bhatthars/nbme_qna huggingface dataset:
Patient Note: 35 yo male presents with stomach pain. Progressive in nature, 5/10, episodes were few/wk now 2x/day lasting 1-2 hr, no radiation, pain wakes him up at night, + nausea, - vomiting, +darkstools. No diarreha, constipation, weight change, fever, NS, rashes, chills, ligh headedness, chest pain, palpitations, dypsnea.
PMH: chronic back pain - motrin 1x week 
FH: uncle w bleeding ulcer
SH: 15y .5-1ppd smoking hx, not ready to quit. occasioanl etoh use. no illicit drug use. use to execercise before the pain. Nml diet. Not sexually active. Going through dovrce.

Keywords and phrases relevant to diagnosis:
uncle w bleeding ulcer
+darkstools
motrin
Progressive, episodes now 2x/day
occasioanl etoh use
male
wakes him up at night
+ nausea
35 yo
Patient Note: HPI: 35 yo M complains of 2 months of stomach distress. Indicates the pain in the epigastric region, epsidic, and intensity of 5/10. Reveals that he is going trhourh a divorce and stress caouses intensify pain. Indicates nausea, bloated, and darkening of stool. Denies urinary symptoms, no flushing, no fever,  no palpiations, and no visual distrubances. Indicates myalgias since early 20s. Pain is mininally alleviated with motrin.
ROS: negative except for above
Allergies none
Meds: motrin
PMH: myalgias since 20s; low back pain
PSH: none
SH: 1 ppd for 20years; occasional alcohol consumtiop; no drugs; not sexuyaly actice; works as construction worker
FH: uncle had a bleeding ulcer

Keywords and phrases relevant to diagnosis:
uncle had a bleeding ulcer
pain in the epigastric region
darkening of stool
motrin, motrin
bloated
occasional alcohol
M
of 2 months
epsidic
nausea
35 yo
Patient Note: Mr. Hamilton is a 35 year old man presenting with "stomach problems"
-Reports experieincing burning sensation in epigastric ("mid-chest") area
-Started 2 months ago with episodes occuring on weekly basis
-Over past week, pain is worsening and becoming more frequent (daily) and is waking up patient from sleep
-Burning sensation episodes lasts 1-2 hours
-Denies associated with food intake
-Took TUMS, which initially helped with symptoms but over the past week, not as useful
ROS: Endorses darker stools than usual over the past 2 weeks. Denies bright red blood in stools. Denies cough. Denies lower abdominal pain. Denies hematuria or urinary changes.
PMHx: None
PSHx: None
Medications: TUMS, motrin
Family history: Uncle had bleeding ulcer
Social Hx: Construction worker. Reports life is very stressful with work and recent divorce). Smoking 1/2 to 1 pack per day currently for past 10 years. Denies EtOH/drug usage. No recent sex. 


Keywords and phrases relevant to diagnosis:
Uncle had bleeding ulcer
sensation in epigastric ("mid-chest") area
darker stools
motrin
burning, Burning
is worsening, more frequent
Mr., man
Started 2 months ago
waking up patient from sleep
Denies bright red blood in stools
episodes lasts 1-2 hours
TUMS, which initially helped, TUMS not as useful
35 year old
Patient Note: 35 Y M presents with stomach problems. Patient has had intermittent stomach pain for the past two months. Located above stomach, described as gnawing, 5/10, non-radiating, slightly better with tums, no better or worse with eating, associated with nausea when painful. Patient also noted darkening of stool for the past two weeks. No vomiting, sour taste in mouth, diarrhea. Patient takes Motrin 2x200mg approximately 1x/wk for back pain.

ROS: No fevers, chills, chest pain, shortness of breath, diarrhea, constipation.
PMH: Denies.
PSH: Denies.
FH: Bleeding gastric ulcer in uncle.
SH: Lives alone, construction worker, not sexually active. Previously drinking 3 beers/wk stopped 3 weeks ago, 20 Y h/o smoking 1/2-1 pack per day, denies recreational drug use.

Medications: Motrin as needed.
Allergies: Denies.

