terms of their duration, range from 2-6 days, range from low to high flow
began 3 years ago
sweating, night sweats
44 year old
Patient Note: Dolores Montgomery is a 44yo F with hx of irregular periods for 3 years. 
- Menstrual history: Menarche at 14yo. Cycle 28-29 days. Mentrual period would typically last for 5 days, require 2-3 pads daily. With mild PMS symptoms including cramps, breast tenderness, low back pain.
- In the past 3yrs, menstrual periods have occurred without pattern, from 3wks apart to 4mo apart. Flow is very light to heavy, lasting 2-6 days. Now without PMS symptoms except for in the most recent period. LMP 2 months ago.
- Also with occassional hot flashes and sweating
- Denies palpitations, hair loss, weight changes, fevers, chills
- IUD in place
ROS: as per HPI
PMH: HTN
Meds: HCTZ
NKDA. No prior surgeries. Hospitalizations for childbirth x2. 
FHx: Brother with HTN. Mom overweight, with osteoarthritis.
SocHx: Office manager. Never smoker. Rare alcohol use. Denies recreational drugs. Sexually active with husband only.
Normal mammogram last year

Keywords and phrases relevant to diagnosis:
Cycle 28-29 days, period would typically last for 5 days, period would typically require 2-3 pads daily
IUD
Sexually active
irregular periods, periods occurred without pattern
without PMS symptoms
F
LMP 2 months ago
hot flashes
from 3wks apart to 4mo apart, Flow lasting 2-6 days, Flow light to heavy
for 3 years, In the past 3yrs
sweating
44yo
Patient Note: Ms. Montgomery is a 44 yo F who presents w/ 3 years of irregular periods. She began menses at 14 years old and was regular (menses q.28-29 days, lasting 5 days, moderate flow with 3-4 pads and mild PMS sxs including breast tenderness, lower back pain and mild pelvic cramping without mood changes). However, over the past 3 years, her periods became irregular, beginning unpredictably, and ranging from light to heavy relative to her baseline moderate flow. She has had one episode of her normal PMS sxs over the past 3 years and that was prior to her LMP which was 2 months ago. Endorses occasional hot flashes and diaphoresis that begin and conclude spontaneosly
ROS: no changes in skin, hair, bowel habits, weight, appetite, energy levels since her menstrual irregularities began. No CP, SOB. PMHx: HTN, G2P2. Meds: Copper IUD in place, HCTZ. NKDA. Sexual hx: monogomous w/ husband. Family hx: HTN in her brother, mother: obesity, osteoarthritis

Keywords and phrases relevant to diagnosis:
menses was regular, menses q.28-29 days, menses lasting 5 days, menses moderate flow with 3-4 pads, baseline moderate flow
IUD
monogomous
irregular periods, periods became irregular, menstrual irregularities
Ms, F
LMP was 2 months ago
hot flashes
beginning unpredictably, ranging from light to heavy
3 years of, over the past 3 years
diaphoresis
44 yo
Patient Note: 44 yo F c/o irregular menstrual period 3 yrs PTA-less flow LMP:3 yrs ago
- OB/GYN: LMP 3 yrs ago, previously regular 5 days*28-29 days, G2P2, no complication, vaginal delivery, vaginal dryness->dyspareunia-needs lubrication
-Reports: cramps with menstruation, back pain, sleeping 
-Denies:irritable mood, edema, constipation, diarrhea, palpitation, vaginal dis
-PMH: HTN 6 yrs ago on HCTZ, no Sx
-FH:noncontributory, cannot recalls mother menopause age
SH: works as an office manager in invesment firm, occasional EtOH, no illicit drug use, no smoking, monogamous with husband, healthy diet, regular exercise


