bhatthars/nbme_qna huggingface dataset:
Patient Note: 17yo M with cc palpitations for the past 2-3 months, palpitations have occurred 5-6 times in total, denies history of palpitations prior to this. pt reports lightheadedness, sob and chest pressure with last episode. episodes last about 3-4 min and resolve on their own. denies alleviating or aggrevating factors. denies N/V, diarrhea, constipation, weight changes, cold or heat intolerance or hair loss, denies changes with appetitie or sleep difficulty. denies allergies or medication use. 

ROS: negative except for above
PMH: denies
FH: mother-thyroid problem, father-MI at 52yo 
SH: denies tobacco use. tried cannabis once a few months ago. drinks socially on weekends with friends. is in his first year of college and becomes stressed with the workload. pt admits to taking adderrall from a friend to stay away. denies any drug use. pt drinks excessive amounts of coffee, red bulls and 5hr energy drinks in other to stay away.

Keywords and phrases relevant to diagnosis:
father-MI
mother-thyroid problem
chest pressure
episode, episodes
lightheadedness
denies cold or heat intolerance, denies hair loss
adderrall
sob
coffee, red bulls, 5hr energy drinks
palpitations, palpitations
past 2-3 months
17yo
M
Patient Note: Dillon Cleveland is a 17 yo M who presents to the clinic for pounding heart. He states it seems to be unprovoked and has been happening for the last 2-3 months. He is has been in college for the last 7-8 months and is generally doing well with his mood and his grades. He did not one episode of heart pounding where he felt SOB and light headed while playing basketball. He denies any flushing, sweating, excessive worrying, recent illness, or allergies. He does not take any medications. No recreation drug other than 1 time with marijuana, he has taken non-prescribed adderall a couple times a week during exam times. Maximimun EtOH consumption is 3-4 beers or mixed drinks on the weekends only. Family history is positive for an MI in his father at age 52, and his mother has thyroid problems. He was never hospitalized or told he had heart problems in the past.

Keywords and phrases relevant to diagnosis:
MI in his father
mother has thyroid problems
light headed
taken adderall
SOB
pounding heart, heart pounding
2-3 months
17 yo
M
Patient Note: HPI: Mr. Cleveland is a 17 yo m that presents with intermittent palpitations for the last 2-3 months.  He notes that the last one was 2 days ago while playing basketball and after taking adderal.  This episode was worse than those prior.  They go away on their own with no alleviating or aggravating factors.  Associated factors possibly include exercise and adderall use.  He has had 5-6 episodes over the last 2 months.  
PMH: None. No surgeries
Allergies: NKDA
Medications: Adderal during test season
ROS: Endorses SOB and lightheaded.  Denies fever, chills, nausea, vomiting, chest pain, headache, dizziness, change in weight, or diaphoresis
FH: Mother thyroid issue. Father MI
Social Hx: Denies tobacco use. Social drinker 3-4 drinks on weekend.  Experiment with marijuana once. Safe at home and in relationships. Student
Sexual Hx: Sexually active monogamously and uses condoms.  No STI Hx


Keywords and phrases relevant to diagnosis:
Father MI
Mother thyroid issue
intermittent, episode, episodes
lightheaded
adderal, adderall, Adderal
SOB
palpitations
or the last 2-3 months, over the last 2 months
17 yo
m
Patient Note: Pt is a 17 year old male presenting with heart palpitations, he state it has been going on for the past 2-3 months and it comes and goes. nothing makes it better or worse. It has happened 5-6 times the past. nothing particualary triggers it. Pt is stressed with college that he started in the fall and has consumed redbull once a week coffee every once and a while. He also states he takes his friends adderal every once and while. last used was 2-3 days ago He has never had this happen to him in the past. he had shortness of breath about 2 days ago. Pt deneies headache, no vision change, no bowel issue, no temperature intolerance.