Keywords and phrases relevant to diagnosis:
Bleeding gastric ulcer in uncle
darkening of stool
takes Motrin, Motrin
gnawing
3 beers/wk
M
past two months
intermittent
slightly better with tums
nausea
35 Y
Patient Note: - 35 yo male with stomach pain
- Pain started 2 months ago, no trigger or trauma to the area. It has been increasing since that time
- Pain is located in epigastric region, no radiation
- Tums used to help the pain but that has not helped recently. Nothing makes the pain worse. No association with food
- Dull pain. Always 5/10
- Nausea, no vomiting, dark colored stools. No changes in bowel habits. No vomiting. No dysuria or polyuria. 
- Pain comes and goes
- No headache, fever, chest pain, no reflux, no diarrhea/constipation
PMH: none, no hospitalizations
Surgical hx: none
Medications: Motrin 400 mg PO as needed (around 1/week)
Allergies: NKDA
Family Hx: uncle with "bleeding ulcer" 
Social hx: lives alone. Works as a construction worker. 20 pack-year smoking history. Used to drink a couple beers on the weekend; has cut down now. No illicit drug use
Diet: fast food; has not exercised recently due to pain

Keywords and phrases relevant to diagnosis:
uncle with "bleeding ulcer"
Pain is located in epigastric region
dark colored stools
Motrin
increasing
couple beers on the weekend
male
started 2 months ago
comes and goes
Tums used to help the pain but that has not helped recently
Nausea
35 yo
Patient Note: Chad Hamilton is a 35 y/o male who comes into clinic with "stomach problems". The burning/gnawing pain is located at the mid-epigastrium and has been a 5/10 pain. It started 2 months ago, happening 1 time per week. The past two weeks it has been happening multiple times per day. It lasts an hour and is random in onset. he endorses belching, nausea, bloating after eating, and the pain wakes him up at night some times. He states his stools have been darker.
ROS: negative 
Mast medical Hx: back related injury
Past surgical hx: none
Medications: tums and motrin
FHx: paternal uncle had ulcer
Social: 2-3 beers per week, .5 ppd since 15 y/o.


Keywords and phrases relevant to diagnosis:
paternal uncle had ulcer
pain is located at the mid-epigastrium
stools have been darker
motrin
burning/gnawing
bloating after eating
happening multiple times per day
2-3 beers per week
male
started 2 months ago
pain wakes him up at night
nausea
35 y/o
Patient Note: 35yo m c/o of epigastic discomfort for the past  2 months. pain has gotten worse and frequent. pain is 5/10, burning in nature, no precipitating factors, feels bloated with meals but not necessarily painful. non radiating, takes pain medication that has not helped he is fatigued. he has associated nausea , dark stools which he noticed  2 weeks ago,. denies palpitaion, he takes motrin occasionaly for aches. no change in bowel habits,no change in urine habits, eats a lot of take outs
fever , vomiting, 
pmh/psh: none
ros negative except above
fh non contributory
nkda
shx smoke 1/2 - 1 ppd since age 15yrs, he has not decided to quit yet.

Keywords and phrases relevant to diagnosis:
epigastic discomfort
dark stools
motrin
burning
feels bloated with meals
gotten worse and frequent
m
past  2 months
nausea
35yo
Patient Note: 35 yo M complaining of pain in upper abdomen since 2 months which gotten worse since last 2 weeks, burning sensation in upper abdomen, started suddenly, progressive, continuous, initially reliefed by tums but not anymore, nothing makes it worse. patient also complains of dark brown stools, nausea, bloating, decreased appetite due to pain, several night time awakenings due to pain. Patient is construction worker and have back pain for which he is taking moltrin.
ROS- negative except as above
PSH- none
PMH- none
SH- smoke x 20 years x half to 1 ppd, drink beers but recently decreased due to belly pain, no illicit drug use, sexually active and monogamous
Allergy- none
Meds- TUMS, Moltrin

Keywords and phrases relevant to diagnosis:
pain in upper abdomen
dark brown stools
Moltrin, taking moltrin
burning
bloating
gotten worse, progressive
M
since 2 months
several night time awakenings
initially reliefed by tums but not anymore
nausea
35 yo
Patient Note: Mr Hamilton is a 35 year old caucasian male who presents to clinic today due to 2 months of mid abdminal pain. Pain is a gnawing 5/10, constant discomfort. He has recently had stress in his life drom pending divorce and increased work realted stress. He has been feeling naucious  - he has not thrown up as of yet. Increased belching and bloating after meals . 