Keywords and phrases relevant to diagnosis:
previously regular, previously 5 days, previously *28-29 days
monogamous
vaginal dryness, dyspareunia-needs lubrication
irregular menstrual period
F
3 yrs PTA
44 yo
Patient Note: 44F with HTN presesing for irreuglar periods for past  3yrs. They occur every 3wk-4mo and she bleeds 2-6d (heavy or light). previously they occured every 28-29d and lasted 5d. LMP was 2 months ago whcih was normal and she has no spotting since then. Endorses hot flashes and vagnal dryness with sex for one year. Had one episode of night sweats last week and also had nausea and vomiting for a few days.  Denies weight loss, fevers or chills, headaches, bowel changes or urinary changes. No STDS in past. G2P2. took home pregnance test whishcwere negative. Denies vaginal discharge, breast discharge. 
pmh- HTN
psh- none
med- HCTZ
all- none
fh- mop- OA, brother htn
SH- lives at home with husband and 2 children, rare drnker, deneis drugs or tob

Keywords and phrases relevant to diagnosis:
previously occured every 28-29d, previously lasted 5d, previously they occured every 28-29d and lasted 5d
with sex
vagnal dryness, Endorses vagnal dryness
irreuglar periods, presesing for irreuglar periods
nausea and vomiting for a few days
F, 44F
LMP was 2 months ago
hot flashes, Endorses hot flashes
occur every 3wk-4mo, bleeds 2-6d, bleeds (heavy or light, lasted 5d
for 3yrs, irreuglar periods for past  3yrs
night sweats, Had one episode of night sweats
44, 44F
Patient Note: 44yo Female presents with irregular period.
-Menarche has irregular pattern. Started 3 years ago. Menarche last 2-6 days, irregular flow and consistency.
-Pt also experiences hot flashes and sweating.
-Pt denies hair loss, hair gain, heart palpitation, cold/heat intolerance, fever, and chills, abdominal pain, stool changes.
PMH: HTN
NKDA, meds include HTCZ
Hospitalize for childbirth 10 and 14 years ago.
Pt works in office Finance investing.
LMP was 2 months ago. Requires 3-4 pads.
No changes in urination/defaction/diet/weight. Sleep changes wakes up early past 3 months.
FMh: Older Brother has HTN, mother is overweight and has osteoporosis.
No tabacco, rarely drinks, no drugs
Sexually active with husband. Pt has IUD.

Keywords and phrases relevant to diagnosis:
IUD
Sexually active
irregular period
Female
LMP was 2 months ago
hot flashes
irregular flow and consistency
Started 3 years ago
sweating
Sleep changes, wakes up early
44yo
Patient Note: 44 year old female c/o irregular periods. Patient states that she has a history or regular periods since menarche at age 13 up until 3 years ago when she began having unpredictive, irregular periods. Menstraution last 2-6 days and can be heavy to light flow. Patient does report hot flashes throughout day for the past year and a recent episode of nt seats last week. She denies any weight changes, hirsutism, cold intolerance, changes in hair, dysmenorrheapalpitations or change in energy
OBGYN: G2P2. Mearche at age 13, LMP 2 months ago. Previously regular periods till about 3 years ago.
ROS: Negative except for above
Medications: HCTZ
Alllergies: None
PMH: HTN, treated with HCTZ and DASH diet
PSH: None
SH: Occasional EtOH, no tobacco or illicit drug. Lives with Husband. Eats a healthy balanced diet and walks 3-4 times a week.  Monogomous with husband.
FH: Mother obese and oseteoarhtrits

Keywords and phrases relevant to diagnosis:
regular periods since menarche, Previously regular periods
Monogomous with husband
irregular periods
female
LMP 2 months ago
hot flashes
heavy to light flow, last 2-6 days
3 years ago
44
Patient Note: 44 year old female who presents with 3 years of irregular periods. Previously regular, her periods are now anywhere from 2-6 days, light to heavy. She is now experiencing hot flashes and sweating. Has had PMS symptoms for the first time in 3 years to include breast tenderness, low back pain, and menstrual cramping. Also last week had 48 hours of flu-like symptoms to include nausea and vomiting. No changes in bowel or bladder habit. She is sexually active her husband, but has a copper iud that was placed 4 years ago with no change in periods at that time. Has a PMH of HTN for which she takes HCTZ. No history of surgeries. Hospitalized twice for the birth of her 2 sons. No abortions or miscarriages. No family history of irregular periods, blood disorders or thyroid disorders. Denies tobacco use or recreational drugs. Drinks very infrequently 1 glass of wine at a time.