PMHX: none
medication: none exepect for friend adderal 2/3 days ago
phx: na
allergy: NA
fHX: father heart issue mother: thyrid
Shx: college student, does not smoke, drinks on weekends 2-3 beers, tried marijwana once but does not use it. Sexually active with one female partner and uses condoms consistently

Keywords and phrases relevant to diagnosis:
comes and goes, happened 5-6 times
no temperature intolerance
adderal, adderal
shortness of breath
consumed redbull, coffee
heart palpitations
past 2-3 months
17 year old
male
Patient Note: Mr. Cleveland is a 17 yo M presenting with epidosidic heart racing. This started 2-3 mos ago and he has had 5-6 episodes of tachycardia during this time. It doesn't seem to be related to exercise or public speaking. During the last episode he had SOB and felt lightheaded, but did not pass out. He also had chest pressure during this episode. Denies diaphoresis, headaches, vision changes, wt changes, fatigue, hair changes, heat or cold intolerance, changes in bowel or urinary habits, and chest and abdominal pain. No PMHx. Takes friend's adderal occassionally. No allergies. No surgeries. Dad had MI at 52; mom has thyroid disease. No tobacco or drug use. Occassionaly drinks on weekends. Sexually active with girlfriend and uses condoms.

Keywords and phrases relevant to diagnosis:
Dad had MI
mom has thyroid disease
chest pressure
5-6 episodes
felt lightheaded
Denies heat intolerance, Denies cold intolerance
adderal
SOB
heart racing
2-3 mos ago
17 yo
M
Patient Note: pt 17y/m c/o palpitation since 2-3 months, episodes come and go, last for 3-4 minutes, no precipitating or releiving factors. last episode happened while playing basketball, pt felt chest pressure, and felt like almost passed out. pt has no chest pain, nause or vomitting, no tremors, no heat or cold intolerance, no changes in bladder or bowel habits. no changes in diet or polydypsia pt had changed college 7-8 months back, and has trouble adjusting to it, no rashes. pt has been taking 3-4 cups of coffee every day and red bull 4-5  in a week.
no mood changes, no anxiety or panic attack
ROS - nothing significant except as above
allergy - none
medication - pt takes aderral multiple times, last 2 days ago.
PMH - none
PSH - none
SH - no smoking, occasional marijuana 5month ago, sexually active with girlfriend, uses condom, no STI
FH - father had problems with heart and mother has hyperthyroid 


Keywords and phrases relevant to diagnosis:
father had problems with heart
mother has hyperthyroid
chest pressure
episodes come and go
felt like almost passed out
no heat intolerance, no old intolerance
takes aderral
coffee every day, taking red bull
palpitation
since 2-3 months
17y
m
Patient Note: Dillon Cleveleand 17yoM with 2-3 months of intermittent episodes of cardiac palpitations. Episodes 3-4min and self resolve, happened 5-6x at rest and while active. Recently lightheadedness and SOB. Between these episodes denies any symptoms. ROS: Denies CP, dizziness, abdominal pain, dysuria, rash, edema, appetite change, weight change, change in BM.
PMH: Denies. vaccines UTD
PSH: Denies
Meds: uses friends adderall 1-2x/week since starting college
Fam hx: Mom with "thyroid problem;" Dad with "heart attack" last year
Social: first year college student studying philosophy, 3-4 beers/week, denies tobacco use, used marijuana 1x last month. Sexually active only with girlfriend, denies STI testing. Healthy high fibe diet, runs and plays basketball 3-4x/week.

Keywords and phrases relevant to diagnosis:
Dad with "heart attack
Mom with "thyroid problem
intermittent episodes, happened 5-6x
lightheadedness
uses adderall
SOB
cardiac palpitations
2-3 months
17yo
M
Patient Note: 17 years old m presents  with c/o heart pounding X 2-3 months. it starts suddenly and is getting worse since then no aggra/alleviating factors. he had 5-6 episodes in last 3 motnhs and each lasted for 3-4 mins. it is associated with sob. pt drinks 5-6 drinks of coffee and red bull and he also takes aderrol 2-3 times/week from past 7-8 months.  denies any changes in the weight, tremors, heat intolerenace, fever, chest pain and cough.
ros: neg exp above
pmh/psh:na
meds: adderrol X 7-8 months, last use : in last week.
allergies/hosp:na
travel/trauma:na
fh: mother -thyroid 
ssh: denies smoking or illicit drug use, uses  alcohol occassionally