ROS was negative for CP, SOA, diarrhea, constipation, emesis, changes to ears and eyes. No urinary changes. 

PMH back pain from physical labor with 10 year history of ibuprofen use 1 time per week
No PSH
FH - uncle with bleeding gastric ulcer
Social - smoked 20 pack years. used to drink socially but stopped since last 2 months. no illicit drug use
Meds: tums and motrin 1 tablet qWeekly
NKDA

Keywords and phrases relevant to diagnosis:
uncle with bleeding gastric ulcer
mid abdminal pain
ibuprofen use, motrin
gnawing
bloating after meals
used to drink socially
Mr, male
2 months of
naucious
35 year old
Patient Note: PT 35 YO M TAKING PAIN MEDS X 10 YRS WITH FH OF PUD, C/O EPIGASTRIC PAIN X 2 MONTHS, INTERMITTENT, STARTED GRADUALLY, GETTTING WORSE, 3 TIMES/NIGHT, USUAL IN NIGHT TIME, SHARP PAIN,  TUMS DOES NOT HELP , NO ALLEVIATING/AGGRAVATING FACTORS. PT HAS BACK PAIN TAKING  PAIN MEDS X 10 YRS.  PT REPORTS ABD DISTENSTION AFTER MEALS AND NOTICED DARK STOOL. PT DENIES ANY FEVER,  VOMITING, CHEST PAIN, SOB, REGURGITATIONS, METALIC TEST IN MOUTH, SKING CHANGES AND PALPITATIONS.
ROS: NO CHANGE IN WEIGHT BUT DECREASED APPETITE. NO CHANGE IN URINARY HABITS. 
PMH: NONE. 
PSH: NONE.  ALLEG: NKA. 
MEDS: TUMS AND MOTTRIN. X 10 YRS 
FH: UNCLE DIED OF PUD. 
SH: SEXUALLY NOT ACTIVE. SMOKING 1/2 PPD X 15 YRS. STOPPED DRINKING ETOH, NO ILLICIT DRUGS. 


Keywords and phrases relevant to diagnosis:
FH OF PUD, UNCLE DIED OF PUD
EPIGASTRIC PAIN
DARK STOOL
MOTTRIN
ABD DISTENSTION AFTER MEALS
GETTTING WORSE
M
X 2 MONTHS
3 TIMES/NIGHT
INTERMITTENT
TUMS DOES NOT HELP
35 YO
Patient Note: HPI: 35 yo M c/o worsening epigastric pain x 2 months.
- 5/10. burning. duration 1-2hr. freq. 2times/day. intermittent pain. better with TUMs in the past - worse with nothing. not related to eating. 
- poor appetite due to bloating sensation. -BM 2 times/day. dark brown colored stool. no particular odor. 
ROS: No prev. similar symptom. No change in wt. no vomiting, diarrhea, constipation. no fever
Allergies: none
Meds: motrin
PMH: none. no hospital. no trauma.
PSH: none
FH; uncle ulcer disease. 
SH: no EtOH. smoking 1/2-1pack a day since age 15. no illicit drugs. not sexually active. works for construction site.

Keywords and phrases relevant to diagnosis:
uncle ulcer disease
epigastric pain
dark brown colored stool
motrin
burning
bloating
worsening, 2times/day
M
x 2 months
intermittent
35 yo
Patient Note: 35 YO M comes to the clinic c/o stomach problems since 2 mo ago. Epigastric pain , getting progressively worse, and intermittent.  Happening 2 times at day and lastinf 1-2hrs. 5/10 in intensity,  gnawing and deep like.  Used to get better w antacid but now nothing makes it better. Nothing makes it worse. It is affeting the pt life.  Denies fever, chills, N/V, HA, relation  w food. No burning sensation on throat or  dysphagia. No changes in appetite or weight. No changes in urinary/bowel habits.
ROS neg except as above 
PMH  hx LBP taking ibuprofem 2 times at week. NKDA 
PSH none 
FH uncle has PUD 
SH 1 PPD x 15 yrs , 1-2 beer/ wks 
sx