Keywords and phrases relevant to diagnosis:
Previously regular
iud
sexually active
irregular periods
last week had 48 hours of flu-like symptoms
female
hot flashes
anywhere from 2-6 days, light to heavy
3 years of
sweating
44
Patient Note: Dolores Montgomery is a 44 yo F c/o irregular periods for the past 3 years. They vary from every 3 weeks to every 4 months. She has had associated night sweats, trouble sleeping, and hot flases well during this time. She denies chest pain, vaginal discharge, vaginal bleeding, palpitation, sensitivity to cold, skin changes, decreased libido, vision changes, dysuria, hair thinning/loss, and weight changes. 
ROS: negative except for above
Ob/Gyn: 2 uncomplicated pregnancies. Vaginal deliveries. Has a copper IUD in place for contraception. Last pap smear was 1 year ago. Has had normal pap smears throughout life.
PMH/PSH: HTN. had gastroenteritis that caused N/V but resolved on its own within 48 hrs. 
Allergies: NKDA
Meds: HCTZ
FH: Arthritis in mom and brother with HTN
Sexual hx: monogamous with husband. no hx of STD's
SH: never smoked, denies illicit drug use. Rarely drinks alcohol. Feels safe at home.

Keywords and phrases relevant to diagnosis:
Last pap smear was 1 year ago
IUD
Sexual hx: monogamous with husband
irregular periods
had gastroenteritis that caused N/V but resolved on its own within 48 hrs
F
hot flases
vary from every 3 weeks to every 4 months
for the past 3 years
sweats
trouble sleeping
44
Patient Note: 44yo F with HTN who presents for evaluation of 3 years of irregular periods. Pt reports that her periods have been unpredictable, lasting 2-6 days, with variable flow. Prior to the irregularity, her periods were regular, lasted 5 days, with moderate flow and mild pain. She denies any pain with intercourse but states that she has experienced vaginal dryness for about a year. One week ago, she woke up drenched in sweat. She also reports that a week ago, she experienced nausea and vomiting for 2 days. Pt has been using copper IUD for 20 years, last replaced 4 years ago. No hx of STDs or HIV. Normal pap smear 1 year ago.
ROS negative other than HPI
PMH: HTN
Meds: HCTZ
NKDA
PSH: none
FH: mom with osteoarthritis and overweight, brother with HTN
SH: lives with husband and 2 sons (ages 10 and 14), works as office manager, no smoking/alcohol/drugs, low fat low salt diet, walks 3-4x/week

Keywords and phrases relevant to diagnosis:
periods were regular
pap smear 1 year ago
IUD
vaginal dryness
irregular periods, periods have been unpredictable
a week ago, she experienced nausea and vomiting
F
with variable flow
3 years of
drenched in sweat
44yo
Patient Note: 44 YO F IN CLINIC C/O IRREGUALR PERIOD X 3 YO. SUDDEN ONSET. HER LMP   2 MO AGO, 4 - 2 MO INTERVAL , SOMETIMES 3 WK INTERVAL , LASTS FOR 2 -6 D, FLOW HEAVY TO LIGHT . MENERCHE AT 14.A/W VAGINAL DRYNESS, SLEEP DIFFICULTY, SHE WAKES UP EARLY IN A.M. SHE HAS SOME  STRESS . DENIES IRRITABILITY, MOOD CHANGE , FEVER. NO WEAKNESS, URINARY OR BOWEL HABIT CHANGE.
PMH FLU LIKE ILLNESS 1 WK AGO, HTN X 6 YO , NKDA, MEDS HCTZ X 6
PSH / HOSP / TRAVEL / TRAUMA NONE
FH N/C
OB / GYN HER LMP   2 MO AGO, 4 - 2 MO INTERVAL , SOMETIMES 3 WK INTERVAL , LASTS FOR 2 -6 D, FLOW HEAVY TO LIGHT . MENERCHE AT 14., G2P2
SH OFFICE MANAGER, NO TOBACCO / REC DRUG, ETOH OCC
SEXUALLY ACTIVE W/ HUSBAND