Keywords and phrases relevant to diagnosis:
mother -thyroid
episodes
denies heat intolerenace
aderrol, adderrol
sob
coffee, red bull
heart pounding
X 2-3 months, last 3 motnhs
17 years old
Patient Note: 17 yo M c/o heart racing
- Episodes have been going on for the past 2-3 months
- Episodes last for 3-4 minutes
- Random with no precipating event. 
- Pt. denies sweating , vision changes, sleep changes.
FHx: Mother had some thyroid issue, Father had some heart issue.
SH: Student. Drinks 3-4 drinks on weekends, Used Pot once. Uses unprescribed Adderal as study aid which he aquires from friend.
Allergies: NKDA

Keywords and phrases relevant to diagnosis:
Mother had some thyroid issue
Episodes Random
Adderal
heart racing
past 2-3 months
17 yo
M
Patient Note: Mr. Cleveland is a 17 yo otherwise healthy male that presents with 3 months of heart palpitations. He states that he has had 5-6 episodes in total and that they do not seem to be associated with anything, including stress or activity. He does however note that he has been taking his friend prescription aderall in order to help him study. He started this in high school but since starting college he has been taking them more often. He has not had any chest pain but he did have one instance of non-radaiting chest pressure that was accompanied with shortness of breath that lasted 15 mimutes 1 week. No fevers, headaches, weight changs, sweating, n/v, diarrhea, constipation, abdominal pain, urinary changes, skin changes, joint pains. No past medical history or surgical history. No meds beyond taking his friend's adderral. No smoking or illicit drugs. 3-4 beers on the weekend. Family hx: Father had MI last yar at 52 yo. Mom has thyroid disease

Keywords and phrases relevant to diagnosis:
Father had MI
Mom has thyroid disease
chest pressure
5-6 episodes
No sweating
aderall, adderral
shortness of breath
heart palpitations
3 months
17 yo
male
Patient Note: HPI:17-year-old male, 2 months ago 6 episodies of heart pounding, the last whit shortness of breath, 4 to 6 minutes of duration , self imited, no sincope , no chest pain , no temperature problems ,no alliviating o , no worsering, no exercise asociation ,no gain or loss weight

ROS: Negative except as above

PMI:Neg,Meds:Neg;PSH:Neg;All:Neg;Hx:Neg
FH: Mom Thyroid problem, Dad MI last year
SH: Drinks: Weekend whit friends;Smoke: Neg;Drugs weed 1 episode;Sexually active  1 parner , uses condoms


Keywords and phrases relevant to diagnosis:
Dad MI
Mom Thyroid problem
6 episodies
no temperature problems
shortness of breath
heart pounding
2 months ago
17-year-old
male
Patient Note: 17 yo previously healthy male who presents  with a 2-3 month history of heart pounding. He says that he has had 5-6 episodes of this sensation where his heart feels like its beating faster and harder since his first episode. Each episode last about 3-4 minuts each and goes away with rest. He has not noticed anything that couses the episodes to occur and no relieving factors other than rest. His lat episode had associated feeling of pressure in his chest like someone was sitting on it and it lasted 10 minutes. No associated chest pain, shortness of breath, or changes to urinary or bowel habits, no changes to vision. Endorses regular use of adderall a few times week to help in study for which he has been taking for the last year. 
ROS Negative except as above 
Family history: Mom thyroid disease, Dad: Heart problem
Social: Full time student. No Tobacco or recreational drugs. drinks 3-4 beers on weekends

Keywords and phrases relevant to diagnosis:
Dad: Heart problem
Mom thyroid disease
pressure in his chest
5-6 episodes
use of adderall
heart pounding, heart feels like its beating faster
2-3 month history
17 yo
Patient Note: 17 yo M who presents with 3 months of episodic "heart beating out of my chest." He endorses 5-6 episodes over the last few months that last approx. 3 min and resolve spontaneously. THe last episode happened while he was playing basketball and he felt SOB and lightheaded. The pain doesn't radiate anywhere and hasn't progressed in severity. He is concerned given paternal FH positive for a recent heart attack. Patient also endorses taking 1-2 Adderrol pills per week to help with school work, which he is taking without prescription. Denies cough, wheezing, changing in vision, changes in hearing, skin/nail changes, tremor, or cold/heat intolerance.