Keywords and phrases relevant to diagnosis:
uncle has PUD
Epigastric pain
taking ibuprofem
gnawing
progressively worse, Happening 2 times at day
1-2 beer/ wks
M
since 2 mo ago
intermittent
Used to get better w antacid
35 YO
Patient Note: 35-year-old male h/o stomach problems; epigastric pain (burning/nawing like pain) for 2 months; causing him nausea but not vomiting. Feels the pain twice a day; no certain time. After eating he feels bloated; was taking tums but no longer working. Patient has not been able to exercise due to pain. ROS: Bowel movements wnl- dark brown stool; no melena; no pain when defecating. Pt denies appetite change/ weight change/ no headache/ chest pain/ SOB.
Pt is a construtction working; stressed going through a divorce and living alone; no sexual activity.
PH: back pain and muscle pain from work
Surgeries: none
Allergies: NKDA Medication: 2 motrin of 200mg 1 time a week
FH: paternal uncle bleeding ulcer
Hx of tobacco use 15 years of half/1 pack per day. quit  recently; gave information on tobacco counseling; ETOH couuple times a week no recreational drug use

Keywords and phrases relevant to diagnosis:
paternal uncle bleeding ulcer
epigastric pain
dark brown stool
motrin
burning/nawing
After eating he feels bloated
twice a day
ETOH couuple times a week
male
for 2 months
no melena
was taking tums but no longer working
nausea
35-year-old
Patient Note: CC: STOMACH PROBLEMS
HPI: 35 YO M C/O EPIGASTRIC PAIN STARTED GRADUALLY 2 MONTHS AGO. THE PAIN IS DULL, REACHING 5/10 INTENSITY, INTEMITTENT 2-3 TIMES/DAY, NONRADIATING. NO PRECIPITATING FACTORS, NO RELATION WITH FOOD. IT WAS PARTIALLY ALLEV BY ANTACIDS, NOT ANYLONGER. HE ALSO HAS NAUSEA W/O VOMITING, AND NOTICED BLACK STOOL FEW TIMES, NO BLOOD. 
ROS: NO WEIGTH CHANGES, NO URINARY CHANGES, NO FEVER, NO CHEST PAIN
PMH: OCC BACK PAIN D/U HEAVY WORK. NO PSH
FH: UNCLE WITH PUD
SH: 1/2-1 PPD/ 20 YRS, OCC ETOH/NO RECR DRUGS

Keywords and phrases relevant to diagnosis:
UNCLE WITH PUD
EPIGASTRIC PAIN
BLACK STOOL
2-3 TIMES/DAY
OCC ETOH
M
STARTED GRADUALLY 2 MONTHS AGO
STOOL NO BLOOD
INTEMITTENT
PARTIALLY ALLEV BY ANTACIDS, NOT ANYLONGER
NAUSEA
35 YO
Patient Note: CC: Stomach problems
35yo M who presents with epigastric pain. Pain present over last 2 months and has been worsening in last few weeks. The pain is a gnawing/burning 5/10 pain with no radiation. It is unrelated to food or time of day, but has woken him up from sleep. The frequency has increased from 1/week to 3x/day. Patient reports increased belching, nausea, bloating and fullness after meals for 2 months, and darker stools over the last 2 weeks. The pain had been relieved by Tums but is no longer. Patient reports 1 year of increased stress due to work and divorce. He denies vomiting, reflux, weight loss. He takes 2 motrin a week on average.
ROS: Negative
PMHx: back aches/muscle spasms; Meds: motrin and tums PRN; NKDA; FHx: uncle with bleeding ulcer; Lives alone, high elevation construction worker; drank a few beers a week, but has now stopped. current smoker w/ 15 pack year smoking history. Diet: frequent eating out high fat foods

Keywords and phrases relevant to diagnosis:
uncle with bleeding ulcer
epigastric pain
darker stools
takes motrin, motrin
gnawing/burning
bloating, fullness after meals
worsening, frequency has increased from 1/week to 3x/day
few beers a week
M
last 2 months
woken him up from sleep
had been relieved by Tums but is no longer
nausea
35yo
Patient Note: 35 yo m, c/o stomach pain since 2 months. Pain is located in the epigastric region, 5/10 intensity, burning in nature, non-radiating. Pain is intermittent and has been getting worse. Would occur once a week earlier, but now occurs 2-3 times a day. Also gives h/o dark stools since 2 weeks. Intermittent back pain. Denies palpitations, chest pain, sweating, changes in urinary / bowel movements. H/o eating junk food. Reduced apetite. No aggravating or relieving factors. 
ROS - negative except as above
Allergies - NKA 
Meds - Tums once a week. 
PMH - noncontributory. No hospitalisation, injuries, trauma, surgeries. 
FH - Uncle who had a bleeding ulcer 
SH - smokes half to one ppd for 20 years. Occasionally drinks beer. Denies illicit drugs. Not sexually active. Construction worker.