Keywords and phrases relevant to diagnosis:
SEXUALLY ACTIVE
VAGINAL DRYNESS
IRREGUALR PERIOD
FLU LIKE ILLNESS 1 WK AGO
F
HAS SOME  STRESS
LMP   2 MO AGO, LMP   2 MO AGO
LASTS FOR 2 -6 D, FLOW HEAVY TO LIGHT, LASTS FOR 2 -6 D, FLOW HEAVY TO LIGHT
X 3 YO
SLEEP DIFFICULTY, WAKES UP EARLY
44
Patient Note: Dolores Montgomery, a 44-year-old female, c/o irregular periods. LMP 2months ago, lighter/shorter duration than previously, previously q28days. Associated with vaginal dryness, breast tenderness, dysmennorhea. Pt eats healthy and exericies. 
ROS: Denies postcoital bleeding, dysparenuia, hirtuisum, cold/hot intolerence, change in BM, abdominal pain, change in weight/appeitie, change in urination, skin changes, 
OBGYN: G2P2, SVD, no complication, IUD 4years ago, menarche 14
PMH: HTN, well controlled
Meds: HCTZ
PSH:none
Allergies: NKA
SHx: EtOH occacionally, denies smoking, illicit drug use, officer manager, sexualy active with husband only
FH: Brother HTN, Mother osteoarthritis

Keywords and phrases relevant to diagnosis:
previously q28days
IUD
sexualy active
vaginal dryness
irregular periods
female
LMP 2months ago
lighter/shorter duration than previously
44-year-old
Patient Note: PT IS A 44 Y/O f W/ CHIEF COMPLAINT OF IRREGULAR PERIODS. PT STATES THAT FOR THE PAST 3 YEARS SHE HAS BEEN EXPERENCING UNPREDICTABLE PERIODS. PT STATES PREVIOUSLY SHE HAD REGULAR PERIODS EVERY 28 DAYS WITH 5 DAYS OF LIGHT BLEEDING. Now, pt is experiencing irregular periods w/ bleeding lasting 2-6 days sometimes bleeding through multiple pads, sometimes light. Pt is also experiencing what she describes at hot flashes and sweating. Pt denies nipple discharge or headaches.
OBHX G2P2 woman with 2 healthy kids born at full term via normal spontaneous vaginal delivery, no complications. Pt is sexually active w/ husband, no concern for STDS, no hx of stds, last PAP 1 year ago no abnormalities. No pain with intercourse. Pt complains of vaginal dryness and discomfort which she treats with lubricant.
PMH: HTN PSH: none allergies: none Meds: HCTZ
FH: mother: osteoarthritis
Social: lives at home with husband no complaint
-ETOh, -T

Keywords and phrases relevant to diagnosis:
PREVIOUSLY SHE HAD REGULAR PERIODS, HAD REGULAR PERIODS EVERY 28 DAYS
sexually active
vaginal dryness
IRREGULAR PERIODS, irregular periods
f
hot flashes
UNPREDICTABLE PERIODS, bleeding lasting 2-6 days
sweating
44
Patient Note: 3 year history of irregular menses. Pt has a copper IUD for 4 years, non hormonal. Periods last 2-6 days and are at intervals of 3wks-4months. Flow ranges from heavy to light.  No pattern or associations between length of periods and flow. She does not usually have symptoms of cramping, back pain, or breast tenderness, but she had these before her most recent period 1 week ago. 2 children, vaginal deliveries at age 30 and 34, no problems during pregnancy. Sexually active with husband only. No vaginal discharge, itching or pain. Occasional vaginal dryness. No history of STIs.Denies dyspareunia, dysuria, or bowel changes. Denies headache or fever. 2 days of vomiting last week associated with abdominal cramping. Denies abdominal pain. No hospitalizations or surgeries.
PMH: hypertension Meds: HCTZ
FHx: no family history of early menopause or painful menses


Keywords and phrases relevant to diagnosis:
IUD
Sexually active
vaginal dryness
irregular menses
does not usually have symptoms of cramping
Periods last 2-6 days, are at intervals of 3wks-4months, Flow ranges from heavy to light, No pattern flow, No pattern length of periods
3 year history