FH: Father- MI; Mother-"Thyroid problem"
PMH: None
PSH: None
Medications: Per HPI
Allergies: NKDA
SH: ETOH-3-4 on weekends. Beer and/or mixed drinks. Tried Marijuana once. No illicit drug use or tobacco.

Keywords and phrases relevant to diagnosis:
FH positive for a recent heart attack, Father- MI
Mother-"Thyroid problem
episodic, episodes, episode
lightheaded
Denies nail changes, Denies cold/heat intolerance
Adderrol
SOB
heart beating out of my chest
3 months of, over the last few months
17 yo
M
Patient Note: Mr. Cleveland is a 17yo male , to office with heart pounding for 3-4 months at epi region of chest. He states "it feels like my chest is going to jump out". He states it is getting worst and pain is at the center or chest. Non radiating. He states mom has thyroid issues and he is concerned. He had a previous episode that went away on its own. He denies vomit, nausea or abdominal pain. He cosumes roommates prescription Aldereol on several occasions.  He states everyone is using it.Sleeps well.  Pain comes and goes without notice.
ROS: Neg, except as per HPI
PHM:None
PSH:None
Allergies:None
Meds:None
FH: Mom has thyroid issues , dad has cardiac issues
Sh; Coolege student lives swith roommate, He consume 3-4 beers on weekend, Has previously used marijuana and presciption Alderol

Keywords and phrases relevant to diagnosis:
dad has cardiac issues
mom has thyroid issues, Mom has thyroid issues
Aldereol, Alderol
heart pounding, feels like my chest is going to jump out
for 3-4 months
17yo
male
Patient Note: CC: worried heart racing will interfere with sports
HPI: Mr. Cleveland is a 17 yo male with complain of heart pounding. He states his heart has been racing for the past 2-3 months, each episode last 3-4 minuts, he has had 5-6 episodes and there is no pain associated. Sometimes it is associated with exercise and sometimes laying down. Has had SOB. It goes away on its own and is random. 4/10 bothersome in life. No change in weight, no cold or heat intolerance, no sweating or chest pain. Of note, he has been using friends prescription aderrall.

PMH: No chronic illnesses, no prescription medications of his own, NKDA, no hx of hospitalizations
FH: mom has thryoid problem, dad had MI last year
SH: no tobacco use, drinks occassionally on weekends, tried marijuana once a few months ago. Goes to college, lives in dorms iwth roommate, no travel outside of US, sex. active w/ GF uses condoms.
ROS: negative except as noted per HPI.

Keywords and phrases relevant to diagnosis:
dad MI
mom thryoid problem
episode, episodes
no cold or heat intolerance
aderrall
SOB
heart racing, heart pounding, heart has been racing
past 2-3 months
17 yo
male
Patient Note: 17 yo male with 2-3 months of intermittent heart racing/pounding episodes. No recent anxiety or stress about college and no recent changes in activities. Episodes come out of the blue with no warning, heart pounds for 3-4 min then resolves. Recent episode associated with chest pressure, light headedness and shortness of breath. No diaphoresis. Uses roommates adderall a few times a week for concentration at school. No tremors, skin changes, or weight changes.
PMH: none
PSH: none
Meds: roommate's adderall, few times per week. No other meds. 
Allergies: NKDA
Family: dad with recent heart attack, mom with thyroid disorder 
Social: freshman in college, lives in dorms, no cigarette smoking. Has smoked pot in the past. Drinks alcohol on weekends, 3-4 beers, no driving under influence. Sexually active with girlfriend of 1 year, uses condoms but wants to switch to OCPs, states they are monogamous.