Keywords and phrases relevant to diagnosis:
Uncle who had a bleeding ulcer
Pain is located in the epigastric region
dark stools
burning
getting worse, now occurs 2-3 times a day
Occasionally drinks beer
m
since 2 months
intermittent
35 yo
Patient Note: This is a 35 yo previously healthy male presents with a 2 months h/o progressive worsening pain in epigastric area with bloating and possible melana. The pain is described as burning, pt has belching. pain worse with eating, rated 3/10. pain is intermittent, no vomiting, no hematemesis, but does have some nausea. Has noticed dark brown stool since the onset of the stomach pain, no bright red blood. 20 pack-year smoking hx. Has a uncle with possible PUD. 

ROS: negative except for listed in HPI
PMH: none 
PSH: none 
Med listed in 
FH: uncle with possible PUD
SH: 20 pack-year smoking, 2-3 beer/week, no STD, no recreational drug
allergy: none

Keywords and phrases relevant to diagnosis:
uncle with possible PUD, uncle with possible PUD
pain in epigastric area
melana, dark brown stool
burning
bloating
progressive worsening
2-3 beer/week
male
2 months h/o
no bright red blood
intermittent
nausea
35 yo
Patient Note: Chad Hamilton is a 35yo M presnting with abdominal discomfort. Describes a burniung nawing midepigastric pain that does not radiate. Occurs 2-3x per day for the last two months. No association with meals. Tums used to make it better but stopped working. Just started happening at night, same pain. Does experience bloating and fullness with meals. Voluntary anorexia to avoid the feelings of fullness. Moderate back pain and muscle pain. Bowel movements have been darker in color just in the last couple of weeks. Denies any episodes of tremulousness, lightheadedness, palpitations.

ROS- negative except for above, no chest pain, palpitations, squeezing or exertional chest pain, no pain in other parts of abdomen.
PMH- negative
Meds- motrin once a week
Allergies- NKDA
Fam Hx- uncle with a bleeding ulcer
Social- Diet- whatevere is available, greasy foods. Exercise has decereased, Tobacco 20 pack year hx, Not sexually active

Keywords and phrases relevant to diagnosis:
uncle with a bleeding ulcer
midepigastric pain
Bowel movements have been darker
motrin
burniung nawing
fullness with meals, bloating with meals
Occurs 2-3x per day
M
happening at night
Tums used to make it better but stopped working
35yo
Patient Note: Chad Hamilton, a 35-year-old male, has come to the physician's office today because of stomach problems. 
Has had pain and discomfort which started 2 months ago. No previous similar complaints, getting worse, located mid epigastrium, does not radiate, pain occurs twice daily and 3 nights a week which causes sleep distrurbance and tiredness as a result. Has nausea everytime pain is there without vomitting, also has noticed dark stools. He feels bloated after meals. Denies sour taste in mouth, sob, fever, chills, night sweats. 
ROS: negative except as above
PMH: back spasms after work
Meds: Motrin
Allergy: none
Family: uncle wit peptic ulcer disease
PSH: none
Social: smoke 1/2-1 pack daily for 20 years, cut down drinking 1 beer before symptoms daily, no drugs
Sexual: not active
Diet: eats fast food, unbalance, excercise decreased due to decreased sleep, no weight or appetite changes


Keywords and phrases relevant to diagnosis:
uncle wit peptic ulcer disease
discomfort located mid epigastrium
dark stools
Motrin
bloated after meals
occurs twice daily, getting worse
male
started 2 months ago
3 nights a week which causes sleep distrurbance
nausea
35-year-old
Patient Note: Pt is a 35 yo M who presents for epigastric pain for 2 months
- 5/10, burning, gnawing pain in upper part of stomach that is not getting worse but is happening more frequently associated with nausea
-happens randomly, not associated with food intake
- has taken tums which helped initially but has now stopped
-noticed dark stools 2 weeks ago. well formed stools. no constipation or diarrhea
-no aggravating sx
-no changes in diet
ROS- no weight loss, dysphagia, myalgias, headaches, fatigue, vomiting, issues with urination, palpitations
meds- motrin 400 mg 1/week for back pain from from work. NKDA
medHX- none
surg hx - none
famHX- uncles had bleeding ulcer
SH- 0.5-1 PPD smoker for 20 years. 1-2 beers/week but has since quit. no drug use. works in construction. does not exercise. Poor diet with no fruits or veggies
surg hx - none