Keywords and phrases relevant to diagnosis:
dad with recent heart attack
mom with thyroid disorder
chest pressure
intermittent, episodes, Episodes, episode
light headedness
adderall, adderall
shortness of breath
heart racing, heart pounding, heart pounds
2-3 months of
17 yo
male
Patient Note: CC: 17 yo M c/o heart pounding. The pt reports episodic heart pounding over the last 2 months. They occur randomly and last 3-4 minutes. There have been 5-6 in that time. There are no alleviating or aggrevating factors. No previous episodes. The last episode he experienced pressure in his chest and SOB. He reports taking adderoll (w/o a prescription)3-4x wk since in college. 
ROS: Negative except as above.
Allergies: NKDA.
Meds: adderoll
PMH: None.
PSH: None.
Prenatal hx: None. Birth Hx: NSVD
SH: College student lives dormatory. Sexually active with girlfriend, uses condoms. Tried "pot once", no other rec drugs. No tobacco hx. EtOH 3-4 beers xwk.
FH: Mother thyroid "problem". Father MI 1 yr ago.

Keywords and phrases relevant to diagnosis:
Father MI
Mother thyroid "problem
pressure in his chest
episodic, episode
adderoll, adderoll
SOB
heart pounding, heart pounding
over the last 2 months
17 yo
M
Patient Note: 17 YO M in student heatlh clinic c/o sudden onset heart pounding x few mo. No precipitating factor, describes heart jumping out of the chest, worsening, intermittent, last 3-4 mins, 1-2 episode in a mo. no allev/aggrav. A/w chest pressure, and SOB, 3-4 cup of coffee a day, 1-2 energy drink a week. No previous episode in the past. Denies fear of having other episode, cough, dizziness, tiredness, tremor, change in skin/hair, change in weight/appetite, change in sleep, weakness/tingling/numbness, change in BM/urine.
Ros neg except as above
PMH none, Meds takes aderal from his roomate, NKDA
PSH/hosp/travel/trauma none
FH father heart disease, mother has thyroid disease
SH student, lives w roommate, denies smoking, occ ETOH, tried pot 1 time in a party, healthy diet, plays soccer and walk few miles, sexually active w GF, 1 partner in the past 6 mo. sometimes use condoms w her. He preffer the pill and no condom use, no STDs in the past

Keywords and phrases relevant to diagnosis:
mother has thyroid disease
chest pressure
intermittent, 1-2 episode in a mo
takes aderal
SOB
3-4 cup of coffee a day, 1-2 energy drink a week
heart pounding, heart jumping
x few mo
17 YO
M
Patient Note: Mr. Dillon is a 17yo mM otherwise healthy presenting with 3-4 month history of intermiitent, palpiations, tachycardia; regular adderol use from roomate; 2 days ago while playing soccer, experienced chest pressure, SOB, resolved on its own. Denies chest paion, diaphoresis, changes in bowel habits.
PMH:
non, NKA
SH: P is a freshman in colleg, plays soccer and runs regularly. Drinks 2-3 beers on the weekends, tried marijuana, denies smoking. Healthy diet.
FH: father- MI at 5yo, Mother- thyroid issues

Keywords and phrases relevant to diagnosis:
father- MI
Mother- thyroid issues
chest pressure
intermiitent
adderol
SOB
palpiations, tachycardia
3-4 month history
17yo
M
Patient Note: CC : 17 yo M presenting for "heart pounding."
HPI: Going on 3-4 months. Has 1-2 episodes a month. Last episode was a week ago while playing soccer, he stated he also felt chest throbbing in center of chest and light headedness which is different from previous episodes. There is nothign that he associates with onset of these episodes. Lasts 3-4 minutes originally and last one lasted 10 minutes. Endorses shortness of breath with episodes. Denies diaphoresis, dizzinses, changes in vision, changes in hearing, radiation of pain, loss of sensation, weakness, anxiety. Endorses using roommates adderall prescription.
PMH: none; PSH: none; meds: vitamins; allergies: none
FH: father - MI (no known heart disorder); mother: thyroid problem
SH: student, doign marketing, active playing soccer and running, denies tobacco use, etoh 3-4 on weekend (CAGE 0/4), adderall use, sexually active with girlfriend uses condoms