Keywords and phrases relevant to diagnosis:
uncles had bleeding ulcer
epigastric pain, pain in upper part of stomach
dark stools
motrin
burning, gnawing
happening more frequently
1-2 beers/week
M
for 2 months
tums which helped initially but has now stopped
nausea
35 yo
Patient Note: 35yo man presenting with epigastrium pain. First noticed pain 2 months ago, burning ngawing pain, intermittent but episodes have been increasing in frequency. Associated with nausea. Endorses melena. Has taken Tums which helped a month ago but not recently. No diarrhea, no BRBPR, no constipation. Also burping a lot recently. No cough. No pain in other parts of the abdomen. No dizziness or syncope. Takes ibuprofen regularly 2x200mg 1x/week for back pain and muscle spasms from construction work. Has cut down alcohol use recently because of pain.
PMHx: None.
PSHx: None
Meds: Moltrin PRN for back pain
NKDA
FHx: Uncle with bleeding ulcer. Otherwise no pertinent.
SHx: Works in construction. Alcohol use 1-2 beers per week. Current smoker, 20-pack year history. No illicit drugs. Not sexually active currently, last activity over a year ago.

Keywords and phrases relevant to diagnosis:
Uncle with bleeding ulcer
epigastrium pain
melena
Takes ibuprofen, Moltrin
burning ngawing
episodes have been increasing in frequency
1-2 beers per week
man
2 months ago
no BRBPR
intermittent
taken Tums which helped a month ago but not recently
nausea
35yo
Patient Note: patient is a 35 y.o. male who presents with stomach pain. He reports that over the past 2 months he has felt a 5/10 gnawing pain in his epigastric region. the pain occurs about 2 times per day and lasts for 1 to 2 hours. it does not radiate anywhere. he has tried tums which initially helped but no longer provide relief. in addition he reports nausea with these episodes but no vomiting. he reports darkening of his stool over the past two weeks. He also reports that he has a sensation of bloating with meals, so he has been eating smaller meals. The pain has been waking him from his sleep roughly 2 times per week. He feels that he is under stress becuase of a recent divorce.
ROS: negative except for above
PMH: denies
Meds: motrin, and tums
Med All: denies
Hospitalizations: Denies
PSH: Denies
Fhx: uncle  bleeding ulcer
SHx: works as construction worker; lives west philly; 2 drinks per week; 15 pack years; no recreational drugs.


Keywords and phrases relevant to diagnosis:
uncle  bleeding ulcer
pain in his epigastric region
darkening of his stool
motrin
gnawing
bloating with meals
2 times per day
2 drinks per week
male
past 2 months
waking him from his sleep
tried tums which initially helped but no longer provide relief
nausea
35 y.o.
Patient Note: patient is a 35-year-old male, has come to the physician's office today because of stomach problems. He says the problem started 2 months ago and is associated with a burning/knawing type pain in the epigastric region. he says he has bloating and fullness every time he eats. he also noticed he stool has been darker recently. Patient says TUMS help for a little while, but has stopped. The pain has progressively gotten worse from onset and is intermittent about 2x a day. Patient says the pain has also been waking him up in the middle of the night. Patients diet consists of food trucks and eating out Denies exacerbating factors such as food, denies recent travel or ill contacts. pt. says he also feels nausea
ROS- - except stated above
pmhx: chronic back pain
medications- TUMS, motrin 200mg
fhx: uncle with cleeding ulder
social- 1 ppd since 15 y/o, few beers a week; has stopped since pain, denies drug use


Keywords and phrases relevant to diagnosis:
uncle with cleeding ulder
pain in the epigastric region
stool has been darker
motrin
burning/knawing
bloating, fullness every time he eats
progressively gotten worse, 2x a day
few beers a week
male
started 2 months ago
waking him up in the middle of the night
intermittent
TUMS help for a little while, but has stopped
nausea
35-year-old