Keywords and phrases relevant to diagnosis:
father - MI
mother: thyroid problem
chest throbbing
1-2 episodes a month
light headedness
adderall, adderall use
shortness of breath
heart pounding
3-4 months
17 yo
M
Patient Note: 17 yo male presents for 3-4 months of intermittent palpitations. He first noticed when he was just sitting. They happend 1-2x/month and last for 3-4 minutes. Nothing makes it better and it goes away on its own. Nothing seems to make it worse. No associated chest pain, but did note substernal chest presure associated with SOB 2 days ago. Denies fevers, chills, diaphoresis, sleeping problems, tremor, diarrhea, or constipation. He has a normal mood but admits to some stress starting college 5-6 months ago. Now feels well-adjusted. Majoring in marketing.
Denies PMHx and PSHx and allergies
FHx: Father with MI at age 52, mother with thyroid problem
Denies tobacco use, alcohol 3-4 drinks on weekend
Drugs: Tried pot a few months ago
Meds: Roommate shares Rx Adderall a few times a week before exams (started about a year ago)


Keywords and phrases relevant to diagnosis:
Father with MI
mother with thyroid problem
substernal chest presure
intermittent, 1-2x/month
Adderall
SOB
palpitations
3-4 months
17 yo
male
Patient Note: 17 YO M Pt c/o racing heart x 2-3 months. Random onset, lasting 3-4 mins. No chest pain or SOB, No dizziness, or LOC. No aggrevating/alleviating factors. He mentions 2 days ago he had an epsiode of palpitations while playing basketball which was accompanied by SOB, lightheadedness, and pressure in the center of his chest. This lasted for 10 mins and went away on its own once he sat down. He did not fall or hit his head. He denies any changes in his bowel habits, appetite, weight or skin. No fever, chills, or visual changes. Pt admits to taking his roomates Adderal since high school. He has been taking 1 pill a few times a week. 

PMH/PSH: none
Medications: as mentioned above
SH: Lives with roomate, is a fulltime student. Denies smokin, Drinks ETOH on the weekends. Occasionally uses Marijuana. 
FH: Father had possible MI last year and has "Heart issues", Mother has "Thyroid Issues"

Keywords and phrases relevant to diagnosis:
Father had possible MI
Mother has "Thyroid Issues
pressure in the center of his chest
epsiode
lightheadedness
Adderal
SOB
racing heart, palpitations
x 2-3 months
17 YO
M
Patient Note: Dillon cleaveland is a 17 yo M presenting for heart pounding. He noticed this 2-3 mo ago. He has had 5-6 episodes of this over that timeframe. No kown triggers, nothing stops them. He gets lightheaded during them. He feels like his heart is bearting really fast " beating out of my chest". They last for 3-4 minutes. Yesterday was the worst of these episdoes. it lasted for 10 minutes, and in additon to the pounding, he has pressure in the middle of his chest that didn't radiate, he was also SOB that that time. Those symtpoms resolved after the pounding went away. He does endorse a historyof taking his friend's adderall prescription but hx does not coincide with symtpoms. No headache, vision changes, diarrhea, fever, chills, or temperature issues.
PMH: none- born at term, immunizations complete, growth curve normal
med: adderall
allergiesl none
FH: mom-thyroid problem, dad, heart attack-52
SH: no smoking, alcohol 3-4drinks, drug- MJ

Keywords and phrases relevant to diagnosis:
dad, heart attack
mom-thyroid problem
pressure in the middle of his chest
episodes, episdoes
lightheaded
No temperature issues
adderall, adderall
SOB
heart pounding, heart is bearting really fast, beating out of my chest
noticed this 2-3 mo ago
17 yo
M